DSM-5 - Knowledge

1903:, MD, president of the American Psychiatric Association, that emphasized that DSM-5 "... represents the best information currently available for clinical diagnosis of mental disorders. Patients, families, and insurers can be confident that effective treatments are available and that the DSM is the key resource for delivering the best available care. The National Institute of Mental Health (NIMH) has not changed its position on DSM-5." Insel and Lieberman say that DSM-5 and RDoC "represent complementary, not competing, frameworks" for characterizing diseases and disorders. However, epistemologists of psychiatry tend to see the RDoC project as a putative revolutionary system that in the long run will try to replace the DSM, its expected early effect being a liberalization of the research criteria, with an increasing number of research centers adopting the RDoC definitions. 1265:

for two individuals with the same diagnosis to have completely different symptoms that would not necessarily overlap. There is also concern as to which model is better for the DSM - the diagnostic model favored by psychiatrists or the dimensional model that is favored by psychologists. The diagnostic approach/model is one that follows the diagnostic approach of traditional medicine, is more convenient to use in clinical settings, however, it does not capture the intricacies of normal or abnormal personality. The dimensional approach/model is better at showing varied degrees of personality; it places emphasis on the continuum between normal and abnormal, and abnormal as something beyond a threshold whether in unipolar or bipolar cases.

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and family advocates. Scientists working on the revision of the DSM had a broad range of experience and interests. The APA Board of Trustees required that all task force nominees disclose any competing interests or potentially conflicting relationships with entities that have an interest in psychiatric diagnoses and treatments as a precondition to appointment to the task force. The APA made all task force members' disclosures available during the announcement of the task force. Several individuals were ruled ineligible for task force appointments due to their competing interests.

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diagnosis offers only a spurious promise of such benefits. Since – for example – two people with a diagnosis of 'schizophrenia' or 'personality disorder' may possess no two symptoms in common, it is difficult to see what communicative benefit is served by using these diagnoses. We believe that a description of a person's real problems would suffice. Moncrieff and others have shown that diagnostic labels are less useful than a description of a person's problems for predicting treatment response, so again diagnoses seem positively unhelpful compared to the alternatives.

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the sexual disorders category and into its own. The name change was made in part due to stigmatization of the term "disorder" and the relatively common use of "gender dysphoria" in the GID literature and among specialists in the area. The creation of a specific diagnosis for children reflects the lesser ability of children to have insight into what they are experiencing and ability to express it in the event that they have insight.

1358:, Mental Disorders and Disability, and Cross-Cultural Issues. Three additional white papers were also due by 2004 concerning gender issues, diagnostic issues in the geriatric population, and mental disorders in infants and young children. The white papers have been followed by a series of conferences to produce recommendations relating to specific disorders and issues, with attendance limited to 25 invited researchers. 1661:

development of pharmacological treatments for mental disorders". They asserted that the development of DSM-5 is the "most inclusive and transparent developmental process in the 60-year history of DSM". The developments to this new version can be viewed on the APA website. During periods of public comment, members of the public could sign up at the DSM-5 website and provide feedback on the various proposed changes.

53: 1354:(NIMH), was held to set the research priorities. Research Planning Work Groups produced "white papers" on the research needed to inform and shape the DSM-5 and the resulting work and recommendations were reported in an APA monograph and peer-reviewed literature. There were six workgroups, each focusing on a broad topic: Nomenclature, Neuroscience and Genetics, Developmental Issues and Diagnosis, Personality and 1392:, marking a change in how future updates will be created. Incremental updates will be identified with decimals (DSM-5.1, DSM-5.2, etc.), until a new edition is written. The change reflects the intent of the APA to respond more quickly when a preponderance of research supports a specific change in the manual. The research base of mental disorders is evolving at different rates for different disorders. 1847:

preordained diagnostic categories to clinical populations, we believe that any classification system should begin from the bottom up – starting with specific experiences, problems or 'symptoms' or 'complaints'... We would like to see the base unit of measurement as specific problems (e.g. hearing voices, feelings of anxiety etc.)? These would be more helpful too in terms of epidemiology.

