Issues of immigration for the health and adjustment of young people.
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Biomedical subjects
Publications and source records attributed to M R Bashir.
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In order to address validity issues which have not been adequately explored in the existing literature on Axis V, the authors compared ratings on this axis with ratings on three other measures of adaptive functioning (Social Competence, premorbid and present) in a diagnostically heterogeneous group of 195 referred adolescents. It was found that correlations amongst the measures were moderate, except between premorbid and present functioning, which was high. Axis V was found to be comparable with a measure of premorbid functioning while Social Competence was similar to present functioning.
Clinicians have traditionally inquired about stressful life events preceding the onset of a psychiatric disorder. Axis IV of DSM-III attempted to improve on this by suggesting that a wide range of events be considered and that the information obtained be integrated into a global rating of severity. After reviewing recent evidence, the authors suggest that this process might result in ratings with lower reliability than expected. They also discuss some of the methodological difficulties in this field and explore directions for further research.
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Lists of stressors recorded for 159 adolescents and rated by two judges showed poor agreement on stressor identification but good concordance for the most severe stressor identified for each patient. Good agreement was also found for a short checklist of chronic stressors. When individual stressors were rated by four judges for 27 patients, global Axis IV ratings were largely determined by the rating of the most severe event. Those results suggest that Axis IV can be made more reliable and easier to use by concentrating on the identification of severe events.