Case Vignettes/Diagnostic Exercises

Please answer both questions below and Provide Diagnosis below from DSM-5

1. Steve, a 22-year-oldcisgender man, who is a college student, comes to see you for psychotherapy. He was referred to you by his primary care physician (PCP) who said he is medically cleared for psychotherapy. The PCP believes Steve's sexual complaints arepsychogenic. You begin your assessment with Steve and you learn that he has relationship issues with his girlfriend Amanda. He said they have sexual problems for the past 7 months. He shares with you that when they engage in penal vaginal intercourse he ejaculates almost instantly, within 15-30 seconds. He is so frustrated. He reports this has never happened to him in any sexual encounter before Amanda. He said this does not occur during manual stimulation or oral sex with Amanda. It does not occur during masturbation either. No evidence of substance use. Please provide the DSM-5 diagnosis you see most appropriate to Steve. Please include ALL specifiers as per the DSM-5.

2. Xu Chen is a 43-year-old cisgender woman. She has been married to her wife Lisa for 10 years. Xu Chen reports that the relationship has always been very good. They have 2 small children (2 & 5 years old). Xu Chen is a dermatologist and has a very busy practice. Lisa is the practice administrator. They work close to 70 hours a week. Xu Chen was referred to you by her psychiatrist, who she sees for medication due to history of ADHD. The psychiatrist believes her issues are psychological and tells you that she is medically cleared for psychotherapy. Xu Chen tells you that she has not had any interest in sex since they had their last child (she carried the baby). She says "I just forget about sex". She laughs nervously the last time Lisa mentioned it I said "Didn't we do that last year". She said Lisa has complained about feeling rebuffed by Xu Chen when Lisa tries to initial sex as Xu Chen seems to avoid it or just refuses. Xu Chen tells you that sometimes they have sex but "I do it just to please Lisa. I fake orgasms so we can get past it. I am barely wet. I feel nothing." No evidence of substance use. Please provide the DSM-5 diagnosis you see most appropriate to Xu Chen. Please include ALL specifiers as per the DSM-5.