01 pertemuan ke-1 dan ke-2 diagnosis mnm,.ultiaksial

8/20/2019 01 Pertemuan Ke-1 Dan Ke-2 Diagnosis Mnm,.ultiaksial

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DIAGNOSISMULTIAKSIAL

Psikologi abnormal


2/22


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Diagnosis Mul#ia+ial

DSM per#ama kali iperkenalkan i #ahun ,-./0

DSM i#erbi#kan oleh APA (Ameri$an Ps!$hia#ri$Asso$ia#ion)

lassi1$a#ion in DSM 2 I3 (,--4) are es$rip#ion"a#heore#i$al" an mul#ia+ial more $omprehensi%(Millon 5 Da6is" /777) DSM I3 2 T8

DSM2I32T8 in$lues 16e a+es 9 mul#ia+ial$lassi1$a#ion s!s#em" b! re:uiring ;ugemen#s onea$h o% #he 16e a+es" %or$es #he iagnos#i$ian #o$onsier a broa range o% in%orma#ion


4/22

Paa #ahun ,-


5/22

5 Axes in DSM-IV-TR A+es I>

lini$al Disorer O#her $oni#ions #ha# ma! be a %o$us o% $lini$al

a##en#ion

A+es II> Personali#! Disorer Men#al 8e#ara#ion

A+es III> General Mei$al oni#ion

A+es I3> Ps!$hoso$ial an en6ironmen#alproblems

A+es 3> Global Assesmen# o% ?un$#ioning(GA?) S$ale


6/22

5 Axes in DSM-IV-TR A+es I>

lini$al Disorer O#her $oni#ions #ha# ma! be a %o$us o% $lini$al

a##en#ion

A+es II> Personali#! Disorer Men#al 8e#ara#ion

A+es III> General Mei$al oni#ion

A+es I3> Ps!$hoso$ial an en6ironmen#alproblems

A+es 3> Global Assesmen# o% ?un$#ioning(GA?) S$ale


7/22

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Tu;uan Pembeaan Aksis I" II" III>

,0 en$ourage #horoughness in e6alua#ion

/0 enhan$e $ommuni$a#ion among heal#h

pro%essionals Tiak mengimplikasikan bah'a aa

perbeaan %unamen#al alamkonsep#ualisasin!a #iak ingin

menga#akan bh'0 Ggn men#al #iakberhubungan engan proses a#au %ak#or1sik" biologis a#au psikososial


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Aksis I dan II:

Isi ma#a kuliah Psikologi Abnormal

(ke$uali men#al re#ara#ion)


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Aksis III:General Medical Condition (GMC

urren# general mei$al $oni#ions #ha#are po#en#iall! rele6an# #o #heuners#aning or managemen# o% #he

ini6iual@s men#al isorer0


10/22

!"

GM $an be rela#e #o men#alisorers in se6eral 'a!s>

ila GM merupakan e#iologi perkembangana#au memburukn!a sim#om men#al e%ek1siologis" mis0 *!po#h!roiism pen!ebabsim#om epresi

Aksis I> moo isorer ue #o h!po#h!roiism

'i#h epressi6e %ea#ures

Aksis III> h!po#h!roiism

*ub an#ara GM mgkn aa" #p #k ;elas

Aksis I> i#uliskan sim#om men#aln!a apa

Aksis III> GM n!a apa


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!!

GM i$a#a# paa Aksis III" meskipun #akberhubungan langsung engan ggn men#al"krn pen#ing un#uk memahami keseluruhan#rea#men# ini6iu0 Mis0 Ini6iu !angepresi karena iagnosis kanker pa!uara

Aksis I> A;us#men# isorer 'i#h epressemoo

Aksis III> kanker pa!uara GM i$a#a# un#uk #u;uan pharma$o#herap!

(supa!a #iak o6erlap alam pemberianoba#)


12/22

!#

Aksis IV: $s%c&osocial and'niron)ental $ro*le)s

Ps!$hoso$ial an en6ironmen#al problems #ha# ma!aBe$# #he iagnosis" #rea#men#" an prognosis o%men#al isorers>

2 nega#i6e li%e e6en#s

2 en6ironmen#al iC$ul#ies or e1$ien$ies

2 %amilial or o#her in#erpersonal s#ress

2 inae:ua$! o% so$ial suppor# or personal

resour$es2 posi#i6e s#ressors (mis0 Promosi" pernikahan) !ang

men!ebabkan s#ress0


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!+

ara menulis paa Aksis I3>

Problems 'i#h primar! suppor# group (e0g0ea#h o% a %amil!" remarriage o% paren#)

Problems rela#e #o #he so$ial

en6ironmen# (e0g0 inae:ua#e so$ialsuppor#" li6ing alone" re#iremen#)

u$a#ional problems (e0g0 a$aemi$"is$or 'i#h #ea$hers)

O$$upa#ional problems (unemplo!men#" ;ob issa#is%a$#ion)


14/22

!,

*ousing problems (e0g0 homelessness"inae:ua#e housing)

$onomi$ problems (e0g0 e+#reme po6er#!)

