The
mulitaxial diagnostic system was first introduced in the DSM-III-R, which evaluates and diagnoses clients on a multi-dimensional level. The multiaxial diagnostic system evaluates a person
on five axes or dimensions, allowing the clinician to have a more complete
picture of a person. A person may have a
psychological disorder that may not affect their functionality, using this
model would allow a clinician to come to a better determination than previous models.
In the current DSM (DSM-IV-TR) the five axes of the multiaxial diagnostic system are: developmental disorders, learning disorders, motor skills disorders and communication disorders are categorized as Axis I. Axis II is personality disorders and mental retardation, Axis 3 is physical disorders and conditions, Axis 4 is psychosocial and environmental problems and Axis 5 which is clinician rated level of adaptive functioning.
For example, a clinician using the multiaxial model to evaluate a client with OCD, would classify the client as having an Axis 1 category disorder. Yet the process doesn't end here, the client could be dealing with multiple problems related or non-related to his OCD. Let's suppose upon further inquiry it becomes clear that he also suffers from Schizoid personality disorder, which is an Axis 2 category disorder. The man did not have any physical conditions so no diagnosis is needed for Axis 3. In his Axis 4 assessment, the client was dealing with occupational difficulties and marital problems. And the clinicians rated score of the client's functionality was a 55, which shows slight obstruction with his functioning. The patients presenting symptoms and subsequent diagnosis require some information and guidance for treatment, but in light of the multiaxial model just demonstrated the clinician has a clear idea of what the problem is and how to treat the patient.
As a side not, this is all likely to change in the very near future since the DSM V is coming out with an entirely new system for diagnosing clients.
In the current DSM (DSM-IV-TR) the five axes of the multiaxial diagnostic system are: developmental disorders, learning disorders, motor skills disorders and communication disorders are categorized as Axis I. Axis II is personality disorders and mental retardation, Axis 3 is physical disorders and conditions, Axis 4 is psychosocial and environmental problems and Axis 5 which is clinician rated level of adaptive functioning.
For example, a clinician using the multiaxial model to evaluate a client with OCD, would classify the client as having an Axis 1 category disorder. Yet the process doesn't end here, the client could be dealing with multiple problems related or non-related to his OCD. Let's suppose upon further inquiry it becomes clear that he also suffers from Schizoid personality disorder, which is an Axis 2 category disorder. The man did not have any physical conditions so no diagnosis is needed for Axis 3. In his Axis 4 assessment, the client was dealing with occupational difficulties and marital problems. And the clinicians rated score of the client's functionality was a 55, which shows slight obstruction with his functioning. The patients presenting symptoms and subsequent diagnosis require some information and guidance for treatment, but in light of the multiaxial model just demonstrated the clinician has a clear idea of what the problem is and how to treat the patient.
As a side not, this is all likely to change in the very near future since the DSM V is coming out with an entirely new system for diagnosing clients.
Thanks for the information, Dan. I think I understand a little better now. I guess you'll have to write another of these when the DSM-V emerges!
ReplyDeleteAs a side, do you ever find the 19th/early-20th Century psychological terminology humorously out of date? Take "functionality," for instance. I can just smell its Industrialist emissions. The earlier generations still have us talking about people like they were Model T's. I wonder if the DSM-V will reevaluate its rhetoric in addition to its diagnostic method.
That's a great observation, he tend to analogize human complexity with the latest and most advanced form of technology available to us. Freud postulated a theory of motivation in terms of a hydraulic system, today we conceive of the brain as a highly advanced super computer. I'm sure the next advancement we have in technology we will be using to compare the magnificent complexity we see in the human body.
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