DSM-5 Overview of DSM-4 Changes
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DSM-5 Overview of DSM-4 Changes

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eBook - ePub

DSM-5 Overview of DSM-4 Changes

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About This Book

Easily accessible overview of highly relevant changes from the fourth edition to the fifth edition of the Diagnostic and Statistical Manual of Mental Health Disorders (DSM) handbook used by health care professionals as a guide to diagnosing mental disorders. Changes and disorders are summarized for quick reference for use by students and/or professionals in the field.
Topics summarized include:

  • Structural and Organizational Revisions
  • Changes in Terminology
  • Neurodevelopment Disorders
  • Schizophrenia Spectrum and Other Psychotic Disorders
  • Bipolar and Related Disorders
  • Depressive Disorders
  • Obsessive Compulsive and Related Disorders
  • Anxiety Disorders
  • Trauma and Stressor Related Disorders
  • Dissociative Disorders
  • Somatic Symptom and Related Disorders
  • Feeding and Eating Disorders
  • Sleep-Wake Disorders
  • Sexual Dysfunctions
  • Disruptive, Impulse-Control, and Conduct Disorders
  • Substance Abuse and Addictive Disorders
  • Neurocognitive Disorders
  • Personality Disorders
  • Paraphilic Disorders

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Intellectual Disabilities
Onset during development with deficits in intellectual, social, and practical areas of functioning; deficits manifest themselves in reasoning, problem solving, and abstract thinking as confirmed by various standardized tests of intelligence. In addition, adaptive functioning deficits manifested in failure to live independently and being socially responsible. Deficits limit functioning in home, school, and community. ƒ
  • Diagnostic criteria have been revised to take account of both cognitive performance and adaptive functioning; the degree of the disability is measured by assessing adaptive functioning rather than IQ. ƒ
  • The term “mental retardation” is no longer used. ƒ
  • Substandard intellectual functioning verified by both IQ test and personalized clinical evaluation. ƒ
  • Substandard adaptive functioning measured by inability to successfully complete activities of daily living without support. ƒ
  • “Intellectual Developmental Disorder” is inside parentheses in deference to the World Health Organizations (WHO) classification scheme that lists disorders in the International Classification of Diseases (ICD) and makes determinations of “disabilities” in reference to the International Classification of Functioning, Disability, and Health (ICF).
Communication Disorders
Persistent difficulties, with onset during early development, in the learning and use of language in its various forms (written, spoken) due to deficits in comprehension or production. Deficits (as being significantly below accepted age norms) manifested in reduced vocabulary, inability to express oneself due to limited sentence structure, and impaired discursive abilities. Difficulties are not attributable to an underlying medical condition.
New conditions and revised names have been added, including:
  • Language disorder (combines DSM-4 TR’s expressive and mixed receptive-expressive language disorders) ƒ
  • Speech sound disorder (a new term for phonological disorder) ƒ
  • Childhood-onset fluency disorder (a new term for stuttering) ƒ
  • Social communication disorder (a new condition indicated by chronic problems in both verbal and nonverbal social communication) ƒ
  • Since social communication inadequacy is one aspect of autism spectrum disorder (ASD), social communication disorder is an incorrect diagnosis if restrictive repetitive behaviors, interests, and activities are also manifest (as these are aspects ASD).
Autism Spectrum Disorder
Characterized by persistent problems in social interaction and communication across a wide range of activities, including reduced ability to share emotions and interests, and poor ability in communication and understanding both verbal and nonverbal cues and gestures. Also indicated by repetitious behaviors and patterns, insistence on sameness in routines, and fixation on restricted interests. Heightened sensitivity or lack thereof to environmental sensory stimuli.
DSM-5 integrates four separate disorders, autism, Asperger’s, childhood disintegrative disorder, and pervasive developmental disorder, as presented in DSM-4 TR, into one condition, with the understanding that these previously separate disorders present themselves by way of different degrees of symptom severity as manifested along a spectrum. Symptoms should manifest at the beginning of the developmental period, but may not be apparent until coping abilities are exceeded.
Autism Spectrum Disorder (ASD): Indicated by chronic problems in engaging in both social communication and interaction as manifested in multiple settings such as:
  • Impaired social-emotional reciprocity ƒ
  • Impaired nonverbal communication skills ƒ
  • Impaired ability to understand, develop, and maintain social relationships
    Indicated by atypical behaviors such as:
  • Repetitive behaviors such as motions, manipulation of objects, or speech patterns ƒ
  • Resistance to change by adhering to immutable routines, rituals, or verbal or nonverbal expressions ƒ
  • Narrowly defined and unaltered interests manifested by excessive interest or focus ƒ
  • Over or under responsiveness to sensory stimuli, or atypical interest in sensory attributes of surroundings
Attention-Deficit/Hyperactity Disorder
Characterized by chronic inability to pay attention, and impulsivity/hyperactivity that impairs functioning and development. Frequently unable to sustain interest in an activity or maintain mental focus required by a task. Easily distracted and forgetful of routine activities. Inability to sit still or remain quiet. Garrulous and impatient. ƒ
  • Reclassified under neurodevelopmental disorders ƒ
  • In order to facilitate application across a life span, examples have been added to criteria. ƒ
  • The cross-situational requirement has been expanded to several symptoms in each context. ƒ
  • The time of onset for the condition has been altered from symptoms manifesting prior to age 7 to several symptoms manifesting before age 12. ƒ
  • Presentation specifiers are now used instead of subtypes, and these specifiers reference the previous subtypes. ƒ
  • Comorbid diagnosis in tandem with autism spectrum disorder is now permitted. ƒ
  • Adult symptom thresholds have been revised, with a limit of five symptoms instead of six previously required for younger persons. This change applies to both inattention and hyperactivity/impulsivity.
Specific Learning Disorder
Characterized by problems in learning across a range of academic activities. Manifested by poor writing skills and reading comprehension, and/or difficulty in learning numerical concepts and applying numerical reasoning skills. Condition persists despite intervention to improve academic skills and is not better explained by intellectual disabilities, specific sensory deficits, or other extraneous factors.
  • The DSM-5 integrates the DSM-4 TR listings for reading disorder, mathematics disorder, written expression disorder, and learning disorder not otherwise specified, since impairments in these areas frequently manifest with one another. ƒ
  • Coded specifiers are provided to reference each type of impairment. ƒ
  • The DSM-5 recognizes that, internationally, dyslexia may refer to a type of reading impairment, and dyscalculia may refer to a type of mathematical ability impairment.
Motor Disorders
Characterized by excessive clumsiness and awkwardness as manifested by poo...

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