How APA DSM-V Manual Moved Past Multiaxial Classification of Disorders
Dr. David Steinbok holds an MS and a doctorate in clinical psychology from Nova Southeastern University’s Center for Psychological Studies. Now working in private practice in Boca Raton, Florida, Dr. David Steinbok provides psychological treatment to people with Axes I and II disorders.
Mental health disorders are classified according to a manual created by the American Psychiatric Association (APA) called the Diagnostic and Statistical Manual of Mental Disorders (DSM) that was first published in 1952. The manual originally organized psychiatric disorders into axes to help mental health professionals provide their patients with comprehensive diagnoses. It also helped them communicate their patients’ needs to insurance companies. However, in its latest edition, DSM-V, which debuted in 2013, APA has since moved away from that multiaxial classification system.
In the fourth edition, when the multiaxial classification was last used, disorders were classified into five axes. Axis I disorders were those that most commonly affected members of the public. They included anxiety, mood, eating, psychotic, and substance use disorders.
Axis II disorders included developmental and personality disorders like borderline personality disorder. Axis III codified the neurological or medical issues that could worsen Axis I and II disorders.
Axis IV described the environmental or psychosocial factors that affected people with mental disorders. They included economic, educational, housing, and occupational problems.
Last, Axis V was a scaled rating that went from zero to 100. It was used by psychologists to summarize how well patients were doing.
In the fifth and latest edition, DSM-V, APA moved away from the multiaxial system. Instead, it categorizes related disorders together without using any form of numbering. The categories include anxiety disorders, depressive disorders, obsessive-compulsive and related disorders, and bipolar and related disorders.
