The Diagnostic and Statistical Manual of Mental Disorders (DSM) is a classification system which encompasses mental disorders along with the associated criteria and is published by the American Psychiatric Association (APA) (American Psychiatric Association, 2013, p. xIi). The criteria are useful in assisting mental health professionals in having more dependable diagnoses of mental disorders. The DSM has recently been revised. The revised version known as the DSM-5 is a classification system including separate disorders by category. However, not all mental disorders fit completely within the boundaries of a single disorder. Within the DSM-5, different components have been added along with 9 enhancements to stimulate ease of use (American Psychiatric …show more content…
Association, 2013, p. xIi). Clinical training and experience is needed to use the DSM for determining a diagnosis. To ensure an efficient examination of the range of symptoms present, the DSM can serve clinicians as a guide to identifying the most noticeable symptoms that should be assessed when diagnosing a disorder (American Psychiatric Association, 2013, p. 6). The initial DSM was published in 1844 as a statistical classification of institutionalized mental patients (American Psychiatric Association, 2013, p.6). The purpose was to improve communication about the types of patients that were treated in these specific hospitals. After World War II, the DSM went through four major editions. Many years later, the APA began an evaluation of the strengths and weaknesses of the DSM based on developing research that did not support the boundaries established for some mental disorders. Soon after, the APA came to an agreement with the World Health Organization (WHO) and with support from multiple other organizations, organized international DSM-5 research planning conferences (American Psychiatric Association, 2013, p. 6). The participants were to review the previous literature on specific diagnostic areas to prepare for revisions involving the DSM-5 and the International Classification of Diseases (ICD). The reports that followed these conferences became the starting point for the new edition of the DSM (American Psychiatric Association, 2013, p. 6). Proposals for the revision were developed based on rationale, scope of change, expected impact on clinical management and public health, strength of the supporting research evidence, overall clarity, and clinical utility (American Psychiatric Association, 2013, p. 7). Proposals for the revision of the DSM-5 also included changes to the diagnostic criteria. These changes included the addition of new disorders, subtypes, and specifiers as well as the deletion of existing disorders. Field trials were conducted for the DSM-5. Two specific designs were used. These included; one in larger, diverse medical-academic settings, and the other in routine clinical practices (American Psychiatric Association, 2013, p. 7). The trial conducted in the medical-academic settings focused on the need for large sample sizes to test the hypothesis on reliability and clinical utility of a range of diagnoses in a variety of patient populations. The clinical setting provided valuable information about how proposed revisions performed everyday among diverse sample of the DSM users (American Psychiatric Association, 2013, p. 8). To allow the public and professionals to review what was being accomplished so far on the DSM-5, the APA began a new website after these trials. This website allowed all the diagnostic criteria changes in organization to be posted (American Psychiatric Association, 2013, p. 8). These changes were posted on the website for a two month commenting period. There were another two more commenting periods after this one, and together they produced more than 13,000 signed comments on the website that were received and reviewed (American Psychiatric Association, 2013, p. 8). The groups tasked with revising both of them had to do so for many reasons including; the existence of two major mental disorders hinders the collection of national health statistics, the design of clinical trials aimed are developing new treatments and the consideration of global applicability of the results by international regulatory agencies; more broadly, the existence of two classifications complicates attempts to replicate scientific results across national boundaries, and even when the intention was to identify individual patient populations, DSM-IV and ICD-10 diagnoses did not always agree (American Psychiatric Association, 2013, p. 11). The DSM-5 has been organized by developmental and lifespan considerations.
