5.1.2 DSM-IV

Question 1

What does ‘DSM’ stand for?

Answer 1

Diagnostic and Statistical Manual of Mental Disorders

Question 2

Who are the authors of the DSM?

Answer 2

The American Psychiatric Association

Question 3

How many versions of the DSM have there been?

Answer 3

7

Question 4

When did the DSM start?

Answer 4

1952

Question 5

What does the DSM recognise about mental disorders?

Answer 5

That causes may be purely biological and others psychological.

Question 6

What 4 factors does the DSM consider for a diagnosis?

Answer 6

1) Biological
2) Psychological
3) Social environment
4) Physical environment

Question 7

What does the DSM cover about mental disorders?

Answer 7

Mental disorders for all ages
Possible causes
Stats in terms of gender, age of onset, etc
Research concerning the optimal treatment approaches

Question 8

How is the DSM descriptive of symptoms not explanatory?

Answer 8

It only describes the diagnostic features (symptoms) of abnormal behaviour, it doesn’t attempt to explain their origins.

Question 9

How does a clinician arrive at a diagnosis?

Answer 9

They match the patient’s behaviours with the criteria of the DSM that define a particular abnormal behaviour.

Question 10

Which version of the DSM brought about the axes?

Answer 10

3

Question 11

How many axes does the DSM-IV have?

Answer 11

5

Question 12

Identify ‘Axis 1’.

Answer 12

Looking at all clinical disorders and their sub-categories.

Question 13

Describe the features of Axis 1.

Answer 13

Looking at all disorders except personality disorders and mental retardation and also looking at conditions that may need more attention than others.

Question 14

What are 2 common examples of what a clinician would find in Axis 1?

Answer 14

1) Schizophrenia

2) Depression

Question 15

Identify ‘Axis 2’.

Answer 15

Personality disorders

Question 16

Describe the features of Axis 2.

Answer 16

Decsribed long term problems in functioning not considered axis 1 disorders

Question 17

What are 2 common examples of what a clinician would find in Axis 2?

Answer 17

1) Paranoid PD
2) Obsessive-complusive PD

Question 18

Identify ‘Axis 3’.

Answer 18

General medical condition; acute med cond and physical disorders

Question 19

Describe the features of Axis 3.

Answer 19

Incls physical + med conds that influence/worsen axis 1/2 disorders

Question 20

What are 2 common examples of what a clinician would find in Axis 3?

Answer 20

1) HIV/AIDS
2) Brain injury

Question 21

Identify ‘Axis 4’.

Answer 21

Psychosocial & envir factors contributing to the disorder

Question 22

Describe the features of Axis 4.

Answer 22

Any factor from patient’s envir that may affect functioning

Question 23

What are 2 common examples of what a clinician would find in Axis 4?

Answer 23

1) Unemployment
2) Divorce

Question 24

Identify ‘Axis 5’.

Answer 24

Global assessment of Functioning/Child Global assessment of Functioning

Question 25

Describe the features of Axis 5.

Answer 25

Rating scale used to assess pateint’s ability to cope w normal life, low score = danger to patient to hurt themselves, high= superior lvl of functioning

Question 26

What are 2 common examples of what a clinician would find in Axis 5?

Answer 26

1) Low score= can’t function, may end up losing something eg job
2) High score= Functions well, eg maintains job

Question 27

Which axes are not compulsory and why?

Answer 27

4&5, they refer to social conditioning

Question 28

Define ‘culture bound syndromes’.

Answer 28

Patterns of abnormal behav occuring in some cultures but not others

Question 29

Give an example of a culture bound syndrome in China.

Answer 29

Koro; fear of genitals shrinking/ retracting into body n causing death

Question 30

Give 4 strengths of the DSM-IV.

Answer 30

1) 5 axes; standardised + less subjective to improve reliability
2)Details of how to conduct diagnostic intervs
3) Addresses culture-bound syndromes to improve V of diagnosis
4)GAF scale taken out of recent DSM to incr objectivity of diagnosis due to GAF referring to social conditioning

Question 31

Give 4 weaknesses of the DSM-IV.

Answer 31

1) DSM produced by APA- USA dominanted, ethnocentric so decr G to other cultures
2)Use of axis 4 can lead to subjectivity of clinician where they judge envir factors impact on patients wellbeing
3) Issues of test-retest R is axis 4 isn’t essential in diagnosis, so inconsistent method for diff clinicians
4) Can’t explain origin of symptoms