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Personality and Paraphilic Disorders

Maureen

Personality and Paraphilic Disorders

Personality and paraphilic disorders are highly subject to controversial interpretations. The controversies surrounding the disorders are based on the diagnosis. For example, most patients are diagnosed with a paraphilic disorder based on having paraphilia. It is insufficient unless negative consequences resulting from paraphilia are exhibited. Based on the DSM system, personality disorder was grouped within axis-one conditions since it was regarded as less important. The legal and ethical consideration of paraphilic condition is that when the paraphilia involves a consenting adult without clinically significant distress, it may not be pathologized.

The controversy that surrounds your selected disorder.

The controversy surrounding personality and paraphilic disorders is that, based on the DSM system, the condition was grouped within axis-one disorders. It is because the disorder was categorized as of lesser importance. It is contrary to the context of psychiatry because the disorder is symptom-based and affects a patient’s whole experience. For example, borderline personality disorder diminishes the functionality of an individual later in life if left untreated. The condition is not considered severe since it can be treated symptomatically. However, research indicates that borderline personality disorder affects a person’s quality and ability to deal with life challenges. Therefore, treatment based on symptoms is unlikely to be a success. The controversy is that the disorder has been conceptualized as axis 1, and the interventions provided are not evidence-based. The disorder was first introduced in the DSM-3, 1980, which described the condition based on traits (MDedge, 2020). Controversy on the diagnosis of paraphilic disorder is prevalent. Most patients are diagnosed with the condition based on paraphilia. However, paraphilia is not adequate for physicians to diagnose an individual with paraphilic disorder. Instead, the patient must exhibit negative consequences resulting from paraphilia.

My professional beliefs about this disorder.

My professional beliefs about personality and paraphilic disorder are that they are challenging to assess and manage. I believe that paraphilic disorder is of different types and patterns rare among females. Research indicates that there are 10-20 males with the disorder for every female (Buchanan, 2020). Also, my professional belief on paraphilic disorder is that most individuals diagnosed with sexual addiction have experienced sexual abuse during childhood. I perceive that sexual abuse as a child may contribute to developing paraphilia later in life. Studies show that 30% of males and 60% of females that portray paraphilia disorders have experienced sexual abuse as a child (Thapar et al. 2015). I believe that personality and paraphilic disorders are significant public health issues. Therefore, legislators, health insurance firms, and the general public should emphasize the impact of the disorders. Increased resources and funding should be allocated to these disorders to promote extensive research and improved findings (Zakhari, 2021).

The strategies for maintaining the therapeutic relationship with a patient that may present with this disorder.

The psychoanalytic approach is one strategy that will help maintain a therapeutic relationship with patients presenting a personality and paraphilic disorder. This tactic aims to conduct therapy sessions with an understanding and goals for the patient. It will help connect the factors that cause a patient to portray symptoms associated with the disorders. The psychoanalytic approach must perform assessments and get to the core of the underlying problem with a patient. Another strategy to maintain a therapeutic connection with a patient with personality and paraphilic disorder is to engage them in a deep exploratory sense of self. It is vital to not only listen to the patient but also find out how they are experiencing the therapist on an implicit level based on the interactions and questions asked (MDedge, 2020).

You need to bring ethical and legal considerations related to this disorder to your practice.

One of the ethical considerations related to paraphilia that I should incorporate into my practice is the treatment approach. It is essential because there are various methods for treating patients. However, the condition may not be a problem when paraphilia involves a consenting adult that does not portray clinically significant distress. It is particularly applicable when the individual does not need treatment and is not experiencing impairment. From the legal aspect, psychologists are not required to pathologize consenting adults that engage in mutually agreed-upon conduct that poses no harm (Buchanan, 2020). However, it is legally questioned when it involves non-consenting adults that show impairment due to urges of the behaviors. Personality disorders should be ethically considered based on the person as a whole instead of focusing on their symptoms and biological aspects. It included a greater understanding of how individuals perceive meaning and self, which influences their personality.

Conclusion

Some of the legal and ethical considerations to incorporate in my practice regarding paraphilic disorder is that it may not be pathologized when the paraphilia involves a consenting adult without significant distress. Various controversies surround the personality disorders, such as being categorized within axis-one disorders. Based on the DSM experience, the condition is considered less critical. One of the strategies that will help maintain a therapeutic relationship with patients presenting a personality and paraphilic disorder is a psychoanalytic approach that involves assessing and getting to the core of the problem with a patient.

Reference

Thapar, A., Pine, D. S., Leckman, J. F., Scott, S., Snowling, M. J., & Taylor, E. A. (Eds.). (2015). Rutter’s Child and adolescent psychiatry (6th ed.). Wiley Blackwell.

Zakhari, R. (2021). The psychiatric-mental health nurse practitioner certification review manual. Springer Publishing Company.Hill, J. (2015). Disorders of personality. Rutter’s child and adolescent psychiatry, 950-965.

MDedge (January 22, 2020). Personality disorders with Dr. Frank Yeomans. Retrieved from: https://youtu.be/ESQIDslCX_s?t=1968

Nicole T. Buchanan (April 14, 2020). Lecture 14 Part 3 Paraphilic Disorders. Retrieved from: https://youtu.be/ykkMo9t0bxs?t=4

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Question 

In this week’s case, you will explore personality and paraphilic disorders in greater detail. You will research potentially controversial elements of the diagnosis and/or treatment and explain ethical and legal considerations when working with these disorders.

Personality and Paraphilic Disorders

Review this week’s Learning Resources and consider the insights they provide on assessing, diagnosing, and treating personality and paraphilic disorders.

Select a specific personality or paraphilic disorder from the DSM-5-TR to use for this Assignment.

Use the Walden Library to investigate your chosen disorder further, including controversial aspects of the disorder, maintaining the therapeutic relationship, and ethical and legal considerations.

In 3 pages:

Explain the controversy that surrounds your selected disorder.

Explain your professional beliefs about this disorder, supporting your rationale with at least three scholarly references from the literature.

Explain strategies for maintaining the therapeutic relationship with a patient that may present with this disorder.

Finally, explain ethical and legal considerations related to this disorder that you need to bring to your practice and why they are important.

Reading Resources

National Institute for Health and Care Excellence: NICE Guidelines. (2010). Antisocial personality disorder: Prevention and managementLinks to an external site..
https://www.nice.org.uk/guidance/cg77

Boland, R. Verdiun, M. L. & Ruiz, P. (2022).  Kaplan & Sadock’s synopsis of psychiatry (12th ed.). Wolters Kluwer.

Thapar, A., Pine, D. S., Leckman, J. F., Scott, S., Snowling, M. J., & Taylor, E. A. (Eds.). (2015). Rutter’s child and adolescent psychiatry (6th ed.). Wiley Blackwell.

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