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Chapter 3

Chapter 3 covered in week 3 of FALL 2010 semester

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University of Toronto Scarborough
Konstantine Zakzanis

PSYB32 CHAPTER 3: CLASSIFICATION AND DIAGNOSIS TH SEPT. 27 . 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 4 edition (DSM-IV) -A BRIEF HISOTRY OF CLASSIFICATION: th th -Early Efforts @Classification: during 19 and early 20 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 wpresent distress or disability or wa 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; we the cause, it must be currently considered a manifestation of a behavioural, psychological, or biological dysfunction in the individual rd -5 Dimensions of Classification: many changes in the 3 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 www.notesolution.com -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 homeparents -conduct disorder: repeatedly violate social norms and rules -attention-deficithyperactivity 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 www.notesolution.com
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