Diathesis-Stress, Comorbidity, and Cultural Impact Respond to the following in y

Diathesis-Stress, Comorbidity, and Cultural Impact
Respond to the following in your initial post:
Choose one disorder covered in the readings for this unit, and apply the diathesis-stress model to understanding it.
Choose two possible categories of substance abuse from the DSM -5-TR and compare and contrast the interactive impact these substance abuse disorders would likely have on the disorder you are writing about.
Choose two different ethnic or cultural groups in the United States. Compare and contrast the impact of this diagnosis on members of these two groups.
Be sure to put the name of the disorder in the subject line of your post.
Note: Your initial post in this discussion needs to address a different disorder than the one you address in the second discussion in this unit (u08d2).
Response Guidelines
Respond to a learner who selected a different disorder than you did. Was their application of the diathesis-stress model valid? Explain your position.
In your DSM-5-TR text, read the following:
Somatic Symptoms and Related Disorders.
This chapter details diagnoses that may appear to reflect a general medical condition but which are not completely explained by medical assessment or exposure to a substance. This section now includes the diagnosis of “Factitious Disorders” where individuals take on the “sick role” through intentional production of physical and/or psychological symptoms in themselves or by imposing them on others.
Dissociative Disorders.
You will learn about disorders reflecting changes or disruptions in an individual’s sense of identity, consciousness, or memory and perception.
Gender Dysphoria.
Carefully review this chapter to help you better understand gender roles at all ages.
Sleep-Wake Disorders.
Carefully review this chapter that details major groupings of sleep disturbances.
Sexual Dysfunctions.
Paraphilic Disorders.
Carefully review these two chapters to understand the disorders that are characterized by disturbances in desire, urges, behaviors, fantasies or cross-gender identification.
Also respond to Robis post in a seperate paragraph please and thank you
Somatic symptom disorder (SSD) is characterized by an extreme focus on physical symptoms that causes major emotional distress and problems functioning (Somatic symptom disorder, 2018). There can be a myriad of contributing influences to the development of somatic symptoms, including genetic and environment factors. Because somatic symptoms can include pain, they can be concurrent with medical illnesses and difficult to distinguish in that regard. For example, an individual who gets into a car accident and experiences a significant injury can have a medical diagnosis involved with that injury and also develop somatic symptoms related to Post-Traumatic Stress Disorder caused by the trauma of being in the accident.
Alcohol Use Disorder (AUD) and Cannabis Use Disorder (CUD) can have an interactive impact with SSD. With AUD, alcohol is often taken in large amounts over a long period of time. This can result in a heavy dependence on alcohol and debilitating withdrawal symptoms. Some of which include headaches, nausea, vomiting, fatigue, anxiety, seizures, tremors and hallucinations (Manarang-Obsioma, 2019). When a person experiences AUD and SSD together, it can be extremely difficult to differentiate between the two. Especially because both disorders can be triggered by environmental and bio-genetic markers. In the case of CUD, it can have much of the same effects when interacting with SSD as AUD. Cannabis use disorder is a problematic pattern of cannabis use leading to clinically significant impairment (Diagnostic And Statistical Manual Of Mental Disorders, Fifth Edition, Text Revision (DSM-5-TR), 2023). When a person becomes dependent on cannabis, they can experience withdrawal symptoms. Withdrawal symptoms of CUD can include headaches, stomach problems, difficulty sleeping, and loss of focus (Theisen, 2023). Again, these symptoms can overlap with SSD, it can be very challenging to differentiate the two, and both can develop from environmental or bio-genetic markers. Interestingly, the diagnostic criteria for SSD does not mention anything about substances needing to be considered as a separate diagnosis as do some of the other diagnostic criteria.
For Pakistani Americans and Native Americans, culture could mean a very different impact in relation to SSD. Mental illness in Pakistan is often contributed to black magic or the evil eye, is thought to be contagious, and is most often cured by visiting shrines (Javed, 2021). As a result, any somatic symptoms have a high likelihood of being contributed to their religious beliefs and practices rather than a mental health issue. Many Native/Indigenous tribes embrace a worldview that encompasses the notions of connectedness (with the past and with others), strong family bonds, adaptability, oneness with nature, wisdom of elders, meaningful traditions and strong spirit (Native and Indigenous Communities and Mental Health, 2023). Indigenous Americans are more likely to contribute any symptoms of SSD to a punishment for disregarding tribal traditions or disobeying tribal rituals, and seek their shaman for guidance on curing their symptoms. Where the two cultures intersect is SSD can exist in both and be triggered by biological and environmental circumstances.
Diagnostic And Statistical Manual Of Mental Disorders, Fifth Edition, Text Revision (DSM-5-TR). (2023). doi:https://doi-org.library.capella.edu/10.1176/appi.books.9780890425787
Javed, S. (2021, September 17). 10 Major Causes of Psychological Problems in Pakistan. Retrieved from Marham: https://www.marham.pk/healthblog/causes-of-psychological-problems/#:~:text=Pakistani%20Culture%20and%20Mental%20Health%20In%20Pakistani%20culture%2C,believe%20in%20black%20magic%20and%20the%20evil%20eye.
