What types of things do counselors consider when diagnosing a patient with a personality disorder? The person’s thoughts, behaviors, and emotions play a primary role. Sometimes there are other far larger factors to consider. According to Larsen and Buss, when diagnosing the presence of a personality disorder, it is important for one to take the contexts of age, gender, and culture into consideration. For different countries and geographical areas, there are different norms. What could be considered “normal” for one region may be entirely out of the norm in another. The differences in cultures can easily lead to misunderstandings when interpreting the factors associated with disorders. The importance of these other factors could determine if one has a personality disorder or not when taken out of their own norm.
Gender plays a very important role when concluding that one has a personality disorder. Since both males and females function in separate ways, it is difficult to make the assumption that they can be diagnosed in the same fashion. For example, “Bulimia nervosa, the severe eating disorder, occurs almost entirely in young females. […] A cultural emphasis on female thinness plagues our society and, increasingly, societies around the world. The pressures for males to be thin are less apparent, and of the few males, to develop bulimia, a substantial percentage belong to the gay subculture where cultural imperatives to be thin are present” <cite pg 64 abnormal psych book> Females are under constant pressure from peers and media to be thin and attractive. For those who struggle with weight, acne, or feel they aren’t good enough, multiple outcomes are possible. Many young girls go to extremes to fit in with their peers. “Gender role is a social and cultural factor that influences the form and content of a disorder” <cite pg 64-65 abnormal psych book>
Aside from gender, culture is also a major component in diagnosis. “Problems are created by transforming syndromes and symptoms prevalent in non-Western cultures to fit Western categorization” <cite>. In the United States, it’s common that we try to diagnose everything according to our status quo. However, we do not take into consideration the norms associated with those of most eastern civilizations, which greatly differ from our own. “A specific example of a difficulty encountered by clinicians using a Western frame of reference to conceptualize a non-Western disorder can be illustrated in the case of huo qi da, a prevalent condition among Chinese that is characterized as a feeling of hot energy rising from the abdomen”<cite>. When compared to the eastern civilization, the west puts more importance upon the individual, unlike the east which focuses more upon the group or civilization as a whole. Eye contact is frowned upon and looked at as a sign of disrespect in the east. There is more emotion and meaning held in regard to their traditions compared to the west. In the United States, eye contact is viewed as important and respectful, as well as linked to honesty.
Another vital factor that should be considered when diagnosing a personality disorder is the subject’s age. Different disorders can be diagnosed at different ages or stages in the patient’s life. Those disorders can have an onset at multiple ages depending upon the disorder. “Personality traits and personality disorders, by definition, have an age of onset that can be traced back at least to adolescence or early adulthood” <cite>. Sigmund Freud’s psychosexual stages of development give light to a theory that can explain part of the development of personality disorders. The psychosexual stages- oral, anal, phallic, latency, and genital represent the different stages in developmental, and pre-adolescent life. The stages according to Freud are our basic needs such as food and physical affection. Based on his theory, if there is an intervention with the development in one of these stages, the individual will be affected by it throughout the rest of their life.
In conclusion, the importance of the contexts of age, gender, and culture prove to be a fundamental defining factor when concluding the diagnosis of a personality disorder.