Diagnostic and Statistical Manual of Mental Disorders Issues

Diagnostic and Statistical Manual of Mental Disorders Issues The vast majority of patients seeking treatment for an eating disorder do not meet full DSM criteria. What are the implications for diagnosis and treatment of eating disorders? What are the broader implications for categorical versus dimensional perspectives on the diagnosis of mental illness? The American Psychiatric Association’s (APA) Diagnostic and Statistical Manual of Mental Disorders (DSM) is a handbook of written guidelines that primarily focuses on the classification of mental disorders rather than the mental disorders itself. It is used in the prevention, management and assessment of a patient’s mental state. Aside from this, it is also serves to provide as a common ground for researchers to work on, to study the criteria to further improve it for future DSM revisions. In clinical practice and research, the DSM’s role is facilitated by its classification system; usually either categorical or dimensional in approach (4th ed., text rev.; DSM–IV–TR; American Psychiatric Association, 2000; Kraemer, 2007). The categorical approach is the assessment of either a positive or negative diagnosis based on a strict set of standardised criteria. Conversely, the dimensional approach is a more relaxed approach than the categorical, where it in volves the classification of mental disorders by quantifying a person’s symptom and representing them with numerical values on one or more scales. It concerns the degree of presence of the mental disorder apparent within the patient, rather than the actual presence; that is, how much of the criteria does the patient correspond with. The higher the scores on the scores of the scales the more likelihood the patient has the disorder. For instance, higher scores on the Hamilton Depression scale, a seven point Likert scale, will indicate a higher chance the patient is depressed (Brown Barlow, 2005). As recognised by Brown and Barlow, there is a potential positive implication of adopting a DSM with an increasingly dimensional approach. However, there is a continual debate regarding the categorical and dimensional perspectives of diagnosis. This is especially present with the richly dimensional oriented DSM-V (5th ed.; DSM–5; American Psychiatric Association, 2013; Machado, Goncalves Hoek, 2013; Regier, Kuhl, Kupfer, 2013). Throughout this paper, the broad implications of this continual debate will be discussed, following by the investigation of the implications for patients who do not meet the full DSM Eating Disorder criteria. A patient has a higher chance of being diagnosed with depression  if they score higher a patient scores on the Hamilton Depression scale, a seven point Likert scale, the higher the likelihood they are depressed (Brown Barlow, 2005). Throughout the various version of the DSM, its use the categorical approach requires the acknowledgement that there are heterogeneous factors among disorder populations that are not within the diagnosis (4th ed., text rev.; DSM–IV–TR; American Psychiatric Association, 2000). As a result of this, there are high levels of co-morbid positive diagnoses – 79% of lifetime mental disorders are observed in people with at least one diagnosed mental disorder (Kessler, Chiu, Delmer Walters, 1994; Krueger, Bezdjian, 2009). From this, an implication of a categorical approach can be deduced; that is, positively diagnosed patients should be assigned standardised treatments that are not necessarily aimed at only treating them due to heterogeneous factors such as co-morbidity. The dimensional approach, however, utilises more clinical information about the heterogeneous factors that are present in patients (Brown Barlow, 2005). The implication formed here for the dimensional ap proach would be assignment of various appropriate treatments that would be deemed most effective for the respective patient, as there is sufficient clinical information regarding the patient’s varying dimensions. Additionally, with regards to the categorical approach, the lack of presence of a single criterion for a particular mental disorder in the DSM can ultimately determine a positive or negative diagnosis. Consequently, the