DSM-IV-TR Multiaxial System

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DSM-IV-TR Multiaxial System the best?
Is the Multiaxial System the best system for diagnosis?
What?s the alternative to this system or is this all we have?

-For decades The Diagnostic and Statistical Manual of Mental Disorders (DSM) published by the American Psychiatric Association (APA) has been use by mental health professionals especially in North America as the standard for classifying mental disorders. The DSM is regarded as a necessary and beneficial tool for collecting and communicating related public health statistics (Berman, n.d.; Lane, 2013). The first version published by the APA was released in 1952, and the DSM has since undergone several revisions. The most recent edition has been the DSM-IV which was published in 1994. Some minor modifications and updates were made to the 4th edition; the DSM-IV-TR, which was released in 2000. The latest and most recent edition - the DSM-5 - will be released in May of this year (2013) (Lane, 2013). For the remainder of this report the DSM-IV-TR will be referred to as DSM.

-The DSM can be applied in a broad variety of contexts and situations and to be able to be used by clinicians and researchers from different backgrounds, and it uses a multi-axial approach for diagnosing. In essence, users can be biological, psychodynamic, cognitive, behavioral, interpersonal, or family/systems oriented. As well, the DSM was designed for use across different settings including but not limited to: in/outpatient, clinics, partial hospitalization, consultative, liaison, private practice and primary care (Berman, n.d.; Burns, 2012).

-The DSM has three major components: a diagnostic classification, a diagnostic set of criteria and a descriptive text. Because the diagnostic classification lists the mental disorders that are officially part of the DSM system, making a diagnosis would then consists of selecting disorders from the classification that best reflects the signs and symptoms of the patient being evaluated(Lane, 2013; Sherman, 2012).

-The DSM is definitely the most in-depth manual in Psychology currently. That said however, it is not free from criticisms-many of which are legitimate: Many DSM users find the diagnostic criteria particularly useful as they provide a cohesive and compact description of each disorder. This has also been shown to increase diagnostic reliability as well as to increase the likelihood that different individuals will be assigned and associated with the same diagnosis. For this reason, it is critical that the criteria be used only by an informed, trained clinician and only as a guideline (Berman, n.d.; Burns, 2012; Lane 2013; Trinidad, 2008).

-As it is in psychiatry, the traditional 'gold standard' of diagnostic assessment is the clinical interview, in which the only requirement of the clinician is education and experience. Interviews tend to show signs and symptoms based on the questions and answers. The clinician will then base his/her diagnosis on a cluster of syndromes. This receives much scrutiny (Trinidad, 2008). Compared with computer-assisted diagnostic interview, the traditional diagnostic assessment method usually produces greater imprecision and ...