Skip to Main Content

++

The diagnostic formulation summarizes and integrates relevant issues from the biopsychosocial, developmental, and temporal axes. The biopsychosocial axis refers to multiple systems, from molecular to sociocultural, that interact constantly and are manifest in current objective behavior and subjective experience. The developmental axis is applied to different levels of the biopsychosocial axis in order to determine whether each level is developmentally normal, delayed, advanced, or deviant. The temporal axis refers to the ontogenesis of the individual from his or her origins to the present and beyond.

++

Biopsychosocial Axis

++

Current functioning is the expression of multiple biopsychosocial levels within the patient, as he or she interacts with the physical, family, sociocultural, occupational, and economic environment. In order to evaluate present functioning, the clinician examines the levels and systems described in Table 12–1.

++
Table Graphic Jump Location
Table 12–1. The Biopsychosocial Axis
++

Developmental Axis

++

Each level of the biopsychosocial axis can be assessed with regard to what would be expected for that age. Some of these assessments (e.g., height, weight, head circumference) are very accurate. For others (e.g., intelligence), although a number of assessment instruments are available, existing measures represent a composite of skills potentially affected by extraneous factors (e.g., social class, motivation). For still others (e.g., ego defenses, working models of attachment), measurement techniques are relatively crude and the norms subjective.

++

Nevertheless, during interviewing and mental status examination, the clinician will scan the levels shown in Table 12–2 for delay, precocity, or deviation from the normal and, when appropriate, order formal special investigations.

++
Table Graphic Jump Location
Table 12–2. The Developmental Axis
++

Temporal Axis

++

All individuals have come from somewhere, exist where they are now, and are headed somewhere. Using the temporal axis, the clinician explores the unfolding of a problem up to the present time and attempts to predict ...

Want remote access to your institution's subscription?

Sign in to your MyAccess profile while you are actively authenticated on this site via your institution (you will be able to verify this by looking at the top right corner of the screen - if you see your institution's name, you are authenticated). Once logged in to your MyAccess profile, you will be able to access your institution's subscription for 90 days from any location. You must be logged in while authenticated at least once every 90 days to maintain this remote access.

Ok

About MyAccess

If your institution subscribes to this resource, and you don't have a MyAccess profile, please contact your library's reference desk for information on how to gain access to this resource from off-campus.

Subscription Options

AccessMedicine Full Site: One-Year Subscription

Connect to the full suite of AccessMedicine content and resources including more than 250 examination and procedural videos, patient safety modules, an extensive drug database, Q&A, Case Files, and more.

$995 USD
Buy Now

Pay Per View: Timed Access to all of AccessMedicine

24 Hour Subscription $34.95

Buy Now

48 Hour Subscription $54.95

Buy Now

Pop-up div Successfully Displayed

This div only appears when the trigger link is hovered over. Otherwise it is hidden from view.