Tuesday, November 18, 2008

DSM Layout

Because this is not the clinical exam, I imagine there is not a lot of in depth questions on less common mental illnesses. However, I feel that as a social worker, it is important to at least be familiar with the DSM and the more common diagnoses and their treatments.

There are five axises in the DSM-IV TR. The following is a direct quote out of the DSM-IV TR from page 27:
Axis I: Clinical Disorders and Other Conditions That May Be a Focus of Clinical Attention.
Axis II: Personality Disorders, Mental Retardation
Axis III: General Medical Conditions
Axis IV: Psychosocial and Environmental Problems
Axis V: Global Assessment of Functioning

So, essentially, Axis I holds all the mental health diagnoses except personality disorders and mental retardation. Mental retardation does NOT include Pervasive Developmental Disorder (PDD) which is the umbrella for Autism and Aspergers. To further complicate things, other (what could be considered developmental disorders) disorders, such as Cerebral Palsy, are not considered mental health at all, but a 'General Medical Condition', so it would be coded under Axis III.

The reasoning is that personality disorders and mental retardation exist throughout the entire person. 'Pervasive', if you will. However, Pervasive Developmental Disorder is a 'clinical disorder'.

No, it doesn't make a whole lot of sense. But we didn't write the book, we just know how to use it. And this is how to use it.

The last Axis, the GAF, is a number scale of overall functioning. Many practitioners find it to be crap and don't use it at all because it is too subjective.

1 comment:

Anonymous said...

Ha! This is great! Thank you for infusing some humor into this blog. I am studying for the exam about 10 years after getting my degree, so your blog is a godsend as a starting place to study. Given the time lapse, I'll need a little remedial studying as well.

I, too, am surprised at the dearth of information on the web for studying, and my (major urban) public library also has NO resources for helping a person study for this exam. Humph.

What kind of social work are you practicing now, and do you find the exam to be related to what you actually do at work, or was it more or less a stamp of approval you needed to obtain?

Thanks for posting all this great information!