Diagnosis and Assessment

Diagnosis and Assessment

Diagnosing Holden Caulfield: A Psychological Reading of “Catcher in the Rye”

The Multi-axial System of Diagnosis

Over time, professionals have progressively accepted that psychological disorders involve complex interactions of biological, social, and psychological factors. With this shift to a more holistic view of mental illness, or the bio psychosocial approach, clinicians and researchers have called for a more comprehensive approach to diagnosis. Consequently, authors of DSM-III accounted for this paradigm shift with the introduction of a multi axial system of diagnosis. This system comprises five axes along which each one-by-one is diagnostically evaluated. Each mental disorder in the DSM is diagnosed on either Axis I or II. The remaining three axes are utilised to distinuish an individual's physical wellbeing (Axis III), environmental and psychosocial Stressors (Axis IV), and general grade of functioning (Axis V). (First et al 1996)

Axis I: Clinical Disorders and “V” Codes

The foremost clinical disorders, or syndromes, such as despondency, schizophrenia, and bipolar disorder, are diagnosed on Axis I. Axis I furthermore encompasses adjustment disorders, or farthest reactions to life events that would not commonly be expected (e.g., prolonged despondency following the decrease of a job). Also established on Axis I are y ciphers that are utilised to accept situation that are not ascribed to a mental disorder (e.g., learned difficulties, acculturation problems), but are the prime reason for searching treatment. When these troubles are evident, but not the prime focus of concern, they are documented on Axis IV.

Axis II: Personality Disorders and Mental Retardation

Personality disorders and mental retardation are identified on Axis II. Personality disorders reflect the occurrence of pervasive, inflexible, and maladaptive behaviors, thoughts, and answers that interfere with usual interpersonal relationships and origin and one-by-one substantial distress or impairment. An example is paranoid personality disorder where an one-by-one is considerably suspicious and distrustful of other persons and understands their aims as intimidating and malevolent. This orientation to other ones is often so farthest that the one-by-one has couple of close relationships. (Frances, First,& Pincus, 1995)

Also established on Axis II is the diagnosis of mental retardation. Although not a character disorder, mental retardation is considered a pervasive status that has a significant leverage on a person's demeanour, character, and cognitive functioning. Of note, it is likely to have multiple diagnoses on Axis I and/or II to account for co-occurring conditions.

Axis III: General Medical Conditions

Practitioners use Axis III to article any personal accusations or medical situation that may play a function in the individual's psychological discomfort. For example, an individual pain from fright disorder may also know-how occasional asthmatic attacks in which he or she know-hows respiratory distress. Given the dynamic interaction between these two experiences, it would be useful to be cognizant of both conditions when conceptualizing the case, evolving a remedy design, and broadcasting the case to other professionals.

Axis IV: Psychosocial and Environmental Problems

Practitioners use Axis IV to article Stressors in the environment that may aggravate, exacerbate, or in some way concern to the individual's current psychological ...