forms large residual undefined categories, such as the Eating Disoder – Not Otherwise Specified (EDNOS) category, where it is a category aimed for patients who do not meet the full criteria for anorexia nervosa, bulimia nervosa or binge eating disorder (that was introduced in the DSM-V) (5th ed.; DSM–5; American Psychiatric Association, 2013; Machado, Goncalves Hoek, 2013). Due to the nature of the dimensional approach, quantifying dimensions of disorders, it will help reduce the formation of large residual categories, thus, can be seen as an implication of the dimensional approach (Brown Barlow, 2005). Hence, patients have less of chance being diagnosed into the residual category of mental disorder under a classification system that priorities the rec ognition of presenting criterion, even though they do not satisfy the fixed diagnostic criteria of a categorical classification approach. The dimensional approach makes use of one or more scales to measure particular dimensions of various mental disorders. This can be seen as a potential positive implication for clinical practice and research (Lopez, Compton, Grant Breiling 2007). Initially, Kraemer (2007) found that the categorical approach is most beneficial to clinical practitioners, whilst the dimensional approach is most beneficial to researchers. However, Lopez et al. (2007) came to realise that clinical practitioners would also come to benefit from the growing popularity of dimensional orientation, since the changes in severity of a mental disorder and its dimensions could be quantitatively measured by fluctuations in multi-ordinal scales. Hence, proving to be more informative than measuring responses to interventions by comparing the fluctuations between the borderlines of a positive and negatives diagnosis, as in a categorical approach. Moreover, this implication relates to how an improvement of research outcomes would be apparent through the adoption of a increasingly dimensional approach. Unfortunately, there are many associated negative implications of adopting a more dimensional approached, which are apparent with the difficulties of changing an existing classification system (First, 2005). With the increase popularity of the use of the dimensional approach, similar to the direction and development of research of the DSM-V, there would be an apparent difficulty in merging past and present research to reach conclusions about present studies (First, 2005; Reiger, Kuhl Kupfer, 2013; 5th ed.; DSM–5; American Psychiatric Association, 2013). Moreover, issues will arise in the clinical use of the DSM, resulting practitioners to revise their diagnoses of existing patients as well as their practice with new patients. Lopez et al. (2007) also outlined a complication of the diagnostic criteria of earlier DSMs, where most were in favour of the dimensional approach, will be present as there will be a varying abilities of different psychiatric disorders to be measured dim ensionally. They highlighted this with comparison between dimensional approach adapted to psychoses obtained from a scarce literature and a dimensional approach for substance use disorder obtained from a supportive literature. Thus, concluding that the shift from categorical classifications approaches to dimensional approaches will be difficult in the future. The implications of categorical approaches of diagnosing mental disorders are evident through the concern with the diagnoses of eating disorders. One of these implications is the large residual EDNOS category. The majority of individuals who seek treatment for eating disorders are diagnosed with EDNOS. Due to the strict nature of the criteria of eating disorders, patients being negatively diagnosed due to not fulfilling the criteria; only having partial eating disorders like partial anorexia nervosa and partial bulimia nervosa, resulting an increase in the EDNOS category. The implication here would be a demand for treatment from an excessively heterogeneous population diagnosed with EDNOS. However, practitioners are at risk in having no solution or intervention to use, due to the EDNOS category lacking homogenous characteristics which are required to determine research-based effective treatments.

