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Table of Contents > Alternative Modalities > Diagnostic and Statistical Manual of Mental Disorders Print

Diagnostic and Statistical Manual of Mental Disorders

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Also listed as: Diet, Zone
Related terms
Background
Theory/evidence
Safety
Author information
Bibliography
Dsm outline
D s m outline

Related Terms
  • Adequate protein diet, Barry Sears, carbohydrate, diet, fat, low carbohydrate diet, protein.

Background
  • The Zone diet is an unproven dietary regime, which has been popularized by Dr. Barry Sears through sales of his 1995 book, The Zone. Despite claims made in the book, there is little available research to support its overall benefit.
  • The Zone diet is a calorie-restricted diet that provides adequate protein, moderate levels of carbohydrates, essential fats and micronutrients spread through three meals and two snacks that approximately maintain the protein-to-carbohydrate ratio throughout the day.
  • Proponents believe that the Zone diet promotes optimal metabolic efficiency in the body by balancing the hormones insulin and glucagon. Insulin is responsible for converting, in the blood, incoming nutrients into cells. Glucagon regulates glucose in the liver. Overall, the Zone's food plan consists of a dietary intake of 40% carbohydrates, 30% protein and 30% fat.
  • Under this diet, recommended foods include fruits and vegetables (fresh or frozen), oatmeal (whole grain), protein powder (e.g. soybean isolate), chicken, turkey, lean beef, fish, low-fat cottage cheese, soy food, nuts (e.g. almonds, cashews, macademia, pistachios), extra virgin olive oil, natural sweeteners, such as fructose or stevia.

Theory / Evidence
  • Recent research seems to indicate that a low total caloric intake is associated with longer life expectancy. Based on animal studies, animals eating calorie-restricted diets may live 1.5 to 2 times as long as animals eating high-calorie diets. Theoretically, similar effects may occur in humans. The caloric restriction recommended by the Zone diet is below that of the average American and may be of benefit in weight loss and if maintained over decades in increasing life expectancy. On the other hand, athletes in training will likely suffer from decreased performance if restricted to the low calorie diet recommended by the Zone.
  • Despite proposed benefits, currently there are no high quality clinical trials available about the Zone diet or similar diets consisting of the recommended 40% carbohydrates, 30% fat, and 30% protein. The Zone diet is quite complex in terms of caloric restriction, ratio of carbohydrates/protein//fat, spacing of meals, preferential intake of certain fats, and avoidance or inclusion of a few specific foods.

Safety




Author information
  • This information has been edited and peer-reviewed by contributors to the Natural Standard Research Collaboration (www.naturalstandard.com).

Bibliography
  1. Cheuvront SN. The zone diet and athletic performance. Sports Med. 1999;27(4):213-228.
  2. Natural Standard: The Authority on Integrative Medicine.
  3. Sears B. The Zone Diet and athletic performance. Sports Med. 2000;29(4):289-294.