Problems 'i#h a$$ess #o heal#h $areser6i$e (e0g0#ranspor# una6ailable)

Problems rela#e #o in#era$#ion 'i#h #he

legal s!s#emE$rime (e0g0 arres#) O#her ps!$hoso$ial an en6ironmen#al

problems (e0g0 e+posure #o isas#ers" 'ars)


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!5

a#a#an>

2 no#e onl! #hose ps!$hoso$ial anen6ironmen#al problems #ha# ha6e been

presen# uring #he !ear pre$eeing #he$urren# e6alua#ion

2 bila masalah #er;ai lebih ari , #ahun $a#a# bila ;elas memberi kon#ribusi"a#au #elah men;ai %okus #rea#men#


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Aksis 5: Glo*al Assess)ent o./0nctionin1 (GA/ Scale

erasarkan per#imbangan ber%ungsin!ase$ara psikologis" sosial 5 okupasional"paa sua#u kon#inum hipo#esis ari

keseha#an2gangguan men#al0 &angan memasukkan hena!a alam

ber%ungsi !ang berhubungan enganke#erba#asan 1sik a#au lingkungan0


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GA/ Scale

onsier ps!$hologi$al" so$ial" an o$$upa#ional%un$#ioning on a h!po#he#i$al $on#inuum o% men#alhealEillness0 Do no# in$lue impairmen# in%un$#ioning ue #o ph!si$al (or en6ironmen#)

limi#a#ions07 > Inae:ua#e in%orma#ion

,2,7 > Persis#en# anger o% se6erel! hur#ing sel% oro#hersE persis#en# inabili#! #o main#ain minimalpersonal h!giene

.,2F7> moera#e s!mp#omsEmoera#e iC$ul#! inso$ial" o$$upa#ional" or s$hool %un$#ioning

-,2,77> No s!mp#oms" superior %un$#ioning in a 'ierange o% a$#i6i#ies


18/22

!8

Conto& $en0lisan Dia1nosisM0ltiaksial

Aksis I > (/-F0/ #iak aa

Aksis I3 > an$aman kehilangan peker;aan

Aksis 3 > GA?9


19/22

Dia1nosis M0ltiaxial

A+es I > (/-F0/ none

A+ess I3 > O$$upa#ional ProblemA+es 3 > GA?9


20/22

C0rrent iss0es related to

DSM-V Disorer #ha# migh# be in$lue in DSM23 eha6ioral Ai$#ion

De1ni#ion> e+$essi6e use se+" shopping" or$ompu#ers ma! signal ai$#ion0 These beha6ior$an be #aken #o su$h e+#remes #ha# #he! easil!mimi$ #he beha6iors o% rug ai$#s0

inge a#ing Disorer De1ni#ion> ini6iuals 'ho binge are unable #o

$on#rol perios o% o6erea#ing an %eel guil#! orisgus#e 'i#h #hemsel6es0 The! o%#en be$omeobese0 Some ea# alone #o a6oi %eelings o% shame0


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ompli$a#e Grie% De1ni#ion> a%#er #he ea#h o% someone

$lose" grie% an saness normall! begin #o

issipa#e 'i#hin si+ mon#hs0 u# somepeople $on#inue #o mourn %or mu$h longer0

urren# issues rela#e #oDSM23


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Disorer #ha# migh# be e+$lue in DSM23 The Paraphilia> In#ense se+ual urges in6ol6ing

animals" $hilren" non$onsensual se+" suBering"or humilia#ion are $lassi1e as paraphilias a

#erm #ha# 'as #hough# #o be rela#i6el! non ;ugmen#al 'hen i# repla$e Hper6ersions in,-J70

Gener Ien#i#! Disorer> Sin$e #he DSM2III

appeare in ,-J7" ini6iual 'ho 'ish #o be o%#he opposi#e se+2an 'ho are un$om%or#able 'i#h#heir o'n2ha6e been iagnose 'i#h GenerIen#i#! Disorer0

urren# issues rela#e #oDSM23

01 pertemuan ke-1 dan ke-2 diagnosis mnm,.ultiaksial

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