Which DSM feature was eliminated in DSM-5 organizational changes?

• A. Clear inclusion and exclusion criteria for disorders
• B. Dimensional classification system
• C. Multiaxial system eliminated
• D. Enhanced assessment procedures

Answer: (C)

This item centers on how DSM-5 reorganized the diagnostic framework by removing the multiaxial structure. In DSM-IV, disorders were arranged across five axes: clinical disorders (Axis I), personality and intellectual disabilities (Axis II), general medical conditions (Axis III), psychosocial and environmental problems (Axis IV), and a global assessment of functioning (Axis V). DSM-5 eliminated this system and moved to a nonaxial, integrated approach where diagnoses, medical conditions, psychosocial/contextual factors, and disability are documented together in a single framework, with separate sections for other conditions that may be a focus of clinical attention. The global assessment of functioning was dropped, and while DSM-5 retains explicit diagnostic criteria, it also adds dimensional and severity specifiers to capture the illness's impact and course.

The other options don’t fit because DSM-5 did not remove the inclusion and exclusion criteria embedded in diagnostic criteria, it did not eliminate dimensional assessment entirely (it added dimensional and cross-cutting measures rather than dropping a dimensional approach), and it did not erase broader assessment reforms—those aspects were revised rather than removed.