The Diagnostic and Statistical Manual IV TR, otherwise known as DSM-IV TR, has a multi-axial approach to psychiatric diagnosis. The diagnosis is specified on five axes. Axis I diagnoses are acute diagnoses. Axis II diagnoses are disorders that are chronic. Axis III are physiological diagnoses that are likely to have influence on the psychological diagnoses. Axis IV are sociological factors that contribute to the psychological diagnoses. Axis V is the Global Assessment of Functioning (GAF) Scale, which is an estimate of how the person is functioning at the present time. Sometimes people specify the highest GAF in the past year.