Dsm-Iv Appendix G Case Study

Axia College Material
Appendix G

The DSM-IV

The DSM-IV is an important tool for clinicians. It provides a standard for diagnoses to be standardized across psychology; however, the DSM-IV is not as precise for diagnosing personality disorders as some psychologists would like.

Give an example of each of the following problems identified in your readings and explain how these problems could negatively affect a diagnosis.

1. Some criteria used for reaching a diagnosis cannot be observed directly.

The Substance Abuse and Mental Health Administration has conducted national surveys to monitor alcohol use prevalence and trends since the early 1960s, very few of these surveys have measured psychiatric syndromes that constitute alcohol dependence (Department of Health and Human Services, 1993; Johnston et al., 1992). Estimates of alcohol use alone are not informative in determining the magnitude and characteristics of that subgroup of alcohol users who are experiencing serious alcohol-related problems that require treatment or in determining the critical relationship between alcohol use and dependence. Therefore, in order to diagnosis it correctly; a thorough detailed correlation must be assessed.

2. Personality disorders can be similar to each other.
DSM-IV cannot be used to diagnose most patients being treated for personality problems.
The range of axis II should be broadened to encompass the range of personality pathology seen in clinical practice. Personality pathology is difficult to measure. Current instruments have problems with validity and rely on a direct-question format that may be inappropriate for the assessment of personality. In addition, they are designed specifically to address current DSM-IV categories and criteria, which limit their utility in making meaningful revisions of those criteria. These problems suggest the need for consideration of alternative approaches to assessing and revising axis
II.

3. People with different personalities can be given the same diagnosis.

One example of people with different personalities that are given the same diagnosis is bi-polar disorder and ADHD/ADD. Some studies accurately rated people who exhibited features of histrionic PD as being higher in extraversion and found them to be more likeable. Laypersons can make accurate judgments regarding some personality characteristics associated with personality disorders, even on the basis of minimal information. These perceptions may influence ways in which people respond to others with PDs (Department of Health and Human Services, 1993; Johnston et al., 1992). To assess the two in many ways can be a difficult task. Through different test, cognitive, and biomedical, an assessment could be gathered that would be more likely than not. These diagnoses are not easy to obtain. After all, many of them have some of the same symptoms. It is imperative that the clinician that determines the diagnosis have gone through all measures to determine a more explainable outcome.

4. Do you think that personality disorders are true mental illnesses? Why or why not?

The risk of violence may be understood in terms of four fundamental personality dimensions: 1) impulse control, 2) affect regulation, 3) narcissism, and 4) paranoid cognitive personality style. Low impulse control and affect regulation increase the risk for violence across disorders, especially for primary and co-morbid substance abuse disorders. By contrast, paranoid cognitive personality style and narcissistic injury increase the risk for violence, respectively, in persons with schizophrenia spectrum disorders and in samples of both college students and individuals with personality disorders. Being that my research supports the hypothesis that these four fundamental personality dimensions operate jointly, and in varying degrees, as clinical risk factors for violence among groups with these classes of mental disorders, leads me to determine that many times personality disorders can truly become serious mental illnesses.