Psychology and DSM Application

Posted by Winnie Melda on March 21st, 2019

 Substance-related disorders refer to disorders of abuse, dependence, intoxication and substance withdrawal from a varied range of substances that may be legal or illegal. They comprise of ten categories of drugs namely caffeine;, hallucinogens; alcohol; cannabis; opioids; inhalants; hypnotics, anxiolytics and sedatives; tobacco; stimulants; and other substances. The classes listed are not distinct. Excessive consumption of any drug affects to a great extent the brain reward system. This system is responsible for behavior reinforcement and memories production. Of essence is that the activation of the reward system is so intense that the brain system neglects functions. At this point, the reward system is no longer dependent on adaptive behaviors. Instead, drugs become responsible for the activation of reward pathways. Each drug produces reward in a different manner (pharmacologically) from the other. One similarity though is the production of pleasure feelings commonly referred to as “high”. Substance-related disorders have two broad categories, substance use, and substance-induced disorders.

One of the substance-related disorders is alcoholism.  This is a behavior related to alcohol seeking and consumption that is harmful in the long-term. There are medical and psychological disorders that may co-occur with alcoholism. They include bipolar and major depression, antisocial personality disorder and anxiety disorder.  Alcoholism, as recognized by the American Psychiatric Association (APA), is a disorder of alcohol dependence. One becomes addicted to alcohol and as such, is unable to stop drinking. Ultimately, problems emerge concerning personal, work or school –related issues. The long-term impact of alcoholism, not only affects an individual’ s personal life and health, but also, the society as a whole. Alcohol dependence encompasses such elements as withdrawal, tolerance and cognitive issues. Withdrawal symptoms occur when an individual currently dependent on the alcohol stops drinking for some time. They include nausea, and irritability. Tolerance occurs when the individual’s response to alcohol consumption reduces. Alcohol abuse is another disorder that is similar to dependence that explains an alcoholic’s impaired ability to achieve life goals and fulfill responsibilities. 

The causes of alcoholism can be biological, behavioral or genetic. Behavior factors encompass internal and external feedback. Internal feedback refers to a person’s experience during and after consumption of alcohol, while external feedback refers to other people’s response towards the person’s drinking. Internal states include hangover and shame while external factors include criticism and encouragement. From a biological viewpoint, alcohol consumption impairs the levels pleasure neurotransmitter in the brain (dopamine). The person no longer enjoys life’s pleasures. Studies have revealed a gene that causes dependence on alcohol is transmitted to male offspring.

Alcoholism diagnosis is dependent on either psychological or medical conditions. When one engages in abusive drinking for a long time, medical conditions may arise and lead to a suspicion of alcoholism case. Such medical conditions include hepatitis and cirrhosis affecting the liver, pancreatitis affecting the pancreas and cardiomyopathy, the heart. Fatigue, depression, sleep disorders and sexual dysfunction may prompt a physician to assess it further as a case of alcoholism. A physician tends to psychological diagnosis through a clinical interview and biopsychosocial assessment. The clinician asks issues that delve on one’s childhood, education, lifestyle and medical history. A tool called the CAGE questionnaire is used during the early stages of the alcoholism diagnosis. Other longer lists may be used to determine the extent of alcohol abuse.

Treatment of alcoholism is mainly through detoxification and rehabilitation. Detoxification involves getting rid of alcohol toxic elements from a patient’s body. Failure to support a patient results in withdrawal. Rehabilitation, on the other hand, involves working from detoxification when drinking has stopped. The physician must assist the patient to stay healthy. Family members must offer encouragement in order to help address healing. Psychosocial support is also an essential factor in stopping alcoholism.

Traumatic events take many forms and can occur in any setting. It is an extreme event that is out of range of an individual’s normal experience. After a trauma, people react and respond differently. It is important to note that as part of team responding to trauma, all people in the scenario experience trauma. They include those who have experienced it first-hand, witnesses and those involved with those affected. The sight or memory of places, persons who items related to the trauma trigger reactions. Of equal importance is the fact that some reactions may seem quite unrelated but are equally important. DSM-IV-TR comprises a list of possible traumatic events such as sexual and physical abuse, kidnap, combat torture, accidents, death, injury, war, disaster or major illnesses. As a member of trauma response team, I would understand that listings of various traumas may imply falsely that these traumas are interdependent. If it is a non-interpersonal trauma for instance, a disaster or a house fire, I would encourage the victim. This is through the understanding that undergoing one trauma may not necessarily mean an increase in the likelihood of undergoing another. However, I would espouse out that there is a greater likelihood of experiencing another trauma for victims of interpersonal traumas. The term revictimization explains this. This information helps inquire from victims whether they have experienced childhood abuse because they are likely to experience the same as adults in cases of abuse. DSM is also an important tool for analyzing the relationship between varied traumas and their symptoms. For instance, I can understand why some victims (adults) are facing a particular type of trauma due to childhood experiences and subsequent maladaptive behavior.

DSM-IV divides psychiatric disorders into five axes. Eating disorders fall under Axis I of DSM and include anorexia nervosa. Anorexia nervosa is a medical condition defining the lack of appetite for food. There is also a person’s refusal to maintain adequate body weight, a disrupted body image and a fear of weight gain. There are two categories of anorexia both with the goal of achieving weight loss. The first one is the restricting type where the victim restricts calories through dieting, fasting, and excessive exercise. The second one is the purging type where the victim forces the act of vomiting or uses laxatives and diuretics. A patient with anorexia nervosa attempts to control their life and emotions and as such, their self-esteem is inclined on how much weight they lose. Symptoms of anorexia nervosa include amenorrhea, headaches and irritability, constipation among others. Achalasia is esophageal motility disorder that may present as anorexia nervosa. One of its symptoms common in anorexia nervosa patients is weight loss.  Other differential diagnoses include celiac sprue, chronic mesenteric ischemia, hyperthyroidism, malabsorption, hypothyroidism, panhypopituitarism, constipation and protein-losing Enteropathy.

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Carolyn Morgan is the author of this paper. A senior editor at MeldaResearch.Com in college research paper services. If you need a similar paper you can place your order from best medical essay service.