Bekah Dsm 5 Basics, Introduction:

Front 1

Basics provides:

Back 1

1. Summary of structure

2. How it works with ICD-11

3. Transition to a non-axial system/ assessing disability

4. History, revision process, organization, cultural, gender, use of specified and unspecified, multiaxial system, online stuff

Front 2

Purpose of DSM

Back 2

1. To provide consistent, strong, and objective scientific validators of individual DSM disorders.

2. Boundaries between disorders are fluid/porous.

3. Science continues to evolve - cognitive neuroscience, brain imaging, epidemiology and genetics.

4. To be an easy tool for not only clinicians but also non-mental health specialists such as PCP

Front 3

Revision process - who and when?

Back 3

1. APA, World Health Organization (WHO), World Psychiatric Assoc, Nat'l Inst of Mental Health (NIMH), Nat'l Inst on Drug Abuse, Nat'l Ins on Alcoholism and Alcohol Abuse - 400 ppl, 39 countries.

2. Used website to put draft out for review and feedback. Approved in Dec 2012.

3. collaborate with ICD-11 to be a more holistic, international approach. ICD-11 coming out in October?

Front 4

Structure of DSM V - Why and what's new?

Back 4

1. Order of diagnosis is based on science and the relationship between the groups.

2. Section III - scientific evidence is not yet available to support widespread clinical use. Further study needed.

3. Clustering of disorders according to internalizing and externalizing factors.

4. To improve clinical utility it is organized on developmental and lifespan considerations.

5.Classification/Organization: (Neurodevelopment and schizoprhenia earliest to bipolar, depressive, anxiety disorders in adolescence to neurocognitive disorders in later life)

6. after neurodevelopmental disorders it is grouped by internalized disorders (emotional and somantic)

Front 5

Cultural-bound syndrome was replaced with:

Back 5

1. Cultural Syndrome-cluster or group of co-occuring, invariant symptoms found in a specific cultural group, community, or context. Patterns of distress or illness.

2. Cultural idiom of distress-Term or phrase or way of communicating suffering, distress, concerns due to social circumstances.

3. Cultural explanation or perceived cause-label, attribution, feature of an explanatory model that provides a culturally conceived etiology or cause for symptoms, illness or distress.

*These all suggest ways to understand/explain.

Front 6

Cultural issues to consider when using the DSM V:

Back 6

1. Boundaries between normality and pathology vary.

2. Thresholds of tolerance differ.

3. Meanings/habits/traditions, coping strategies, acceptance or rejection of a diagnosis, and conduct at encounter - are all influenced by culture.

4. Mental disorders are defined in relation to cultural, social and familial norms and values.

5. provides interpretation frameworks affecting the symptoms, signs and behaviors

Front 7

Gender differences as they relate to diagnosis:

Back 7

1. Sex differences- individual's reproductive organs and XX or XY chromosomal complement.

2. Gender differences-biological sex as well as individual's self-representation (psychological, behavi0ral, social).

3. Important in 3 ways- risk factor, risk of development of disorder, influence likelihood of symptoms..

4. Affects the experience of the disorder.

5. Reproductive life cycle events - estrogen, testosterone.

Front 8

Why should the social worker be familiar with the perspective of psychopathology?

Back 8

1. Derives from the medical model

2. interdisciplinary practice settings and communication with other professionals

3. The DSM is a shared meaning system amongst healthcare professionals

4. The social worker needs to be "bilingual" to operate within the system and to make change from outside

Front 9

The DSM is heavily influenced by what perspective?

Back 9

1.Medical model (Biomedical Psychiatry)-suffering is illness and has biological origin.

2. illness can be identified through objective signs and treated through physical means

Front 10

What to know about the DSM

Back 10

1. Defines mental illness as intersection between biological vulnerabilities, stressors and deviance in behavior from sociocultural norms resulting in distress for the individual and/or impairment in psychological or social functioning.

2. a compilation, a categorization of descriptions of diseases of synromes identfiable by signs and symptoms

3. what's important to the clinician is the degree/severity of the deviance of the illness from the norm and the differentiation from other forms of mental illness

Front 11

What is a symptom?

Back 11

1. subjective complaint of patient

Front 12

What is a sign?

Back 12

1. objective, observable behavior

Front 13

Strengths and Weaknesses of this conceptualization

Back 13

1. illness-deviance, who defines the norm?

2. no definition of what constitutes healthy psychological function

3. surface descriptions-no consensus, theoretical support for underlying disease mechanism as of yet

4. How does it inform the clinician's attempt to help? Is environment taken into consideration? Client's strengths?

Front 14

Questions to ask when assessing suffering

Back 14

1. How does environment impact manifestation of illness?

2. What is the quality of relationships in the client's support network and family functioning?

3. Has the client been able to meed basic needs?

Front 15

Cultural Assessment

Back 15

1. Be mindful of bias, misdiagnosis, lack of awareness of cultural standards of what's considered pathological

2. find an informant who understands the standards of behavior

3. language: what language do they express emotions and distress in?

4. Degree of acculturation: to what extent is the individual adapted to and identified with host culture?

5. Truama: is the client a victim

6. roles around illness: role of the "sick" and the "healer"; is illness addressed?

Front 16

Things to know

Back 16

* diagnosis is the construct of the Therapist not an absolute truth

* stigma is real and shame sticks

* feeling understood is the essence of being connected

* awareness of her affect on others began her healing

* noticing the healthier, positive part of clients

* put labels aside and see the person as a whole

Front 17

How will the diagnoses be used?

Back 17

a. accessing services

b. treatment planning

c. systemic treasures necessitating the services (insurance reimbursement)

Front 18

To what degree does assigning the diagnosis empower or stigmatize the client?

Back 18

a. how will other people react

b. how will the client react

c. can the diagnosis affect how people treat them or be used against them

Front 19

What is the meaning of the diagnosis to the client?

Back 19

a. does the client experience relief, or shame of being labelled

b. does it cause the client to disavow responsibility to take care of oneself or how they relate to others?

i. does it shut down or open up the client to further exploration

Front 20

4. How does the act of diagnosis impact the relationship between the client and the clinician?

Back 20

a. does it open up a partnership?

Front 21

5. to what extent does the dx correspond to or conflict with a theoretical perspective that informs treatment?

Back 21

a. client's motivation

Front 22

6. How is the client's experience of mental illness different from another client's experience of the same illness?

Back 22

a. how to individual treatment and be aware of the contextual experience of the client

b. individualizing a solution to the problem not stigmatizing the client

Front 23

7. what is the dividing line between what can be labelled a mental illness and what is un usual behavior?

Back 23

a. resist political pressure

Front 24

8. How will you maintain a vision of your client as a person and resist "othering" or distancing through labeling/language?

Back 24

a. where is the line when the client becomes a person and a category

b. how will you maintain that category

c. how will you utilize language with client