PRAC 6675 Controversy Associated with Personality and Paraphilic Disorders Essay

PRAC 6675 Controversy Associated with Personality and Paraphilic Disorders Essay

PRAC 6675 Controversy Associated with Personality and Paraphilic Disorders Essay

Controversy Associated with Personality and Paraphilic Disorders

Paraphilic disorders are characterized by the presence of strong and persistent sexual thoughts, actions, or cravings that may be distressing to the person experiencing them, impair their ability to function, or even cause damage to others. Based on evidence-based practice, the DSM-V has defined diagnostic criteria for several personality and paraphilic disorders. Despite the limited number of treatments that are now accessible as a result of the little study that has been done on these conditions, this serves the aim of promoting rapid treatment. There are a variety of paraphilic illnesses have been recognized, including voyeurism, sexual masochism, sadomasochism, exhibitionism, pedophilia, transvestism, and fetishism (Perrotta, 2019). Both psychotherapy approaches and pharmaceutical interventions, notably the prescription of selective serotonin reuptake inhibitors (SSRIs) and antiandrogens, are available as treatments for these illnesses. This paper focuses on the ethical and legal issues that are vital in therapeutic practice, as well as the debates surrounding the diagnosis and treatment of pedophilic illness.

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Controversy Surrounding Pedophilic Disorder

 Considerable controversies have arisen regarding the delineation of pedophilic disorder, with legal, ethical, and scientific viewpoints offering divergent perspectives. Pedophilic disorder is recognized as a genuine psychiatric condition by the ICD-10, and the DSM-V. This diagnosis applies to adult individuals aged 16 years and above who exhibit sexual attraction towards prepubescent children, typically under the age of 13 years, and may pose a risk of harm to them.  In contrast, prevailing cultural and social norms maintain that pedophilia represents morally reprehensible and socially unacceptable conduct, for which individuals are expected to bear the repercussions of their actions (Oronowicz-Jaśkowiak & Lew-Starowicz, 2021). Based on legal perspectives from the United States, Europe, and Canada, it is deemed that any manifestation of pedophilic behavior is regarded as a criminal offense, necessitating the initiation of legal proceedings against the perpetrator. Consequently, the presence of these aforementioned controversies poses significant challenges in the diagnosis and treatment of patients afflicted with this disorder.  

Professional Beliefs about Pedophilic Disorder

 As a healthcare professional, it is my perspective that Pedophilia is a mental disorder that warrants diagnosis according to the criteria delineated in the DSM-V and ICD-10, in conjunction with other relevant clinical guidelines (Perrotta, 2019). It is argued that the timely identification of this disorder can facilitate prompt intervention, thereby fostering favorable outcomes that enhance the mental health and well-being of persons, while also mitigating potential harm to minors (Moser, 2019). Nonetheless, it is imperative to establish a clear distinction between persons who exhibit behaviors indicative of sexual misconduct, and those who experience social distress and challenges related to their sexual desires, which may potentially harm others (Gnanapragasam et al., 2023). The exemption from legal action for sexual offenders should only be granted to persons who meet the criteria for diagnosis.

Maintaining Therapeutic Relationship

 Psychotherapy is considered the primary treatment modality for persons diagnosed with pedophilia, as supported by the evidence-based approach. To facilitate favorable outcomes, the psychiatrist must establish and cultivate a robust therapeutic alliance with the patient (Pukall et al., 2019). The implementation of effective communication strategies, characterized by the utilization of a compassionate, empathetic, and impartial demeanor, has the potential to enhance the patient’s sense of assurance and reliance on the psychiatrist (Bradford et al., 2020). To effectively involve the patient and acquire the essential information required to gain a comprehensive understanding of the patient’s condition, the psychiatrist must exhibit active listening abilities and maintain an unbiased perspective. Ultimately, it is crucial to provide comprehensive education to the patient regarding the pedophilic condition and the potential advantages of the diverse treatment modalities to enhance their confidence in the entirety of the medical intervention.

Ethical and Legal Considerations

Clinicians frequently encounter a central legal challenge when providing care for persons with pedophilia, namely the preservation of the patient’s entitlement to privacy and confidentiality. Determining the appropriate timing for disclosing a patient’s information to the authorities poses a challenging task, as it entails navigating a complex landscape of ethical and legal implications (Moser, 2019). For example, persons who are attracted to minors but do not engage in illegal activities are permitted to pursue mental health treatment, provided that their entitlement to confidentiality and personal privacy is upheld. Nevertheless, it is imperative to acknowledge that psychiatrists are legally obligated to disclose information regarding persons who have committed acts of pedophilia, thereby infringing upon their right to privacy (Gnanapragasam et al., 2023). Consequently, the psychiatrist encounters difficulty in discerning between the two scenarios due to the shared possibility of harm to children.

