Sheila L Videbeck PhD RN The focus of this overview is major changes between DSMIVTR 2000 and DSM5 2013 Both organizational and conceptual changes in diagnoses are included Further inclusive and detailed changes and explanations for changes are available at wwwDSM5orgHighlight ID: 1046130
Download Presentation The PPT/PDF document "Changes in DSM-5: An Overview" is the property of its rightful owner. Permission is granted to download and print the materials on this web site for personal, non-commercial use only, and to display it on your personal computer provided you do not modify the materials and that you retain all copyright notices contained in the materials. By downloading content from our website, you accept the terms of this agreement.
1. Changes in DSM-5: An OverviewSheila L. Videbeck, PhD, RN
2. The focus of this overview is major changes between DSM-IV-TR (2000) and DSM-5 (2013).Both organizational and conceptual changes in diagnoses are included.Further, inclusive and detailed changes and explanations for changes are available at www.DSM5.org/HighlightsofChangesOverview
3. Elimination of the only age-based section: Disorders Usually First Diagnosed in Infancy, Childhood or Adolescence. Diagnoses from this section have been distributed to other sections based on disorder categories.Creation of new sections: Neurodevelopmental Disorders; Obsessive-Compulsive and Related Disorders; Trauma- and Stressor-Related Disorders.Major DSM-5 Changes
4. Sections renamed to better reflect disorders in the sectionChange in the name of diagnoses (with minimal change in individual diagnosis)Change in conceptual approach to a set of diagnoses, specifically Autism Spectrum DisorderChanges in definition, criteria for diagnoses, and/or specifiers of the disorderMajor DSM-5 Changes (continued)
5. The term “General medical condition” has been replaced throughout DSM-5 with “Another medical condition”Diagnoses are no longer placed on the multi-axial system of Axes I-VThe Global Assessment of Functioning Scale (GAF) has been eliminatedMajor DSM-5 Changes (continued)
6. This category has been eliminated Disorders formerly in the section have been distributed in other sections Neurodevelopmental Disorders is a new section that contains many of the diagnoses from this old sectionDisorders Usually First Diagnosed in Infancy, Childhood, or Adolescence
7. Mental Retardation diagnosis has been replaced with Intellectual DisabilityBoth cognitive capacity (IQ) and adaptive functioning are assessed with severity based on adaptive functioning rather than IQIntellectual Disability
8. Language Disorder (combines Expressive and Mixed Receptive-Expressive Disorder)Speech Sound Disorder (replaces Phonological Disorder)Childhood Onset Fluency Disorder (formerly Stuttering)Social Pragmatic Disorder (New)Communication Disorders is a category in Neurodevelopmental Disorders that includes:
9. A conceptual change defines Autism Spectrum Disorder as a single condition with different levels of symptom severity – 2 symptom categories are: social communication & interaction; and repetitive, behavior, interests, & activitiesEncompasses previous diagnoses of Autistic Disorder, Asperger’s Disorder, Childhood Disintegrative Disorder, and Pervasive Developmental Disorder NOSAutism Spectrum Disorder
10. Attention Deficit/Hyperactivity DisorderSpecific Learning Disorder (includes former reading, math, written expression, and NOS diagnoses)Motor Disorders (includes Developmental Coordination Disorder, Stereotypic Movement Disorder, Tourette’s Disorder, and other vocal and motor tics, & unspecified disorders)Additional Neurodevelopmental Disorder Diagnoses
11. Elimination of paranoid, undifferentiated, disorganized, and residual subtypesDelusional Disorder – can now include bizarre delusion(s)Schizoaffective Disorder – major mood episode must be present for a majority of the total duration of disorderSchizophrenia Spectrum and other Psychotic Disorders
