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Diagnostic Manual.pptx

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Diagnostic Manual.pptx

  1. 1. DSM-5 Psychology-
  2. 2. Contents: 01 02 03 04 Introduction to DSM Revision of DSM Conclusion References Editions of DSM
  3. 3. Introduction to DSM The Diagnostic and Statistical Manual of Mental Disorders (DSM) was created in 1952 by theAmerican PsychiatricAssociation so that mental health professionals in the United States would have a common language to use when diagnosing individuals with mental disorders. It is the handbook used by health care professionals as the authoritative guide to the diagnosis of mental disorders. DSM contains descriptions, symptoms, and other criteria for diagnosing mental disorders. Used by clinicians and researchers to diagnose and classify mental disorders, the criteria are concise and explicit, intended to facilitate an objective assessment of symptom presentations in a variety of clinical settings—inpatient, outpatient, partial hospital, consultation-liaison, clinical, private practice, and primary care.
  4. 4. Revision of DSM TheAPAprepared for the revision of DSM for nearly a decade, with an unprecedented process of research evaluation that included a series of white papers and 13 scientific conferences supported by the National Institutes of Health. This preparation brought together almost 400 international scientists and produced a series of monographs and peer-reviewed journal articles. 1952 1968 1980 1987 1994 DSM-I DSM-II DSM-III-R DSM-III DSM-IV-TR DSM-IV 2000 DSM-5 2013
  5. 5. Diagnostic and Statistical Manual of Mental Disorders (DSM) Edition Publication Date Number of Pages Number of Diagnoses Number of Disorders DSM-I 1952 132,130 128 106,60 DSM-II 1968 119,134 193 182 DSM-III 1980 494 228 265 DSM-III-R 1987 567 253 292 DSM-IV 1994 886 383 297,410 DSM-IV-TR 2000 943 383 DSM-5 2013 947 541 312
  6. 6. DSM-I (1952) The first edition of DSM (1952) was titled 'Diagnostic and Statistical Manual of Mental Disorders'. It did not carry any number attached to its title. DSM-I was created after World War II, and was partially a reaction to the return of military veterans from the war. Many veterans showed non-psychotic but non- physical disorders, and a number of military medical officers from World War II turned their attention to the treatment of these disorders. (Baker & Pickren, 2007; Pickren & Schneider, 2005). The DSM-I contained 128 categories. Organizationally, it had a hierarchical system in which the initial node in the hierarchy was differentiating organic brain syndromes from “functional” disorders which were subdivided into psychotic versus neurotic versus character disorders. DSM contained a glossary of descriptions of the diagnostic categories and was the first official manual of mental disorders to focus on clinical use.
  7. 7. DSM-II (1968) DSM II listed 182 disorders, and was 134 pages long. It was quite similar to the DSM-I. The term "reaction" was dropped, but the term "neurosis" was retained. In the 1960s, there were many challenges to the concept of mental illness itself. These challenges came from sociologists,behavioural psychologists and psychiatrists like Thomas Szasz, who argued mental illness was a myth used to disguise moral conflicts. Unlike the DSM-I, many of the new categories added in the DSM-II were categories of relevance to outpatient mental health efforts. Anxiety disorders, depressive disorders, personality disorders (PDs), and disorders of childhood/adolescence were larger subsets than they had been in the DSM-I. LIMITATIONS: Fleiss and Spitzer concluded "there are no diagnostic categories for which reliability is uniformly high. Reliability appears to be only satisfactory for three categories: mental deficiency, organic brain syndrome, and alcoholism.
  8. 8. Sixth printing of the DSM-II (1968) As described by Ronald Bayer, a psychiatrist and gay rights activist, specific protests by gay rights activists against theAPAbegan in 1970. After a vote by theAPAtrustees in 1973, and confirmed by the wider APAmembership in 1974, the diagnosis was replaced with the category of "sexual orientation disturbance". Homosexuality removed as a mental disorder following the protests at the 1974 annual convention of theAPAin San Francisco.
  9. 9. DSM-III (1980) Work began on DSM–III in 1974, with publication in 1980.  DSM-III heralded a paradigm shift in the history of psychiatric diagnosis, with its incorporation of empirically-based, a theoretical and agnostic criteria for psychiatric diagnosis. Other criteria, and potential new categories of disorder, were established by consensus during meetings of the committee, as chaired by Spitzer. DSM–III introduced a number of important innovations, including: Explicit diagnostic criteria Amultiaxial diagnostic assessment system. An approach that attempted to be neutral with respect to the causes of mental disorders. It was developed with the additional goal of providing precise definitions of mental disorders for clinicians and researchers.
  10. 10. DSM-III-R (1987) APA appointed a work group to revise DSM–III, which developed the revisions and corrections that led to the publication of DSM–III–R in 1987. Categories were renamed and reorganized, and significant changes in criteria were made. Six categories were deleted while others were added. Controversial diagnoses, such as pre-menstrual dysphoric disorder and masochistic personality disorder, were considered and discarded. "Ego-dystonic homosexuality" was also removed.
