Chapter 16 - Diagnosing Mental Disorders

Question 1

What is the meaning of a disorder?

Answer 1

A set of symptoms that interfere with daily functioning. Symptoms are reasonably consistent between patients but origins/causes may differ.

Question 2

What is the meaning of a Syndrome?

Answer 2

A particular profile of symptoms. The origins and clinical severity may vary.

Question 3

What is the meaning of a Disease?

Answer 3

A condition with a known cause, predictable course and standard protocols for treatment.

Question 4

Explain the DSM

Answer 4

DSM is Diagnostic and Statistical Manual of Mental Disorders. It is published by the American Psychiatric Association

The DSM is descriptive - it does not specify the causes of the mental disorder nor does it direct treatment, though it includes the onset, course and persistence of symptoms.

Question 5

Explain the ICD

Answer 5

ICD is the International Classification of Diseases and is produced by the World Health Organisation

It is descriptive and largely based on symptoms reported by the patient and criteria ranked as importance by professionals.

Question 6

What are the 5 Axes of the DSM?

Answer 6

• AXIS I: Clinical Disorders
• AXIS II: Mental Retardation and Personality Disorders
• AXIS III: General Medical Conditions
• AXIS IV: Psychosocial and Environmental Problems
• AXIS V: Global Assessment of Functioning (GAF score)

Question 7

Criticisms of these systems of diagnosis

Answer 7

• Cultural Variation: The DSM is created based on American culture, tradition and norms. Appendix I of the DSM gives instructions for diagnosing people within their cultural context.
• Validity of Categories: The goal of the system has been to enable and increase the consistency of diagnosis, but it can be argued that this means that the validity of the categories may be overlooked. (homosexuality used to be considered a disorder till 1973)
• Writing by Committee: Eloquent and persuasive committee members may have a disproportionate influence on the committee listing the diagnostic criteria for a particular disorder.
• Subjectivity: Classification is based on symptoms reported by the person or behaviours they are subjectively observed to exhibit in the judgement of others.
• Health Insurance: The health insurance industry in the USA is very commercial and often will only pay for treatment for mental disorders that are listed in the DSM. As a result, there is a great tendency for conditions such as alcohol addiction or pathological gambling disorder to appear as diagnosable conditions in their own right, rather than (possibly) being symptomatic of other conditions.

Question 8

What are the Dimensional Categories?

Answer 8

• Neuroticism: (with emotional stability as opposite), which means a person is anxious, stressed, depressed and self-conscious
• Agreeableness: (with self-interest and suspicion as its opposite), which means a person is compassionate and trusting
• Conscientiousness: (laziness and carelessness as its opposite), which means that a person is self-disciplined and reliable.
• other possible dimensions would be compulsiveness, antisocial responses and social withdrawal

Question 9

What is the biopsychosocial model?

Answer 9

Biological, psychological and social/cultural influences are considered together in the assessment and treatment of mental and physical health.

• Biological Factors
  
  • bodily structures
  • biochemical processes
  • genetics
• Psychological Factors
  
  • individual’s personality predisposition
  • thoughts, feelings and behaviours (e.g. sadness, depression, anxiety)
• Social/Cultural Factors
  
  • home
  • school
  • friends
  • work
  • societal expectations
  • cultural expectations