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Psychiatric Classification

Psychiatric Classification. By Drew Bradlyn, Ph.D. West Virginia University. Moral insanity Laziness Asthma Chronic Masturbation Epileptic Fits Vicious Vices Uterine Derangement Small Pox . Spinal Irritation Grief Sunstroke Immoral Life Foolishness of Intellect

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Psychiatric Classification

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  1. Psychiatric Classification By Drew Bradlyn, Ph.D. West Virginia University

  2. Moral insanity Laziness Asthma Chronic Masturbation Epileptic Fits Vicious Vices Uterine Derangement Small Pox Spinal Irritation Grief Sunstroke Immoral Life Foolishness of Intellect Seduction and Disappointment Moul (1998) Weston State HospitalProblems at Admission: 1864 - 1889

  3. What is “abnormal?” • Moral definitions • Statistical definitions • Current psychiatric definition

  4. DSM-IV Diagnostic and Statistical Manual of Mental Disorders. Fourth Edition, by the American Psychiatric Association (1994).

  5. DSM-I and DSM-II Systems • Essentially only lists of names, many of which were thought to be “explanations” for psychiatric phenomena • Psychoanalytic overemphasis • No operational criteria--poor reliability • Little consideration of course of illness • Little formal conceptual structure

  6. Benefits of Classification • Standardized vocabulary that permits effective communication • Communication structure that places named phenomena into some conceptual order • Context for providing causal understanding of phenomena • Context for developing expectations about effects and interventions

  7. DSM-IV“A mental disorder is….” …conceptualized as a clinically significant behavioral/psychological distress…disability…or with significant risk of death, pain, disability, or important loss of freedom…must not be merely an expectable or culturally sanctioned response to a particular event (e.g., death of a loved one). …neither deviant behavior (e.g., political, religious, or sexual) nor conflicts that are primarily between the individual and society are mental d/o unless the symptom is dysfunctional (in the individual).

  8. DSM-IV: Multiaxial Classification • Axis I: Psychiatric Syndromal Diagnoses • Axis II: Personality Disorders and Mental Retardation • Axis III: Medical Conditions • Axis IV: Psychosocial Stresses • Axis V: Level of Functioning

  9. DSM-IV General Categories • Disorders seen first in infancy or childhood • Delirium, dementia, cognitive, or other amnestic • Disorders due to other medical conditions • Substance-related disorders • Affective (mood) disorders • Anxiety disorders • Somatoform disorders • Factitious disorders • Dissociative disorders • Sexual and gender identity disorders • Sleep disorders • Adjustment disorders • Personality disorders

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