Dsm-Iv & 5

Abnormal Psychology in a
Changing World
SEVENTH EDITION
Jeffrey S. Nevid / Spencer A. Rathus / Beverly Greene
Chapter 3
(Pp 69-77)
Classification and
Assessment of
Abnormal
Behavior
HOW ARE ABNORMAL BEHAVIOR
PATTERNS CLASSIFIED?
The DSM was introduced in 1952. The latest version, published in
2013, is the DSM-5.
Another common system of classification, published by the World

Health Organization, is used mainly for compiling statistics on the
worldwide occurrence of disorders: the International Statistical
Classification of Diseases and Related Health Problems (ICD),
which is now in its tenth revision (the ICD-10).
The DSM-V is compatible with the ICD, so that DSM diagnoses

could be coded in the ICD system as well.
HOW ARE ABNORMAL BEHAVIOR
PATTERNS CLASSIFIED?
In its third edition, the CCMD (Chinese Classification of

Mental Disorders) maintains a focus on issues that are of
interest to Chinese culture.
Some disorders identified in the ICD-10 and the DSM-5 that

are not common in China (ie, anorexia nervosa) are left out;
others are included that appear to be culture-bound
disorders (ie, ego-dystonic homosexuality).
The DSM and Models of Abnormal
Behavior
The DSM system, like the medical model, treats abnormal

behaviors as signs or symptoms of underlying disorders or
pathologies.
However, the DSM does not assume that abnormal behaviors

necessarily reflect biological causes or defects.
The authors of the DSM recognize that their use of the term mental
disorder is problematic because it perpetuates a long-standing but
dubious distinction between mental and physical disorders.
Features of the DSM
The DSM is descriptive, not explanatory.
It describes the diagnostic features—or, in medical terms,

symptoms—of abnormal behaviors.
It does not attempt to explain their origins or adopt any particular

theoretical framework, such as psychodynamic or learning theory.
Features of the DSM
The DSM IV recommended that clinicians assess an individual’s
mental state according to five factors, or axes. Together the five
axes provide a broad range of information about the individual’s
functioning, not just a diagnosis.
The system contained the following axes (see textbook):
Axis I Clinical Disorders and Other Conditions That May

Be a Focus of Clinical Attention.
Axis II Personality Disorders and Mental Retardation.
Axis III General Medical Conditions.
Axis IV Psychosocial and Environmental Problems.
Axis V Global Assessment of Functioning.
THE DSM-5 HAS MOVED TO A

NONAXIAL DCUMENTATION OF DIAGNOSIS
Features of the DSM
Features of the DSM
Culture-Bound Syndromes
Culture-bound syndromes - Patterns of abnormal behavior
found within only one or a few cultures.
Culture-bound syndromes may reflect exaggerated forms of

common folk superstitions and belief patterns within a
particular culture.
Culture-bound syndromes in the United States include anorexia

nervosa and dissociative identity disorder (formerly called
multiple personality disorder).
Culture and Psychology
• If all abnormal behaviors were entirely etic in
their expression and presentation, then creating
reliable and valid diagnostic categories would not
be a problem
• DSM-5 does not require an assessment of

cultural elements that may be necessary to
recognize and classify a culture-bound syndrome
• Local diagnostic systems (CCMD) have been

created to address the problem of the lack of
cultural considerations in the assessment of
mental disorders
Culture and Psychology
• It can be difficult to use a psychological

assessment from one culture to another
• Overpathologizing and underpathologizing can

be problems if a clinician does not understand a
person’s culture
Evaluating the DSM System
To be useful, a diagnostic system such as the DSM must
demonstrate reliability and validity.
Reliability - In psychological assessment, the consistency of a

measure or diagnostic instrument or system.
Validity - The degree to which a test or diagnostic system

measures the traits or constructs it purports to measure.
Advantages and Disadvantages of the
DSM System
The major advantage of the DSM may be its designation of specific
diagnostic criteria.
Critics challenge the utility of particular symptoms or features

associated with particular syndromes or of specified diagnostic
criteria.
Another concern is that the medical model focuses on categorizing

psychological (or mental) disorders rather than describing people’s
behavioral strengths and weaknesses.
Advantages and Disadvantages of the
DSM System
Critics also complain that the DSM system might stigmatize people
by labeling them with psychiatric diagnoses.
Sanism - The negative stereotyping of people who are identified as

mentally ill.
The DSM system, despite its critics, has become part and parcel of
the everyday practice of most U.S. mental health professionals.
What are some possible consequences
of being labeled with a “mental illness”?
A Continuum of Mental Illness
(Dr. Tom Burish, 1977)
Normal Neurotic Psychotic

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Abnormal Psychology in a

Another common system of classification, published by the World

The DSM-V is compatible with the ICD, so that DSM diagnoses

In its third edition, the CCMD (Chinese Classification of

Some disorders identified in the ICD-10 and the DSM-5 that

The DSM system, like the medical model, treats abnormal

However, the DSM does not assume that abnormal behaviors

The DSM is descriptive, not explanatory.

It describes the diagnostic features—or, in medical terms,

It does not attempt to explain their origins or adopt any particular

The system contained the following axes (see textbook):

Axis I Clinical Disorders and Other Conditions That May

THE DSM-5 HAS MOVED TO A

Culture-bound syndromes may reflect exaggerated forms of

Culture-bound syndromes in the United States include anorexia

• DSM-5 does not require an assessment of

• Local diagnostic systems (CCMD) have been

• It can be difficult to use a psychological

• Overpathologizing and underpathologizing can

Reliability - In psychological assessment, the consistency of a

Validity - The degree to which a test or diagnostic system

Critics challenge the utility of particular symptoms or features

Another concern is that the medical model focuses on categorizing

Sanism - The negative stereotyping of people who are identified as

Normal Neurotic Psychotic

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