Analyzing Psychology Dual Diagnosis

Psychology Dual Diagnosis: Substance Related Disorders and Co-Occurring Disorders The abuse of substances and the dependence on it are considered to be two separate types of disorders. This is according to the DSM-V use of the terms. The DSM-V is a manual that is made use of by professionals in the field of medicine and mental health. They specifically refer to this manual when they are diagnosing disorders related to the mental health of a patient and the use of substances.

Through the use of this manual, there is a standard way of diagnosing disorders (Rockville, 2005). Substance use disorders are often found to exist with co-occurring disorders. This report highlights the assessment and treatment of substance related disorders and the co-morbid disorders. Introduction The abuse of substances and the dependence on it are considered to be two separate types of disorders. This is according to the DSM-V use of the terms. The DSM-V is a manual that is made use of by professionals in the field of medicine and mental health.

They specifically refer to this manual when they are diagnosing disorders related to the mental health of a patient and the use of substances. Through the use of this manual, there is a standard way of diagnosing disorders (Rockville, 2005). Discussion The DSM-V progresses from the DSM-IV in that it has disorders on a range, replacing the separate categories of disorders that were previously seen. The range moves from what is mild to what is acute.

It further classifies the use of specific substances into specific disorders with the exclusion of caffeine. Thus, the disorders are specific under the DSM-V. Other changes include the requirement that there be identified at least two symptoms for a disorder to be diagnosed as mild. These two symptoms must be from the list of 11 symptoms that the DSM-V provides. This is a change from the requirement in the DSM-IV, which required just one symptom to be present in order to come up with a mild disorder diagnosis.

The DSM-V has included the craving for drugs as a symptom, while it has removed some, which do not cut across the globe, such as a person having negative encounters with law enforcement (American Psychiatric Association, 2013). The professionals who are working with substance abuse patients must be aware of the co-occurrence of mental disorders and disorders of substance use or those which present their symptoms, for example, symptoms of withdrawal or persons being inebriated.

This material has an objective of helping counselors to be more familiar with the terms in use with regard to mental disorders and how they can be of help when they encounter patients who are exhibiting these symptoms of disorders (Rockville, 2015). The counselors who deal with addiction are the ones who are most likely to observe personality disorders as is the case with quadrant III settings for the treatment of substance abuse. The people with personality disorders exhibit traits that are present for the long-term in their life.

These traits and symptoms are not temporary, and thus, result in the person being dysfunctional socially and occupationally. They demonstrate symptoms through their thoughts, emotions, interactions, and how well they are able to control their impulses. Counselors can see these symptoms when they observe the perception that the person has of the world, how they think of themselves and others, how intense their emotions are, how they fit a particular situation and also the kind of relationships that the person has (Rockville, 2005). Flynn et al.

(1997) note that there is great co-occurrence of substance abuse and anti-social personality disorders. Treatment for substance abuse has been seen to be given more to those who are suffering from this personality disorder. Psychotic disorders have symptoms, which are mainly about the problems with cognition. Some of the thought problems that are seen in this case include those of a person experiencing hallucinations and delusions. These delusions affect the person's thoughts concerning something, even though they are based on false premises. They can hinder a person's functionality.

A person with delusions may see himself/herself as being in danger from others or even see himself as someone else. In hallucinations, the person may perceive something that is not there, or hear non-existent sounds, smell what others cannot smell and even feel things that are not present. These psychotic disorders are more frequent in mental health situations and when they are put together with the abuse of substances, this abuse is carried to extensive levels.

They make up the population of the mentally ill that is severe and extensive. Gustafson (1999), states that this population has more and more been seen in the treatment services of substance abuse programs. There are substances such as cocaine, which can bring about the occurrence of delusions and hallucinations, in addition to the toxicity of the drugs. A psychotic person may, however, exude these symptoms after being intoxicated (Rockville, 2005).

Some of the symptoms of mood disorder are the inability to properly express emotions, and the expression of emotions that are not appropriate or may be excessive. It is normal for individuals to experience highs and lows emotionally. The person with mood disorder, however, has these emotions at levels that are higher than normal. Mood disorder may be co-occurring with a substance abuse disorder, and may even influence the kind of drug that is used. Depression, mania and bipolar disorders are some of the presentations of a mood disorder (Rockville, 2005).

