Signs of Bulimia Nervosa - Essay Example

450077DX-8 Assignment Bulimia Nervosa (BN) is characterized by binge eating and by the use of inappropriate methods to prevent weight gain (American Psychiatric Association, 2000). Also, those who suffer form BN are "excessively influenced by body shape and weight" (American Psychiatric Association, 2000, p. 589). The DSM-IV-TR defines a binge as eating large quantities of food in one sitting that is more than most people would eat in the same amount of time. The clinician working with the client must be sure that the bingeing happens outside of a holiday because a single episode of binge eating does not mean the individual is bulimic. Also, the episode of bulimia does not have to be done in one place. As an example, the individual can start when they are at a restaurant and finish when they get home (American Psychiatric Association, 2000). Bulimia also has two subtypes: Purging, in which the individual induces vomiting after eating or the non-purging type. In purging, the individual misuses laxatives, diuretics, or enemas in their most current episode. In the non-purging type, the individual misuses laxatives, diuretics or enemas but they do not purge afterward (American Psychiatric Association, 2000). In contrast, Binge-Eating Disorder (BED) has recurrent eating binges but they do not purge afterwards (Nevid, Rathus and Greene, 2005). BED is usually occurring in obese individuals and is often associated with long-term attempts to lose weight; they also experience depression. In BN, the individual is usually thin and vomiting to stop from getting fat. I believe that EDNOS is more often diagnosed because there can be gray areas when dealing with eating disorders and because there needs to be a history of certain types of behavior. Generally, the counselor must do an interview with the individual and they must be able to give the counselor this history. Also, when there are specific factors that look like BN or Anorexia, but all the criteria is not met, ENOS can be the better diagnosis. As an example, an individual may have all the characteristics of AN but they still have a normal weight (American Psychiatric Association, 2000). This also may be a "safer" diagnosis critically when the clinician does not have enough medical history. References American Psychiatric Association (2001). Diagnostic and statistical manual of mental disorders. 4th ed. Text Revision (DSM-IV-TR). DC: American Psychiatric Association. Nevid, J.S., Rathus, S.A. and Greene, B. (2005). Abnormal psychology in a changing world. NJ: Pearson Assignment 3 Axis 1 302.3 Transvestic Fetishism Mr. A has come to counseling because he enjoys dressing as a woman. He has his own wardrobe and makeup and he belongs to a networking group in his area. Also, Mr. A may be experiencing depression so the clinician should talk to him more about this depression to determine whether it is clinical or not. Axis 2 None Axis 3 None Axis 4 Problems with primary support group -- Mr. As wife does not accept his transvestism and does not want to talk about it with him. This has caused a rift between them and in turn makes him feel guilty. Problems related to the social environment -- Although Mr. A has support for his transvestism through a local network, he is now ashamed to attend. His wifes attitude towards his lifestyle prevents him from expressing himself in this way. He also cannot tell his friends or family members for fear of humiliation. Axis 5 GAF-80 Mr. A functions well overall. His problems are more related to his wifes non-acceptance of his lifestyle. If she were to relate to him differently or if he would assert himself differently, this issue may be resolved so he can life a fuller life. Family and Social Issues Mr. A is in a situation that is very uncomfortable for him. On the one hand, he is comfortable with his need to dress in womens clothes and he has sought others who also engage in cross dressing. He has explored telling his wife and she does not want him to talk about it. The greatest challenge for his is that he needs to find a way to accept himself and his cross dressing. As in many situations with a sexual or gender disorder, he will need to find a way to accept this as "normal" for him. Mr. As wife may also need to go to counseling to understand his behavior and how she can accept him. According to the American Psychiatric Association (2000) cross dressing can be a part of gender identity disorder, but this is not the case for Mr. A; he just likes wearing womens clothes. In addition to helping him stay involved in the networking group he found, there may be a support group in his area that may be helpful for him to show that many people experience this lifestyle. He must address his own issues and a support group can often help. Additional informant that may be important is the level of depression that is being felt by Mr. A and whether it is clinical or only because he is unable to express himself openly. I would also want to know whether he had any other friends or family that he felt he could tell to see whether they are supportive. According to Langstrom and Zucker (2005), 87% of males engage in Transvestic Fetishism so it would be helpful for Mr. A to know he was not alone. My Thoughts On Assessing Our society suggests that men who dress in womens clothing are "weird" and they have something wrong with them. The media through television and movies has shown men in dresses from "Tootsie" to "Mrs. Doubtfire." Although this is glamorized, I believe that these movies have opened the way for men in dresses. When I think of these characters, I see that cross dressing is not something harmful. On the other hand, although this disorder does not harm anyone physically, it can potentially harm the mates or the children as in Mr. As case, if the situation is not handled well. I do not have any people that I know who have this fetish, and I am not sure what I would do if I had a friend who told me they had it. To diagnose this situation is simple when the individual is as open about it as Mr. A. and meets the symptoms as stated in the DSM-IV-TR. When looking at this information, the counselor can very clearly see that Mr. A has this fetish. As far as I know, I do not have any biases or background issues regarding Transvestic Fetishism. I do not see it as abnormal behavior per se because it has been so much a part of our society. I understand that it can be seen as abnormal because most men are not sexually aroused by wearing womens clothing, but it is a lifestyle for many others. If I were to work with someone who revealed this challenge to me, I would hope that if any biases or challenges came up for me that I would be able to step aside form them and work with the client. I would talk with my supervisor about how to work with my own challenges or biases that may come up. References American Psychiatric Association (2001). Diagnostic and statistical manual of mental disorders. 4th ed. Text Revision (DSM-IV-TR). DC: American Psychiatric Association. Lagstrom, N. and Zucker, K.J. (2005). Transvestic fetishism in the general population" Prevalence and correlates. Journal of Sex & Marital Therapy, 3, 87-95. doi: 10.1080/00926230590477934 Read More