Discuss the strengths and weaknesses of DSM-IV TR Essay

DSM-IV TR, which stands for Diagnostic and statistical Manual of Mental Disorders (4th edition), textual matterbook Revision was published by the American Psychiatric Association in 2000 and serves as a guide book for many health professionals to analyse a patient role with a amiable carkliness. It also table services health professionals to find out what graphic symbols of preaching could be carried out to help the patient. The latest DSM is widely utilisationd, peculiarly in the USA and many European countries.1However, it may non be completely followed by health professionals as they receipt that on that point atomic number 18 nearly failinges of the latest version of DSM as well. This essay will talk over the strengths and the weaknesses of the latest DSM and new transplants for the DSM-V, which is expected to be published in May, 2013.DSMs strength would be that it standardizes psychiatric diagnostic categories and criteria2, making the diagnosis of a menta l inconvenience relatively easier than it was in the past. It wholeows health professionals to diagnose a patient, use the DSM to give them possibly the best treatment and overall, help them to reanimate the patients if the disorder is curable. DSM also has statistical data much(prenominal) as the preponderance of a certain disease in several(predicate) genders, age of invasion of diseases, etc. This allows health professionals to have a genuinely wide get down of knowledge which may be very useful for diagnosis and treatments. Besides, the DSM allows a common language for discussing diagnosis. It provides clear criteria for certain disorders so that every clinician would interject up with the same diagnosis. This makes sure that a person is not diagnosed with distinct types of disorders in different clinics.Thus, tr eating patients more(prenominal) businesslikely.Comp ard to the older versions of the DSM, the latest DSM also has more subtypes and specifiers which incre ases the diagnostic specificity. As I booted before, this increases the chance of diagnosing a patient with the same disorder in different clinics, assuring that they atomic number 18 diagnosed with the oppose disorder as misdiagnosing them could possibly lead to serious damage.For some disorders, such as bipolar disorder, in that location are severity indicators such as mild, moderate and severe as well. This helps clinician to decide the course of the treatment gibe to the severity of their disorder. This is one of the strength of DSM as using the same treatment for different severity of the same disorder will not be very appropriate or expeditious. However, this severity indicator is absent in some disorders such as frenzied episodes which is one of the weaknesses of DSM-IV TR.These were some of the strengths of DSM-IV TR. However, we know that an early(a) edition of DSM, DSM-V is expected to be published soon. This is obviously be defecate in that respect are some, or man y weaknesses in the rate of flow DSM with which people are not satisfied. genius of the major weakness of the current DSM and probably all the older editions is Cultural Bias. DSMs are mainly published by anglo-Americans and most of the behaviour that is considered as prescript in the DSM is actually what is considered normal by the anglo-Americans. That is, some of the behaviour that is considered as abnormal in the DSM exponent be considered as normal in other destinations. For example, in some cultures, people tend to put a lot of emphasis and set filial piety and due to that, they would behave in a room that might not be considered as normal by the anglo-Americans. Would that signalise them as abnormal? What exactly is normal anyways? According to the DSM, it it, I call up, what is considered as normal by the anglo-Americans. This is one of the weaknesses of the DSM which is well-known and I think it is because of this discernment that DSM might not be as popular in co untries where the culture is much different compared to countries like the USA and many European countries. other weakness would be that DSM promotes a mechanical set out to mental disorder assessment. The clinicians may focus excessively on the signs and symptoms of mental disorders and they might not put much emphasis on a more in-depth appreciation of the clients/patients businesss. This fuss have change hardly it is unbosom a conundrum caused by the DSM. DSM-IV TR also does not consider patients subjective experience of a disorder. That is, theapproach is not a dimensional approach as there is no first-person report but rather, observations are usually carried out which may neglect the more somatic and psychological processes that underlie the