DSM IV-R
Discussion Board to answer:
The DSM IV-R used a multi-axial system and a Global Assement of Functioning Scale to
diagnose and asess level of fucntioning respectively. In the DSM 5, all mental health diagnoses
are now under section 2 and level of functioning is left up to the World Health Organization
Disability Assessment Schedule. After reading the notes from course content on the changes
between the IV_R and the DSM 5, talk about which of those changes you feel is better and
which you feel maybe should have been left
Respond to Classmate 1:
After reading the notes from course content on the changes between the DSM IV_R and the
DSM 5, talk about which of those changes you feel is better and which you feel maybe should
have been left?
I am new to the DSM-IV-R and the DSM-5. So, I had to go back and look at the DSM IV-R. I
believe the DSM-5 is a great tool for diagnostic criteria and its text are primarily designed to
assist clinicians in conducting clinical assessment, case formulation, and treatment planning. If
you were trained during the era of DSM IV-R you would have used the multi-axial system and a
Global Assessment of Functioning Scale a assess level of functioning to diagnose clients. To me
it looks like the DSM-5 should be easier to navigate through and it is less confusing. Subtypes
have been replaced with presentation specifiers. It Creates a common language between
clinicians and easier to diagnose clients. Examples is the verbiage in diagnose between the
simultaneous presence of two chronic diseases or conditions in a patient is now just one. Like
Anxiety disorders – The criteria that individuals over the age of 18 realize that their anxiety is
excessive and unreasonable has been eliminated for Specific Phobia and Social Phobia. Slide 27
New Disruptive Mood Dysregulation Disorder for children up to 18 years of age addresses the
overdiagnosis of bipolar disorder in children. This is a good change, now children won’t be over
medicated and labeled.
However, I am on the fence about Autism Spectrum Disorder which now encompasses the old
DSM IV diagnoses, Autistic disorder (Autism) Asperger’s Disorder, Childhood Disintegrative
Disorder, Rhett’s Disorder, Pervasive Developmental Disorder. They all share similar symptoms,
they have different symptoms, but they are not all the same. Some are said to be genetic and
some are neurological, but they all have issues functioning socially. In my opinion the GAF
(Global Assessment of Functioning Scale) should still be used for diagnosing like PTSD OR
DEPRESSION. Sometimes a person is dealing with a traumatic event during a period of time not
for a lifetime and the GAF (Global Assessment of Functioning Scale) would allow for a clinician
to observe the client for about 90 days to see if the symptoms have decreased or increased.
Reference
Alli. (2018, November 11). Pervasive development disorders: What are they? Retrieved May 29,
2020, from https://www.webmd.com/brain/autism/development-disorder
Bhandari, S. (2018, May 20). Asperger’s syndrome: Symptoms, Tests, diagnosis, and treatment.
Retrieved May 29, 2020, from https://www.webmd.com/brain/autism/mental-health-aspergers-
syndrome
Diagnostic and statistical manual of mental disorders (dsm–5). (n.d.). Retrieved May 29, 2020,
from https://www.psychiatry.org/psychiatrists/practice/dsm
Goldberg. (2017, February 07). Chronic depression (dysthymia): Symptoms, treatments, and
more. Retrieved May 29, 2020, from https://www.webmd.com/depression/guide/chronic-
depression-dysthymia#2
Respond to Classmate 2:
This is my second semester of graduate school and the last time I saw the DSM was before 2008
when I completed my B.S in Psychology. According to our notes in course content the changes
were made in order to create a more homogeneous and scientifically valid and reliable set of
criteria for diagnosis. The criteria for individual disorder definitions in the DSM-5 have been
subjected to scientific review and field testing for reliability. Increase comprehensibility and
utility. Formerly high rates of comorbidity across axes, creating an overuse of the NOS criteria.
There were other changes listed in the notes as well. From what I read it appears that the changes
are to make it easier and clearer to diagnose a patient. Also the changes made were to help those
who are diagnosing to communicate better with other professionals.
I feel that the changes which are better are the ones that relate to communication Disorders. It
appears that previously it was a broad and two category disorder (phonological disorder and
stuttering). Now it is the language disorder and contains: speech disorder, child-onset fluency
disorder and social (pragmatic) communication disorder. The last one is new and it related to
persistent difficulties in the social uses of verbal and nonverbal communication. I think this was
a change to the positive as it allows for an additional category that was severely lacking before. It
also seems to identify the disorders better and makes it easier to communicate about them. It is
also apparent that some disorders were moved to different sections or they have been separated
into individual disorders. The restructure makes more sense to me and I feel that it makes for a
clear diagnosis and it is less broad. I also liked that panic attacks can now be listed as a specifier
that it applicable to all DSM-5 disorders. The biggest change for me that I am impressed by was
the Trauma related and stress disorders section. The fact that PTSD and acute stress disorder
have been removed from anxiety disorders and moved to the new chapter is monumental. I am a
police officer and have personally seen and experienced PTSD. I feel that research and
understanding in this area is evolving and growing rapidly. People are taking this serious and it
shows in the restructure of the DSM-5.
I am still very new and trying to understand the material. What I found confusing or was better
left along was the range of severity. It seems to be very broad and could affect those with severe
issues. Having mild symptoms could allow someone to take advantage of a diagnosis. In my
profession I see where people take advantage any way they can, you give them an inch and they
take a foot. I would hope with better understanding of the DSM-5 my opinion on this part will
change or that maybe I am interpreting this through life experiences and not through an unbiased
opinion.
