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Chapter 3

PHSI 208 Chapter Notes - Chapter 3: Passive-Aggressive Behavior, Dysthymia, Defence Mechanisms


Department
Physiology
Course Code
PHSI 208
Professor
Neil Hibbert
Chapter
3

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Diagnostic and statistical manual of mental disorders (DSM) now in its 4th edition,
commonly referred to as DSM –IV or DSM –IV-TR. The DSM is published by the
American psychiatric association
A BRIEF HISTORY OF CLASSIFICATION
Bloodletting was part of treatment of all physical problems
Development of the WHO and DSM systems
In 1939 the world health organization (WHO) added mental disorders to the international
list of causes of death
In 1948 the list was expanded to become the international statistical classification of
diseases, injuries and causes of death (ICD) a comprehensive listing of all diseases
including a classification of ab beh. Metal disorders section was not widely accepted
American psychiatric association published its own diagnostic and statistical manual
(DSM) in 1952
In 1969 the WHO published a new classification system that was more widely accepted.
A 2nd version of the American psychiatric associations DSM, DSM-II was similar to the
WHO system
The WHO classifications were simply a listing of diagnostic categories; the actual beh or
symptoms that were the bases for the diagnoses were not specified
In 1980 the American psychiatric association published an extensively revised diagnostic
manual; a somewhat revised version DSM-III – R appeared in 1987
DSM –IV is used throughout the U.S and Canada is becoming widely accepted around
much of he world
THE DIAGNOSITIC SYSTEM OF THE AMERICAN PSYCHITIARTC ASSOCIATION
(DSM-IV AND DSM-IV-TR)
The term mental disorder is problematic and that no definition adequately specifies
precise boundaries for the concept. DSM-IV-TR provides the following definition:
A clinically significant beh or psychological syndrome or pattern that occurs in an indiv
and that is associated with present distress or disability or with a significantly increased
risk of suffering death, pain, disability or an important loss of freedom
Five dimensions of classification
Most sweeping change in the use of multiaxal classification whereby each indiv is rated
on 5 separate dimensions or axes
The five axes are:
1) axis I- all diagnosis categories except personality disorder and mental retardation
2) axis II- personality disorders and mental retardation
3) axis III- general medical conditions
4) axis IV- psychological and environmental problems
5) axis V – current level of functioning
most ppl consult a mental health professional for an Axis I condition
although the remaining three axes not needed to make the actual diagnosis their inclusion
in the DSM indicates that factors other than a persons symptoms should be considered in
an assessment so that the persons overall life situation can be better be understood
axis III conditions may be quite common. A recent study in Toronto found that more tan
half of the inpatients had an identifiable medical condition and that having an infectious
disease was associated with disruptive beh
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