Review the case study below and reflect on which DSM-5 sexual dysfunction/disorder might be the most reflective of the clients symptoms.

Respond to your colleagues postings, offering and support an opinion gained from your reading.


DSM Diagnosis Most Closely Reflecting Susans Symptoms

The DSM diagnosis that most closely reflects Susans symptoms is 302.70 Unspecified Sexual Dysfunction. While her symptoms do partially align with the diagnosis of Female Sexual Interest/Arousal Disorder (A1 and A3), there is not enough information in the vignette to ascertain whether her symptoms meet three of criteria A.

Biopsychosocial Factors Impacting Susan and Steves Sexual Relationship

Sexual functioning involves a complex interaction between biological, psychological, and social processes (American Psychiatric Association [APA], 2013). The complex biopsychosocial factors in Susan and Steves environment that impact their sexual relationship may be building on each other, causing Susans total lack of interest in sex. Research indicates that context and stimuli need to be just right for a woman to become aroused and involves both cognitive and physical aspects (Levine et al., 2016). Cognitive aspects of arousal involve processes of evaluating sexual stimuli and result in physical autonomic, emotional, and motivationally related responses (Levine et al., 2016). Emotional closeness is critical to sexual desire for women; whether a partner demonstrates caring, affectionate behavior during non-sexual activities can impact the way a woman appraises sexual stimuli (Levine et al., 2016). Mental health issues such as depression can affect neurotransmitters that affect arousal (Levine et al., 2016). Similarly, stress, biological processes, and normal aging can cause hormonal changes that limit ones ability to be physically aroused (Levine et al., 2016). According to Levine et al. (2016), becoming sexually aroused is intentional for women; initiating and participating in sexual activities is motivated by a desire to increase emotional intimacy and show their partner that they are loved and attractive. Susan may be experiencing normal or pathological hormonal changes or could be suffering from untreated depression. She has a busy schedule between her familial and work responsibilities, which may have increased her stress level in the past year. A partners behavior during non-sexual activities enhances the effectiveness of sexual stimulation later in the day (Levine et al., 2016). If a woman feels bad about herself in relation to her sexual health, she may be unable to focus on sexual stimulation (Levine et al., 2016). The vignette mentions that Susan and Steve are not affectionate with each other, which could be creating an emotional disconnection and negatively impacting her sexual self-image. The lack of a sexual relationship has been causing them to fight, widening their emotional divide, increasing her stress level, and further contributing to her lack of interest in sex. The net result of these biopsychosocial factors is a lack of interest in sexual activities because the sexual stimulus does not elicit the same emotional, psychological, and physical rewards it once did (Levine et al., 2016).


American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.).

Levine, S. B., Risen, C. B., & Althof, S. E. (Eds.). (2016). Handbook of clinical sexuality for mental health professionals (3rd ed.). Routledge.


Discussion: Analyzing Diagnostic Criteria

Marriage, couple, and family helping professionals work from a systemic vantage pointthey view issues and change as relational. That being said, they must be familiar with the diagnostic criteria of the DSM-5 in order to work within the field of mental health care at large. The DSM-5, of course, is individual rather than systemic in focus, and therefore it is wise for marriage, couple, and family helping professionals to view diagnostic criteria through a critical lens. Many of the disorders also are not based on clear, clinical cut-off criteria, and they require informed clinical judgment in order to be applied appropriately.

Note also that helping professionals should consider intersections of physical, mental health, and relationship considerations as they relate to sexual dysfunctions, compulsions, and addictions. For example, a physical examination by a qualified healthcare professional is typically warranted prior to making a diagnosis of a sexual dysfunction in order to rule out any physical causes for the symptoms.

Analyze the diagnostic criteria of major sexual dysfunctions and disorders in the DSM-5. Review the case study below and reflect on which DSM-5 sexual dysfunction/disorder might be the most reflective of the clients symptoms. Then consider a counterargument as to why this dysfunction/disorder might not be appropriate for this client.

Susan, age 34, is a married mother of two preschool-age children (ages 4 and 2). Her husband, Steve, age 35, works full time, and Susan works part time on the weekends but primarily is a stay-at-home mother to her children.

The couple sought couples counseling, and their primary presenting concern was that Susan has not had any interest in sex with Steve for the past year. The couple reports that they have had intercourse about three times in the past year (always at Steves initiation); they rarely display physical affection toward one another; and they fought frequently about their lack of sex for about the first 6 months of the past year, but lately they have not fought often about the issue.

The partners indicate that, up until a year ago, Susan was very interested in sex, and they had sex approximately three times per week throughout their marriage (aside from immediately following the birth of their children). Susan states that she cant pinpoint any particular reason for her lack of interest in sex and says, Really, I just dont want it anymore. Im not sure if I ever will again. Steve says that he is very frustrated but doesnt want to fight about it. He says, I just want my wife back.