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DSM-5 Approach

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  1. Categorical Approach: divides the disorders into types defined by a diagnostic criteria.
    1. Works best when all members of each category are homogeneous
  2. Dimensional Approach: sees behavior in terms of a continuum that rages from healthy to pathological.

Polythetic Criteria Set: to allow for heterogeneity, requires individual to present with only a subset of characteristics from a larger list.

Two people can have same diagnosis, but somewhat different symptoms

DSM-5 has discarded the multiaxial system of diagnosis (formerly Axis I, Axis II, Axis III), listing all disorders in Section II. It has replaced Axis IV with significant psychosocial and contextual features and dropped Axis V (Global Assessment of Functioning, known as GAF). The World Health Organization’s (WHO) Disability Assessment Schedule is added to Section III (Emerging measures and models) under Assessment Measures, as a suggested, but not required, method to assess functioning

GAF: DROPPED

Diagnostic Uncertainty:

  1. Diagnosis Deferred: insufficient info to make a definite diagnosis.
  2. Specific Diagnosis (Provisional): is sufficient information for a tentative, but not firm, diagnosis.

The new version replaces the NOS categories with two options: Other Specified Disorder: specify the reason that the criteria for the specific disorder are not met.

Unspecified Disorder: allows the clinician the option to forgo specification.

Cultural formulation and glossary of culture-bound syndromes.

  1. client’s cultural identity
  2. cultural explanation for the illness
  3. cultural factors relevant to the client’s psychosocial environment and level of functioning.
  4. cultural factors relevant to the relationship between client and therapist
  5. how cultural factors may impact the client’s diagnosis and care.
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