Dsm outline
  • A statement released by the American Psychological Association states that an individual requires specialized training to use the DSM.
  • The American Psychiatric Association has added and omitted diagnoses over time. For instance, homosexuality was once listed as a diagnosis but was omitted in 1973; attention deficit disorder (ADD) was added to the DSM-III in 1983.
  • A considerable amount of dialogue occurs before a diagnosis is created, modified, or removed. Many articles are published in scientific and psychological publications. The American Psychiatric Association also establishes what is known as a congress to debate the diagnostic categories before a new edition of the DSM is released. In congresses, mental health professionals and experts in the field of psychology discuss the categorization of a disorder. Members may also create, modify or remove a diagnosis from the DSM. Sometimes, social activists play a role in diagnoses. For instance, public protests and activism on the part of homosexual groups created enough pressure for the 1980 version of the DSM to drop "homosexuality" as a diagnosis.
  • For each diagnosis, the DSM includes a list of behaviors that commonly accompany the disorder. In order for an individual to be diagnosed, they must acknowledge experiencing, and the therapist must observe, at least a majority of those behaviors. For instance, for an individual to be diagnosed with a major depressive episode an individual must self-report, and a mental health professional must observe, at least 5 of the 9 listed behaviors.
  • A person may be diagnosed with multiple disorders at the same time. Some of the criteria for diagnosis in the DSM are open to interpretation; different clinicians may diagnose the same patient differently.
  • The DSM-IV-TR specifies that reports of an individual's mental illness are organized on 5 axes. Each axis provides specific information about an individual's life experience, stress level, and cognitive functioning. The axes were developed as a diagnostic tool because the American Psychiatric Association believes that life circumstances influence emotional functioning. The DSM-IV-TR is not organized on the basis of these axes.
  • Axis I: Clinical disorders. These include major mental disorders, developmental disorders and learning disabilities. Common disorders on this axis may include: depression, anxiety disorders, bipolar disorder, ADD, and schizophrenia.
  • Axis II: Personality disorders and mental retardation. These may include borderline personality disorder, schizotypal personality disorder, antisocial personality disorder, mild mental retardation, and substance abuse.
  • Axis III: General medical condition. This axis includes any non-psychiatric medical condition. These conditions are also known as somatic conditions. Axis III acknowledges that a handicap or illness influences an individual's emotional wellbeing. Examples of these may include diabetes, HIV/AIDS or paraplegia.
  • Axis IV: Psychosocial and environmental factors. This axis discusses social functioning and the impact that symptoms of emotional illness may have on an individual's day-to-day life. This axis acknowledges that one's social environment and life circumstances have an impact on an individuals' mental health. Recent bankruptcy, childhood trauma, and a death of a close relative are examples of factors that may be included on this axis.
  • Axis V: Uses the Global Assessment of Functioning (GAF), which is a scale of 100 - 0. This scale was created by the American Psychiatric Association and is intended to give a numeric "snapshot" of a person's social, occupational and psychological functioning. This scale is only used for adults. For children, the Children's Global Assessment Scale is used. Individuals receiving psychological treatment should show improvement in their Global Assessment of Functioning over time. The ranking is as follows:
  • 91-100: Superior functioning in a wide range of activities; life's problems never seem to get out of hand; is sought out by others because of his or her many qualities. No symptoms.
  • 90-81: Absent or minimal symptoms; good functioning in all areas; interested and involved in a wide range of activities; socially effective; generally satisfied with life; no more than everyday problems or concerns.
  • 80-71: If symptoms are present, they are transient and expectable reactions to psychosocial stresses; no more than slight impairment in social, occupational, or school functioning.
  • 70-61: Some mild symptoms OR some difficulty in social, occupational, or school functioning, but generally functioning pretty well; has some meaningful interpersonal relationships.
  • 60-51: Moderate symptoms OR any moderate difficulty in social, occupational, or school functioning.
  • 50-41 Serious symptoms OR any serious impairment in social, occupational, or school functioning.
  • 40-31: Some impairment in reality testing or communication OR major impairment in several areas, such as work or school, family relations, judgment, thinking, or mood.
  • 30-21: Behavior is considered influenced by delusions or hallucinations OR serious impairment in communications or judgment OR inability to function in all areas.
  • 20-11: Some danger of hurting self or others OR occasionally fails to maintain minimal personal hygiene OR gross impairment in communication.
  • 10-1: Persistent danger of severely hurting self or others OR persistent inability to maintain minimum personal hygiene OR serious suicidal act with clear expectation of death.
  • 0: Not enough information available to provide GAF.

