Miranda, a 26 year old Caucasian woman, has come in for an evaluation. She reports a...

Miranda, a 26 year old Caucasian woman, has come in for an evaluation. She reports a history of sexual problems and is concerned about whether there is something physically wrong with her. She has been engaged for 2 years and has not yet had intercourse with her partner, but has noticed when they are physically close with one another, she doesn't "feel anything." Miranda reports that she rarely has sexual fantasies and generally does not feel a strong urge to engage in sexual behaviors. Miranda is planning to marry in two months and wants to increase her interest in sex before her wedding. She has not told her partner that she doesn't feel anything and does not want him to know she is seeking help. Miranda works as school teacher at a middle school, and she relates that her work is becoming increasingly stressful. She becomes distracted during the day because she worries that her fiance will think less of her if he finds out she is seeking help for this issue. The stress has become so bad that she has recently snapped at a student, and the students' parents have had to talk with her about the issue.
What diagnosis would be most appropriate for Miranda? Assess her degree of functional impairment, and include additional information about psychosocial stressors or concerns in Miranda's life right now. What could Miranda's therapist suggest as a viable treatment?

Expert Solution

Sexual difficulties are a common occurrence among females and males both. Among females, it may be a cause of significant distress in their sexual lives. For females, they may experience a lack of sexual desires and do not involve much in sexual fantasies, this is diagnosed as Hypoactive Sexual Desire Disorder (HSDD). It is defined as a persistent deficiency or absence of sexual fantasies and desire for sexual activity that causes marked distress or interpersonal difficulty. Miranda is suffering from HSDD.

Because of this, Miranda is not able to concentrate on her work and is remaining stressed. She is aware and at most of the times thinking about how will she cope with the problem when she marries her fiancé.

Other psychosocial factors which may be affecting her are her apprehensions about the future, how to tell this to her fiancé? what will be his reactions? Whether this revelation will influence her relationship, will his fiancé support her to get over with this or not? And many more such issues.

Through medicines and proper counseling, Miranda will be able to handle and overcome this problem.

Hayet Jeridi answered 2 years ago

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