It is introduced with diagnosis believed to reflect developmental processes that appear early in life such as neurodevelopmental and schizophrenia spectrum (American Psychiatric Association, 2013, p. 13). It is then followed by diagnoses that appear more frequently in adolescence and young adulthood such as bipolar and anxiety disorders. Then it ends with diagnosis that are relevant to adulthood and older life such as neurocognitive disorders (American Psychiatric Association, 2013, p. 13). In the DSM, mental disorders are defined in relation to cultural, social and familial norms and values. Culture provides enlightening frameworks that shape a person’s experience and expression of the symptoms, signs, and behaviors that make up the criteria for each diagnosis (American Psychiatric Association, 2013, p. 14). Culture-bound in the DSM-5 has been replaced with three important concepts. These three concepts include: the definitions of cultural syndrome, cultural idiom of distress, and cultural explanation of perceived cause (American Psychiatric Association, 2013, p. 14). Gender differences, use of other specified and unspecified disorders, the multi-axial system and online enhancements are also included in the DSM-5 (American Psychiatric Association, 2013, p. …show more content…
15). A mental disorder is defined as a syndrome characterized by clinically significant disturbance in an individual’s cognition, emotional regulation, or behavior that reflects a dysfunction in the psychological, biological, or developmental processes underlying mental function (American Psychiatric Association, 2013, p.
20). Mental disorders are usually connected with substantial stress or disability in social, occupational, or other important activities. An expectable or culturally appropriate response to a common stressor or loss, such as the death of a loved one, is not a mental disorder. Socially deviant behavior and conflicts that are mainly between the individual and society are not mental disorders unless however, the deviance or conflict results from a dysfunction in the individual as described before (American Psychiatric Association, 2013, p. 20). The diagnosis of a mental disorder should have a clinical utility. Meaning, it should help clinicians to determine prognosis, treatment plans, and potential treatment outcomes for their patients. The diagnosis of a mental disorder is not always a need for treatment, because need for treatment is a complex clinical decision that takes into consideration multiple factors. Some of these factors include: symptom severity, amount of distress (mental pain) associated with symptoms, and risk and availability of treatments (American Psychiatric Association, 2013, p. 20). Each diagnosis in the DSM-5 includes diagnostic criteria,
descriptors, subtypes and specifiers, as well as coding and reporting procedures (American Psychiatric Association, 2013, p. 21). The use of DSM-5 by nonclinical, medical or any inadequately trained individual is not recommended. A diagnosis does not carry any necessary implications regarding causes of the individual’s mental disorder or the individual’s ability to control behaviors associated the disorder (American Psychiatric Association, 2013, p. 25).
As an expat child having gown up and lived across three continents-politely labelled as a third culture kid, but in reality not belonging to any one culture-I doubt if my own parents would understand me let alone a doctor in another country. My mother suffers from trichotillomania and on visiting a psychiatrist in a foreign country, he mentioned not seeing this disease often in his country: he had made her feel at once both alienated and awkward, and not likely to trust his diagnosis or his treatment. I have seen her throwing her medication away- Pharmacotherapy cannot work without psychotherapy-and the demands of psychotherapy seem to be only increasing when you add a complex cultural element to it. Gold and his brother argue that both biological and social factors contribute to psychosis. In the field of psychiatric and behavioural sciences this would call for physicians skilled in appreciating all sorts of cultures and environments and while this may seem a tall order, a first step towards a solution would lie in acknowledging the role and importance of such external stimuli. Doctors cannot know it all but at least when they give a label it will be real. In a field where labels tend to stick and where the social stigma attached to mental illness is still considerable, it is worth while for doctors to make more informed diagnoses. Diagnoses that we can
Culture is a collection of religion, traditions, and beliefs that are passed down from generation to generation. Culture is created and maintained through the repetition of stories and behavior. It is never definite because it is continuously being modified to match current trends, however, historical principles are still relevant. With respect to mental illness, culture is crucial to how people choose to deal with society and the methods used to diagnose and cope with mental illnesses. In Watters’
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.
The DSM-5 lists approximately 400 mental disorders, each one explains the criteria for diagnosing the disorder and key clinical features, and sometimes describes features that are often times not related to the disorder. The classification is further explained by the background information such as: research findings, age, culture, gender trends, and each disorder’s prevalence, risk, course, complications, predisposing factors, and family patterns (Comer, 2013, pp.100).... ... middle of paper ... ...