Conclusion

  The comprehension of paraphilic conditions is often challenging for people due to the presence of divergent perspectives stemming from cultural, social, scientific, and legal domains. In contrast, while community and state laws perceive pedophilia as criminal behavior that warrants legal intervention against the offender, the DSM-V and other clinical standards categorize this behavior as a mental disorder. Nevertheless, scholarly investigations have demonstrated that persons afflicted with pedophilic disorder may experience significant advantages from interventions aimed at improving their psychological well-being and overall state of health.

References

Bradford, J. M., Firestone, P., & Ahmed, A. G. (2020). The Paraphilic Disorders and Psychopathy. The Wiley International Handbook on Psychopathic Disorders and the Law, 671-691. https://doi.org/10.1002/9781119159322.ch29

Moser, C. (2019). DSM-5, Paraphilias, and the Paraphilic Disorders: Confusion Reigns. Archives of Sexual Behavior, 48(3), 681–689. https://doi.org/10.1007/s10508-018-1356-7

Oronowicz-Jaśkowiak, W., & Lew-Starowicz, M. (2021). Personality variables among sexual offenders with and without a diagnosis of paraphilic disorders. European Psychiatry, 64(S1), S380-S381. doi:10.1192/j.eurpsy.2021.1020

Perrotta, G. (2019). Paraphilic Disorder: Definition, Contexts and Clinical Strategies. Neuro Research, 1(1), 1–15. https://www.jneuro.org/full-text/paraphilic-disorder-definition-contexts-and-clinical-strategies

Pukall, C. F., Eccles, T., & Gauvin, S. (2019). Sexual Dysfunctions, Gender Dysphoria, and Paraphilic Disorders. Diagnostic Interviewing, 349–373. https://doi.org/10.1007/978-1-4939-9127-3_14

Sam Nishanth Gnanapragasam, Scott, F., & Dinesh Bhugra. (2023). Sexual Dysfunctions, Gender Dysphoria, and Paraphilic Disorders. 711–725. https://doi.org/10.1007/978-3-031-15401-0_2

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Controversy Associated with Personality and Paraphilic Disorders

Between 10% and 20% of the population experience personality disorders. They are difficult to treat as individuals with personality disorders are less likely to seek help than individuals with other mental health disorders. Treatment can be challenging as they do not see their symptoms as painful to themselves or others.

Paraphilic disorders are far more common in men than in women, and generally quite chronic, lasting at least two years. Treatment of these disorders usually involves both psychotherapeutic and pharmacologic treatments.

In this Assignment, 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.

To Prepare

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.

Resources

Be sure to review the Learning Resources before completing this activity.

Click the weekly resources link to access the resources.

WEEKLY RESOURCES

Learning Resources

Required Readings

National Institute for Health and Care Excellence: NICE Guidelines. (2010). Antisocial personality disorder: Prevention and management

Links 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.

Chapter 19 “Personality Disorders”

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.

Chapter 67, “Disorders of Personality”

Chapter 68, “Developmental Risk for Psychopathy”

Chapter 69, “Gender Dysphoria and Paraphilic Sexual Disorders” (pp. 988–993 only)

Zakhari, R. (2021). The psychiatric-mental health nurse practitioner certification review manual. Springer Publishing Company.

Chapter 14, “Personality Disorders”

Required Media

Buchanan, N. T. (2020, April 13). Lecture 14 part 3: Paraphilic disorders

Links to an external site. [Video]. YouTube. https://www.youtube.com/watch?v=ykkMo9t0bxs

MDedge. (2020, January 22). Personality disorders with Dr. Frank Yeomans

Links to an external site. [Video]. YouTube. https://www.youtube.com/watch?v=ESQIDslCX_s

The Assignment

In 2–3 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.

By Day 7 of Week 7

Submit your Assignment.

submission information

Before submitting your final assignment, you can check your draft for authenticity. To check your draft, access the Turnitin Drafts from the Start Here area.

To submit your completed assignment, save your Assignment as WK7Assgn_LastName_Firstinitial

Then, click on Start Assignment near the top of the page.

Next, click on Upload File and select Submit Assignment for review.

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Rubric

NRNP_6675_Week7_Assignment_Rubric

NRNP_6675_Week7_Assignment_Rubric

Criteria Ratings Pts

This criterion is linked to a Learning Outcome In 2–3 pages, address the following: • Explain the controversy that surrounds your selected personality or paraphilic disorder.

15 to >13.0 pts

Excellent 90%–100%

The response includes an accurate and concise explanation of the controversy within the field related to the disorder.

13 to >11.0 pts

Good 80%–89%

The response includes an accurate explanation of the controversy within the field related to the disorder.

11 to >10.0 pts

Fair 70%–79%

The response includes a somewhat vague or inaccurate explanation of the controversy within the field related to the disorder.

10 to >0 pts

Poor 0%–69%

The response includes a vague or inaccurate explanation of the controversy within the field related to the disorder. Or the response is missing.

15 pts

This criterion is linked to a Learning Outcome • Explain your professional beliefs about your selected disorder, supporting your rationale with at least three scholarly references from the literature.

