Definitions

- patient vs. client

- clinician

o Ph.D. vs. Psy.D. vs. psychiatrist

Prevalence

- Surgeon General

o 21%

- ECA

o 32% over lifetime

- National Comorbidity Study

o comorbid = co-existing

o 56%

Diagnostic and Statistical Manual of Mental Disorders – IV

(DSM IV)

- diagnostic tool

- atheoretical approach

- treatment plan

- development

o DSM I, 1952

§ vague, poor reliability

§ theoretical approach

o DSM II, 1968

§ Still vague

o DSM III, 1980

§ precise criteria

§ atheoretical approach

o DSM IV, 1994

§ text revision, 2000

- problems

o high comorbidity

o outside influences

Definition of Mental Disorder

- clinically significant

- syndrome

o distress, impairment, risk

o loss of freedom

o behavior violates norms

Assumptions of DSM IV

- medical model

o diseases

- atheoretical orientation

- categorical approach

o yes or no

o dimensional approach

§ continuum

- multiaxial system

o summarize info

o DSM III

o 5 axes

§ 1. Axis I

· clinical disorders

· episodic

§ 2. Axis II

· chronic, long-lasting

· personality disorders, mental retardation

§ 3. Axis III

· medical conditions

· medications used

§ 4. Axis IV

· psychosocial, environmental problems

o negative, positive stressors

o previous year

§ 5. Axis V

· global assessment

· Global Assessment of Functioning (GAF)

o current functioning

o 1 to 100