While the proportion of mental health problems is approximately the same for younger adults, older adults are more vulnerable than younger adults to develop psychological problems resulting from factors that impact the quality of life such as stress, ill health, loss, decline in cognitive skills, and changes in living situations.
Some of the revisions are seen as positive. However, there are several that are raising concern among clinicians. I have presented dozens of workshops on the DSM-5 and have trained thousands of clinicians in its use.
People have told me that they are overwhelmed, confused, and even a bit disoriented by all the changes. They have some anxiety with the upcoming conversion to the DSM-5 and the many ways it will affect them as they diagnose people, and the major adjustments that agencies will need to make to adapt.
No More Multiaxial System The change that has been universally upsetting to people in my workshops is the loss of the multiaxial system.
Axis I listed clinical disorders. Axis II included personality disorders and mental retardation. Axis III was where we listed general medical conditions.
Axis IV was where we described psychosocial and environmental problems. Axis V was the place to put the Global Assessment of Functioning the GAFwhich summarized how severely a person was affected by his or her mental health condition.
Those five aspects of a diagnosis are no longer going to be listed in the diagnostic description. Instead, diagnoses will just be recorded in a list, with the principle diagnosis being listed first, and others following in order of importance to treatment.
We can reflect contributing factors by using appropriate V codes, and these factors will be reflected in the body of the assessment information as alwaysbut they will no longer be part of the diagnosis. I really like being able to look at the five axes of a diagnosis and being able to get a feel for the person.
Shannon comes in to see you for an initial appointment.
She has been less patient and engaged with her friends and family. She has a long history of disrupted relationships, beginning in early adulthood. Shannon often struggles with her identity and seems to reinvent herself periodically.
Sometimes when the stress is too much, she ends up cutting herself, not in a suicide attempt, but to stop her emotional pain.
Unfortunately, Shannon has developed multiple sclerosis. She is still able to be independent, but has balance problems and needs to make some decisions about treatment options. Along with a recent job loss, her financial situation has gotten desperate. She has been evicted from her apartment because she was so behind in her rent, and she is now staying with various friends.
This is now considered high-functioning autism, and will be incorporated as part of autism spectrum disorder. This change has been one of the most controversial of the whole revision. Many feel that their condition, which they may have come to accept, is being replaced with a term that they are less than enthusiastic about.
Noah is a year-old whose parents bring him to see you.
They have often wondered why he seems so different from their other two children. Noah has few friends, makes little eye contact, and spends a lot of time alone. Noah has a keen interest in movies and superheroes.
He can quote long pieces of dialogue from his favorite movies, which he has watched many times. To fall asleep at night Noah usually bounces on his bed enough to make the mattress jiggle a bit.
His parents sometimes notice that he rocks himself gently, especially when he is feeling a lot of stress. Noah likes to write stories about superheroes that he creates, and he is interested in clocks and lamps.
You would diagnosis him with autism spectrum disorder, and you would indicate the severity of that.Developmental coordination disorder (DCD), also known as developmental dyspraxia or simply dyspraxia, is a chronic neurological disorder beginning in childhood.
It is also known to affect planning of movements and co-ordination as a result of brain messages not being accurately transmitted to the body. Impairments in skilled motor movements per a child's chronological age interfere with.
The fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM), the DSM-5, was approved by the Board of Trustees of the APA on December 1, Published on May 18, , the DSM-5 contains extensively revised diagnoses and, in some cases, broadens diagnostic definitions while narrowing definitions in other cases.
The DSM-5 is the first major edition of the manual in. I purchased this textbook brand new only due to the inclusion of the access code for online content. In every other text I've had with online access, there is an electronic copy of the textbook and then varying amounts of other student resources (e.g., review questions, assessment videos, etc.).
Nov 07, · In moderate doses caffeine has mainly positive effects for most people. But it increases production of cortisol, which can lead to health problems including anxiety, weight gain and heart disease.
Using the DSM-5 in the Differential Diagnosis of Depression Wayne Bentham, MD Clinical Assistant Professor Department of Psychiatry and Behavioral Sciences. In lieu of the NOS diagnosis, the DSM-5 offers two options when these situations arise. The other specified and unspecified disorders should be used when a provider believes an individual’s impairment to functioning or distress is clinically significant, however, it .