Manarang-Obsioma, M. A. (2019, August 7). Alcohol Withdrawal Symptoms: Don’t Underestimate Going Sober. Retrieved from AlcoRehab: https://alcorehab.org/the-effects-of-alcohol/withdrawal-symptoms/
Native and Indigenous Communities and Mental Health. (2023). Retrieved February 27, 2023, from Mental Health America: https://www.mhanational.org/issues/native-and-indigenous-communities-and-mental-health#:~:text=Many%20Native%2FIndigenous%20tribes%20embrace%20a%20worldview%20that%20encompasses,factors%20when%20it%20comes%20to%20mental%20health.%20%5B3%5D
Somatic symptom disorder. (2018, May 8). Retrieved from Mayo Clinic: https://www.mayoclinic.org/diseases-conditions/somatic-symptom-disorder/symptoms-causes/syc-20377776#Overview
Theisen, E. (2023, January 17). What to Expect from Marijuana Withdrawal. Retrieved from Healthline: https://www.healthline.com/health/marijuana-withdrawal.
Also respond to Nikki in a seperate paragraph thanks
Exhibitionistic disorder is a condition in which an individual experiences recurrent and intense sexual arousal from the exposure of their genitals to an unsuspecting person, as manifested by fantasies, urges, or behaviors for at least six months. To qualify for diagnosis, the individual must have acted on these urges or have fantasies that result in clinically significant distress or dysfunction in major life areas. The individual may achieve arousal from exposure of their genitals to prepubertal children, physically mature adults, or both.
There is a difference between exhibitionist behaviors and exhibitionistic disorder (as we know, there is no disorder without dysfunction) and as such, the risk factors for the act of exhibitionism should be considered when the risk for the development of exhibitionistic disorder is assessed. Antisocial history, antisocial personality disorder, alcohol misuse, and pedophilic sexual preference are considered risk factors for exhibitionistic disorder in men with exhibitionistic sexual preferences, and thus represent a set of potential diatheses.
According to the DSM, childhood sexual and emotional abuse have also been suggested as risk factors for exhibitionism and represent potential stressors. While childhood trauma is of course a major stressor, it seems it is also possible for the tipping point stressors to occur later in life. In a 2020 analysis of exhibitionism that details the case of an afflicted patient, relief is described as the emotion following his bouts of exposure: “the compulsion to expose came after disappointments in relationships or at work; the excitement of exposing himself relieved the stress. An aspect of the comfort that exposure provided was reassurance that, even if friendships or work were disappointing, he was still adept at an activity that other men did not know how to perform (exposing himself in public, evoking a strong response, getting away with it).” (Seeman) In this case, exhibitionism even to a criminal extent is used as a coping mechanism for major emotional events in adult life.
Should a patient suffer from alcohol use disorder and exhibitionistic disorder concurrently, the alcohol misuse would likely have a negative impact. Alcohol, especially when consumed in excess, can produce feelings of disinhibition. This may make it difficult for the individual with urges to expose himself to resist doing so, even if he had those inhibitions while sober. Conversely, alcohol could be used to gain the confidence to go through with exposure. Alcohol use disorder is also a condition that requires dysfunction in major life areas, which could precede the exhibitionistic behavior, and history of alcohol misuse is cited as a potential risk factor for the disorder.
Similarly, if the same individual were to suffer from stimulant use disorder, the exhibitionistic behavior would likely become more frequent. Stimulants increase activity in the brain and can temporarily elevate alertness and mood as well as produce an instant feeling of well-being, confidence, and euphoria. These feelings would likely aid the individual in overcoming any inhibitions or guilt they felt about exposure and could increase the arousal they experience from exposing themselves. The chaotic behavior, social isolation, aggressive behavior, and sexual dysfunction that can result from long-term stimulant use disorder are also risk factors and exacerbating symptoms to exhibitionistic disorder.
The Church of Jesus Christ of Latter-Day Saints teaches that dressing and behaving modestly and not engaging in extremes of appearance are ways to serve God. In fact, it is a rule of thumb to ask whether one would be comfortable being in the presence of God when considering a certain article of clothing to determine if it serves the religion. Because of this attitude, I believe that the impact of a diagnosis of exhibitionistic disorder of an individual in the church would be shock to those around them and could possibly be grounds for excommunication from the church for both the social and criminal implications.
In contrast, I believe there would be less backlash for an exhibitionistic disorder diagnosis in the kink and fetish subcultures. While considerably more underground than the Mormon church, there is certainly a large population (36% of Americans, according to a 2005 study by Durex) who willingly engage in sexual behavior that is considered “out of the ordinary.” This includes behaviors like voyeurism and exhibitionism, meaning that an individual who engages in this behavior may be welcomed. However, this community often stresses the importance of obtaining consent before performing sexual acts. Because behavior that warrants a diagnosis of exhibitionistic disorder is often impulsive and associated with criminal activity, the individual may be shunned or at least dissuaded from exposing themselves outside of an environment of consent by this culture.
Durex Network. (2005). The face of global sex 2005.
Seeman, M. V. (2020). Portrait of an Exhibitionist. Psychiatric Quarterly, 91(4), 1249-1263.
American Psychiatric Association. (2022). Paraphilic Disorders. In Diagnostic and statistical manual of mental disorders (5th ed., text rev.).

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