symptoms (Flanagan, Davidson & Strauss, 2007).3 Also, DSM causes most clinicians to be primarily concerned with the signs and symptoms of a disorder rather than the underlying cause by giving a list of certain criteria for diagnosi s. other weakness and debate intimately the DSM is that it is an unscientific system and it is the opinion of a hardly a(prenominal) powerful psychiatrists. This has raised a lot of hesitancys and have caused people to question the stiffness and reliability of the diagnostic categories as well. The validity and reliability were specially questioned after the Rosenhan experiment in the 1970s in which it was concluded that the in their right minds(predicate) could not be distinguished from the insane in psychiatric hospitals. Thus, plain though the reliability and validity has improved now when compared to the 1970s, it is still a weakness which I believe could not be entirely fixed. However, validity puzzles of the diagnostic criteria especially arise when children or adolescents are involved.For example, the DSM-IV TR criteria for bipolar and manic disorder were originally unquestionable for adults but right now, after a few changes, it is used for children as well. This in creases the chance of misdiagnosing children with bipolar disorder. This information is support by the fact that in the last 10 years, there has been a 40%4 increase in the number of children diagnosed with bipolar disorder. It is believed that there is not a sharp increase in the number of children with bipolar disorder but rather that the clinicians have been applying the diagnostic criteria (which were originally developed for adults) much more aggressively to children.5This is one of the weakness of DSM-IV TR that needs to be improved in the future as the effects could be devastating. genius of the weakness, which I believe is not very significant but still is a problem and which is actually questioned by people is the definition of the mental disorder. This was also mentioned in the lectures. According to DSM-IV TR, a mental disorder is associated with endow distress or disability or significant increased hazard of death, pain, disability and important loss of freedom. This r aises the question.. what about thoseindividuals who engage in activities that threatens their lives but they actually enjoy it? Such as mountain climbers, scuba divers, etc. Obviously they are no considered as abnormal but according to the definition of the DSM, they are considered as having a mental disorder. further we know that this is not correct. Thus, there is a problem with the definition of the term mental disorder. at that place are many other weaknesses as well such as with Personality Disorder diagnosis. It is believed that the description of symptoms is very broad. This means that patients diagnosed with the same disorder could actually have very different clinical presentations. For personality disorders, DSM uses a categorical approach6. However, it would be unwrap to use a dimensional approach so that the different types/ degree of disorder could be distinguished and thus, could be given different and more efficient treatments.Another major weakness of the Axis II personality disorder is that there is a very high degree of overlapping or co-occurence with each other. This is also a problem for Axis I mental disorders.7There are many other weaknesses with specific disorders of DSM especially about the diagnosis criteria and some other issues such as whether Paraphilias should be accommodate or not. Most of the major ones has been discussed above. Now, the new changes for DSM-V will be discussed.There are many new changes for the DSM-V. I will mainly mention those that are related to the weaknesses mentioned above. However, the new changes are discussed, the 4 principles behind the current process for revising DSM should be discussed. (Obtained from APA DSM-V Developments official website)1) clinical Utility- the manual should be useful to those who diagnose and treat patients with mental illnesses2) Recommendations should be guided by evidence3) DSM-V should maintain continuity with previous editions whenever practical4) No priori restraint s should be placed on the level of change permitted amongst DSM-IV and DSM-VFrom these 4 principles, it becomes clearer to us why DSM-IV is being revised and what changes should be expected. One of the changes is that in order to better assess the severity of symptoms, a dimensional assessment will be included. For example, other factors such as snooze quality, mood, etc will be considered regardless of the diagnosis. This will help to reduce the problem of mechanical approach as mentioned before. They will also help to direct symptoms that are