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PSYB32H3 (1,000)
Chapter 3

Chapter 3 covered in week 3 of FALL 2010 semester


Department
Psychology
Course Code
PSYB32H3
Professor
Konstantine Zakzanis
Chapter
3

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PSYB32 CHAPTER 3: CLASSIFICATION AND DIAGNOSIS
SEPT. 27TH. 2010
-a disorder must be classified correctly before its causes or best treatments can be found; the
DSM-IV is the official diagnostic system widely employed by mental health professionals
-the Diagnostic and Statistical Manual of Mental Disorders (DSM): a publication of the
American Psychiatric Association that is an attempt to delineate specific and discrete
syndromes or mental disorders; it has been through several revisions and the current one
is the 4th edition (DSM-IV)
-A BRIEF HISOTRY OF CLASSIFICATION:
-Early Efforts @ Classification: during 19th and early 20th Cs, there was great inconsistency
in the classification of abnormal behave
-Development of the WHO and DSM Systems: in 1939, the WHO added mental disorders
to the International List of Causes of Death; in 1948 the list expanded to become the
International Statistical Classification of disease, Injuries, and Causes of Death, a
comprehensive listing of all diseases, including a classification of abnormal behav; but the
mental disorders section was not widely accepted.
-APA published its own Diagnostic and Statistical Manual (DSM) in 1952
-in 1969, WHO published a new classification system that was more widely
accepted: DSM; actual diagnostic practices still varied widely. In 1980, the APA
revised the diagnostic manual.
-THE DIAGNOSTIC SYSTEM OF THE AMERICAN PSYCHIATRIC ASSOCIATION (DSM-IV
AND DSM-IV-TR):
-Definition of Mental Disorder: how does the DSM define mental disorder? :no definition
adequately species boundaries for the concept
-a clinically sig behave or psychological syndrome or pattern that occurs in a indiv
and that is associated w/present distress or disability or w/a significantly increased
risk of suffering death, pain, disability, or an important loss of freedom.
-a number of conditions are excluded from consideration;
-also, the syndrome or pattern must not be merely an expectable culturally
sanctioned response to a particular event, i.e., the death of a loved one; w/e the
cause, it must be currently considered a manifestation of a behavioural,
psychological, or biological dysfunction in the individual
-5 Dimensions of Classification: many changes in the 3rd edition of DSM, the most major
change is the use of multiaxial classification = whereby each individual is rated on 5
separate dimensions, or axes:
-Axis I: all diagnostic categories except personality disorders and mental retardation
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-Axis II: Personality disorders and mental retardation
-Axis III: General medical conditions
-Axis IV: Psychosocial and environmental problems
-Axis V: Current level of functioning
-axes I and II compose the classification of abnormal behave; axes I and II are
separated to ensure that the presence of long-term disturbances is not overlooked
-i.e. prior to the onset of their Axis I conditions, they may have had an Axis II
conditions, such as dependent personality disorder; this separating
encourages clinicians to be attentive to this possibility; presence of an axis II
disorder along with an axis I disorder, generally means that the persons
problems will be more difficult to treat.
-the remaining 3 axes are 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
understood
-axis IV may include occupational problems, economic problems, interpersonal
difficulties with family members, and a variety of problems in other life areas that
may influence psychological functioning;
-for axis V, the clinician indicates the persons current level of adaptive functioning;
life areas considered are social relationships, occupational functioning, and use of
leisure time;
-ratings of current functioning are supposed to give information about the need for
treatment
-Diagnostic Categories: for many of the diagnoses, the DSM indicates that the disorder
may be due to a medical condition or substance abuse; disorder in Axis I & II:
-Disorders Usually First Diagnosed in Infancy, Childhood, or Adolescence:
-separation anxiety disorder: excessive anxiety about being away from
home/parents
-conduct disorder: repeatedly violate social norms and rules
-attention-deficit/hyperactivity disorder: difficulty sustaining attention and
are unable to control their activity when the situation calls for it
-mental retardation: show subnormal intellectual fcning and deficits in
adaptive fcning
-pervasive developmental disorders: include autistic disorder, a sever
condition in which the indiv has problems in acquiring communication skills
and deficits in relating to other ppl
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-learning disorders: delays in the a changed the behave acquisition of speech,
reading, arithmetic, and writing skills
-Substance-Related Disorders: diagnosed when the ingestion of some substance
alcohol etc has changed the behave enough to impair social or occupational fcning;
these substances may also cause or contribute to development of other Axis I
disorders such as mood/anxiety disorder
-Schizophrenia: contact t to understand; experience delusions, sometimes plagued
by hallucinations w/reality is faulty; language and communicatn are disordered;
shifts from one subject to another make them difficult to understand; commonly
experience delusions, hallucinations;
-Mood Disorders: these diagnoses are applied to ppl whose moods are extremely
high or low;
-major depressive disorder = person is deeply sad and discouraged; likely to
lose weight and energy and have suicidal thoughts/feelings of self-reproach
-mania = exceedingly euphoric, irritable, more active than usual, distractible,
and possessed of unrealistically high self-esteem
-bipolar disorder = episodes of mania or of both mania and depression
-Anxiety Disorders: irrational or overblown fear as the central disturbance
-phobia = fear objects/situations so intensely that they must avoid it, even
though it is unwarranted/unreasonable and disrupts their lives
-panic disorder = sudden but brief attacks of intense apprehension,
tremble/shake/dizzy/trouble breathing;
-agoraphobia = person so fearful of leaving familiar surroundings
-generalized anxiety disorder = fear and apprehension are pervasive,
persistent and uncontrollable; they worry constantly
-obsessive-compulsive disorder = subject to persistent obsessions or
compulsions;
-obsession = recurrent thought/idea/image that uncontrollably
dominates a persons consciousness
-compulsion = an urge to perform a stereotyped act to reduced the
anxiety;
-attempts to resist a compulsion which creates so much tension that
the indiv usually yields to it
-post-traumatic stress disorder = anxiety/emotional numbness in the
aftermath of a very traumatic event; intrusive recollections at night; difficult
to concentrate and feel detached from others
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