A personality disorder is also known as a mental disease (Paris, 2013) . When studying a person for such disorders, psychiatrists often aim at gaining insight into the patient’s long-term behavior and thoughts. This examination comprises of a video session between a therapist and a male client. The male client was made to visit a psychiatrist by his mother. The man asserts that the mother complains and nags him too much because he does not have a girlfriend.
The client, on the other hand, states that he has been alone for quite some time and that it would not be easy for him to change. Therefore, he believed that he would make a good friend to himself. The client’s secluded life becomes apparent when he talks about how he learned a lot when he opted out from classes. Nevertheless, from his explanation, it is evident his father made him start living a solitude life. He says that the father used to yell at him for no reason whenever he found him playing with his friends in the yard.
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Appropriate Diagnostic
The client is a victim of a personality disorder known as schizoid. According to the American Psychiatric Association, (2013), this personality disorder is coded 301.20 (F60.1). Some of the behaviors presented by the male client were also present in other personality disorders. However, the client was not diagnosed for them. For instance, the client showed behaviors that were characteristic of narcissistic personality disorder coded 301.81 (F60.81) (American Psychiatric Association, 2013). Nevertheless, this disorder was ruled out due to reasons that will be explained in later sections.
In addition, based on his unfriendly nature one would quickly diagnose him for schizotypal, antisocial or avoidant personality disorders coded [301.22 (F21)], [301.7 (F60.2)], and [301.82 (F60.6)] (American Psychiatric Association, 2013). Nonetheless, like in the former case, the client did not belong to any of these categories owing to the reasons that will be explained explicitly in the sections that will follow. The other types of disorders were not considered since the client did not demonstrate behaviors that are typical of such personality disorders.
Important Considerations during the Diagnosis Process
The diagnosis and treatment of personality disorders can be influenced by both psychological and environmental factors. It is, therefore, necessary to understand the context or rather the situation that led to the mental disorder to develop. For instance, in this case, study, there is no significant incident such as divorce, bereavement or loss of a job that would have yielded a major stress. Nagging was the main issue that was affecting the client in this study.
Personality Functioning of the Client
The client in this study shows varying levels of functioning. In that respect, Table 1 in the latest version of DSM will be used to assess his functioning (American Psychiatric Association, 2013). The table identifies four elements that can be used to determine the personality functioning. These are identity, self-awareness, empathy, and intimacy. These factors will be discussed as follows:
Identity : The client in this study is very much aware of the distinction between him and others. That implies that self-identity is functioning properly for this man. He is aware of his computer and internet oriented job he does at home. Also, it is hard to comment about his self-esteem since it is not evident from the conversation. However, he makes a narcissistic comment stating that he has always been imagining himself making some novel discoveries. Apparently, he has been unable to do that, and that is the reason why he opted to be playing online games like the World of Warcraft. In so doing, he would make a world of fantasy satisfy his desires. Besides, he is emotionally stable since he is overpowered neither by his frustrations nor by the excitement of expectation when he commences the talk about the shift to playing online games.
Self-Direction : The client demonstrated a problem in this second element of personality functioning. Notably, he does not show coherence and justifiable short-term objectives. Besides, he does not use the prosocial internal standards of the code of conduct. The client only demonstrated a long-term goal, and that lasted for only three semesters when he was in a college of electrical engineering. He also calls other student idiots to show that he has a different view to them. The client is in a position to recall the sour relationship he had with his father and how the relationship affected him negatively.
Empathy : The client did not demonstrate this third element. For instance, he does not empathize with his mother’s age. In fact, he finds her to be irritating despite the fact that she is the only one close to him in his life.
Intimacy : This is the fourth personality functioning test element. The man in the video shows no interest in relationships. He goes ahead to explain that he is used to a solitude life and it is hard for him to change now. The client frankly asserts that he is not ready for any relationship because he had none while growing up.
Criteria for Disqualifying Other Diagnosis
The diagnosis advocated for in this paper was reached at through the elimination method. First, schizotypal personality disorder was ruled out because the client did not demonstrate delusional logic thinking. For instance, none of his thinking was superstitious, suspicious or paranoia related. Such features are typical of schizotypal personality disorder. In addition, the client would not be deemed antisocial, as he never showed any impulsive or aggressive acts. The only problem he has was the irritation that was caused by his mother. Notably, antisocial personality disorder is characterized by irresponsible actions which the client did not demonstrate. Apparently, the symptoms that the client expressed would quickly make a psychiatrist diagnose him for narcissism. This is because the signs he was showing are close to this disorder as opposed to the first two that have been mentioned because he operates in solitude. However, he does not demonstrate the exploitative or rather manipulative behavior, which is characteristic of this disorder.
As it is characteristic of narcissist personality disorder, the client is non-conformable as well as unsympathetic. He proves to be visionary when he talks about the desire to make a significant novel discovery, in addition, he does not show sympathy to his mother. Such traits are typical of narcissist personality disorders. Nevertheless, he is not envious of others, and he has not concealed the sense of entitlement. Besides, he can understand the origin of his crisis as opposed to a typical narcissist. Furthermore, the client would not be diagnosed with avoidance personality disorder since fear did not drive his reason to avoid contact with people. He is only not interested in relationship and socialization.
Justification of the Diagnosis
The client in the video is a victim of schizoid personality since he demonstrates the seven behaviors that are typical of this disorder (American Psychiatric Association, 2013). For instance, he enjoys working in secluded environments, does not like relationships, he is sexually inactive, and he does not find pleasantries in other activities other that the World or Warcraft. Additionally, the client does not have friends, he likes criticizing others, and he is emotionally flat. As aforementioned earlier, he does demonstrate some narcissistic behavior. However, schizoid tendencies are manifested sufficiently. Apparently, it is clear that the reaction of the father towards the client was the main reason why the man opted to live a secluded life. His father was abusive in nature. Nonetheless, we cannot tell whether his father was a victim of schizoid personality disorder or not. It ought to be noted that schizoid personality disorder can be inherited. This is an implication that, the tendencies being demonstrated by the client might have been amplified more if the father happens to be a victim of schizoid personality disorder.
Conclusion
The client in this case study is a victim of schizoid personality disorder. He has no friends and does not intend to have one. The man perceives that he can become a good friend to himself. The situation becomes worse when he finds the only person close to him to be irritating. He neither shows empathy nor desire to engage in an intimate relationship. The client does demonstrate some narcissistic behavior. However, schizoid tendencies are manifested sufficiently.
References
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.
Laureate Education. (Producer). (2012). Psychopathology: Personality disorders. [Video file]. Retrieved from https://class.waldenu.edu.
Paris, J. (2013). Personality disorders begin in adolescence. Journal of the Canadian Academy of Child and Adolescent Psychiatry , 22 (3), 195.
