th Edition DSM5 Martin Dorahy Department of Psychology University of Canterbury 2 systems used to classified Psychiatric disorders ICD10 DSM Classification Issues Critical issues ID: 241910
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Slide1
The Diagnostic and Statistical Manual of Mental Disorders – 5th Edition (DSM-5)
Martin Dorahy
Department of Psychology
University of CanterburySlide2
2 systems used to classified Psychiatric disorders:
- ICD-10
DSMSlide3
Classification Issues
Critical issues
Reliability
DSM tries to increase reliability to ensure everyone who sees client diagnoses the same thing
Validity
Work to increase validity by trying to ensure the key symptoms actually classify the disorder.
Need to balance reliability and validitySlide4
Communication
Prognosis
Treatment planning
4
Purposes and benefitsSlide5
Criticisms of DSM/Classification
Comorbidity
Emphasize reliability, sometimes at the expense of validity
Complexity of categorizing psychopathologySlide6
Pathologising
normal
behaviour
6Slide7Slide8
A Caution About Labeling and Stigma
Problems and pitfalls with labels
Negative connotations
Stigmas
ReificationSlide9
DSM-I (1952)
132 pages
Definitions were simple,
brief paragraphs
with prototypical descriptions
Slide10
DSM-II (1968)
134 pages
Users
encouraged to record
multiple psychiatric diagnoses
(in order of importance)
and associated physical conditions
Coincided with ICD-8
(first time ICD included mental disorders)
Slide11
DSM-III (1980)
494
pp
Descriptive and neutral
“
atheoretical
”
) regarding etiology.Coincided with ICD-9.Multiaxial
classification system.
Goal to introduce
reliablilty
.
Slide12
DSM-
III-R
(
1987)
567
pp
Some relabelling and reorganisationSlide13
DSM-IV (1994)
886
pp
Inclusion of a clinical significance criterion
New disorders introduced
(e.g., Acute Stress Disorder, PTSD
Bipolar II Disorder, Asperger
’
s Disorder),
others deleted
(e.g., Cluttering,
Passive-Aggressive Personality Disorder).
Slide14
DSM-IV-TR (2000)
943
pp
Text revision – no change to diagnostic criteriaSlide15
DSM-IV and
DSM-IV-TR
The Five
DSM-IV
AxesI – Major disorders
II – Stable, enduring problems
III – Medical conditions (related)
IV – Psychosocial problems V – rating of adaptive functioningSlide16
DSM-5 (2013)
947
pp
“
5
”
instead of “V”
Anticipates change
e.g. DSM 5.1 … 5.2
…
12 year processSlide17
DSM-5
22 Chapters
DSM-IV
17 ChaptersSlide18
1.
Broad Collaboration
2. Inclusion of Cultural Considerations
3. More Descriptive Diagnosis
4. Reorganized to reflect etiology & shared factors
18Positives of DSM5Slide19
Recognition of life span issues related to specific disorders.
6. Gender & cultural notes for individual diagnosis.
7. Removed diagnostic criterion not relevant across cultural groups.
8. 30% international in each work group
19
Positives of DSM5Slide20
1
. Elimination of 5 Axis Diagnosis
Significant overlap with ICD-10/11
Integration of emerging genetic & neuroimaging research
20
Major Changes of DSM5Slide21
Lanius
et al., 2010
Dissociative subtype of PTSDSlide22
22
Three Major Sections
1.
The Basics
2. Diagnostic Criteria & Codes
3. Emerging Measures & Models -
Slide23
Neurodevelopmental disorders
Schizophrenia
spectrum and other psychotic disorders Bipolar and related disorders
Depressive disorders Anxiety disorders
Obsessive-compulsive and related disorders
Trauma- and stressor-related disorders Dissociative disorders DSM-5 disorder categoriesSlide24
Somatic symptom and related disorders
Feeding
and eating disorders Sleep–wake disorders
Sexual dysfunctions Gender dysphoria
Disruptive, impulse-control, and conduct disorders
Substance-related and addictive disorders Neurocognitive disorders Paraphilic disorders
Personality disorders
DSM-5 disorder categoriesSlide25
Marked fear or anxiety about a specific object or situation (e.g., flying, heights, animals, injections)
The phobic object/situation almost always provokes immediate fear
The phobic object/situation is actively avoided or endured with intense fear.
Fear is persistent ≥ 6 months
Causes sign. distress or impairment (social, occupational functioning)
Specific phobia criteria - DSM-5Slide26
26Slide27
What are the benefits for us as counsellors with the DSM?What are the deficits/limitations/concerns for us as
counsellors
with the DSM
Thoughts?Slide28
28