Diagnosing Individuals with Axis I Clinical Syndromes as outlined in the Diagnostic and Statistical Manual for Mental Disorders

Diagnosing Individuals with Axis I Clinical Syndromes as outlined in the Diagnostic and Statistical Manual for Mental Disorders. It is in the world domain that the human species is faced by many challenges. These challenges can be classified under natural disasters or man induced disasters. If we were to look at epidemics, we can say that the human species dwells in a world where at one time or the other one has to be attacked by an abnormal condition.

Abnormal condition negatively affects some part or the whole body of an organism, preventing it from operating at maximum potential. When an organism experiences abnormal conditions it is said it is sick or has a disease.

There are many disorders in the world. Some are curable while others are not. For example, ever since the discovery of Hiv/Aids, no cure has been engineered yet. However, the disease can be contained through medication, although it is not curable once it has attached itself on an organism. The purpose of this case study is to investigate how individuals are diagnosed with Axis I Clinical Syndrome. This will be as par the outlined directives in the Diagnostic and Statistical Manual for Mental Disorders (DSM). This statistical manual was published by the infamous American Psychiatric Association. All psychiatric physicians and other legal frameworks in this country use it for reference as it offers a common standard criteria as well as a common language when it comes to classification of mental disorders (Beutler & Malik, 2002). This manual is also relied upon as well as referred to by researchers, clinicians, health insurance companies, the legal system, psychiatric drug regulation agencies, pharmaceutical companies and also the policy makers in this country (Greeberg, 2013). The above groups also supplement the information offered by this manual with other alternative sources like the infamous International Statistical Classification of Diseases and Related Health Problems (ICD). This referencing material was compiled and produced by WHO (WORLD Health Organization), after doing numerous researches across the world. The Diagnostic and Statistical Manual of Mental Disorders has witnessed a couple of developments in the recent year with the production of better, efficient and more reliable editions. For instance, this manual is already on its fifth edition, DSM-5, after it was published on the 18t of May 2013.

The Diagnostic and Statistical Manual of Mental Disorder was developed after psychiatric researchers collected information from different statistics recorded in psychiatric hospitals around the world, and also from a manual of the Army of the United States (Beutler & Malik, 2002). The first complete manual was adopted in 1952 from these statistics, although there have been revisions as the publications go by, removing the ones no longer considered as relevant and also adding  a number of recently discovered mental disorders. This manual has received mixed feelings from different psychiatric experts citing inadequacy and blurred clarity of the information provided in it. These critics have also been coming from the National Institute of Mental Health saying that the system stipulated for in the manual is subjective and unscientific (Greenberg, 2o13).  On the other hand, this manual has also received in the field of mental health for standardizing the criteria in which mental disorders are diagnosed.

There are ongoing concerns on the issue of the reliability as well as the validity of the information provided for in this manual especially when it comes to addressing of mental disorders. They include; the diagnostic categories, the medicalization of human distress, superficial symptoms reliance on diagnosis, possible cultural bias as well as the artificial means of drawing the line between normality and cultural bias. This is more so when it comes to disorders like Axis I which require sound diagnostic skills from mental physicians. The Diagnostic and Statistical Manual of Mental Disorders IV provides five dimensions in which each psychiatric diagnosis is related to, with a particular aspect of a disability or disorder (Greenberg, 2013).

The dimensions provided for in the DSM-IV include;

  • Axis I: All disorders that are subjected to psychological diagnostic categories are classified in this dimension. This is with the exception of those with personality disorder and mental retardation characteristics.
  • Axis II: in this dimension, only the ones with mental retardation and personality disorders are classified under it.
  • Axis III. This dimension comprises of all the disorders with general medical conditions. This is the ones with physical disorders and the ones with acute medical conditions.
  • Axis IV: This dimension comprises any disorders which may have been triggered by environmental or psychosocial factors.
  • Axis V: conditions organized in this dimension deal with children under the age of 18 years, on the Children’s Global Assessment Scale.

