Diagnosis Classification: DSM-IV Flashcards
What does ‘DSM’ stand for?
Diagnostic and Statistical Manual of Mental Disorders
Who are the authors of the DSM?
The American Psychiatric Association
How many versions of the DSM have there been?
7
When did the DSM start?
1952
What does the DSM recognise about mental disorders?
That causes may be purely biological and others psychological.
What 4 factors does the DSM consider for a diagnosis?
1) Biological
2) Psychological
3) Social environment
4) Physical environment
What does the DSM cover about mental disorders?
- Mental disorders for all ages
- Possible causes
- Stats in terms of gender, age of onset, etc
- Research concerning the optimal treatment approaches
How is the DSM descriptive of symptoms not explanatory?
It only describes the diagnostic features (symptoms) of abnormal behaviour, it doesn’t attempt to explain their origins.
How does a clinician arrive at a diagnosis?
They match the patient’s behaviours with the criteria of the DSM that define a particular abnormal behaviour.
Which version of the DSM brought about the axes?
3
How many axes does the DSM-IV have?
5
Identify ‘Axis 1’.
Looking at all clinical disorders and their sub-categories.
Describe the features of Axis 1.
Looking at all disorders except personality disorders and mental retardation and also looking at conditions that may need more attention than others.
What are 2 common examples of what a clinician would find in Axis 1?
1) Schizophrenia
2) Depression
Identify ‘Axis 2’.
Personality disorders and mental retardation.
Describe the features of Axis 2.
Uses a rating scale to measure mental retardation. This and the personality disorders may not need immediate attention but must be taken into account as may affect treatment.
What are 2 common examples of what a clinician would find in Axis 2?
1) Paranoia
2) OCD
Identify ‘Axis 3’.
General medical conditions.
Describe the features of Axis 3.
Important to establish medical conditions as they may be the cause of the clinical disorder or may affect how treatment is proposed.
What are 2 common examples of what a clinician would find in Axis 3?
1) Brain injury
2) Heart disease
Identify ‘Axis 4’.
Psychosocial and environmental problems.
Describe the features of Axis 4.
Any factors from the patient’s environment that may effect functioning are considered.
What are 2 common examples of what a clinician would find in Axis 4?
1) Poverty
2) Dysfunctional families
Identify ‘Axis 5’.
Global assessment of functioning (GAF scale).
Describe the features of Axis 5.
A rating scale is used to assess a patient’s ability to cope with normal life where low scores indicate danger for the patient to hurt themselves and high scores indicate superior level of functioning.
What are 2 common examples of what a clinician would find in Axis 5?
1) Low score = Cannot function and may end up losing something such as their job
2) High score = Can function well in every day life such as maintaining their job
Which axes are not compulsory and why?
4 and 5 due to the referring to social functioning.
Define ‘culture bound syndromes’.
When patterns of abnormal behaviour occur in some cultures but not in others.
Give an example of a culture bound syndrome in China.
Koro is the fear that one’s genitals are shrinking or retracting back into the body that may result in death.
Give 4 strengths of the DSM-IV.
1) Provides 5 axes making it standardised and less subjective to improve reliability
2) Includes details of how to conduct diagnostic interviews and other tests
3) Addresses culture-bound syndromes to improve validity of diagnosis
4) The GAF scale was taken out of recent version to increase objectivity of the diagnosis
Give 4 weaknesses of the DSM-IV.
1) The DSM being produced by the APA means that it is USA dominated and so may be less generalisation to other cultures
2) The use of axis 4 can lead to subjectivity of the clinician where they judge the environmental factors’ impact on the patient’s wellbeing
3) Issues of reliability if axis 4 isn’t essential in diagnosis so inconsistent method for different clinicians
4) Whilst trying to provide a possible explanation for cause of disorder, it cannot explain the origins of symptoms
