Gender Identity Disorder Case Study

Case Study Analysis of Phil

Phil is a 35 year-old male suffering from gender identity disorder. This condition exists when an individual displays symptoms of distress related to his or her physical gender. In his early years, the patient suggested that his male features would fall fo and reveal his feminine body, and when he entered adolescence, he began having sexual encounters with other males. The patient indicates that he never felt comfortable with his sexual identity and became intimately involved with women that he either admired or envied (Hansell, & Damour, 2008). Phil obviously suffers from a conflict between his physical gender and the gender he identifies as , and is very uncomfortable with his male body.

Gender Identity Disorder

Gender identity disorder, also referred to as transsexualism is a condition referenced and cataloged in the DSM IV-TR, but does not focus on the individuals’ sexual symptoms. Gender identity disorder involves a disruption in an individual’s gender identity, which is directly related to his or her sexuality (Hansell, & Damour, 2008). Defining gender identity disorder is done via two individual variables; sex, or the individual’s biological body, and gender, or the individual’s psychological sense of being male or female (Hansell, & Damour, 2008). Individuals suffering from gender identity disorder may act and present themselves as members of the opposite sex, and may display symptoms like altered choice of sexual partners, mannerisms, behavior, choice of attire, and self-concept (PubMedHealth, 2012).

According to PubMedHealth (2012) “identity conflicts need to continue over time to be a gender identity disorder” (p. 1). Symptoms of gender identity disorder can vary depending on the subject’s age and social environment. Children suffering from gender identity disorder can display symptoms ranging from a disgust for his or her genitals, rejection from peers, a belief that he or she will grow up to become the opposite sex, and state that he or she wants to be the opposite sex (PubMedHealth, 2012). Adults suffering from the disorder may dress like the opposite sex, feel alone and isolated, suffer from anxiety or depression, show a desire to live as a member of the opposite sex, and show a desire to eliminate his or her genitals (PubMedHealth, 2012).

In order for a proper diagnosis to be made, the individual must show an expression of being in the body of the wrong gender for a period no less than two years (PubMedHealth, 2012). This helps clinicians determine if the individual is actually suffering from gender identity disorder, or another disorder that has similar desires (PubMedHealth, 2012). Gender identity disorder also has little to no relevance in the individual’s choice of sexual partners, meaning a man who feels he is truly a woman may still be physically attracted to women. The cause of gender identity disorder are not known, but hormones in the womb, genetics, and social and environmental factors are suspected (PubMedHealth, 2012).

Patient History

The patient is a highly educated and successful professor of anthropology. As a child he found himself more interested in playing with girls and dolls. He had a very close relationship with his mother, and found it easier to make friends with girls than boys. His father was an abusive alcoholic who regularly abused Phil’s mother. Phil expressed to his parents in early childhood that his male genitals would fall off, and spent time with a child therapist because his parents were alarmed by his belief. In his early teen years, Phil expressed his attraction of other males to his mother. She was very supportive of the possibility that Phil was a homosexual. When he came out as a homosexual, he experimented with same-sex relationships, but never felt full comfortable with his own male body. He experimented with cross-dressing, and portraying a feminine role with his sexual partners, but continued to lack internal happiness with his gender.

Components of Phil’s Gender Identity Disorder

The primary component of Phil’s gender identity disorder is his life-long belief that he was a female born in the body of a male. Phil often displayed dissatisfaction or distress with his male genitals, and showed signs of distress and anxiety over believing that something in his life was wrong. Phil experimented with cross-dressing, and taking on more feminine roles with sexual partners, and found himself researching the concept of sexual reassignment surgery.

Conclusion

Gender identity disorder is not the same as homosexuality. It is a disorder that occurs when an individual strongly believes that he or she was born with the body of the wrong sex. People suffering from gender identity disorder are prone to serious symptoms ranging from emotional distress, depression, isolation, and in worst cases, become suicidal. Gender identity disorder is not age specific, and affects both children and adults. An individual that has displayed signs of gender identity disorder for more than two years should receive proper treatment base don his or her age. Children and adults suffering form identity gender disorder require a supportive environment, and may want to consider the option of gender reassignment surgery once he or she has reached adult age. He or she must weigh all the options of treatment available, including therapy before making the decision to perform gender reassignment. People who do complete gender reassignment surgery may continue to need therapy as the procedure may not cure the identity problems the individual has experienced.

