Introduction to Behavioral Health
Updated: 04/22/2016
The Multiaxial System - used previously in DSM 4 (now DSM 5 is used, but we should still understand and recognize the importance of these axes).
- Axis I – serious mental illnesses (mood, anxiety, eating, sleep, impulse-control, adjustment)
- Axis II – personality disorders +/- mental retardation
- Axis II – general medical conditions (neoplasms, injury, poisoning)
- Axis IV – psychosocial and environmental problems (educational problems, economic, housing, access to healthcare)
- Axis V – GAF (1-100) = global assessment of functioning
Terminology
AFFECT - The patient’s present emotional responsiveness, inferred from patient’s facial expression, including amount and range of expressive behavior [objective: what you observe about pt]
Appropriate
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Inappropriate
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Congruent
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Incongruent
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Appropriate amount of eye contact, facial expression, responsiveness, etc.
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Incongruent with content or social norms
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Psychotic content consistent with patient's mood
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Psychotic content inappropriate to patient's mood
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Restricted
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Constricted
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Blunted
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Reduced intensity of affect – lesser degree than blunted
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Restricted affect
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Severe reduction in intensity of affect
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Flat
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Exaggerated
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Labile
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Virtually no signs of affective expression, no facial expression, monotonous voice
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Dramatic, overly expressive
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Fluctuating, rapid changes in emotion unrelated to external stimuli
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