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Bursztajn, MD noted that "the fact that 70% of the task force members have reported direct industry ties—an increase of almost 14% over the percentage of DSM-IV task force members who had industry ties—shows that disclosure policies alone, especially those that rely on an honor system, are not enough and that more specific safeguards are needed".

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soaring ambition and weak methodology" and is concerned about the task force's "inexplicably closed and secretive process". His and Spitzer's concerns about the contract that the APA drew up for consultants to sign, agreeing not to discuss drafts of the fifth edition beyond the task force and committees, have also been aired and debated.

1896:, with headlines such as "Goodbye to the DSM-V", "Federal institute for mental health abandons controversial 'bible' of psychiatry", "National Institute of Mental Health abandoning the DSM", and "Psychiatry divided as mental health 'bible' denounced". Other responses provided a more nuanced analysis of the NIMH Director's post. 1304:

research techniques focused on diagnosis, taking into account the sociocultural context, and also presents a hybrid-dimensional-categorical model of personality disorders. Specific personalities (antisocial, borderline, avoidant, narcissistic, obsessive-compulsive, schizotypal) and non-specific disorders were distinguished.

1653:, effectively conducting the whole process in secret: "When I first heard about this agreement, I just went bonkers. Transparency is necessary if the document is to have credibility, and, in time, you're going to have people complaining all over the place that they didn't have the opportunity to challenge anything." 1560:, had criteria agreed upon by consensus in a one day in-person workshop sponsored by the APA. A 2022 study found that higher rates of diagnosis of prolonged grief disorder in the ICD-11 could be explained by the DSM-5-TR criteria requiring symptoms persist for 12 months, and the ICD-11 requiring only 6 months. 1725:, led to an internet petition to remove them. According to MSNBC, "The petition accuses Zucker of having engaged in 'junk science' and promoting 'hurtful theories' during his career, especially advocating the idea that children who are unambiguously male or female anatomically, but seem confused about their 1850:

While some people find a name or a diagnostic label helpful, our contention is that this helpfulness results from a knowledge that their problems are recognised (in both senses of the word) understood, validated, explained (and explicable) and have some relief. Clients often, unfortunately, find that

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a revision of the way mental distress is thought about, starting with recognition of the overwhelming evidence that it is on a spectrum with 'normal' experience, and that psychosocial factors such as poverty, unemployment and trauma are the most strongly-evidenced causal factors. Rather than applying

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hurting people, 'in my own career, my primary motivation in working with children, adolescents and families is to help them with the distress and suffering they are experiencing, whatever the reasons they are having these struggles. I want to help people feel better about themselves, not hurt them.'"

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Section I describes DSM-5 chapter organization, its change from the multiaxial system, and Section III's dimensional assessments. The DSM-5 dissolved the chapter that includes "disorders usually first diagnosed in infancy, childhood, or adolescence" opting to list them in other chapters. A note under

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Among other wording changes, criterion A and criterion B (cross-gender identification, and aversion toward one's gender) were combined. Along with these changes comes the creation of a separate gender dysphoria in children as well as one for adults and adolescents. The grouping has been moved out of

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It also expressed a major concern that "clients and the general public are negatively affected by the continued and continuous medicalisation of their natural and normal responses to their experiences... which demand helping responses, but which do not reflect illnesses so much as normal individual

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Blanchard responded, "Naturally, it's very disappointing to me there seems to be so much misinformation about me on the Internet. my views, they completely reversed my views." Zucker "rejects the junk-science charge, saying there 'has to be an empirical basis to modify anything' in the DSM. As for

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issued a statement questioning the APA's decision to appoint Kenneth Zucker and Ray Blanchard to the working group for Gender and Sexual Identity Disorders, stating that, "Kenneth Zucker and Ray Blanchard are clearly out of step with the occurring shift in how doctors and other health professionals

