- How would you incorporate the DSM-5 and the relational codes into the assessment phase with this couple or family?
DSM 5 and relational codes
DSM-5 and Z Codes are other conditions that may be a focus of clinical attention. They include issues that affect diagnosis and treatment of a patient’s mental disorder.
In the case study of Nancy; the following codes can be incorporated
V61.29 (Z62.898) Child Affected by parental relationship distress
Nancy’s had traced her eating obsession to her family discord when she was young. Family discord, in this case, could have been parental relationship distress between her parents or with her. This led to her indulging in food because she felt that this calmed her and helped her deal with the stress.
Also, this Z code could be seen in the fact Nancy felt that she had transferred these habits to her 12-year-old son. The paediatrician diagnosed that he is overweight for his age.
V61,20 (Z62.820) Parent-Child relationship problem
This relational code involves parent-child relational problem. Nancy had a negative relationship with her mom. When Nancy began to gain weight, her mom teased her that no one would like her if she was fat. Nancy was yearning for the approval of her mom and other people. This had a negative impact on her self-esteem and resulted in her thinking too much to the point of researching people who had the same issue as her. She ended up in binge eating and vomiting after that as well as compulsive exercises and fasting for protracted periods. These symptoms from Nancy is closely related to an eating disorder known as Bulimia Nervosa (American psychiatric Association, 2013). Nancy’s mom played a role in the development of this eating disorder. Nancy’s mother teasing can also be linked to the V code V15.42 (Z62.811) Personal History of psychological abuse in childhood.
- What other diagnostic or assessment processes would you use?
Other diagnostic or assessment procedures that I would use will include a clinical interview to determine History, mental status tests, behavioural observation of the client, and assessment instruments specific to the diagnostic findings for example post-traumatic stress disorder and an eating disorder.
- How do larger systems impact the development of eating disorders?
Development of eating disorders is largely affected by larger systems like Socio-cultural background, a family of origin, current relationship dynamics, and the influence on media.
The socio-cultural background where someone has grown may influence eating habits. These include family and friends. For example, in families, parents attitude and perception or dissatisfaction of their bodies or other peoples bodies have been associated with how children develop eating disorders. Peer influence and friends also contribute to eating disorders. The pressure to conform to a particular ‘ideal body type” for example, emphasis on being thin to be a model, teasing or body shaming ( Plivy, Janet and Herman, 2002).
The current relationship dynamics have been found to contribute to eating disorders. This can occur through negative comments about appearance and the pressure to lose weight from a spouse.
References.
Polivy, Janet, and C. Peter Herman. “Causes of eating disorders.” Annual review of psychology 53.1 (2002): 187-213.
Files, Teaching, and V (ICD-10). “V Codes (DSM-5) & Z Codes (ICD-10)”. Psychdb, 2020, https://www.psychdb.com/teaching/dsm-v-icd-z-codes#educational-and-occupational-problems.
Fulkerson JA. “Weight-Related Attitudes And Behaviors Of Adolescent Boys And Girls Who Are Encouraged To Diet By Their Mothers. – Pubmed – NCBI”. Ncbi.Nlm.Nih.Gov, 2020, https://www.ncbi.nlm.nih.gov/pubmed/12461674.
“Bulimia Nervosa DSM-5 307.51 (F50.2) – Therapedia”. Theravive.Com, 2020, https://www.theravive.com/therapedia/bulimia-nervosa-dsm–5-307.51-(f50.2).