Diagnostic Analysis of Human Behavior in the Social Environment Stephen Brown is an African-American aged 55 years of age, divorced with the custody of 2 children every weekend. Stephen was a Director of supportive housing program however, he was incarcerated because of an embezzlement. After serving a jail term and released, Stephen faces challenges in securing another employment despite that he has a CASAC license. However, he is a very capable individual despite a history of his disorder.

I am an employment specialist, and Stephen approaches me that he needs employment to sustain himself and his family. As an employment specialist, I have given a counsel to avoid a dishonest behavior because his dishonesty has taught him a lesson. When we were discussing on how he got himself into the dishonest behavior, he was unable to face the fact and digressed into another topics when we reached the discussion about his past fraudulent behavior.

However, Stephen has a difficulty in falling asleep in the night because of his anxious thoughts of being unable to provide to himself and his two kids. Stephen was divorced after losing his job and was preoccupied with an anxious thought of wining the love of his kids and their mother. His mind is also preoccupied on how he will treat his kids with lavish birthday parties, have a trip with them to Disneyworld and buy them jewelry. However, he cannot afford the expenses since he is unemployed and only a beneficiary of SNAP, SSI, and unemployment benefit, which are his only sources of income. Sometimes, he is able to find a short-term work such as delivering milk in small truck to prisoners or deliver a lecture to prisoners. Only a reputable job Stephen is able to secure is a two-day job at Belmont Stakes as a Parking Attendant. However, Stephen still tries to make himself feel big by accusing me of having a little experience as an employment specialist, which make me unable to find work for him. Sometimes, he speaks highly about himself, talk like a big shot, laugh loudly, and communicate his needs for an employment opportunity.

Symptom: Lack of employment and experience of jail term have made Stephen to develop symptoms such as anxiety, intrusive thoughts, inability to sleep, nervousness, always exhausted and tired, and pain at upper back because of worrying. The outcomes of CBT (Cognitive Behavioral Therapy) reveals that Stephen is suffering narcissistic personality disorder because he is always emphasizing on his difficult situation.

Moreover, Stephen has HIV symptom because of his weight loss, and always cold, which make him to wear sweater constantly. A significant behavioral pattern revealed that Stephen was being haunted from his childhood social environmental background, loss of employment, and unable to take care of his children making him to develop an anxiety narcissistic personality disorder.

Part 2: Formulation

The paper carries out the differential diagnosis for Stephen using DSM-5 technique. In order words, the differential diagnosis determines which of the two or more factors that the client is suffering. The strategy is to systematically compare the clinical findings. The DSM-5 reveals that the symptom of the disorder can be diagnosed using the following criteria:

A. Significant impairments of personality functioning that manifests by:

1. Self-functioning impairments (a or b):

a. Identity: such as exaggerated self-appraisal, vacillate between extremes, and self-esteem regulation.

b. Self-direction: Unreasonably seeing oneself as exceptional.

AND

2. Interpersonal functioning impairment (a or b):

a. Empathy: Impaired ability to identify or recognize with the feelings or the needs of others.

b. Intimacy: Relationships largely superficial

B. Pathological personality

Antagonism, which is characterized by:

a. Grandiosity: a feeling of entitlement, self-centeredness; firmly holding a belief that he is better than others.

b. Attention seeking: Admiration seeking.

C. Impairments in personality

D. impairments in one's personality functioning. (Ronningstam, 2009).

Differential diagnosis

Stephen is not suffering from depression because he is able to get out of bed in the morning, and perform different home functions. Moreover, he is able to attend his two-day job when hired and is able to take care of his two kids on weekends by taking them to the amusement parks. Additionally, he has ability to visit the Social Security office if he does not receive his unemployment check at the end of week. However, Stephen is suffering emotional abuse from his father who devoted his entire love to his five female children. Stephen was emotional abused in his early age, and always feel insecurity. In his early age, he was always subconsciously trying to impress his father by proving to his father that he was powerful and smart. Thus, Stephen believes that he is not manlike, masculine, and powerful if he is unable to earn a dollar to take care of children. Moreover, Stephen is always troubled with thinking whether he will get hired and provide for his family...

