Axis IV - psychosocial and environmental problems - in the DSM-IV

作者：Ramirez A^*; Ekselius L; Ramklint M

来源：Journal of Psychiatric and Mental Health Nursing, 2013, 20(9): 768-775.

DOI：10.1111/jpm.12009

• assessment
• axis IV
• concurrent validity
• DSM-IV
• psychosocial stress
• young adults

The aim of this study was to further explore the properties of axis IV in the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (DSM-IV). In a naturalistic cross-sectional design, a group (n = 163) of young (18-25 years old) Swedish psychiatric outpatients was assessed according to DSM-IV. Psychosocial and environmental problems/axis IV were evaluated through structured interviewing by a social worker and by self-assessment on a questionnaire. Reliability between professional assessment and self-assessment of axis IV was examined. Concurrent validity of axis IV was also examined. Reliability between professional and self-assessed axis IV was fair to almost perfect, 0.31-0.83, according to prevalence and bias-adjusted kappa. Categories of psychosocial stress and environmental problems were related to the presence of axis I disorders, co-morbidity, personality disorders and decreasing Global Assessment of Functioning (GAF) values. The revised axis IV according to DSM-IV seems to have concurrent validity, but is still hampered by limited reliability.

• 出版日期2013-11