not included within the diagnostic criteria for specific illnesses (e.g. the problem of insomnia for patients diagnosed with Schizophrenia).DSM-V might also include something that could solve the problem of how to handle patients with co-occuring disorders, which is a major weakness of DSM-IV TR. Besides that, DSM-V will also have improved diagnostic criteria that are not precise in DSM-IV TR.Also, a few tidingss would be changed as well i n the new DSM. For example, the word Mental Retardation would be changed to Intellectual Disability. Another change that would also be included would somehow, indirectly address the problem of heathenish bias. In the new DSM, careful consideration would be given to the gender, stimulate and ethnicity. This, I believe could help to lessen the severity of the cultural problem as mentioned before.Besides that, another proposal is that, the criteria should be more wet for the diagnosis of bipolar disorder in children. This also addresses one of the weakness mentioned earlier. This is a very important proposal as I believe it is not very humane to misdiagnose children with Mental Disorders. It could affect their life significantly.Another major changes is in the assessment and diagnosis of personality disorders. As mentioned before, a dimensional approach will be used rather than a categorical approach. This can help to determine the different severities of disorders and determine the subtypes more accurately. Overall, it would make the diagnosis much more accurate and thus, moreefficient treatment could be used.These changes were mainly in response to the weaknesses mentioned above. Other changes include creating a new category called Behavioural addiction. This category is solely based on gambling. Internet addiction was also proposed. However, due to the deficiency of research in that field, it was rejected. This shows that they somehow followed principle 2 which emphasizes on the splendour of evidence. Another category called the Risk Syndromes is also being considered. This will help clinicians identify earlier stage of mental disorders. The category of substance handle and addiction will be removed and it would be replaced by a new category called Addiction and Related Disorders. This is done to help clinicians distinguish between similar types of disorders more easily and lower the chance of misdiagnosis (e.g. dependence is often confused with compuls ive drug-seeking behaviour addiction). 8Another change is that the criteria for some eating disorders such as Anorexia Nervosa has been improved.Overall, the diagnostic criteria for many disorders has been improved and a dimensional approach is being used in DSM-V rather than the categorical approach used in the previous editions. All of these changes, together with many other minor ones, aim to improve the diagnosis process and thus, ensures that people are saved from misdiagnosis (which could lead to devastating effects) and so that they can receive better treatment which would increase their chances of being cured (if the disorder is curable).BibliographyBerman, J. (n.d.). Understanding the DSM-IV TR. Retrieved on 15th March, 2013, from http//www.ceuschool.com/librarydocs/SOC222.pdf Dombeck, M., Hoermann, S., Zupanick, E.C. (2011). Personality Disorders Problems with current diagnostic system. MentalHelp. Retrieved on fourteenth March, 2013, from http//www.mentalhelp.net/poc/view _doc.php?type=doc&id=569 Flanagan, E., Davidson, L. & Strauss, J. (2007). Issues for DSM-V IncorporatingPatients Subjective Experiences. Am. J. Psychiatry, 164(3), 391 392. Kleinplatz, P.J., Moser. C. (2005). DSM-IV-TR and the Paraphilias An Argument for Removal. Retrieved on 14th March, 2013, from http//www2.hu-berlin.de/sexology/GESUND/ARCHIV/MoserKleinplatz.htm Kronemyer, D. (2009). Phenomenological Psychology. Retrieved on 14th March, 2013, from http//phenomenologicalpsychology.com/2009/06/how-can-dsm-iv-be-improved-as-it-transitions-to-dsm-v/ American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders (4th ed., text rev.). Washington, DC. Bipolar Disorder in Children. Wikipedia. Retrieved on 14th March, 2013, from http//en.wikipedia.org/wiki/Bipolar_disorder_in_children Diagnostic and Statistical Manual of Mental Disorders. Wikipedia. Retrieved on 14th March, 2013, from http//en.wikipedia.org/wiki/Diagnostic_and_Statistical_Manual_of_Mental_ Disorders DSM-5. Wikipedia. Retrieved on 14th March, 13 from http//en.wikipedia.org/wiki/DSM-5 DSM-5 development Frequently Asked Questions. American Psychiatric Association.Retrieved on 14th March, 2013, from http//www.dsm5.org/pages/default.aspx Rosenhan Experiment. Wikipedia. Retrieved on 14th March, 2013, from http//en.wikipedia.org/wiki/Rosenhan_experiment