The difference between a dimension and a syndrome is critical to understanding scales and schedules. A scale involves a series of questions about symptoms from one or more dimensions of psychopathology. A dimension, sometimes called a domain, is a collection of interrelated symptoms about a given aspect of psychopathology that constitutes a continuum from a few to many symptoms. Thus a dimension involves a quantitative gradient based on symptoms representing a qualitative theme. Many scales reflect influence from psychometric theory and survey methodology, and psychologists and sociologists have been more prominent as their designers than psychiatrists.
The concept of a syndrome is fundamental to diagnostic classification as illustrated in the recent Diagnostic and Statistical Manuals (DSM-III, DSM-III-R, DSM-IV (American Psychiatric Association, 1980, 1987, 1994). The clinical tradition of psychiatry indicates that a disorder is usually identified by a pattern of symptoms that is made of some central symptoms that define the syndrome and other symptoms that frequently accompany the defining features. The central symptoms are called essential features and the symptoms that accompany the essential features are called associated symptoms.
Anxious and depressive symptomatology has been assessed in virtually all scales and schedules and will frequently be used for illustration. The type of anxiety involved at the beginning of this history was called free-floating but would now be called generalized anxiety. The type of depression would now be called unipolar.
Where anxiety is concerned, frightened and nervous apprehension is at the heart of the syndrome and constitutes its essential feature. The associated symptoms involve autonomic hyperactivity such as palpitations and cold sweats, motor tension such as trembling and muscle-twitching, and vigilance such as being "keyed-up" or easily startled. Where depression is concerned, the essential features involve dysphoria and anhedonia (the former referring to pervasive sadness and the latter to loss of interest and pleasure) and the associated symptoms involve disturbances of sleep, appetite, energy, and concentration as well as lack of self-esteem and thoughts about death and suicide.
The syndrome concept also takes the duration of symptomatology into account. In DSM-IV, disability or distress was added as a requirement for many diagnostic categories. The full complement of components for syndrome recognition and diagnosis includes essential features, associated symptoms, duration, distress and disability. Depending on the completeness of the pattern, the syndrome is considered to be present or absent thereby reflecting dichotomous measurement. Schedules are oriented to syndrome recognition for different diagnostic categories, and psychiatrists have played active roles in their construction.
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With all the stresses and strains of modern living, panic attacks are become a common problem for many people. Panic attacks occur when the pressure we are living under starts to creep up and overwhelm us. Often it's a result of running on the treadmill of life and forgetting to watch the signs and symptoms of the effects of excessive stress on our bodies. Thankfully panic attacks are very treatable. Often it is just a matter of learning to recognize the symptoms and learn simple but effective techniques that help you release yourself from the crippling effects a panic attack can bring.