Week 7

* Use a spreadsheet to develop a point-scoring matrix and determine which system Mark should select. Software| Â  | Â  | Weighted Score| weighted score| weighted score| Fulfillment of business needs| 100| Â  | 600| 800| 900| Acceptance in marketplace| 30| Â  | 180| 180| 180| Quality of documentation| 50| Â  | 350| 450| 400| Quality of warranty| 50| Â  | 200| 400| 350| Ease of use| 80| Â  | 560| 480| 400| Control features| 50| Â  | 450| 350| 450| Flexibility| 20| Â  | 80| 100| 180| Security features| 30| Â  | 120| 120| 240| Modularity| 30| Â  | 240| 150| 120|Integration with other software| 30| Â  | 240| 270| 180| Quality of support utilities| 50| Â  | 450| 400| 250| Vendor| Â  | Â  | Â  | Â  | Â  | Reputation and reliability| 10| Â  | 30| 90| 60| Experience with similar systems| 20| Â  | 100| 100| 120| Installation assistance| 70| Â  | 630| 280| 430| Training assistance| 35| Â  | 140| 280| 210| Timeliness of maintenance| 35| Â  | 175| 140| 140| Hardware| Â  | Â  | Â  | Â  | Â  | Internal memory size (RAM)| 70| Â  | 350| 420| 560| Hard-drive capacity| 40| Â  | 360| 360| 200| Graphics capabilities| 50| Â  | 350| 350| 400| Processing speed| 30| Â  | 240| 240| 150|Overall performance| 40| Â  | 360| 400| 400| Expandability| 50| Â  | 350| 100| 500| Support for network technology| 30| Â  | 90| 120| 210| Â  | Â  | Â  | Â  | Â  | Â  | | Â  | Â  | 6645| 6580| 7030| * b. Susan Shelton did not agree with Mark’s weightings and suggested the following When the changes are made, which vendor should Mark recommend? Mark should recommend VENDOR 3 * c. Mark’s manager suggested the following changes to Susan’s weightings: Reputation and reliability| 90| Installation assistance| 40| Experience with similar systems| 40| Training assistance| 65| Internal memory size| 10| Will the manager’s changes affect the decision about which system to buy? Yes the sum total of all the changes will directly affect the outcome of which system they will purchase. * d. what can you conclude about point scoring from the changes made by Susan and Mark’s manager? Develop your own weighting scale to evaluate the software packages. What other selection criteria would you use? Be prepared to discuss your results with the class. I take the weighted sum of all the packages and compare them based on the scoring system and average them out to see who's strong and weak.Based on my approval I would pick the one that is nearest middle of the road compared to the other 2. This way all attributes are about equal rather than struggling with one issue and excelling at another. This would be my way of defining an accurate and realistic scoring system. * e. What are the weaknesses of the point-scoring method? Point scoring method doesn't mean it's the right scoring method. Its only good for what you are prioritizing in your goals and what you are looking for. Based on your needs and wants the scoring system may not be what you are looking for if you are going for the efficient way of grading rubrics.

The Walt Disney Control Factors - 4105 Words

Chris Harper April 10, 2012 Management and Organization Dr. Scruton The Walt Disney Company’s Control Factors Disney has different types of controls that help their business run efficiently on a daily bases. Two examples of controls are financial and operational. Also, Disney has information systems that play a role within their company. Disney has different managerial innovation practices from encouraging their employees to possess entrepreneurial spirit to their job tasks. In response, Disney has ethical dilemmas that they face from giving employee empowerment to seeing how technology plays a role in managerial practices. Disney may or may not show social responsibility. This leaves to question if Disney an organization that I†¦show more content†¦According to this cycle control process is monitored by doing changes on a small scale first to trail and see if they will work or not. Disney does this by assigning small groups to complete projects and allow them to use the leadership skills they have to complete the task. Disney continues to do this through having experimental designe rs, conflict resolution methods, and on-job training for employees to learn what is expected of them in the company. Disney remains to check their controlling by monitoring graphical analysis, control charts, data check-sheets, and key performance indicators. Then, lastly Disney will act on their control process. Disney acts on their control process by process mapping, process standardization, controlled reference information, and formal training for standard processes (Deming, 2011). Again, I have seen some of these aspects of the Plan-Do-Check-Act cycle first hand by seeing example hearing an example of their employee training process. Disney will do some activities during employee training that include role plays to situations that could occur and give them solutions on how they should handle them. What are financial controls? Financial controls are the avenues in which a company monitors and protects its finances by implementing policies that document where, how, when money is being spent by the company. This is my own personal representation. According to Disney’s Charter of the Audit Committee of theShow MoreRelatedAnalysis Of Walt Disney s Snow White, Dumbo 1200 Words   |  5 PagesWalt Disney, animator, cartoonist, and entrepreneur, was a man of incredible vision and passion. He fundamentally transformed the entertainment industry in America. Prior to Walt Disney Studios, the art of animation was simply a moving comic strip, void of sound or color and generally constrained to short vignettes featuring friendly characters like cats. 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Social and Economic Impact of Bipolar Disorder - Free Essay Example

