Discussion: Analyzing Diagnostic Criteria
Marriage, couple, and family helping professionals work from a systemic vantage point-they view issues and change as relational. That being said, they must be familiar with the diagnostic criteria of the DSM-5 in order to work within the field of mental health care at large.
The DSM-5, of course, is individual rather than systemic in focus, and therefore it is wise for marriage, couple, and family helping professionals to view diagnostic criteria through a critical lens. Many of the disorders also are not based on clear, clinical cut-off criteria, and they require informed clinical judgment in order to be applied appropriately.
Note also that helping professionals should consider intersections of physical, mental health, and relationship considerations as they relate to sexual dysfunctions, compulsions, and addictions. For example, a physical examination by a qualified healthcare professional is typically warranted prior to making a diagnosis of a sexual dysfunction in order to rule out any physical causes for the symptoms.
Analyze the diagnostic criteria of major sexual dysfunctions and disorders in the DSM-5. Review the case study below and reflect on which DSM-5 sexual dysfunction/disorder might be the most reflective of the client's symptoms. Then consider a counter argument as to why this dysfunction/disorder might not be appropriate for this client.
Susan, age 34, is a married mother of two preschool-age children (ages 4 and 2). Her husband, Steve, age 35, works full time, and Susan works part time on the weekends but primarily is a stay-at-home mother to her children.
The couple sought couples counseling, and their primary presenting concern was that Susan has not had any interest in sex with Steve for the past year. The couple reports that they have had intercourse about three times in the past year ("always at Steve's initiation"); they rarely display physical affection toward one another; and they fought frequently about their lack of sex for about the first 6 months of the past year, but lately they have not fought often about the issue.
The partners indicate that, up until a year ago, Susan was very interested in sex, and they had sex approximately three times per week throughout their marriage (aside from immediately following the birth of their children).
Susan states that she can't pinpoint any particular reason for her lack of interest in sex and says, "Really, I just don't want it anymore. I'm not sure if I ever will again." Steve says that he is very frustrated but doesn't want to fight about it. He says, "I just want my wife back."
Post by Day 4 identifying a DSM-5 sexual dysfunction disorder that might reflect Susan's symptoms. Research the literature to further understand Susan and Steve's situation. What biopsychosocial factors may be affecting the sexual aspects of the couple's relationship?
References
Levine, S. B., Risen, C. B., & Althof, S. E. (Eds.). (2016). Handbook of clinical sexuality for mental health professionals (3rd ed.). New York, NY: Routledge.
Chapter 5, "Clinical Challenges of Sexual Desire in Younger Women" (pp. 43-59)
Chapter 6, "Problems With Orgasm" (pp. 60-70)
Chapter 10, "The Sexual Challenges for Adolescent Boys and Young Men" (pp. 111-122)
Chapter 11, "The Mental Health Professional's Treatment of Erection Problems" (pp. 123- 133)
Chapter 12, "Premature Ejaculation" (pp. 134-149)
Chapter 13, "Delayed Ejaculation" (pp. 150-163)
American Psychiatric Association. (2013). Sexual dysfunctions. In Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.