Diagnostic & Statistical Manual Of Mental Disorders Essay

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Diagnostic & Statistical Manual Of Mental Disorders Essay

Question:

There are several changes from DSM IV to DSM 5 manuals in diagnostic criteria and grouping. Critically evaluate three of these major changes.

Answer:

Diagnostic and Statistical Manual of Mental Disorders (DSM) is an authoritative guide published by American Psychological Association (APA) used by health care professionals guiding the diagnosis for mental disorders containing symptoms, descriptions and criteria. Many editions of DSM are being modified, reviewed and enlarged when first DSM I was introduced by APA in 1952. New categories of diagnosis were introduced with distinct hierarchy in well-known practice recommending single pathology identification explaining clinical status symptoms (Birgegård, Norring and Clinton 2012). Gradually, the concept of DSM III was abolished and the concept of co-morbidity was introduced confirming DSM IV during 1990s. In 2013, a new version was introduced by APA providing an official list of mental disorders. It guides treatment for mental disorders being the largest change reflecting scientific understanding of the mental issues and its treatment. A lot of modifications took place from DSM IV to DSM V having implications on the understanding and treatment of mental disorders. Diagnostic & Statistical Manual Of Mental Disorders Essay. The modifications took place in seven aspects; autism spectrum, bipolar disorder, ADHD diagnosis, PTSD symptoms, dementia reclassification, intellectual disability and artificial categorization modification (Regier, Kuhl and Kupfer 2013). The following discussion involves the critical evaluation of three major changes from DSM IV to V in terms of bipolar disorder, autism spectrum and dementia reclassification.

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The main change occurred in DSM V is that the terminology of “general medical condition” is modified to “another medical condition” relevant for disorders. DSM IV failed to reflect upon the shared symptoms or features of diagnostic groups like bipolar disorders with psychotic disorders, internalizing (depressive, anxiety, somatic) or externalizing disorders (conduct, substance abuse, impulse control) (Cosgrove and Krimsky 2012). On a contrary, DSM V restructured interrelationships, across and within diagnostic chapters. The strength of earlier DSM classification was to diagnose baseline psychiatric diagnosis on the defined and operational criteron that resulted in inter-rater reliability. This was the greatest weakness in DSM IV where patients were formally diagnosed under which only half of the patients were actually treated. There was lack of operational categorization of subthreshold diagnoses in DSM IV whereas in DSM V, there is high recognition where large number of patients is seeking treatment who were formally under “Not Otherwise Specified” (NOS) group (Kupfer, Kuhl and Regier 2013). Diagnostic & Statistical Manual Of Mental Disorders Essay.

Elimination of bipolar disorder is a major modification from DSM IV to V. DSM IV contains diagnosis of mixed episode, bipolar I disease requires that the person meet the full criteria simultaneously for major depressive episode and mania that is removed in DSM V. There is enhancement in the accuracy for diagnosis and its facilitation at early stage detection in t

The Diagnostic and Statistical Manual of Mental Disorders (DSM) has a number of features. First of all, every disorder is identified using a name and a numerical code. In addition, the manual provides the criteria for diagnosing each disorder as well as establishes subtypes of a disorder and examples that would illustrate the disorder. The manual goes further by addressing the typical age of onset, culturally related information, gender-related information, prevalence of a disorder, typical clinical course of a disorder, typical predisposing factors of a disorder and genetic family patterns of a disease (Summers, 2009). The DSM-IV is a tool that is used by mental health practitioners and social service workers. As has been demonstrated…show more content…
Personality disorders have a sex prevalence rate and there has been some suggestion that those rates reflect gender bias. Diagnostic & Statistical Manual Of Mental Disorders Essay. The bias concerns derived from the “conceptualization of personality disorders, the wording of diagnostic criteria, the application of diagnostic criteria, thresholds for diagnosis, clinical presentation, researching sampling, the self-awareness and openness of patients and the items included within self-report inventories” (Butcher, 2009, p. 356). Studies have failed to prove that there is significant gender bias in the DSM. However, research has showed there is gender bias within clinical judgments. For example, gender related items would be included within self-report inventories (Butcher, 2009). Clinicians tend to judge female patients as being mentally ill more readily than male patients, even when the symptoms are the same. Moreover, women are more likely to be cast as overly emotional, have a need for mood-altering medication and require ongoing monitoring/treatment (Zur and Nordmarken, 2010).
Sexual orientation has also caused considerable bias.Homosexuality was listed in the DSM as a mental disorder up until 1974.Diagnostic & Statistical Manual Of Mental Disorders Essay. Even law had identified homosexual behavior as criminal; for instance, sodomy laws. Although homosexuality is no longer listed in the DSM, therapists still have the option of considering homosexual behavior as a sexual disorder not otherwise specified. The ability to still classify homosexuality as a

