Module 22 Assessment & Anxiety Disorders Virginia Union University Introduction to Psychology

Diagnosing Mental Disorders An individuals must be formally diagnosed as having a mental disorder to receive appropriate treatment Clinical diagnosis A process of matching an individual’s specific symptoms to those that define a particular mental disorder American Psychological Association (APA) developed a uniform diagnostic system in 1952 Diagnostic & Statistical Manual of Mental Disorders IV Text Revision (DSM IV TR) Uniform system for assessing specific symptoms and matching them to almost 300 different mental disorders

DSM IV TR Describes 297 mental disorders (compared to 106 in the first addition published in the 1950s) Improvement compared to past additions Criteria/symptoms based more on research findings than clinical opinions Next version likely to use findings from genetics & neuroscience research to better understand underlying causes of mental disorders

DSM IV TR – Making a Diagnosis In making a clinical diagnosis, client symptoms assessed & matched with symptoms described in the DSM IV TR Sample ADHD exercise DSM IV TR has 5 axes that serve as guidelines to make diagnoses

DSM IV TR Axis 1: Nine Major Clinical Syndromes Disorders usually 1st diagnosed in infancy, childhood or adolescence includes ADHD, autism, mental retardation (i.e. intellectual disabilities), enuresis & stuttering Organic mental disorders includes disorders that are temporary or permanent dysfunctions of brain tissue caused by diseases or chemicals, such as dementia (Alzheimer’s) Substance-related disorders includes maladaptive (& abnormal pattern) use of drugs & alcohol difference b/t use & abuse

DSM IV TR Axis 1: Nine Major Clinical Syndromes Schizophrenia & other psychotic disorders schizophrenias characterized by psychotic symptoms (i.e., grossly disorganized behavior, delusions & hallucinations) & by over 6 months of behavioral deterioration also includes delusional & schizoaffective disorders Mood disorders characterized by emotional disturbance includes major depression, bipolar disorder, dysthymic disorder & cyclothymic disorder

DSM IV TR Axis 1: Nine Major Clinical Syndromes Anxiety disorders characterized by physiological signs of anxiety and subjective feelings of tension, apprehension or fear. may be acute & focused (i.e. phobias) or continual & diffuse (i.e. generalized anxiety disorder) Somatoform disorders characterized by somatic symptoms that resemble physical illness but that cannot be accounted by organic damage. includes hypochondriasis

DSM IV TR Axis 1: Nine Major Clinical Syndromes Dissociative disorders feature a sudden, temporary alteration or dysfunction of memory, consciousness, identity, and behavior. includes dissociative amnesia & multiple personality disorder Sexual & gender-identity disorders includes gender-identity disorders, paraphilias and sexual dysfunctions

DSM IV TR Axis 2: Personality Disorders Disorders that involve patterns of personality traits that are long-standing, maladaptive & inflexible and involve impaired functioning or subjective distress Includes borderline, schizoid & antisocial personality disorders

DSM IV TR Axis 3: Physical Disorders Physical disorders or conditions that have an influence on someone’s mental disorder Includes diabetes, arthritis, and hemophilia

DSM IV TR Axis 4: Psychosocial & Environmental Problems Psychosocial and & environmental problems that may affect the diagnosis, treatment, and prognosis of mental disorders in Axes 1 & 2. Includes negative life events, an environmental difficulty or deficiency, a familial or interpersonal stress, and inadequacy of social support or personal resources, or another problem that involves the context E.g. Post-traumatic Stress Disorder

DSM IV TR Axis 5: Global Assessment of Functioning Scale Axis used to rate the overall psychological, social, and occupational functioning of the individual on a scale

Usefulness of DSM IV TR Arriving at a diagnosis Clinical interviews - Psychological tests - Neurological tests - Clinical assessment - DSM IV TR All 5 axes of the DSM IV TR used to make a clinical diagnosis 3 advantages to using the DSM IV TR Professionals use the classification system to communicate with one another & discuss client problems Researchers use the classification system to study & explain mental disorders Therapists use the classification system to design treatment programs

Potential Problems with using DSM IV TR Labeling Mental Disorders Labeling: identifying & naming differences among individuals. The label places individuals into specific categories which have either positive or negative associations Advantage of diagnostic label – easy to communicate information about disorder Disadvantage of diagnostic label – label has negative associations Social & Political Implications Can influence diagnosis & likelihood to seek treatment Homosexuality listed in the DSM in the 1970s, later dropped Sexist self-defeating personality disorder listed in the DSM in the 1980s, later dropped Japanese less likely to seek professional help b/c of stigma associated with mental illness (same with African Americans)

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