EVOLUTION OF THE DIAGNOSTIC STATISTICAL MANUAL OF MENTAL ILLNESS (DSM)|My homework helper

Posted: March 8th, 2023

After studying Module 2: Lecture Materials & Resources, (SEE ATTACHED) submit one QUESTION  for the week.

Instructions

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  1. Each student should post a QUESTION regarding the  content designed for the Muddy Point assignment by Thursday at 11:59 pm.
  2. The muddy point question must be UNIQUE and ASSOCIATED WITH THE CONTENT PROVIDED AS ATTACHMENT .  Questions SHOULD NOT BE EASILY FOUND with an internet search or clearly defined in your textbook or other course resources.  The best muddy point question asks to DESCRIBE, DISTINGUISH, EXPLAIN, SUMMARIZE AND TRANSLATE CONTENT THAT NEED FURTHER CLASSIFICATION.
  3. The student may use the required course materials or another scholarly resource. However, the PAGE NUMBER  to any textbook MUST BE INCLUDED to receive full credit.

REQUIREMENTS:

at least 500 words ( 2  pages of content) formatted and cited in current APA style 7 ed  with support from at least 3 academic sources which need to be journal articles or books from 2019 up to now. NO WEBSITES allowed for reference entry. Include doi, page numbers, etc. Plagiarism must be less than 10%

EVOLUTION OF THE DIAGNOSTIC STATISTICAL MANUAL OF MENTAL ILLNESS (DSM)

NUR 620: Psychiatric Management I

History of the DSM

Prior to 1980, diagnoses were made based on biological or psychoanalytic theory

Introduction of DSM-III in 1980 revolutionized classification

Classification newly relied on specific lists of symptoms, improving reliability and validity

Diagnoses classified along five “Axes” describing types of problems (e.g. disorder categories, health problems, life stressors)

DSM-IV introduced in 1994

Eliminated previous distinction between psychological vs. organic mental disorders

Reflected appreciation that all disorders are influenced by both psychological and biological factors

DSM-IV-TR (“text revision” of DSM-IV) incorporated new research and slightly altered criteria accordingly

Previously, psychopathology was categorized along five axes. Axis I = Clinical syndromes (most psychological disorders). Axis II = personality disorders and mental retardation (more pervasive), Axis III = relevant medical conditions. Axis IV = Relevant life stressors. Axis V = Global assessment of functioning (0-100 rating). DSM-5 no longer uses the axis system. This information is still taken into account by clinicians, but it’s not discussed in terms of axes.

2

The DSM-5

Basic characteristics

Removed axial system

Clear inclusion and exclusion criteria for disorders

Disorders are categorized under broad headings

Empirically-grounded, prototypic approach to classification

New disorder labels are created when groups of individuals are identified whose symptoms are not adequately explained by existing labels

Example: Premenstrual dysphoric disorder

New disorder in DSM-5

Relatively rare and severe emotional disturbance present during the majority of premenstrual phases

Example of new disorder that did not make it into the DSM-5: Mixed anxiety-depression

Insufficient research to justify the creation

DSM-5 represented some changes to classification. One major change is that the Axis system used in DSM-IV-TR was eliminated. NOTE: PMDD is not the same as the colloquial term “PMS”; rather, it is much more persistent, severe and interfering.

For a detailed outline of all changes in DSM-5, see Boettcher et al. 2013 – A Student’s Guide to Important Changes in DSM-5, part of the instructor resources for Barlow/Durand Abnormal Psychology and Durand/Barlow Essentials of Abnormal Psychology.

3

Issues with Classifying and Diagnosing Psychological Disorders

Widely used classification systems

Diagnostic and Statistical Manual of Mental Disorders (DSM)

Updated every 10 to 20 years

Current edition (released May 2013): DSM-5

Previous edition called DSM-IV-TR

ICD-10

International Classification of Diseases (ICD-10)

Published by the World Health Organization (WHO)

Unresolved Issues in DSM-5

The problem of comorbidity

Defined as two or more disorders for the same person

High comorbidity is extremely common

Emphasizes reliability, maybe at the expense of validity (i.e., may artificially “split” diagnoses that are very similar)

Dimensional classification:

DSM was intended to move toward a more dimensional approach, but critics say it does not improve much from DSM-IV

Labeling issues and stigmatization

Some labels have negative connotations and may make patients less likely to seek treatment

Discussion Tip: Have students discuss how these problems have changed over time and across diagnoses. Are there differences within this culture in terms of demographic factors (i.e., SES, ethnicity, geography, age)?

THE PSYCHIATRIC INTERVIEW

NUR 620| Psychiatric Management I| Module 2

NOTE:

To change the image on this slide, select the picture and delete it. Then click the Pictures icon in the placeholder to insert your own image.

6

Preparing For the Interview

NUR 448

Meet with patients during a consistent time of day, week

Make you space comfortable for you and the patient

Arrange your chair so you can see the clock

Align your chair higher than the patient’s

Signs of an engaged interviewer:

Relaxed

Unhurried

Good eye contact,

Alert to verbal and non-verbal cues

Chief Complaint

What brought the patient in (Why now)? Patient’s own words

OLDCARTS

Onset

Location

Duration

Character

Aggravating Factors

Relieving Factors

Timing Severity

Is there an emergency that should be addressed immediately?

Physical aggression

Self harm or suicide attempt

Alcohol or benzodiazepine withdrawal

Failure to eat or sleep deprivation

Social Versus Therapeutic Communication

Social

Disclosure can be equal

Spontaneous

Meets personal needs of both

Confidentiality might or might not be observed.

Listener could be biased

Therapeutic

Patient-centered

Planned

Directed by professional

Meets patient’s needs

Guides the patient to explore personal issues

Listener objective

Information shared with health team

Techniques

Therapeutic Techniques

Offering self

Active listening

Silence

Empathy

Questioning

 

SOLUTION

The Diagnostic and Statistical Manual of Mental Disorders (DSM) is a widely used tool for the classification and diagnosis of mental illnesses. It has undergone several revisions since its inception in 1952, reflecting changes in diagnostic criteria and understanding of mental illness. The purpose of this paper is to discuss the evolution of the DSM and the impact it has had on the field of psychiatry.

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