DSM-IV Axis IV: Psychosocial and Environmental Problems

Problems with primary support group Specify
(e.g., Death of family member; health problems in family; disruption of family by separation, divorce or estrangement; removal from the home; remarriage of parent; sexual or physical abuse; parental overprotection; neglect of child; inadequate discipline; discord with siblings; birth of a sibling)

Problems related to the social environment Specify
(e.g., death of loss of friend; inadequate social support; living alone; difficulty with acculturation; discrimination; adjustment to life-cycle transition (such as retirement, menopause)

Educational problems Specify
(e.g., illiteracy; academic problems; discord with teachers or classmates; inadequate school environment)

Occupational problems Specify
(e.g., unemployment; threat of job loss; stressful work schedule; difficult work conditions; job dissatisfaction; job change; discord with boss or co-workers)

Housing problems Specify
(e.g., homelessness; inadequate housing; unsafe neighbourhood; discord with neighbours or landlord)

Economic problems Specify
(e.g., extreme poverty; inadequate finances; insufficient welfare support)

Problems with access to health care services Specify
(e.g., inadequate health care services; transportation to health care facilities unavailable; inadequate health insurance)

Problems related to interaction with the legal system/crime Specify
(e.g., arrest; incarceration; litigation; vicitm of crime)

Other psychosocial and environmental problems Specify
(e.g., exposure to disasters, war, other hostilities; discord with nonfamily caregivers such as counselor, social worker, or physician; unavailability of social service agencies)