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Despite all of these challenges, however, many people overcome psychological disorders and go on to lead productive
lives. It is up to all of us who are informed about the causes of psychological disorder and the impact of these
conditions on people to understand, first, that mental illness is not a “fault” any more than is cancer. People do not
choose to have a mental illness. Second, we must all work to help overcome the stigma associated with disorder.
Organizations such as the National Alliance on Mental Illness (NAMI; n.d.), [14] for example, work to reduce the
negative impact of stigma through education, community action, individual support, and other techniques.
Diagnosing Disorder: The DSM
Psychologists have developed criteria that help them determine whether behavior should be
considered a psychological disorder and which of the many disorders particular behaviors
indicate. These criteria are laid out in a 1,000-page manual known as
theDiagnostic and Statistical Manual of Mental Disorders (DSM), a document that provides a
common language and standard criteria for the classification of mental disorders (American
Psychiatric Association, 2000).[15] The DSM is used by therapists, researchers, drug companies,
health insurance companies, and policymakers in the United States to determine what services
are appropriately provided for treating patients with given symptoms.
The first edition of the DSM was published in 1952 on the basis of census data and psychiatric
hospital statistics. Since then, the DSM has been revised five times. The last major revision was
the fourth edition (DSM-IV), published in 1994, and an update of that document was produced in
2000 (DSM-IV-TR). The fifth edition (DSM-V) is currently undergoing review, planning, and
preparation and is scheduled to be published in 2013. The DSM-IV-TR was designed in
conjunction with the World Health Organization’s 10th version of the International
Classification of Diseases (ICD-10), which is used as a guide for mental disorders in Europe and
other parts of the world.
As you can see in Figure 12.7, the DSM organizes the diagnosis of disorder according to five
dimensions (or axes) relating to different aspects of disorder or disability. The axes are important
to remember when we think about psychological disorder, because they make it clear not only
that there are different types of disorder, but that those disorders have a variety of different
causes. Axis I includes the most usual clinical disorders, including mood disorders and anxiety
disorders; Axis II includes the less severe but long-lasting personality disorders as well as mental