The abuse of substances is something that has been observed in all ages other than early childhood. There are periods of growth when the risk for substance abuse is accentuated. One of these periods is adolescence, when there is a lot of pressure placed on a person by their peers, coupled with the discovery of self and the feeling of being able to do anything. The psychopathology of a child is greatly affected by their parents being substance abusers as well as their peers being deviants (Moss, et al., 2002).

Where a person has a problem with substance abuse, it is likely that their children who are raised in this circumstance will also begin to abuse substances, and when there is the addition of peer pressure, the child is more likely to develop a problem of substance abuse. Hansell & Demour (2005), note that it is more likely for men to abuse substances than women. Some of the research that has been done on this has been directed at the genetic contribution to this problem.

One of the findings has been that the problem of alcoholism has been seen to occur in generations of the same family. 25% of the male children of alcoholic parents became alcoholics. In another study by Bierut, et al. (1998), the focus was on how substances like cocaine and marijuana are diffused in families. From these studies, it was noted that the dependence on these substances as well as on alcohol was high in the siblings of those who were dependent on alcohol.

These siblings were noted to be more likely to develop dependence on cocaine, marijuana and alcohol. Thus, the dependence on these substances is habitual and there are factors that are transmitted in families that are common and specific in addictions. The client who has his father as a drug addict may be more predisposed to develop this addiction because of his genes.

It has been noted that a person will be more likely to develop the problem of substance abuse as a result of repeated exposure to circumstances that induce stress. Stress may have a great impact on the person using a substance. It is actually a fact that stress has led to the initial intake of alcohol as well as the continued use of it, leading to addiction. It has also contributed to the relapse of the patient to substances after there has been a time of abstinence.

There is also a relationship between the abuse of substances and specific social elements. This can be seen when the rates of abuse among males who are just starting out and are not employed, are higher than those of the rest of the population. This is the same case for the rates of abuse in occupations that bring in a lot of stress. The field of medicine, for example, has more drug abuse than any other. Thus, sociocultural factors also affect the abuse of substances.

As reported by proponents of family risk factors, patterns are present in families that could lead to the abuse of drugs (Hansell and Demour, 2005). There could be patterns of co-dependence and even denying the existence of a problem, leading to addiction of the drug user. A person can also be influenced to abuse substances by the environment he/she is in as well as the company they keep (Powell, 1973). This was the case with heroin users who were interviewed in a study.

The respondents felt that their identity was tied to the practices of the group that they participated in. Behavioral theory can be used to explain the problem of abuse of substances. For example, the positive and negative reinforcement in operant conditioning, elaborates the fact that substance users gain pleasurable feelings when they consume drugs and get rid of unpleasant thoughts in the process.

Cravings can be felt by drug addicts as a result of classical conditioning where they associate the drugs with a feeling of belonging, friendship and other pleasant things (Collins, Blane & Leonard, 1999; Hansell & Demour, 2005). Another influence for the use of drugs is modelling. Learning in the family can contribute to this through transmission that happens as a result of familial bonds. Learning can also be from peers and exposure to media.

The expectation of a feeling that will be derived from the consumption of a substance influences the actual feeling. It is seen as a self-fulfilling prophesy, when a person expects to feel relaxed, happy and contented from the consumption of a substance as it really happens. The use of substances may be triggered by the fact that a person fears negative social interactions, reverting to using drugs. (Collins, et al., 1999; Hansell & Demour, 2005). This is the opinion of cognitive psychologists.

In the psychodynamic theory, the abuse of a substance is considered a symptom of something that is affecting the person. There has been a debate about what actually affects the substance abuser. In its earliest times, the theory proposed that the requirement for comfort and something to depend on as well as the pursuit of pleasure contributed to substance abuse. The patient was a person who would go to extreme lengths to look to be nurtured or pleasured.

Today, the view is that it is a coping mechanism that is maladjusted. It is a way for the patient to escape from their emotions, which may be painful. Meehan, et al., 1996 compared both sexes in terms of the depression, shame and guilt that they had as they recovered. They were paralleled with those who were not addicted to substances. The results were that the recovering addicts had higher levels of these factors.

It was also found out in other studies that severe depression occurred in those who had co-morbid psychiatric conditions. One week after the abstinence of clients who were previously dependent on heroin, there was hypo perfusion detected in their ear lobes (Rose, et al., 2003). These abnormalities in the ear lobes were, however, not present two weeks after abstinence, indicating a regularization of blood flow as abstinence continues (Kalechstein & Gorp, 2007). One hundred eighteen-year-olds were evaluated to find out their ways of using drugs.

