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What are the 6 steps of differential diagnosis?
- 1. Rule our Substance Abuse Etiology
- 2. Rule out Etiology due to General Medical Condition
- 3. Determine the Specific Primary Disorder
- 4. Differentiate Adjustment Disdorder from NOS category
- 5. Establish the Boundary with no Mental Disorder
- 6. Rule out Factitious Disorder or Malingering
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What are the 5 axes of diagnosis for the DSM-IV-TR?
- I. Clinical Disorder
- II. Personality Disorders and MR
- III. Medical Conditions
- IV. Psychosocial and Environental problems
- V. GAF (Global Assessment of Functioning Scale)
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Is the DSM categorical or dimensional?
Are disorders homogenous or heterogeneous?
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What is a mental disorder?
A mental disorder is conceptualized as a clinically significant behavioral or psychological syndrome or pattern that occurs in an individual and that is associated with present distress, disability, or with a significantly increased risk of suffering death, pain, disability, or an important loss of freedom.
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Is it possible to have a medical condition, substance abuse, and primary disorder occurring all at one time?
How would you indicate this using the DSM?
- Yes.
- Use the NOS (Not Otherwise Specified) category to indicate multiple, concurrent etiologies.
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Can you rely only upon a psychological test to arrive at a DSM diagnosis?
Why not?
- No.
- Psychological tests do not cover the criteria content (the specific criteria for a DSM diagnosis).
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What are the ONLY 2 categories of mental disorders coded on Axis II?
Mental Retardation and Personality Disorders
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What are the characteristics of disorders on Axis II that set them apart from Axis I disorders?
- Learned/not organic
- Little or no response to medication
- Ego syntonic (consistent with sense of self) vs. dystonic
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Name the major cluster of personality disorders and their basic characteristics.
- Odd/Eccentric
- Dramatic/Emotional
- Anxious/Fearful
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In order to be diagnosed with a personality disorder, a patient must have active symptoms for how long?
There is no absolute timeframe; it is mostly a matter of clinical judgment. A timeline of 1-3 years of pervasive symptoms can be helpful, but only when considered along with detailed history and content.
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