Diagnosis Classification: 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 and mental retardation.

Question 16

Describe the features of Axis 2.

Answer 16

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.

Question 17

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

Answer 17

1) Paranoia

2) OCD

Question 18

Identify ‘Axis 3’.

Answer 18

General medical conditions.

Question 19

Describe the features of Axis 3.

Answer 19

Important to establish medical conditions as they may be the cause of the clinical disorder or may affect how treatment is proposed.

Question 20

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

Answer 20

1) Brain injury

2) Heart disease

Question 21

Identify ‘Axis 4’.

Answer 21

Psychosocial and environmental problems.

Question 22

Describe the features of Axis 4.

Answer 22

Any factors from the patient’s environment that may effect functioning are considered.

Question 23

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

Answer 23

1) Poverty

2) Dysfunctional families

Question 24

Identify ‘Axis 5’.

Answer 24

Global assessment of functioning (GAF scale).

Question 25

Describe the features of Axis 5.

Answer 25

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.

Question 26

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

Answer 26

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

Question 27

Which axes are not compulsory and why?

Answer 27

4 and 5 due to the referring to social functioning.

Question 28

Define ‘culture bound syndromes’.

Answer 28

When patterns of abnormal behaviour occur in some cultures but not in others.

Question 29

Give an example of a culture bound syndrome in China.

Answer 29

Koro is the fear that one’s genitals are shrinking or retracting back into the body that may result in death.

Question 30

Give 4 strengths of the DSM-IV.

Answer 30

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

Question 31

Give 4 weaknesses of the DSM-IV.

Answer 31

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