Before beginning my argument I would like to clarify the current criteria for diagnosing mental illness. First, the patient must show “clinically significant detriment” (Gray 578). This could be shown by way of “distress (painful feelings) or impairment of functioning (interference with the ability to work, play, or get along with people” (578). Second, the distress must have “an internal source… in the person’s biology, mental structures (ways of perceiving, thinking, or feeling) or learned habits) – and not i...
Frances, A., & Ross, R. (1996). DSM-IV case studies a clinical guide to differential diagnosis. Washington, DC: American Psychiatric Press, Inc.
Identification of any psychosocial or contextual factors to be considered, as outlined in the DSM-5
The ICD-10 Classification of Mental and Behavioural Disorders: Clinical Descriptions and Diagnostic Guidelines. Geneva: World Health Organization, 1992. Print.
Culture has a huge influence on how people view and deal with psychological disorders. Being able to successfully treat someone for a mental illness has largely to do with what they view as normal in their own culture. In Western cultures we think that going to a counselor to talk about our emotions or our individual problems and/or getting some type of drug to help with our mental illness is the best way to overcome and treat it, but in other cultures that may not be the case. In particular Western and Asian cultures vary in the way they deal with psychological disorders. In this paper I am going to discuss how Asian cultures and Western cultures are similar and different in the way they view psychological disorders, the treatments and likelihood of getting treatment, culture bound disorders, and how to overcome the differences in the cultures for optimal treatments.
Classification refers to the procedure in which ideas or objects are recognized, distinguished and understood. Currently, two leading systems are used for grouping of mental disorder namely International Classification of Disease (ICD) by World Health Organization (WHO) and the Diagnostic and Statistical Manual of Mental disorders (DSM) by the American Psychiatric Association (APA). Other classifications include Chinese classification of mental disorder, psycho-dynamic diagnostic manual, Latin American guide for psychiatric diagnosis etc. A survey of 205 psychiatrists, from 66 different countries across all continents, found that ICD-10 was more customarily used and more valued in clinical practice, while the DSM-IV was more valued for research [1].
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (DSM-5®). American Psychiatric Pub.
Diagnostic and statistical manual of mental disorders: DSM-5. (5th ed.). (2013). Washington, D.C.: American Psychiatric Association.
The Diagnostics and Statistical Manual of Mental Disorders and other assessment tools assist in the identification and development of treatment options. Application of the DSM-5 requires knowledge of possible advantages and limitations. Is it also helpful to understand when it is appropriate to apply the information provided in the DSM-5. The DSM was essentially developed to provide a ‘common language for mental health professionals (Butcher, Hooley, & Mineka, 2014). This fifth edition continues an evolutionary process aimed at maintaining guidelines for diagnoses that advise and analyze clinical practice (APA, 2013).
Mental illness is the condition that significantly impede with an individual’s emotional, cognitive or social abilities (Savy and Sawyer, 2009). According to (Savy and Sawyer, 2009) neurological, metabolic, genetic and psychological causes are contributing factors for various types of mental illness like depression, schizophrenia, substance abuse and progression of condition. An elaborate system known as DSM-IV-TR gives a classification system that acts to separate mental illness into diagnostic categories based on the description of symptoms of illness (Savy and Sawyer, 2009). The exact primarily causes of mental illness are complicated, however, it seems to occur in a psychologically and biologically prone individual, in the trigger of environmental and social stress (Elder, Evans and Nizette, 2007).
People sometimes have symptoms of mental disorders, but they usually do not meet the criteria or are not clinically significant, severe enough to necessitate treatment. Before a person can be diagnosed with a mental disorder, his or her problematic thoughts, feelings, and actions must meet the criteria for the mental disorder and must prevent adequate social, occupation, or other forms of functioning.