17/01/2025
The Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) was published in 1994 by the American Psychiatric Association (APA). Here's an overview:
✅Key Features
1. 👉Diagnostic criteria*: The DSM-IV provided standardized criteria for diagnosing mental health conditions, ensuring consistency across clinicians and settings.
2. 👉Multiaxial assessment*: The manual introduced a multiaxial assessment system, which evaluated patients on five axes:
1. Axis I: Clinical disorders (e.g., depression, anxiety)
2. Axis II: Personality disorders (e.g., borderline, narcissistic)
3. Axis III: General medical conditions (e.g., diabetes, hypertension)
4. Axis IV: Psychosocial and environmental problems (e.g., relationship issues, financial difficulties)
5. Axis V: Global Assessment of Functioning (GAF) score, which rated a patient's overall functioning
3. 👉Categorical approach*: The DSM-IV used a categorical approach, grouping conditions into distinct categories (e.g., anxiety disorders, mood disorders)
✅Conditions Covered
The DSM-IV covered a wide range of mental health conditions, including:
1. 👉Disorders usually first diagnosed in infancy, childhood, or adolescence* (e.g., ADHD, autism)
2. 👉Delirium, dementia, and amnestic and other cognitive disorders*
3. 👉Mood disorders* (e.g., depression, bipolar disorder)
4. 👉Anxiety disorders* (e.g., generalized anxiety, panic disorder)
5. 👉Somatoform disorders* (e.g., somatization disorder, hypochondriasis)
6. 👉Factitious disorders* (e.g., Munchausen syndrome)
7. 👉Dissociative disorders* (e.g., dissociative amnesia, dissociative identity disorder)
8. 👉Sexual and gender identity disorders* (e.g., s*xual dysfunctions, gender identity disorder)
9. 👉Eating disorders* (e.g., anorexia nervosa, bulimia nervosa)
10. 👉Sleep disorders* (e.g., insomnia, sleep apnea)
11. 👉Impulse-control disorders not elsewhere classified* (e.g., pathological gambling, pyromania)
12. 👉Adjustment disorders*
✅Criticisms and Controversies
The DSM-IV faced criticisms and controversies regarding:
1. 👉Over-medicalization*: Concerns that the manual pathologized normal human experiences.
2. 👉Lack of cultural sensitivity*: Criticism that the manual did not adequately address cultural differences and nuances.
3. 👉Overemphasis on biological factors*: Concerns that the manual prioritized biological factors over psychological and social factors.
