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

2. 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

3. 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

4. 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

5. 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

6. 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

7. 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

8. 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

9. 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

10. 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

11. 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

12. 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

13. 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

14. 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)

15. Class Announcements
Cross Cultural Project
Class Study Groups