D s m outline
  • A statement released by the American Psychological Association states that an individual requires specialized training to use the DSM.
  • The American Psychiatric Association has added and omitted diagnoses over time. For instance, homosexuality was once listed as a diagnosis but was omitted in 1973; attention deficit disorder (ADD) was added to the DSM-III in 1983.
  • A considerable amount of dialogue occurs before a diagnosis is created, modified, or removed. Many articles are published in scientific and psychological publications. The American Psychiatric Association also establishes what is known as a congress to debate the diagnostic categories before a new edition of the DSM is released. In congresses, mental health professionals and experts in the field of psychology discuss the categorization of a disorder. Members may also create, modify or remove a diagnosis from the DSM. Sometimes, social activists play a role in diagnoses. For instance, public protests and activism on the part of homosexual groups created enough pressure for the 1980 version of the DSM to drop "homosexuality" as a diagnosis.
  • For each diagnosis, the DSM includes a list of behaviors that commonly accompany the disorder. In order for an individual to be diagnosed, they must acknowledge experiencing, and the therapist must observe, at least a majority of those behaviors. For instance, for an individual to be diagnosed with a major depressive episode an individual must self-report, and a mental health professional must observe, at least 5 of the 9 listed behaviors.
  • A person may be diagnosed with multiple disorders at the same time. Some of the criteria for diagnosis in the DSM are open to interpretation; different clinicians may diagnose the same patient differently.
  • The DSM-IV-TR specifies that reports of an individual's mental illness are organized on 5 axes. Each axis provides specific information about an individual's life experience, stress level, and cognitive functioning. The axes were developed as a diagnostic tool because the American Psychiatric Association believes that life circumstances influence emotional functioning. The DSM-IV-TR is not organized on the basis of these axes.
  • Axis I: Clinical disorders. These include major mental disorders, developmental disorders and learning disabilities. Common disorders on this axis may include: depression, anxiety disorders, bipolar disorder, ADD, and schizophrenia.
  • Axis II: Personality disorders and mental retardation. These may include borderline personality disorder, schizotypal personality disorder, antisocial personality disorder, mild mental retardation, and substance abuse.
  • Axis III: General medical condition. This axis includes any non-psychiatric medical condition. These conditions are also known as somatic conditions. Axis III acknowledges that a handicap or illness influences an individual's emotional wellbeing. Examples of these may include diabetes, HIV/AIDS or paraplegia.
  • Axis IV: Psychosocial and environmental factors. This axis discusses social functioning and the impact that symptoms of emotional illness may have on an individual's day-to-day life. This axis acknowledges that one's social environment and life circumstances have an impact on an individuals' mental health. Recent bankruptcy, childhood trauma, and a death of a close relative are examples of factors that may be included on this axis.
  • Axis V: Uses the Global Assessment of Functioning (GAF), which is a scale of 100 - 0. This scale was created by the American Psychiatric Association and is intended to give a numeric "snapshot" of a person's social, occupational and psychological functioning. This scale is only used for adults. For children, the Children's Global Assessment Scale is used. Individuals receiving psychological treatment should show improvement in their Global Assessment of Functioning over time. The ranking is as follows:
  • 91-100: Superior functioning in a wide range of activities; life's problems never seem to get out of hand; is sought out by others because of his or her many qualities. No symptoms.
  • 90-81: Absent or minimal symptoms; good functioning in all areas; interested and involved in a wide range of activities; socially effective; generally satisfied with life; no more than everyday problems or concerns.
  • 80-71: If symptoms are present, they are transient and expectable reactions to psychosocial stresses; no more than slight impairment in social, occupational, or school functioning.
  • 70-61: Some mild symptoms OR some difficulty in social, occupational, or school functioning, but generally functioning pretty well; has some meaningful interpersonal relationships.
  • 60-51: Moderate symptoms OR any moderate difficulty in social, occupational, or school functioning.
  • 50-41: Serious symptoms OR any serious impairment in social, occupational, or school functioning.
  • 40-31: Some impairment in reality testing or communication OR major impairment in several areas, such as work or school, family relations, judgment, thinking, or mood.
  • 30-21: Behavior is considered influenced by delusions or hallucinations OR serious impairment in communications or judgment OR inability to function in all areas.
  • 20-11: Some danger of hurting self or others OR occasionally fails to maintain minimal personal hygiene OR gross impairment in communication.
  • 10-1: Persistent danger of severely hurting self or others OR persistent inability to maintain minimum personal hygiene OR serious suicidal act with clear expectation of death.
  • 0: Not enough information available to provide GAF.

Copyright © 2011 Natural Standard (www.naturalstandard.com)


The information in this monograph is intended for informational purposes only, and is meant to help users better understand health concerns. Information is based on review of scientific research data, historical practice patterns, and clinical experience. This information should not be interpreted as specific medical advice. Users should consult with a qualified healthcare provider for specific questions regarding therapies, diagnosis and/or health conditions, prior to making therapeutic decisions.

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