Psychologists and psychiatrists have classified psychological disorders into categories. Classification allows clinicians and researchers to describe disorders, predict outcomes, consider treatments, and encourage research into their etiology.
Psychologists and psychiatrists use a reference book called the Diagnostic and Statistical Manual of Mental Disorders (DSM) to diagnose psychological disorders. The American Psychiatric Association published the first version of the DSM in 1952. It has been revised several times, and the newest version is commonly referred to as the DSM-IV.
The DSM-IV uses a multi-axial system of classification, which means that diagnoses are made on several different axes or dimensions. The DSM has five axes:
- Axis I records the patient’s primary diagnosis.
- Axis II records long-standing personality problems or mental retardation.
- Axis III records any medical conditions that might affect the patient psychologically.
- Axis IV records any significant psychosocial or environmental problems experienced by the patient.
- Axis V records an assessment of the patient’s level of functioning.
Criticisms of the DSM
Although the DSM is used worldwide and considered a very valuable tool for diagnosing psychological disorders, it has been criticized for several reasons:
- Some critics believe it can lead to normal problems of living being turned into “diseases.” For example, a child who displays the inattentive and hyperactive behavior normally seen in young children could be diagnosed with attention-deficit/hyperactivity disorder by an overzealous clinician. In earlier versions of the DSM, homosexuality was listed as a disorder.
- Some critics argue that including relatively minor problems such as caffeine-induced sleep disorder in the DSM will cause people to liken these problems to serious disorders such as schizophrenia or bipolar disorder.
- Other critics argue that giving a person a diagnostic label can be harmful because a label can become a self-fulfilling prophecy. A child diagnosed with attention-deficit/hyperactivity disorder may have difficulty overcoming his problems if he or other people accept the diagnosis as the sole aspect of his personality.
- Some critics point out that the DSM makes the process of diagnosing psychological disorders seem scientific when, in fact, diagnosis is highly subjective.
In general, psychologists view the DSM as a valuable tool that, like all tools, has the potential for misuse. The DSM contains many categories of disorders, and the following sections will cover a few of these categories.