Axis I vs. Axis II

It occurs to me that what are classified as "Axis II" disorders in the (rather hateful) DSM are actually "Axis I" disorders (depression, bipolar, anxiety) that are expressed through certain behaviors due to environment. In other words, Axis I is the "nature"; Axis II is the "nurture."

Thoughts?

It's more complicated than that. It seems Axis I has more episodic conditions. Almost anyone can experience a period of clinical depression. Axis II conditions are more deeply entrenched. It's not exactly cut-and-dry though. It's hard for someone with chronic Axis I symptoms not to also have traits consistent with Axis II. The distinctions are largely invented. It's more art than science. It certainly isn't hard science.

frostfern wrote:It's more complicated than that. It seems Axis I has more episodic conditions. Almost anyone can experience a period of clinical depression. Axis II conditions are more deeply entrenched. It's not exactly cut-and-dry though. It's hard for someone with chronic Axis I symptoms not to also have traits consistent with Axis II. The distinctions are largely invented. It's more art than science. It certainly isn't hard science.

Just some Axis I disorders are episodic.

Bipolar disorder, schizophrenia and OCD are lifetime, but they are still mental illness. Even it they do have treatment patients are never considered cured, just remmited.

Personality disorders on the other hand, are not illness, are just ways of behaving that are completely maladaptative and ego-syntonic. That is the person with a PD, strongly believes that their ways of dealing with situations are correct.

When it comes to BPD, one must realized that it will always involve other Axis I disorders that will make things much worse, even if not diagnosed.

Borderlines usually have generalized anxiety, depression(uni or bipolar) and attention defficit disorder. Now even if you combine all of these things, it is still not borderline personality disorder.

I dont think schizotypal PD is a PD, neither does WHO. Maybe they will move BPD on the future, I really dont now. BPD is not so clearly ego-syntonic like other PDs, such as NPD, OCDP, HPD, PPD and ASPD.

creative_nothing wrote:Just some Axis I disorders are episodic.

Bipolar disorder, schizophrenia and OCD are lifetime, but they are still mental illness. Even it they do have treatment patients are never considered cured, just remmited.

True.

Personality disorders on the other hand, are not illness, are just ways of behaving that are completely maladaptative and ego-syntonic. That is the person with a PD, strongly believes that their ways of dealing with situations are correct.

I don't know where you come up. There's some pretty hard evidence that people with BPD simply feel emotions much more strongly than ordinary people. You give a normal person the same kind of extreme emotional experience they will likely display the same behaviors. It really has nothing to do with "beliefs".

My comments werent bpd specific, but we all now that borderline is not merely emotional disregulation. This is bipolar disorder and can be treated with a combination of antidepressants and mood stabilizers. If evidences show otherwise it should be moved to axis I

Of course that for every particular PD, there is a common temperament pattern, high introversion for instance is found on all individuals on cluster A. However the temperament alone doesnt constitute any PD.

creative_nothing wrote:My comments werent bpd specific, but we all now that borderline is not merely emotional disregulation. This is bipolar disorder and can be treated with a combination of antidepressants and mood stabilizers. If evidences show otherwise it should be moved to axis I

Bipolar isn't emotional dysregulation. It's mood dysregulation. The two are very different. Mood fluctuations with bipolar last months and aren't necessarily situational. Emotional dysregulation is triggered by situations and is a hallmark of BPD, not bipolar. When emotional dysregulation occurs with bipolar disorder it's almost always associated with a so-called "mixed state" mania. Not everyone with bipolar experiences a "mixed state".

Of course that for every particular PD, there is a common temperament pattern, high introversion for instance is found on all individuals on cluster A. However the temperament alone doesnt constitute any PD.

People with BPD can be introverted or extroverted. There isn't a temperament bias.

Right, but BPD is marked by an extremelly high neuroticism, and also about high openess. This contrast with ASPD who are unconcerned and fearless. Anyone with this combination would probrably be regarded as moody at least.

You could check this. I remember reading it a time ago.

Is borderline personality disorder a mood disorder?
http://bjp.rcpsych.org/content/204/4/252

Abstract

Borderline personality disorder is by its very naming positioned as an Axis II personality disorder and thus seemingly distinct from an Axis I mood state. Clinical differentiation of those with a borderline condition and those with a bipolar disorder is commonly held to be difficult, so raising the question as to whether they may be independent or interdependent conditions, and allowing several possible answers.

In the past cyclothymia was also a PD, and there was also depressive PD, but no dysthimia. And as I mentioned schizotypal disorder is classified as a PD only on DSM.

It really has nothing to do with "beliefs".

It does have. One of the characteristics of BPD are deficits on cognitive empathy and problems with boundaries and responsability.

From what I see in this forum, sometimes people blame others for their problems, and at other times tend to be vulnerable to gaslighting, accepting partners despicable behaviours as completely normal.

-- Fri May 22, 2015 3:37 pm --

However, what I've mentioned before may be valid reason, yet not enough reason to place it on Axis II?

I mean people with schizophrenia also have a tendency to attribute malicious intent to other people and it is still on Axis I.

Axis I is stuff with an acute treatment need. It is usually what causes a person to seek treatment. Panic attacks, hallucinations, major depression, etc. For me a year ago that would have been depression NOS with suicidal ideation.

Axis II is stuff that may be affecting how the person responds to treatment of Axis I stuff. Nearly all of the developmental stuff goes in here, along with personality disorders.

Axis III is for straight medical stuff, no psych.

Axis IV is all the psychosocial events and status changes and stresses that are affecting the individual. In my case that would be divorce, bankruptcy, being a single father, career transition, and a titch of early mid-life crisis.

Axis V is a score that represents a general indicator of how functional the individual is in their life, 0-100.