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DSM-5 Changes

dsm-5-changes-By Timothy Lyons

The newest revision of the American Psychiatric Associations Diagnostic and Statistical Manual of Mental Disorders (5 Ed.) (DSM-5) has many changes. Some of these changes are the discussion by Dr. Jeffrey Nevid in his YouTube video presentation. This helps to define what the study of abnormal psychology is and is not. One particular aspect to note is that abnormal psychology is not a complete study of the DSM-5. The DSM-5 changes are to be reviewed but not necessarily studied. It is more of an overview with deeper understanding coming from the course material.

DSM-5 Changes

Some of the most important and welcomed DSM-5 changes are the elimination of the multiaxial system which is now grouped into categories of shared characteristics and dropping the Global Assessment Functioning (GAF) scale. In the DSM introduction it is noted that this changed to be more consistent with the World Health Organizations’ (WHO) recommendation to note diagnosis separate from psychosocial and contextual factors. It was also important because the GAF was inconsistent, not clear. It has been replaced by WHO’s Disability Assessment Scale (WHODAS) to allow greater measure of disability and to be used more globally.

One of the most controversial changes to take place is the removal of axes in diagnosis.  The axes have now been replaced with categories that are judged on continuum. This is done by a scale representing the amount of pathology caused by the category. It is a scale from 0, meaning little to no impairment to 4 which means extreme impairment

So here are some of the changes that came out of the DSM-5.

Neurodevelopmental Disorders
The term Metal retardation has been changed to intellectual disability and it’s severity is no longer based on IQ score but on adaptive functioning.

Communication Disorders

The expressive and mixed receptive-expressive language disorders are now language disorder. Phonological disorder is now speech sound disorder and stuttering is now childhood-onset fluency disorder. Newly included is social (pragmatic) communication disorder, a new condition for persistent difficulties in the social uses of verbal and nonverbal communication.

Autism Spectrum Disorder

Autism spectrum disorder is one of the new DSM-5 changes. It is a category that reflects scientific studies that four older disorders (Asperger’s disorder, childhood disintegrative disorder, and pervasive developmental disorder not otherwise specified ) are really the same condition but on different levels of severity.

Attention-Deficit/Hyperactivity Disorder

There are in this area of the DSM-5 there are a number of examples that have been added to criterion to ease application across life span. The cross-situational requirement has been strengthened to “several” symptoms in each setting. Onset symptoms have been changed to “several inattentive or hyperactive-impulsive symptoms were present prior to age 12”. There is now a comorbid diagnosis with autism spectrum disorder which is allowed. It is easier to diagnose adults with ADHD. They need to show 5 symptoms instead of six. This reflects their substantial evidence of clinically significant ADHD impairment. ADHD is placed in the neurodevelopmental disorders chapter to show a correlation of brain development with ADHD. There are many more DSM-5 changes. You can read about more of the changes in this document from the American Psychiatric Association.

References

DSM-5 Changes

American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders (5 ed.). Arlington, VA: American Psychiatric Publishing.

Barnhill, J. W. (Ed.). (2014). DSM-5 Clinical Cases (1 ed.). Arlington, VA: American Psychiatric Publishing.

Comer, R. J. (2015). Abnormal Psychology (9 ed.). New York, NY: Worth Publishers.

HSSPearson. (2013). Dr. Jeffrey Nevid’s DSM-5 Updates Webinar [Video podcast]. Retrieved from https://www.youtube.com/watch?v=3akfbnmhOM8

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