References

Hansell, J. & Damour, L. (2008). Abnormal psychology (2nd ed.). Hoboken, NJ: Wiley.

PubMedHealth. (2012). Retrieved from http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0002495/

Case Study of Social Phobia

Case Study Analysis of Dave

Dave is a young adult male in college, and suffers from social phobia. This condition usually begins during the individual’s early years, and is represented by symptoms that include a fear of being judged by other people, and being embarrassed in public situations (National Institute of Mental Health, n.d.). Dave also displays symptoms related to obsessive-compulsive disorder, and control issues.

Social Phobia

According to the National Institute of Mental Health (n.d.) “people with social phobia are afraid of doing common things in front of other people” (para. 2). Examples of social phobia include the fear of eating or drinking in front of others, or going to public events where the individual perceives a potential exposure to embarrassment (National Institute of Mental Health, n.d.).  Symptoms of social phobia range based on individual experiences. Some people will display symptoms during certain situations, whereas other people will experience symptoms under any social or public situation (National Institute of Mental Health, n.d.). Individuals suffering from social phobia are normally aware that their fears are over-exaggerated: however, the individual is not able to control his or her fear (National Institute of Mental Health, n.d.).

Social phobia is recognized as a treatable debilitating psychiatric condition that often remains undetected and untreated. Symptoms are likely to include blushing of the skin, and muscle twitching (Franklin, 1991). Social phobias may be as minor as a treatable fear of social interactions, or may include more serious conditions like agoraphobia that result on possible severe panic attacks that render a the individual unable to leave his or her perceived safe environment (Franklin, 1991).

Patient History

The patient’s case study indicates that his symptoms started within the last year. His interview reflects that he suffers from obsessive-compulsive disorder, and control issues (Hansell, & Damour, 2008). The patient believes that he always has to be perfect and in control of all situations he is associated with. His current condition has elevated his stress and anxiety levels to a point of being completely uncomfortable around other people (Hansell, & Damour, 2008). The patient’s interview indicates that his brother suffers from anxiety disorder resulting from family issues, and that his brother’s disorder has become a primary focus of the family dynamic (Hansell, & Damour, 2008). Dave believes that his brother’s problems have produced a situation where he is forced to take on a stronger role in the family, and that his family, especially his father, would not be able to contend with him having a mental disorder as well. Various test results indicate that the patient does not display any severe impairments associated with psychotic disorders; however, the test results are based on predictions that the patient has accurately and honestly answered the questionnaire (Hansell, & Damour, 2008).

Components of Dave’s phobia

The primary component of the patient’s condition is the fear of not being in control, and the reinforcement of anxiety within his family. Dave displays a tendency to feel extreme shame and embarrassment, and comparing himself to family members and peers. Further documentation indicates that the patient suffers from anxiety, and insecurity. He has a lack in self confidence, but is conventional thinking and controlled (Hansell, & Damour, 2008). Further documentation indicates that the patient shows a strong belief that he is less attractive and inferior to others around him. His anxiety levels became elevated when he was exposed to social situations, and that he compared himself to his friends, and family members in an unfavorable position (Hansell, & Damour, 2008).

Conclusion

The assessment of the patient indicates that he suffers from a persistent, irrational fear of social situations that results in his attempts to avoid any social interaction with his peers. The classification of social phobia is important to the development of a treatment regimen focusing on a combination of behavioral, cognitive, psychodynamic, and family influences to help the patient overcome his fears of inadequacy, and help alleviate the extreme symptoms of fear when involved in social situations. Social phobia affects people on different levels of extremity. Some people may display symptoms under certain situation, whereas other people will display symptoms in all social interactions. Understanding the individual underlying factors that result in individual diagnosis helps medical professionals determine the proper course of treatment best suited for the individual situation.

