Please no plagiarism and make sure you are able to access all resources on your own before you bid. Main references come from Murray, C., Pope, A., & Willis, B. (2017) and/or American Psychological Association (2014). You need to have scholarly support for any claim of fact or recommendation regarding treatment. Please respond to all 3 of my classmates with references separately. You need to have scholarly support for any claim of fact or recommendation like peer-reviewed, professional scholarly journals. I need this completed by 04/25/2020 at 7pm.

Expectation:

Responses to peers. Note that this is measured by both the quantity and quality of your posts. Does your post contribute to continuing the discussion? Are your ideas supported with citations from the learning resources and other scholarly sources? Note, that although it is often helpful and important to provide one or two sentence responses thanking somebody or supporting them or commiserating with them, those types of responses do not always further the discussion as much as they check in with the author. Such responses are appropriate and encouraged; however, they should be considered supplemental to more substantive responses, not sufficient by themselves.

Read your colleagues’ postings. Respond to your colleagues’ postings.

Respond in one or more of the following ways:

· Ask a probing question.

· Share an insight gained from having read your colleague’s posting.

· Offer and support an opinion.

· Validate an idea with your own experience.

· Make a suggestion.

· Expand on your colleague’s posting.

1. Classmate (C. Als)

Case Study

Susan is a 34-year-old woman who is married with two younger children. It appears after the birth of her two children she stated, she no longer had the desire to be sexually active with her husband. Her husband has been patient with her over the year not wanting to cause conflict within their relationship but states he is frustrated and wants his wife back.

DSM Sexual Dysfunction Disorder

It appears Susan may be experiencing low libido which is a lack of desire for sexual intimacy. For Susan to want to be sexually active with her husband her desire must be followed by arousal, excitement, orgasm, and resolution when her body returns to normal functioning. The DSM sexual dysfunction disorder Susan seems to be suffering from is Hypoactive Sexual Desire Disorder. Hypoactive Sexual Desire Disorder. HSDD is defined as the individual experiences an absence of sexual desires or fantasies for receptivity to sexual activity that causes personal distress or difficulties in their relationship (APA, 2013). This disorder is an important distress component that can hinder a relationship causing the individual with the disorder to lack the sexual attraction which encourages sexual arousal towards their partner. Postpartum, anxiety, low self-esteem, and depression can be some of the causes of HSDD. In this case, HSDD is treatable and can be manageable with medication or even counseling. There are a series of questions that can be asked by the healthcare provider or the clinician to determine why there is a concern or a lack of sexual desire in the relationship and the level of stress and fatigue and other issue’s that may have occurred since Susan gave birth to her children (ASHA, 2020).

Hypoactive Sexual Desire Disorder Counter-Argument

The counter-argument for this disorder, it can be caused by several other associations such as breast cancer, diabetes, urinary incontinence, thyroid problems, and multiple sclerosis, etc. The other possibility that can trigger HSDD is an imbalance of neurotransmitters in the brain that causes a chemical imbalance that inhibits the individual from sexual desires and excitement. There are also certain medications that an individual can take that can also cause this disorder as to why Susan feels the lack of sexual desire to be intimate with her husband. Per the DSM the only way to justify whether HSDD is something Susan suffers from the clinician would need to perform a four-question series called the Decreased Sexual Desire Screener. This screener will be able to determine if there is a lack of intimacy arousal possibly triggered by Susan childbirth’s or were there other scenarios surrounding the HSDD that can also be factored in her lack of sexual desires (ASHA, 2020). Therefore, the only way to make this confirmation would stem from the results of Susan’s assessment.

References

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: Author.

American Sexual Health Association (2020). Hypoactive Sexual Desire Disorder Retrieved from. http://www.ashasexualhealth.org/hypoactive-sexual-desire-disorder/

2. Classmate (L. Gre)

Female Sexual Interest/Arousal Disorder (F52.22)

The diagnosis of F52.22 Female Sexual Interest/Arousal Disorder would be most appropriate for Susan’s case. It was mentioned that Susan has not had any interest in sex with her husband for the past year and if they did engage in sexual intercourse it was at the initiation of her husband, Steve. This is consistent with criterion A of Female Sexual Interest/Arousal Disorder (American Psychiatric Association, 2013). Susan has been experiencing this lack of sexual interest for the past year which has caused marital challenges as she and Steve have fought over this issue frequently in the past. This behavior is consistent with criteria B, C, and D (American Psychiatric Association, 2013). I would also specify with acquired, generalized, with mild severity due to the information provided regarding her case.

