Personality Disorder Axes
Personality Disorder Axes
Like iceberg tips, personality disorders are real. Personality Disorder Axes The foundation of these lies in the interplay of causes and consequences, interactions and events, emotions and cognitions, functions, and dysfunctions that collectively shape the patient and define who they are. These data are analysed, categorised, and described by the DSM using five axes. A mental health diagnostician evaluates the patient (or subject) when they see him, gives them tests, has them fill out questionnaires, and makes a diagnosis. The diagnostician organises the data he has acquired in this procedure in a meaningful way by using the DSM’s five axes to “make sense” of it.
Orientation I insist that he list every clinical mental health issue that the patient has that isn’t related to mental illness or personality issues. Accordingly, Axis I comprises conditions that were initially identified as mental health problems in infancy, childhood, or adolescence; cognitive issues (such as delirium, dementia, or amnesia); mental disorders resulting from a medical condition (such as dysfunctions brought on by brain injury or metabolic diseases); disorders related to substances; psychosis and schizophrenia; mood disorders; anxiety and panic; somatoform disorders; factitious disorders; eating disorders; problems with impulse control; and issues related to adjustment.
Our upcoming articles will go into great detail on Axis II. It includes mental retardation and personality abnormalities (interesting combination!).
Personality Disorder Axes III
Personality Disorder Axes III is where medical issues that impact the patient’s mental state and well-being are recorded. Certain physical conditions directly contribute to psychological difficulties (depression is induced by hyperthyroidism). In some instances, the latter worsens or coexists with the former. Almost all biological diseases have the potential to alter a patient’s behaviour, emotional state, cognitive abilities, and psychological makeup.
However, life’s machinery—the body and the “soul”—is both proactive and reactive. It is shaped by one’s surroundings and psychological conditions. Problems in life, pressures, shortcomings, and insufficient assistance combine to cause instability and, in extreme cases, to destroy one’s mental well-being. Numerous negative factors are listed in the DSM under Axis IV, and these include death in the family or of a close friend, health issues, divorce, remarriage, abuse, sibling rivalry, neglect, social isolation, discrimination, life cycle transition (like retirement), unemployment, workplace bullying, housing or economic issues, limited or no access to health care services, incarceration or litigation, traumas, and many more incidents and situations. Lastly, the DSM acknowledges that the first-hand impression that the clinician has of the patient is just as significant as any “objective” information that he may obtain in the course of the diagnostic process. The diagnostician can document “the individual’s overall level of functioning” on axis V. It must be acknowledged that this is an ambiguous and biassed report. The DSM advises mental health practitioners to utilise the Global Assessment of Functioning (GAF) Scale in order to mitigate these risks. Just by using this organised exam, the diagnostician is forced to meticulously establish his opinions and eliminate social and cultural biases.
The therapist, psychologist, psychiatrist, or social worker
The therapist, psychologist, psychiatrist, or social worker now has a comprehensive understanding of the patient’s life, medical history, background, surroundings, and mental state after completing this drawn-out and complex process. At this point, she is prepared to proceed and provide a formal diagnosis of personality disorder, with or without co-morbid (coexisting) disorders. What exactly is a personality disorder, though? They seem so similar to each other or so different, and there are so many of them! What are the threads connecting them? What characteristics do all personality disorders have in common?
Adel Seyam
Paris 2005
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