Analysis of the Stephen disorder may be linked to some elements of ego functions such as adaptation, defenses, effective stability, impulse control, reality testing, and capacity for sublimation. However, Stephen might have developed ego functions to meet basic needs, to solve his personal problem, and to successful copy with his present problems. The outcome of the differential diagnosis reveals that Stephen has symptoms of Narcissistic Personality Disorder, HIV and Anxiety disorder.
Part 3:

Literature of Narcissistic Personality Disorder (diagnosis & treatment; theoretical approach; epidemiology)

Ronningstam & Baskin-Sommers (2013) argue that narcissistic personality disorder is one of the symptom of human behavior characterized by the long standing pattern of patients' grandiosity such as actual behavior or fantasy. The disorder is also characterized by an overwhelming needs for administration. The Narcissistic Personality disorder is characterized by arrogance, envy and lack of empathy. Other feature of the Narcissistic disorder include a feeling insecurity, hypersensitive, vulnerability, and prone to shame. Several components are associated to narcissistic disorders that include a feeling of fear.

Fiscalini (2004) point out a major feature of narcissistic disorder is fear associated to narcissistic humiliation and injury. The author further argues that the fear is associated with isolation, rejection and loss of contact with reality. Thus, narcissistic trauma is associated with a loss of bond that threatening sense of coherence, well-being, continuity, and stability.

Theoretically, NPD narcissistic personality disorder is a form of a personal belief of having a flawless personality, which may be unaccepted to others. People suffering from this disorder makes a strong attempt to control the views of others. A pathology narcissism can be from an impairment in an individual quality of life or personal relationships. For example, a child may perceive himself as unimportant due to a societal problem he/she might have experienced. It is estimated one percent of the U.S. population is suffering from the narcissistic personality disorder.

Celani, (2014) argues that "Fairbairn's structural theory is based on the developing child's need to dissociate actual events between himself or herself and his or her objects that are excessively rejecting in order to continue an uninterrupted, pristine attachment to them." (Celani, 2014 p 385).

Celani, (2014) continues by pointing out that the disorder is the outcome of the developmental history that a child finds himself based on the hostile interpersonal environment.

Diagnosis

A well trained mental health professional such as psychiatrist or psychologist is capable of diagnose the Narcissistic Personality Disorder. However, a general practitioner or family physicians are generally not well trained or equipped to carry out this type of diagnosis. One of the strategies that a mental health care professional can employ to diagnose the disorder is to compare the patient's symptoms with their life history and make a determination whether the patient's symptoms meet the criteria. American Psychiatric Association classifies the Narcissistic Personality Disorder as a specific personality disorder that is characterized by a pattern of grandiosity such as behavior or fantasy, lack of empathy and need for administration. American Psychiatric Association reveals that an individual suffering from narcissistic personality disorder needs to show five of the following criteria:

Has a sense of grandiose of self-importance such as expect to be recognize as being superior without having a commensurable achievement.

Preoccupied with fantasies such as having unlimited power, success and brilliance.

Believes that he is unique or special

Requires excessive admiration.

Shows arrogant, attitudes or haughty behaviors.

Unreasonable expectation such having favorable treatment.

This paper concludes Stephen is suffering from the Narcissistic Personality Disorder because Stephen shows five of the listed symptoms in his behaviors. The outcome of the DSM-5 technique for the diagnosis also reveals that Stephen is suffering from the Narcissistic Personality Disorder.

Treatment

A treatment for the Narcissistic Personality Disorder involves a long-term psychotherapy by a therapist who has a long year experience in this type of personality disorder. Typically, a healthcare professional can use the following strategies to treat the case of Stephen:

Psychosocial Treatment and Medication

The first approach is that a healthcare professional must convey a sense of respect for patients to avoid the reinforcement of sense of grandiosity that the patient is suffering. Moreover, a healthcare professional must increase patient's sense of confidence. A therapist should also assist a patient to develop a self-esteem regulation. Moreover, a therapist should assist patients to reconstitute…