Those who repeatedly used drugs were those who had had problems with school, their families and even with their emotions by age seven. Those who were better adjusted emotionally, though having tried drugs in school, did not experience problems as a result of the abuse. When services are being provided for people who have a co-occurring disorder, there are challenges that are experienced. It is sometimes difficult to provide the services for both disorders, and the services that the client accesses may not address the common elements in both disorders.

Professionals have thus, come up with ways in which to put together the interventions of both mental and substance abuse disorders (Petrakis, Nich & Ralevski, 2006). Example One of my acquaintances was a case of substance abuse disorder. He had been taking drugs for about 7 years and had been sent to rehabilitation twice, but it was not fruitful. When he stopped taking drugs for a few months, he experienced withdrawal symptoms, such as headaches, vomiting, body aches, insomnia and body tremors. He had intense craving for the drugs.

He experienced symptoms of depression and mood disorder. This makes it clear that substance abuse disorder makes a way for other related disorders as well. Management and Treatment Psychosocial Interventions This has been the practice adopted by many professionals, and studies are being done on it (Brunette, Mueser & Drake, 2004). Forty-Five clinical trials were done and various conclusions drawn from the same. Psychotherapy designed for an individual has no evidential basis. Where a professional leads an intervention among peers, there has been success and good outcomes.

The less researched and rarely used contingency management strategy is effective. Where the intervention is long-term and residential, the outcomes are improved and substance abuse reduces. Where there is intensive case management, the outcomes, in terms of substance abuse, are not consistent. There is need for further study into other interventions, including programs for self-help, intensive outpatient and even psychoeducation (Drake, Mueser & Brunette, 2007). Pharmacological Interventions This is an important treatment for the patients who have mental illness and disorders of substances abuse co-occurring.

There is little research into how effective medication is on patients. Nevertheless, what little research has been done has resulted to various observations. In treatment of disorders related to alcohol, the medications, such as naltrexone, are used, and these are expected to be effective as well as in mental disease cases (Petrakis, Nich, Ralevski, 2006). Another observation is that the severity of the abuse of substances may be diminished by using the medication recommended for mental illness.

When a patient used drugs to reduce depression, the symptoms of the abuse of alcohol also reduce. Even the medication used to regulate moods works on those with alcohol dependence. However, the antipsychotics have not been seen to improve substance abuse though they work on the schizophrenia. The most recent antipsychotics, such as Clozapine, have however, been seen to work on the related substance abuse in schizophrenic patients (Salloum, Cornelius & Daley, 2005). The programs that are designed for those suffering from acute mental disorders must be dual diagnosis based.

Co-occurring disorders are the most frequent, thus, they are to be expected. As a result, the programs must be designed this way, as a single occurring disorder is an exception. Failure to face up to this situation will cause a missed diagnosis among a lot of people as well as treatment being delayed and patients lacking the support that they need. It is possible for a person who has had dual diagnosis to recover as revealed in the modal process through research.

Many times, the people who are concerned with this process, including the patient, the patient's families and even the clinicians providing the treatment, encounter major challenges, which can lead them to despair. This may possibly be because of being unaware of the treatments that exist as well as the fact that there is a good chance of recovery. When there is hope and good prospect, it is in line with the thinking of dual diagnosis.

Thus, clinicians should be encouraging the hope for recovery in clients because they can be seen as having the prospects of recovering in the long run (Drake, Mueser & Brunette, 2007). Conclusion For dual diagnosis, a patient's life is fully encompassed, including their styles and preferences, as well as their timing. Some of the things that must be present when considering individualized intervention are educating the client, targeting recovery in different areas of their lives and involving them in decisions.

In this way, the client can commit to a certain path because they were involved in the whole process. At the same time, the involvement of the client will ensure that the program is helpful as the effect of medications can be assessed. In supporting the client, especially in terms of a job, this should be done in a way that encourages the client to abstain from the use of substances.

The client can be trained in the skills that will enable them to make friends as well as know how to deal with substance purveyors (Mueser, Noordsy & Drake, 2003). In dual diagnosis treatment, one of the major factors, is groups of peers. Groups are highly rated in terms of intervening in the life of.