Counterargument

There are many other explanations for the behaviors that Susan are exhibiting that may not be specific to sexuality. It would be more appropriate to get more information regarding why Susan may have a lack of interest in sexual intercourse. It may be due to another mental health disorder that have not been explored yet. Mental health and sexuality are intimately connected. Mental health symptoms also can have indirect impacts on sexual functioning (Murray, Pope, & Willis, 2017). It was mentioned that Susan is primarily a stay at home mother and has two preschool aged children. The stress of being home and having to care for these children could be the cause of her behaviors which could translate into an anxiety disorder. Anxiety can impact sexuality by increasing or decreasing blood flow to the vagina, relationship intimacy, and sexual satisfaction and can lead to sexual difficulties (Murray, Pope, & Willis, 2017).

References

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.
Retrieved from the Walden Library

Murray, C., Pope, A., & Willis, B. (2017). Sexuality counseling: Theory, research, and practice. Thousand Oaks, CA: Sage

3. Classmate (C. Rod)

Referencing the DSM-5, there are three sexual dysfunctions that are specifically related to females. According to Laumann, the most common female sexual dysfunctions are lack of sexual interest and lubrication difficulties, which is characterized in the DSM-5 as the sexual dysfunction of female sexual interest/arousal disorder (Murray, Pope, & Willis, 2017). Susan not being interested in sex is something new to this couple. A couple who once had sex 3 times a week, now have had sex 3 times this year. Susan cannot give an explanation for her lack of interest, she states “I just don’t want it anymore. I’m not sure if I ever will.”  Based on the limited information provided, I would have to say Female Sexual Interest/Arousal Disorder. For the client to meet the criteria she would have to experience at least 3 out of 6 of the symptoms. Reading the symptoms, the first one we can relate to Susan the others would be a guess. We do not know what she is thinking, she may be dissatisfied with her husband. 

1. Absent/reduced interest in sexual activity 

2. Absent/reduced sexual/erotic thoughts or fantasies 

3. No/reduced initiation of sexual activity and typically unreceptive to partner’s attempts to initiates. 

4. Absent/reduced sexual excitement/pleasure during sexual activity in almost all or all sexual encounters

5. Absent/reduced sexual interest/arousal in response to any internal or external sexual/erotic cues

6. Absent/reduced genital or nongenital sensations during sexual activity in almost all or all sexual encounters

Counter Argument

    There are so many missing details from this case study. Something that I wish I could ask is, was the sex enjoyable before? Just because it is happening 3 times a week, does not mean that both parties are satisfied. The information is limited there could be many other possible diagnoses. Susan could have genito-pelvic pain/penetration disorder. The APA reported that 15% of North American women experience pain during intercourse and that 19.7% of women said sex was not pleasurable (Murray et al., 2017). There could be an issue with Steve’s performance such as delayed ejaculation. What if Steve is not ejaculating and Susan is internalizing it? Or premature ejaculation and Susan has lost the hope for pleasure. As we have discussed talking about sex can be uncomfortable for some especially when expressing what you want. To come to an affirmative conclusion there would have to be more details available. The couple has decided to go to counseling so at least they are on the path for discovering a solution. 

References

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.

Murray, C., Pope, A., & Willis, B. (2017). Sexuality counseling: Theory, research, and practice. Thousand Oaks, CA: Sage

Required Resources

Readings

· Course Text: Murray, C., Pope, A., & Willis, B. (2017). Sexuality counseling: Theory, research, and practice. Thousand Oaks, CA: Sage

· Chapter 6, “Sexuality and Mental Health”

· Article: Benfield, J. (2018). Sex Addiction: The Search for a Secure Base. Healthcare Counselling & Psychotherapy Journal, 18(4), 14–17. Retrieved from the Walden Library databases.

· Article: Kraus, S. W., Voon, V., Kor, A., & Potenza, M. N. (2016). Searching for clarity in muddy water: future considerations for classifying compulsive sexual behavior as an addiction. Addiction, 111(12), 2113–2114. Retrieved from the Walden Library databases.

· Reference Text: American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.
Retrieved from the Walden Library