References

Franklin, R. S. (1991). Social phobia. Psychiatric Annals, 21(6), 349-353. Retrieved from http://search.proquest.com/docview/894193799?accountid=35812

Hansell, J. & Damour, L. (2008). Abnormal psychology (2nd ed.). Hoboken, NJ: Wiley.

National Institute of Mental Health. (n.d.). Retrieved from http://www.nimh.nih.gov/health/publications/social-phobia-social-anxiety-disorder-always-embarrassed/what-is-social-phobia.shtml

Historical Perspectives of Abnormal Psychology

Historical Perspectives of abnormal Psychology

Abnormal psychology is a model of psychological study of the abnormal human behavior. Clinical applications focus on defining, classifying, explaining, and providing clinically sound treatments for the many illnesses that fall under the abnormal behavior classification (Hansell, & Damour, 2008). Considered a young science, abnormal psychology has evolved over the past 100 years to outline six basic concepts that provide researchers with a relatively more accurate definition of study. Understanding modern-day theories of abnormal psychology requires consideration of the origins, theoretical models, and evolution related directly to abnormal behavior.

The Origins of Abnormal Psychology

One major difficulty in studying the origins and continuation of abnormal psychology is the definition of what is and is not abnormal behavior (Hansell, & Damour, 2008). Because behavior is a product of various influences like cultural differences, and societal views, researchers must  account for these differences, and look at past behavior of an individual (Feist, & Feist, 2009). Abnormal behavior in humans has been recorded as far back as biblical times. These early behavioral abnormalities included descriptions of behavior similar to modern day cases of schizophrenia and depression (Hansell, & Damour, 2008). One of the earliest recorded explanations for abnormal behavior in early cultures was a condition known as animism (Esper, 1964 as cited by Hansell, & Damour, 2008). Because early humans regarded many issues as acts of the spirit world, a person suffering from mental illness would be considered to be possessed by the devil or malevolent spirits (Hansell, & Damour, 2008). Treatments for individuals deemed possessed could include a procedure where holes were drilled into the patient’s skull to release the possessing spirit; a process known as trephination. Another recorded method of treatment associated with animism is exorcism, or the ritualistic practice of religious authorities used to cast out the evil sprits responsible for the individual’s abnormal behavior (Selling, 1940; Taylor, 1958 as cited in Hansell, & Damour, 2008).

Another major influence on the origins of abnormal psychology is connected to early Greek biological theories. Hippocrates theorized that diseases, including mental abnormalities were the result of an imbalance of four fluids believed to circulate through the human body (Hansell, & Damour, 2008). Treatments were designed to return the proper balance of these fluids, and included dietary and behavioral modifications. Hysteria was another biological theory associated with abnormal psychology developed by Greek physicians based on their own medical observations (Hansell, & Damour, 2008). The theory of hysteria involves the development of symptoms related to neurological damage form injury or disease (Hansell, & Damour, 2008). Common symptoms associated with hysteria included confusion, loss of sensation, paralysis, and physical pain or ailments (Hansell, & Damour, 2008).

Defining Normal and Abnormal Behavior

One major problem that faces researchers is the definition and classification of abnormal behavior. According to Hansell, & Damour (2008) “Explanatory paradigms for mental illness have shifted back and forth over many centuries among the spiritual, biological, and the psychological realms” (p. 31). The different theoretical approaches to abnormal psychology advance and change over time based on cultural and societal changes, and explanations of abnormal psychology depend on relation to cultural and historical context, and scientific progress (Hansell, & Damour, 2008). Thomas Kuhn (1922-1996) surmised that some philosophical views of scientific progress resulted from a series of radical paradigm shifts, and nota gradual accumulation of scientific knowledge associated to scientific advances (Hansell, & Damour, 2008).

Defining and classifying abnormal behavior requires an understanding of what is expected and acceptable behavior based on cultural, societal, and individual norms (Hansell, & Damour, 2008). Determining the point where an individual’s behavior deviates from these norms and becomes abnormal is challenging at best. Using the theory of relativism one could conclude that normalcy and abnormality is defined as the relative parameter of cultural and societal behavior during a specific period of human evolution (hansell, & Damour, 2008). To aid researchers in the development of these definitions, six core concepts were developed. These core concepts include contextual importance, continuum between abnormal and normal behavior,   consideration of cultural and historical relativism, understanding benefits and drawbacks of diagnosis, the understanding of causality, and the importance of mind/body connections (Hansell, & Damour, 2008).

