DSM-5

The DSM-5 uses a multiaxial, categorical system, which is a major shift from the DSM-IV-TR’s five-axis
classification system:
Axis I – Psychiatric and Medical Diagnoses
Axis II – Psychosocial and Environmental Problems
Axis III – Specific rating scales for each disorder
Read the following scenario and discuss which symptoms would go on which axes. This is an exercise
that will allow you to think in terms of where groups of symptoms would be placed using DSM-5
multiaxial system.
Neill is a 30-year-old man who has spent much of his adult life alone. He lives by himself and works from
home programming computers. On average, he leaves his apartment once weekly to go grocery shopping,
which he does at night because he is afraid of doing something “embarrassing” in front of large crowds of
people. When asked about his social life, Neill reports that he has 2 friends that he met in internet chatrooms. He has not met these individuals in-person, stating “If I meet them, they won’t like me. People
always make fun of me.” His fears of being criticized are immense. These fears have kept him from
applying for jobs outside of the home and from forming in-person social relationships. Neill has frequent
headaches and stomach aches. He describes himself as being “functional but stressed.” On a scale of 1-10,
with 1 being the least stress and 10 being the most stress, Neill ranks himself as a 7.