The Diagnostic and Statistical Manual of Mental Disorders (DSM) is the comprehensive guide to diagnosing psychological disorders. This manual is published by the American Psychiatric Association (APA) and is currently in its fifth revision. Moreover, the manual is utilized by a multitude of mental health care professionals around the world in the process of identifying individuals with disorders and provides a comprehensive list of the various disorders that have been identified. The DSM serves as the essential resource for diagnosis of mental disorders based off of the various signs and symptoms displayed by individuals while also providing a basic reference point for the treatment of the different disorders. The manual attempts to remain scientific in its approach to identifying the underlying symptoms of each disorder while meeting the needs of the different psychological perspectives and the various mental health fields. The DSM has recently gone through a major revision from the DSM-IV-TR to the DSM-5 and contains many significant changes in both the diagnosis of mental disorders and their classifications. Diagnostic & Statistical Manual Of Mental Disorders Essay.
History of change
Originally published in 1952, the DSM has been through a number of revisions in its history. The original manual was the culmination of an extended journey of its own. According to Tartokovsky (2011), the DSM was born out of the need to minimize the confusion that had developed in the world of mental health care with regard to classifying disorders. Prior to this, there had been an initial attempt to create a system of classification that had emerged in 1917 known as the Statistical Manual for the Use of Institutions for the Insane. The manual was written by the early predecessor to the APA and wa…

…pfer, D. (2013). The DSM-5 – an interview with David Kupfer. BMC Medicine, 11, 203.
Nemeroff, C. B., Weinberger, D., Rutter, M., MacMillan, H. L., Bryant, R. A., Wessely, S., …Lysaker, P. (2013). DSM-5: a collection of psychiatrist views on the changes, controversies, and future directions. BMC Medicine, 11, 202.
New Diagnostic guidelines redefine addiction: changes may lead to earlier interventions, better prognoses. (2012). Mind, Mood & Memory, 8(10), 6. Diagnostic & Statistical Manual Of Mental Disorders Essay.
Schneider, M. E. (2013, May). Five ways the DSM-5 could change your practice: elimination of five-axis system expected to make diagnoses less burdensome. Clinical Psychiatry News, 41(5), 1+.
Tartakovsky, M. (2011). How the DSM developed: What you might not know. Psych Central. Retrieved on November 21, 2013, from http://psychcentral.com/blog/archives/2011/07/02/how-the-dsm-developed-what-you-might-not-know/

Classification and Assessment of Mental Disorders

The Diagnostic and Statistical Manual (DSM) system is a classification tool that is highly used in North America. This manual covers many different disorders such as: learning, developmental, anxiety, and substance disorders. The DSM uses a specific diagnosis criteria to group patterns of abnormal behaviors that share common features. The DSM also uses a multiaxial system of evaluation, which consists of the following: clinical syndromes, personality disorders and mental retardation, general medical conditions, psychosocial and environmental problems, and global assessment of functioning. The DSM system uses specified diagnostic criteria and a multiaxial system to provide an understanding of the person’s functioning.Diagnostic & Statistical Manual Of Mental Disorders Essay. The DSM contains more than two hundred specific diagnostic categories that are arranged under eighteen primary headings.

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For example, the category of anxiety disorders contains subtypes i.e. panic disorders, phobias, and obsessive compulsive disorders. The DSM outlines the specific criteria for each mental disorder. Disorders are also classified in terms of exclusion criteria. With the help of these criteria the diagnoses are understood and misdiagnosis are avoided.

There are three weaknesses in the DSM. These weaknesses include, the questions about reliability (level of consistency of measurements), validity (extent to which the test measures what it is supposed to measure) and about the medical model framework.

There are some major changes between the DSM-IV and DSM-5. One of the changes include the DSM-5 replacing the multiaxial system with a nonaxial assessment system combining axes I, II, and III at the same diagnostic level, with special reference of psychosocial factors and disabilities. Another major change is the reorganization of disorders according to developmental lifespan progressions. The DSM-5 includes an official diagnostic criteria that appears in section II chapters compared to section III chapters. When comparing the two, section III chapters now contains optional dimensional, cultural, alternative personality disorder model and conditions for further study. Diagnostic & Statistical Manual Of Mental Disorders Essay.

Some deletions were made to the the DSM-IV for example, the removal of the Global Assessment of Function (GAF) scale due to validity and reliability issues. The DSM-V replaced the DSM-IV designation with two options: other specified disorders and unspecified disorders. The DSM-V has a greater emphasis on dimensionality and has a Cultural Formation Interview presented in section III that assesses the impact of culture on clinical presentation. Diagnostic & Statistical Manual Of Mental Disorders Essay.