The Evolution of Abnormal Behavior

Referenced earlier were the theoretical models of spirituality and early biology. Hippocrates theory that mental illness was a result of a fluid imbalance in the body, although flawed, were a significant contribution to modern-day medical thinking (Hansell, & Damour, 2008). His theories influences other physicians of his time to move away from spiritual beliefs, and rely on medical observations to diagnose mental illness. As science progressed, these early biological theories inspired new thinking in the field psychology (Hansell, & Damour, 2008). In the sixteenth and seventeenth centuries abnormal behavior was still considered by many to be related to demonic possession (AllPsych Online, 2003). Treatments of mentally ill people during this time included various forms of torture designed to drive out the demons possessing the individual (AllPsych Online, 2003). Unfortunately, most of these methods of torture failed in curing the individual, and in many cases the individual would be exiled or executed (AllPsych Online, 2003).

Views of mental illness started to shift by the eighteenth century, and abnormal behavior started to be viewed as an illness rather than demonic influence (AllPsych Online, 2003). During this period patients suffering from mental illness were moved from the torturous environment of dungeons and placed in asylums that focused on medical forms of treatment (AllPsych Online, 2003). In the early twentieth century somatogenic and psychogenic theories emerged. Somatogenic theory suggested that abnormal behavior was directly related to physiological factors, whereas psychogenic theory suggests that the root causes of abnormal behavior were psychological in nature. Modern-day models of abnormal psychology are influenced primarily by evolved versions of these early medical models (AllPsych Online, 2003).

Model Comparison

Theoretical models associated with abnormal behavior point to the importance of therapeutic relationships involved in the treatment process. While all these models converge and intersect at points, each explains causality from different perspectives (Hansell, & Damour, 2008). Psychosocial models explain how individuals process internal conflicting processes between the conscious and unconscious combined with environmental interactions. It emphasizes the importance of social relationships, immediate environments, internal conflicts, concerns, and memories in relation to individual behavior (Hansell, & damour, 2008). Biological and medical theories identify biological and physical associations to mental diseases and dysfunctions. It factors the contributions of biochemical and physical body functions, especially within the brain, as important factors related to understanding abnormal overt behavior and unobservable deviant behavior (Hansell, & Damour, 2008). Sociocultural theory suggests that social, cultural, and familial environments influence individual mental dysfunction and illness, and that environmental stressors influence and enhance abnormal behavior.

In modern-day research clinicians use the DSM-IV as the primary tool to diagnose various mental disorders by using a multidimensional approach to diagnosing mental dysfunction (AllPsych Online, 2003). The five primary dimensions of the DSM-IVIV are divided up into clinical syndromes, or axis I, developmental and personality disorders, or axis II, physical conditions, or axis III, severity of psychosocial stressors, or axis IV, and highest level of functioning, or axis V (AllPsych Online, 2003). The DSM-IV also identifies 15 general areas of adult mental illness (AllPsych Online, 2003).

Conclusion

The science of abnormal psychology is young and filled with a rich history of theoretical approaches ranging from early animistic approaches to the modern technology of medical science. Psychology has continued to evolve theoretical approaches based on constantly evolving cultural and societal views, and advancements in technology. Every theoretical approach focused on some measure of reliving individuals of the discomfort and dysfunction associated with abnormal behavior, and with through various advancements like the DSM-IV new progressions in diagnosis and treatments are discovered.

References

 AllPsych Online. (2003). Psychology 101. Retrieved from http://allpsych.com/psychology101/psychopathology.html

Feist, J., & Feist, G. (2009) Theories of Personality (7th ed.). New York: McGraw Hill

Hansell, J., & Damour, L. (2008). Abnormal Psychology (2nd ed.). Hoboken, NJ: Wiley.