12. Criteria for mania and hypomania now include changes in activity and energy as well as mood changesChanges in diagnosis of Bipolar Disorder in children on slide #13Bipolar and Related Disorders
13. Disruptive Mood Dysregulation Disorder – for children under age 18 who have persistent irritability and frequent extreme out of control behavior (to address concerns about potential overdiagnosis of Bipolar Disorder)Persistent Depressive Disorder (replaces Dysthymic Disorder)Bereavement no longer excluded from depression diagnosisDepressive Disorders
14. PTSD moved to new section called Trauma and Stressor Related DisordersOCD moved to new section called Obsessive-Compulsive and Related DisordersSocial Anxiety Disorder (replaces Social Phobia)Panic Disorder with Agoraphobia – now 2 diagnoses, no longer one diagnosisSeparation Anxiety Disorder – moved from the old First Diagnosed in Infancy…sectionAnxiety Disorders
15. Obsessive-Compulsive Disorder – moved from Anxiety Disorder sectionNew Diagnosis: Hoarding DisorderBody Dysmorphic Disorder – moved from old Somatoform Disorder sectionTrichotillomaniaSkin-picking DisorderSubstance-induced OCD and OCD due to another medical conditionObsessive-Compulsive and Related Disorders
16. Reactive Attachment Disorder – moved from the old First Diagnosed in Infancy…sectionDisinhibited Social Engagement DisorderPTSD – moved from Anxiety Disorders sectionAcute Stress Disorder – moved from Anxiety Disorder SectionAdjustment Disorders – old section of Adjustment Disorders eliminatedTrauma and Stressor-Related Disorders
17. Depersonalization/Derealization Disorder – concepts of depersonalization and derealization combined to replace former Depersonalization DisorderDissociative Fugue – now a specifier under Dissociative Amnesia instead of a stand-alone diagnosisDissociative Disorders
18. Formerly called Somatoform DisordersSomatic Symptom Disorder (replaces Somatization Disorder)Illness Anxiety Disorder (replaces Hypochondirasis)Conversion Disorder – also called Functional Neurological Symptom DisorderFactitious Disorder: Imposed on self or Imposed on other colloquially known as Munchausen’s Syndrome and Munchausen’s by proxy)Somatic Symptom and Related Disorders
19. Adult diagnoses of Anorexia Nervosa and Bulimia Nervosa are essentially unchangedNew Diagnosis: Binge Eating DisorderNew Diagnosis: Avoidant/Restrictive Food Intake DisorderPica and Rumination Disorder - moved from former First Diagnosed in Infancy…sectionFeeding and Eating Disorders
20. Conduct Disorder and Oppositional Defiant Disorder – moved from former First Diagnosed in Infancy…sectionIntermittent Explosive Disorder, Kleptomania, & Pyromania – moved from former Impulse-Control Disorder sectionDisruptive, Impulse-Control, and Conduct Disorders
21. Gambling – moved from former Impulse-Control Disorder sectionNo longer a separation of substance abuse and dependenceCategories reduced by combining amphetamine and cocaine into stimulants; phencyclidine included in hallucinogens; and nicotine expanded to tobaccoSubstance-Related and Addictive Disorders
22. Formerly Delirium, Dementia, and Amnestic and other Cognitive Disorders sectionDelirium remains in sectionAmnestic Disorder and Dementia are now in a new category called Mild or Major Neurocognitive Disorder specified according to etiology (vascular, HIV Infection, Traumatic Brain Injury, Alzheimer’s Parkinson’s Huntington’s, Prion, other medical condition, multiple etiologies), location (Frontotemporal), or characteristics (with Lewy Bodies)Neurocognitive Disorders
23. Personality Disorder diagnoses remain unchanged in Section IIAnother alternative approach is proposed in Section III to be used for further study; it contains changes proposed in drafts of DSM-5 which were not ultimately acceptedThe alternate section has 6 rather than 10 diagnoses with criteria focusing on personality traits and personality functioningPersonality Disorders
24. For changes in criteria, definitions, or specifiers that are routinely used by clinicians making diagnoses, see the website www.DSM5/HighlightsofChangesAdditional Changes