  11. 11. DSM-IV (1994) Numerous changes were made to the classification (e.g., disorders were added, deleted, and reorganized), to the diagnostic criteria sets, and to the descriptive text. A major change was the inclusion of a clinical significance criterion to almost half of all the categories, which required symptoms cause "clinically significant distress or impairment in social, occupational, or other impo rtant areas of functioning". Some personality disorder diagnoses were deleted or moved to the appendix.
  12. 12. Axis I: Clinical Syndromes Described clinical symptoms that cause significant impairment. Disorders were grouped into different ca tegories such as mood disorders, anxiety disorders, or eating disorders. Described long-term problems in functioning that were not considered discrete axis I disorders. These include such things as unemployment, relocation,divorce, or the death of a loved one. Allowed the clinician to rate the client's overall level of functioning. Based on this assessment, clinicians could better understand how the other four axis interacted and the effect on the individual's life. DSM-IV-TR (2000) The DSM-IV-TR described disorders using five different dimensions.  This multiaxial approach was intended to help clinicians and psychiatrists make comprehensive evaluations of a client's level of functioning because mental illnesses often impact many different life areas. Axis II: Personality and Mental Retardation Axis III: Medical Conditions Axis IV: Psychosocial and Environmental Problems Axis V: Global Assessment of Functioning or Child Global Assessment of Functioning These included physical and medical conditions that influence or worsen Axis 1 andAxis II disorders. Some examples include HIV/AIDS and brain injuries.
  13. 13. DSM-5 (2013) Dr. Dilip Jeste, the then President of the American Psychiatric Association, released the Fifth Edition of the Diagnostic and Statistical Manual of Mental Disorders on May 18, 2013 at the 166 th Annual Meeting of theAPAat San Francisco. As the process of developing the manual progressed, the Roman numerical 'V' was replaced by the alpha numerical '5'. This would facilitate subsequent revisions being numbered as 5.1, 5.2 and so forth. It is an authoritative volume that defines and classifies mental disorders in order to improve diagnoses, treatment, and research. It does not claim to be the ultimate or the final word in classification of mental disorders. Some examples of categories included in the DSM-5 include anxiety disorders, bipolar and related disorders, depressive disorders, feeding and eating disorders, obsessive-compulsive and related disorders, and personality disorders.
  14. 14. DSM-5 It is a 947 page manual, divided into three sections and an appendix: Section Includes: Introduction, Instruction on how to use the manual, and a chapter on cautionary of DSM 5. statement for forensic use axis format and considers the relevance of age, gender, and culture. Covers: Self-rated cross-cutting symptom measures for adults, children, and adolescents between age 6 and 17 years. 01 02 03 Section Section Lists: Diagnostic criteria and codes of 22 diagnostic categories. It has a single
  15. 15. Changes in The DSM-5 It eliminated the axis system, instead listing categories of disorders along with a number of different related disorders. Asperger's disorder was removed and incorporated under the category of a utism spectrum disorders. Disruptive mood dysregulation disorder was added, in part to decrease over-diagnosis of childhood bipolar disorders. Several diagnoses were officially added to the manual including binge eating disorder, hoarding disorder, and premenstrual dysphoric disorder. It is based on explicit disorder criteria, which taken together constitute a “nomenclature” of mental disorders, along with an extensive explanatory text that is fully referenced for the first time in the electronic version of this DSM.
  16. 16. Conclusion DSM serves as the principal authority for psychiatric diagnoses. It also provides a common language for researchers to study the criteria for potential future revisions and to aid in the development of medications and other interventions. DSM is an important tool for those who have received specialized training and possess sufficient experience are qualified to diagnose and treat mental illnesses. The strength of each of the editions of DSM has been "reliability". The weakness is its lack of validity . While DSM has been described as a "Bible" for the field, it is, at best, a dictionary, creating a set of labels and defining each.
  17. 17. References:  American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 5th ed. Arlington: American Psychiatric Association; 2013  Alina Surís et al.(2016) The Evolution of the Classification of Psychiatric Disorders  Vahia V. N. Diagnostic and statistical manual of mental disorders 5: A quick glance. Indian J Psychiatry 2013;55:220-3  http://apsychoserver.psych.arizona.edu/JJBAReprints/PSYC621/Blashfield_etal 2014_ARCP.pdf  https://dhss.delaware.gov/dsamh/files/si2013_dsm5foraddictionsmhandcrimi naljustice.pdf  http://pepsic.bvsalud.org/pdf/psipesq/v8n1/09.pdf  https://tpb.psy.ohio-state.edu/5681/notes/dsm/01.htm  https://www.psychiatry.org/psychiatrists/practice/dsm/history-of-the-dsm  https://www.verywellmind.com/the-diagnostic-and-statistical-manual-dsm- 2795758  https://www.sciencedirect.com/topics/social-sciences/diagnostic-and-

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