2. DSM, including DSM IVR and DSM V

AO1

• DSM → provides comprehensive list of mental disorders → with specific diagnostic criteria → used by clinicians → to make diagnosis

• Mainly used throughout US → also in other countries

• Helps to ensure → diagnoses are consistent → across different health professionals → promoting accuracy + reliability

  • Important → helps to provide specific support → needed for children

• DSM outlines specific criteria → for each mental disorder → often including symptoms + duration + impact on individual’s daily life

  • Disorders classfied → into different categories → e.g. mood disorders, anxiety disorders, psychotic disorders → based on shared characteristics

• Inaccurate diagnosis → leads to incorrect + ineffective treatment

  • Patients can suffer → from being labelled + stigmatized

• DSM-IV (4th edition) → mental health professionals → assess an individual → across five different axis

  • System designed → to give more comprehensive view of patient

  • Takes into account → different dimensions of mental health

Axis 1 → Clinical Disorders + Other Conditions

• May be a focus of clinical attention → description of mental health disorders

• Covered primary psychiatric disorders → e.g. depression, anxiety disorders, schizophrenia + other conditions → e.g. learning disabilities + substance abuse disorders

Axis 2 → Personality Disorders + Intellectual Disabilities

• Describes symptoms related to disorder

• Dealt with long-term + pervasive disorders → affect person’s overall functioning + behaviour over time

  • Conditions considered → stable over time → often requiring long-term management/therapeutic approaches → e.g. BPD

Axis 3 → General Medical Conditions

• Describes medical conditions + how it might explain clinical issues → e.g. brain damage

• Physical illnesses → e.g. chronic conditions + illnesses affecting mood/cognition/behaviour = included

• Understanding medical conditions = cruicial → could influence course/treatment → of mental disorders

  • E.g. strokes, diabetes, epilepsy

Axis 4 → Psychosocial and Environmental Factors

• Assessed social + environmental stressors → could impact individual’s mental health + continue to onset of disorder

• Considered factors → family problems + employment issues + other life stressors

  • E.g. divorces, job loss

Axis 5 → Global Assessment of Functioning (GAF)

• Used to access → how individuals cope → with normal activities

• Designed to access → how well a person → able to carry out everyday activities + ability to function socially/occupationally

• Rated an individual’s overall level of functioning → on scale of 0-100

  • High number = better functioning → lower number = severe dysfunctionality

DSM-5 → New Version

• Similar in terms → using categorical classification of separate disorders → with list of symptoms each

• Difference = single condition → Autism Spectrum Disorder (ASD) → for DSM-5

• Removal of multi-axial system → recognizing classification of disorders → changing how disorders resulting from general medical conditions → are conceptualized

Strength → research evidence to support the predictive validity of DSM in diagnosing disorders

• Tested for predictive validity → diagnosis is established + expected symptoms’ fruition → identified in the long-term

• Lahey (2015) studied DSM-IV diagnosis of ADHD @ 4-6 years old → finding that symptoms + associated impairments = persisted into elementary school

  • Therefore → DSM = effective tool + effective in later administrations of later treatments

Strength → Research evidence for inter-rater reliability

• Different clinicians → have consistenly diagnosed → same condition → in multiple patients

• Brown (2001) → tested DSM-IV → with an independent panel → for patients with mood + anxiety disorders → same diagnosis based on DSM classification

  • Provides increased confidence → in clinical diagnosis → of psych. disorders

Strength → cultural sensitivity

• Constant revisions → include cross-cultural variations + updates

• Symptoms may be interpreted differently → depending on cultural identity

• Clinical formulation interview guide → includes cultural questions

  • E.g. Japanese ettiquette → involves ‘fear of offending others’ → which can be mistaken as social anxiety

  • Disparity = outlined in DSM

• Acknowledges individual experience → of disorder being diagnosed

Weakness → varied issues with different types of validity

• Clinicians may interpret symptoms of disorders differently → reducing construct validity → of clearly operationalized diagnosis criteria

• Clinical perceptions → may reduce validity of clear-set diagnosis → e.g. depression/schizophrenia