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Perspectives of Abnormal Psychology
- Behavioral- the perspective focus on observable behaviors
- Medical- the perspective focus on biological causes on mental illness
- Cognitive- the perspective focus on how internal thoughts, perceptions and reasoning contribute to psychological disorders
- The standard abnormal psychology and psychiatry reference book in North America is the Diagnostic and Statistical Manual of the American Psychiatric Association. The current version of the book is known as DSM IV-TR. It lists a set of disorders and provides detailed descriptions on what constitutes a disorder such as Major Depressive Disorder or anxiety disorder. It also gives general descriptions of how frequently the disorder occurs in the general population, whether it is more common in males or females and other such facts.The DSM-IV TR identifies three key elements that must be present to constitute a mental disorder. These elements include:
- Symptoms that involve disturbances in behavior, thoughts, or emotions.
- Symptoms associated with personal distress or impairment.
- Symptoms that stem from internal dysfunctions (i.e. specifically having biological and/or psychological roots)
Clinical disorders, which would include major mental and learning disorders. These disorders make up what is generally acknowledged as a disorder including major depressive disorder, generalized anxiety disorder, schizophrenia, and substance dependence. To be given a diagnosis for a disorder in this axis the patient must meet the criteria for the particular disorder which is presented in the DSM in that particular disorders section. Disorders in this axis are of particular importance because they are likely to have an effect on the individual in many other axes. In fact the first 3 axes are highly related. This axis is similar to what would be considered an illness or disease in general medicine.
Personality Disorders and a decrease of the use of intellect disorder. This is a very broad axis which contains disorders relating to how the individual functions with the world around him or herself. This axis provides a way of coding for long lasting maladaptive personality characteristics that could have a factor in the expression or development of a disorder on Axis I although this is not always the case. Disorders in this axis include disorders such as antisocial personality disorder, histrionic personality disorder, and paranoid personality disorder. Mental retardation is also coded in this axis although most other learning disabilities are coded in Axis I. This Axis is an example of how the Axes all interact with one another help to give an overall diagnosis for an individual.
General medical conditions and "Physical disorders". The conditions listed here are the ones that could potentially be relevant to the managing or understanding of the case. Axis III is often used together with an Axis I diagnosis to give a better rounded explanation of the particular disorder. An example of this can be seen in the relationship between major depressive disorder and unremitting pain caused from a chronic medical problem. This category could also include use of drugs and alcohols as these are oftentimes symptoms of a disorder themselves such as substance dependence or major depressive disorder. Due to the nature of Axis III it is often recommended that the patient visit a medical doctor when he or she is being assessed in order to determine if the problem could potentially require medical intervention such as surgery. When the first 3 axes are used multiple diagnosis are often found which is actually encouraged by the DSM.
Psychosocial/environmental problems, which would contribute to the disorder. Axis IV is used to inspect the broader aspects of a person’s situation. This axis will examine the social and environmental factors that could affect the person’s diagnosis. Stressors are the main focus of this axis and particular attention is paid to stressors that have been present in the past year; however it is not a requirement that the stressor had to form or continued in the past year. Due to the large number of potential stressors in an individual’s life, therapist often find such stressors via a checklist approach which is encouraged by the DSM. An example of the checklist approach would be examine the individual’s family life, economic situation, occupation, potential legal problems and so on. It is crucial that the patient is honest in this section as environmental factors can have a huge impact on the patient especially in certain schools of therapy such as the cognitive approach.
Global assessment of functioning (often referred to as GAF) or "Children's Global Assessment Scale" (for children and teenagers under the age of 18). Axis V is a score given to the patient which is designed to indicate how well the individual is handling their situation at the current time. The GAF is based on a 100 point scale which the examiner will use to give the patient a score. Scores can range from 1 to 100 and depending on the score on the GAF the examiner will decide the best course of action for the patient.“According to the manual, scores higher than 70 indicate satisfactory mental health, good overall functioning, and minimal or transient symptoms or impairment, scores between 60 and 70 indicate mild symptoms or impairment, while scores between 50 and 60 indicate moderate symptoms, social or vocational problems, and scores below 50 severe impairment or symptoms”. As GAF scores are the final Axis of the DSM the information present in the previous 4 axes are crucial for determining an accurate score.