There are different disorders that are categorized under the Axis I dimension. They include; anxiety disorders, autism spectrum disorders, ADHD, depression, bipolar disorder, bulimia nervosa, schizophrenia, substance abuse disorders and also mood disorders (Greenberg, 2013). Looking at an example of clinical diagnosis of a disorder in this dimension, I feel the bipolar disorder is one of the most common ones in this category. The clinical manifestation of bipolar disorder varies according to the episodes or nature of subcategory the individual is suffering. For example during a depressive episode the signs and symptoms exhibited by the patient experiences may include anxiety, lack of sleep, hopelessness, indifference, aggression, isolation, irritability, lack of interest in sexual activity, inability to concentrate, depersonalization, increased fatigue, impaired decision making, low esteem and suicidal tendencies.

On the other hand, the mania and hypomania episode manifests in symptoms such as surges of energy, low attention span, feelings of increased creativity, intelligence and sexual drive, impaired judgment, irritability, and substance abuse or spending sprees. In addition, hypomania or mania episodes may also manifest as unsubstantiated elation, restlessness and agitation, loss of social inhibitions, pressured speech, and a low need for sleep.

According to Parens & Johnston (2010), bipolar disorder in children may manifest as restlessness/fidgetiness, separation anxiety, hyperactivity, rages and explosive temper tantrums, destruction of property, goofiness, impulsivity, low self-esteem, silliness, difficulties waking up in the morning, lying, bed-wetting (especially in boys)and social anxiety (Parens & Johnston, 2010).

There is also the emotional disorder under the Axis I, which have almost similar diagnosis characteristics. Children and youth with emotional and behavioral disorders are special needs children. Their learning and education is affected because they do not perform in the same way as the rest of the learners. Their interpersonal relations and focus is not normal because they exhibit limited abilities in connecting with people and things. They are characterized by the inability to learn that cannot be explained by sensory, intellectual or health factors. These children have an inability to build and maintain fulfilling interpersonal relationships with teachers and peers. These learners have inappropriate behavior and a general pervasive mood of unhappiness or depression. In addition, these learners have a tendency to develop fears and symptoms associated with school or personal factors (Laurent Clerc, 2013).

Identifying a leaner with emotional or behavioral disorder is not difficult given their different behavior and emotions. These characteristics have little to no consideration or understanding of cultural and social rules. A learner with this disorder is inattentive and distractible, impulsive, disrupts classroom activities, preoccupied, aggressive, resists change or transitions in routine, has low self-esteem, bullies and intimidates other students, has poor concentration, difficulty working in groups, absent from school regularly, demonstrates a self-injurious behavior, manipulates situations often and cannot apply social rules to other’s personal belongings and space or follow class rules (Lehr & McComas, 2005). Emotional and behavioral disorders most often consist of antisocial and externalizing behaviors. A child will often do things that other children do not do given his/her condition. They disturb peers, bite and hit, complain, yell and curse, lie, steal and have temper tantrums. The learners ill have a hard time staying oat her/his seat, will argue excessively, destroy property and do not respond to teachers corrections. The noncompliance behavior is the source of all other behavioral excesses exhibited by a learner with emotional and behavioral disorder.









Beutler, L. E., & Malik, M. L. (2002). Rethinking the DSM: A psychological perspective. Washington, DC: American Psychological Association.

Greenberg, G. (2013). The book of woe: The DSM and the unmaking of psychiatry.

Laurent Clerc.  (2013). Emotional/Behavioral. Gallaudet university National Deaf education center. Disorders. Retrieved November 21, 2013. http://www.gallaudet.edu/clerc_center/information_and_resources/info_to_go/educate_children_%283_to_21%29/students_with_disabilities/emotionalbehavioral_disorders.html

Lehr, C. A. and McComas, J. (2005). Students with Emotional/Behavioral Disorders: Promoting Positive Outcomes. Retrieved November 21, 2013. http://ici.umn.edu/products./impact/182/over1.html

Parens, E., & Johnston, J. (2010). Controversies concerning the diagnosis and treatment of bipolar disorder in children. Child and Adolescent Psychiatry and Mental Health, 4(9), 1-14.