25 to >22.0 pts

Excellent 90%–100%

The response includes a thorough and well-organized explanation of the student’s professional beliefs about the disorder. Rationale demonstrates critical thinking and is strongly supported with three scholarly references.

22 to >19.0 pts

Good 80%–89%

The response includes a well-organized explanation of the student’s professional beliefs about the disorder. Rationale is clear and appropriately supported with three scholarly references.

19 to >17.0 pts

Fair 70%–79%

The response includes a somewhat vague explanation of the student’s professional beliefs about the disorder. Rationale is somewhat unclear and references either provide weak support for the rationale or are not scholarly/current.

17 to >0 pts

Poor 0%–69%

The response includes a vague explanation of the student’s professional beliefs about the disorder. Rationale is unclear and references are inappropriate. Or the response is missing.

25 pts

This criterion is linked to a Learning Outcome • Explain strategies for maintaining the therapeutic relationship with a client that may present with the disorder.

30 to >26.0 pts

Excellent 90%–100%

The response includes an accurate and concise explanation of strategies for maintaining the therapeutic relationship with a client that may present with the disorder.

26 to >23.0 pts

Good 80%–89%

The response includes an accurate explanation of strategies for maintaining the therapeutic relationship with a client that may present with the disorder.

23 to >20.0 pts

Fair 70%–79%

The response includes a somewhat vague or incomplete explanation of strategies for maintaining the therapeutic relationship with a client that may present with the disorder.

20 to >0 pts

Poor 0%–69%

The response includes a vague or inaccurate explanation of strategies for maintaining the therapeutic relationship with a client that may present with the disorder. Or the response is missing.

30 pts

This criterion is linked to a Learning Outcome • Finally, explain ethical and legal considerations related to the disorder that you need to bring to your practice and why they are important.

15 to >13.0 pts

Excellent 90%–100%

The response includes an accurate and concise explanation of ethical and legal considerations related to the disorder that are important to clinical practice and why they are important.

13 to >11.0 pts

Good 80%–89%

The response includes an accurate explanation of ethical and legal considerations related to the disorder that are important to clinical practice and why they are important.

11 to >10.0 pts

Fair 70%–79%

The response includes a somewhat vague or incomplete explanation of ethical and legal considerations related to the disorder that are important to clinical practice and why they are important.

10 to >0 pts

Poor 0%–69%

The response includes a vague and inaccurate explanation of ethical and legal considerations related to the disorder that are important to clinical practice and why they are important. Or, response is missing.

15 pts

This criterion is linked to a Learning Outcome Written Expression and Formatting – Paragraph Development and Organization: Paragraphs make clear points that support well-developed ideas, flow logically, and demonstrate continuity of ideas. Sentences are carefully focused—neither long and rambling nor short and lacking substance. A clear and comprehensive purpose statement and introduction are provided that delineate all required criteria.

5 to >4.0 pts

Excellent 90%–100%

Paragraphs and sentences follow writing standards for flow, continuity, and clarity…. A clear and comprehensive purpose statement, introduction, and conclusion are provided that delineate all required criteria.

4 to >3.5 pts

Good 80%–89%

Paragraphs and sentences follow writing standards for flow, continuity, and clarity 80% of the time…. Purpose, introduction, and conclusion of the assignment are stated, yet they are brief and not descriptive.

3.5 to >3.0 pts

Fair 70%–79%

Paragraphs and sentences follow writing standards for flow, continuity, and clarity 60%–79% of the time…. Purpose, introduction, and conclusion of the assignment are vague or off topic.

3 to >0 pts

Poor 0%–69%

Paragraphs and sentences follow writing standards for flow, continuity, and clarity < 60% of the time…. No purpose statement, introduction, or conclusion were provided.

5 pts

This criterion is linked to a Learning Outcome Written Expression and Formatting – English writing standards: Correct grammar, mechanics, and proper punctuation

5 to >4.0 pts

Excellent 90%–100%

Uses correct grammar, spelling, and punctuation with no errors

4 to >3.5 pts

Good 80%–89%

Contains 1-2 grammar, spelling, and punctuation errors

3.5 to >3.0 pts

Fair 70%–79%

Contains 3-4 grammar, spelling, and punctuation errors

3 to >0 pts

Poor 0%–69%

Contains five or more grammar, spelling, and punctuation errors that interfere with the reader’s understanding

5 pts

This criterion is linked to a Learning Outcome Written Expression and Formatting – The paper follows correct APA format for title page, headings, font, spacing, margins, indentations, page numbers, parenthetical/in-text citations, and reference list.

5 to >4.0 pts

Excellent 90%–100%

Uses correct APA format with no errors

4 to >3.5 pts

Good 80%–89%

Contains 1-2 APA format errors

3.5 to >3.0 pts

Fair 70%–79%

Contains 3-4 APA format errors

3 to >0 pts

Poor 0%–69%

Contains five or more APA format errors

5 pts

Total Points: 100