Sample details Pages: 2 Words: 672 Downloads: 9 Date added: 2019/10/30 Category Medicine Essay Level High school Tags: Bipolar Disorder Essay Did you like this example? Bipolar disorder is recognized as a possibly treatable psychiatric illness that has substantial humanity and high social and economic impact (Swann, A. C. (2006).Bipolar disorder is a common, complex, and consistent severe mental health condition with progressive social and cognitive function disturbances and comorbid medical problems. Don’t waste time! Our writers will create an original "Social and Economic Impact of Bipolar Disorder" essay for you Create order Bipolar disorder is a regular chronic disorder characterised by fluctuations in mood state and energy. It touches more than 1% of the worlds population regardless of nationality, ethnic origin, or socioeconomic status. Bipolar disorder is one of the key causes of disability between young people( J Alonso, M Petukhova, G Vilagut, et al.(2011), leading to cognitive and functional impairment and raised mortality, particularly death by suicide. A high prevalence of psychiatric and medical comorbidities is typical in affected individuals. Accurate finding of bipolar disorder is hard in medical practice since onset is most commonly a depressive episode and looks similar to unipolar depression. The trademark characteristic of bipolar disorder is the propensity to move between the two contrasting poles of elevated mood and depression, with a reoccurrence to largely usual working in between these episodes. The periods of preeminent mood are termed mania or hypomania, these portion common characteristic symptoms. patients who have experienced an episode of mania are diagnosed as having bipolar I disorder, however those with only hypomanic episodes are said to have bipolar II disorder. Most patients with bipolar disorder, extra of their lives are spent in depressed mood than in periods of elevation, even for those with bipolar I disorder. furthermore, the illness regularly first presents with a depressive episode, meaning that some young people with depressive episodes could go on to have hypo/manic episodes in the future. It is serious that the depressive episodes of bipolar disorder are recognised early and treated vigorously, as most suicides occur during depressive episodes .one aspect of refining credit of bipolar depressive episodes has been instructive if there are symptoms more commonly observed in bipolar than unipolar depression. It appeared that the diagnosis was being made in many people with transient mood instability. the formal interviews demonstrated that many of these patients had other conditions such as borderline personality disorder, unipolar depression and impulse control disorders. Bipolar I disorder is considered to be approximately equally common in men and women, whereas bipolar II disorder may be more common in women than in men (American Psychiatric Association, 1994). Three main explanations may account for this difference. The first clarification is linked to the fact that we included only patients who were hospitalised. It has been previously stated that women may experience a significantly superior number of hospitalisations for mania equated with men (Hendrick et al., 2000). This finding was believed to replicate a superior propensity for women to seek and obtain treatment (Mechanic, 1986). family members may be more expected to bring ill female relatives rather than ill male relatives to mental health facilities. This difference may be due to the different outlooks of normative behaviours conferring to gender and/or, as it was the case in the current study, to the higher likelihood for women to live with their families. The second reason is that the high comorbidity rate of alcohol and drug use in men may have led to a psychiatric admission diagnosis of constituent misuse rather than mania (Hendrick et al., 2000). Finally, as the prevalence of mixed mania is higher in women than in men, women are more likely to be hospitalised to prevent the risk of suicide associated with mixed pictures (Hantouche et al., 2006). Dealing of bipolar disorder predictably emphases on serious stabilisation, which the purpose stands to carry patients with mania or depression to a suggestive repossession with euthymic (stable) mood; and on maintenance, in which the goals are weakening prevention, decrease of subthreshold symptoms, and better-quality social and work-related functioning. Treatment of both phases of the disease can be complicated, since the same treatments that recover depression can cause mania, hypomania, or rapid cycling (defined as four or more episodes in 12 months), and the treatments that reduce mania might reason rebound depressive episodes.