DSM CLASSIFICATION SYSTEM

1
DSM CLASSIFICATION SYSTEM

• Why use a classification system?
• In working together with those clients
  experiencing a mental illness we need a way to
  identify disorders, have a common language, have
  a basis for research

2

• Brief history of classification and DSM
• For research as far back as the civil war in US
  mental disorders classifications could be found
  in census data (e.g..) dementia praecox, moral
  insanity, dipsomania, paresis.
• Following WWII there was an increased awareness
  of mental illness due to the needs of veterans
• WHO of 1947 (e.g..) depression, psychosis, mania

3

• History (cont.)
• ICD classifications in early 1950s psych was
  included in medical disorders
• DSM (1956) 6 pages and no text (neurotic
  reaction)
• DSM II (1968) 10 pages and no text
• DSM III (1980) For the most part neurotic
  reaction disappears. Homosexuality disappears
• DSM IIIR (1987), DSM IV (1994), DSM IVTR (2000)

4
WEAKNESSES AND CRITICISMS OF DSM SYSTEM

• It is a categorical classification
• You have a list of criteria and you tally the
  number of symptoms present to determine if the
  client is experiencing a disorder
• This system does not take into consideration the
  wide variability of symptom presentation and
  differences in the character, temperament,
  manner of thinking of the individual as well as
  the environment, socio economic issues and
  culture

5

• Individual categories are not discrete Symptom
  clusters overlap two or more disorders therefore
  two clinicians can look at one person and come up
  with two different diagnoses
• It is a strange mix of social values, political
  compromise, scientific evidence and material for
  insurance claim forms

6

• Clinician subjectivity
• Weak empirical data for some disorders
  (personality disorders)
• Does not explain etiology
• Can be stigmatizing
• Self esteem effects?
• Self-fulfilling process
• Insensitive to culture bound disorders

7

• WHAT IS YOUR OPINION OF SOCIAL WORKERS USING THE
  DSM IN MENTAL HEALTH PRACTICE AND IN SOME CASE
  MANAGEMENT SETTINGS?

8
DSM AND DIVERSITY EXERCISE

• In pairs review and discuss two diversity case
  studies
• What do you think of these two cases?
• Did you identify with the worker?
• Did you identify with the client?
• What aspects of your diversity training thus far
  come to mind?
• How can you relate your training to using a model
  of psycho-pathology?