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Diagnostic and Statistical Manual and Current Forensic Diagnosis, Essay Example

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The 1952 publication of the Diagnostic and Statistical Manual: Mental Disorders(DSM-I) was a groundbreaking event for the profession of psychiatry in the United States and eventually resulted in the DSM-IV, which is invaluable for forensic clinicians.  Heretofore, the American Psychiatric Association Committee on Nomenclature and Statistics, later the American Psychiatric Association, had focused their efforts on the collection of statistical information.  Two efforts to classify mental health disorders, one by the United States (U.S.) Government and the other by World Health Organization (WHO), prompted the creation of the DSM-I.

First, after World War II, the U.S. Army and the Veteran’s Administration developed a system for diagnosing outpatient veterans with serious mental disorders.  Secondly, the World Health Organization published the sixth edition of the International Classification of Diseases (ICD) and included an innovative section, entitled ICD-6, on the classification of mental disorders.  The DSM-I was printed, and the document borrowed heavily from the contents of the ICD-6 and was very influenced by the work of Adolf Meyer, who believed that psychiatric disease was the result of a reaction to outside factors, such as the patient’s biology.  DSM-II was published eliminating the theories of Adolf Meyer from its pages.

In 1980, DSM-III was printed by the American Psychiatric Association (APA).  It was based upon empirical findings and, for the first time, included extensive diagnostic criteria and a multiaxial system.  With clinical usage of the DSM-III, inconsistencies were found.    The APA appointed a work group to correct the deficiencies of the DSM-III, and in 1987 the DSM-III-R was published.  Finally, in 1987, the DSM-IV was published, which utilized an extensive literature review by numerous individuals and organizations.It greatly expanded and improved upon the DSM-III.  In 2000, the DSM-IV-TR (TR for text revisions) provided even more detailed descriptions of each disorder, with few substantive changes.

In summary, for the forensic clinician, the DSM-IV is essential and far superior to its predecessors.  The DSM-III was a relatively small volume and required too much supposition as to the formation of a diagnosis.  Personality disorders, such as the Antisocial, Borderline, and Narcissistic are often the cause of criminal behaviors, and being able to identify clients with these rigid disorders, using the DSM-IV, is very helpful.

In addition, the multiaxial nature of the DSM-IV is useful in forensic diagnosis and counseling, in those situations in which the individual has been influenced by environmental factors beyond their control.  For example, an individual could become involved in gang activity due to a lack of socioeconomic resources, pressure from a gang, and a need to belong.  This situation needs to be documented on Axis IV, because it is a “psychosocial or environmental stressor.” The greatly expanded format of the DSM-IV provides the forensic clinician with the tools to make an accurate diagnosis.

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