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On July 23, 2007, the APA announced the task force that would oversee the development of DSM-5. The DSM-5 Task Force consisted of 27 members, including a chair and vice chair, who collectively represent research scientists from psychiatry and other disciplines, clinical care providers, and consumer

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There is a call for the DSM-5 to provide relevant clinical information that is empirically based to conceptualize personality as well as psychopathology in personalities. The issue(s) of heterogeneity of a PD is problematic as well. For example, when determining the criteria for a PD it is possible

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The goal of this new manual, as with all previous editions, is to provide a common language for describing psychopathology. While DSM has been described as a "Bible" for the field, it is, at best, a dictionary, creating a set of labels and defining each. The strength of each of the editions of DSM

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on individuals by attributing it to mental pathology has been criticized as hindering change of the root causes of the distress. The DSM-5's expansive criteria that attribute mental pathology to people with distress or impairment from a wide-ranging constellation of experiences has been criticized

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The financial association of DSM-5 panel members with industry continues to be a concern for financial conflict of interest. Of the DSM-5 task force members, 69% report having ties to the pharmaceutical industry, an increase from the 57% of DSM-IV task force members. A study of the DSM-5-TR found

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It includes dimensional measures for the assessment of symptoms, criteria for the cultural formulation of disorders and an alternative proposal for the conceptualization of personality disorders, as well as a description of the currently studied clinical conditions. It presents selected tools and

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and PTSD, the stressor criteria (Criterion A1 in DSM-IV) was modified to some extent. The requirement for specific subjective emotional reactions (Criterion A2 in DSM-IV) was eliminated because it lacked empirical support for its utility and predictive validity. Previously certain groups, such as

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In June 2009, Allen Frances issued strongly worded criticisms of the processes leading to DSM-5 and the risk of "serious, subtle, ubiquitous" and "dangerous" unintended consequences such as new "false 'epidemics'". He writes that "the work on DSM-V has displayed the most unhappy combination of

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stated in its June 2011 response to DSM-5 draft versions, that it had "more concerns than plaudits." It criticized proposed diagnoses as "clearly based largely on social norms, with 'symptoms' that all rely on subjective judgements... not value-free, but rather reflect current normative social

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Three review groups for sex and gender, culture and suicide, along with an "ethnoracial equity and inclusion work group" were involved in the creation of the DSM-5-TR which led to additional sections for each mental disorder discussing sex and gender, racial and cultural variations, and adding

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Although the APA has since instituted a disclosure policy for DSM-5 task force members, many still believe the association has not gone far enough in its efforts to be transparent and to protect against industry influence. In a 2009 Point/Counterpoint article, Lisa Cosgrove, PhD and Harold J.

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from DSM-IV-TR have been combined into single substance use disorders specific to each substance of abuse within a new "addictions and related disorders" category. "Recurrent legal problems" was deleted and "craving or a strong desire or urge to use a substance" was added to the criteria. The

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DSM-5 has discarded the multiaxial system of diagnosis (formerly Axis I, Axis II, Axis III), listing all disorders in Section II. It has replaced Axis IV with significant psychosocial and contextual features and dropped Axis V (Global Assessment of Functioning, known as GAF). The World Health

1805:." Instead, it proposed the name "emotional regulation disorder" or "emotional dysregulation disorder." There was also discussion about changing borderline personality disorder, an Axis II diagnosis (personality disorders and mental retardation), to an Axis I diagnosis (clinical disorders). 1660:

David Kupfer, chair of the DSM-5 task force, and Darrel A. Regier, MD, MPH, vice chair of the task force, whose industry ties are disclosed with those of the task force, countered that "collaborative relationships among government, academia, and industry are vital to the current and future

1686:, Robbins notes that under the new guidelines, certain responses to grief could be labeled as pathological disorders, instead of being recognized as being normal human experiences. In 2012, a footnote was added to the draft text which explains the distinction between grief and depression. 1808:

The TARA-APD recommendations do not appear to have affected the American Psychiatric Association, the publisher of the DSM. As noted above, the DSM-5 does not employ a multi-axial diagnostic scheme, therefore the distinction between Axis I and II disorders no longer exists in the DSM

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were expanded to include "possession-form phenomena and functional neurological symptoms". It is made clear that "transitions in identity may be observable by others or self-reported". Criterion B was also modified for people who experience gaps in recall of everyday events (not only

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Dr. Ray Blanchard, a psychiatry professor at the University of Toronto, is deemed offensive for his theories that some types of transsexuality are paraphilias, or sexual urges. In this model, transsexuality is not an essential aspect of the individual, but a misdirected sexual

1294:. There is no change in the basic diagnostic structure since DSM-III-R; however, people now must meet both qualitative (criterion A) and negative consequences (criterion B) criteria to be diagnosed with a paraphilic disorder. Otherwise they have a paraphilia (and no diagnosis). 1175:

without outbursts of physical aggression. Criteria were added for frequency and to specify "impulsive and/or anger based in nature, and must cause marked distress, cause impairment in occupational or interpersonal functioning, or be associated with negative financial or legal

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may have unduly influenced the manual's content, given the industry association of many DSM-5 workgroup participants. The APA itself has published that the inter-rater reliability is low for many disorders, including major depressive disorder and generalized anxiety disorder.

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The role of the DSM-5 in protecting the interests of wealthy and politically powerful owners of the means of production in the United States has been criticized as well. Placing the blame for predictable and common psychological distress caused by the deleterious effects of

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expectations," noting doubts over the reliability, validity, and value of existing criteria, that personality disorders were not normed on the general population, and that "not otherwise specified" categories covered a "huge" 30% of all personality disorders.

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The Society suggested as its primary specific recommendation, a change from using "diagnostic frameworks" to a description based on an individual's specific experienced problems, and that mental disorders are better explored as part of a spectrum shared with

4409:"Suggestions and ideas for members of the work groups were also solicited through the DSM-5 website. The proposed draft revisions to DSM-5 are posted on the website, and anyone can provide feedback to the work groups during periods of public comment." 373:(ICD) systems and share organizational structures as much as is feasible. Concern about the categorical system of diagnosis is expressed, but the conclusion is the reality that alternative definitions for most disorders are scientifically premature. 1689:

The DSM-5 has been criticized for purportedly saying nothing about the biological underpinnings of mental disorders. A book-long appraisal of the DSM-5, with contributions from philosophers, historians and anthropologists, was published in 2015.

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disorders, DSM-5 removes the requirement that the subject (formerly, over 18 years old) "must recognize that their fear and anxiety are excessive or unreasonable". Also, the duration of at least 6 months now applies to everyone (not only to

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A 2015 essay from an Australian university criticized the DSM-5 for having poor cultural diversity, stating that recent work done in cognitive sciences and cognitive anthropology is still only accepting western psychology as the norm.

730: 478:(ADHD) no longer specifies autism as an exclusionary diagnosis. The requisite age of symptom onset was changed from 7 years old to 12 years old, and symptom thresholds were reduced for diagnosis of ADHD as an adolescent or adult. 5151: 742: 1160:

are of three types: angry/irritable mood, argumentative/defiant behavior, and vindictiveness. The conduct disorder exclusion is deleted. The criteria were also changed with a note on frequency requirements and a measure of

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Cipriani A, Furukawa TA, Salanti G, Chaimani A, Atkinson LZ, Ogawa Y, Leucht S, Ruhe HG, Turner EH, Higgins JP, Egger M, Takeshima N, Hayasaka Y, Imai H, Shinohara K, Tajika A, Ioannidis JP, Geddes JR (April 7, 2018).

258:(ICD), and scientific studies often measure changes in symptom scale scores rather than changes in DSM-5 criteria to determine the real-world effects of mental health interventions. The DSM-5 is the only DSM to use an 1593: 388:

to increase the utility to the clinician. The first allows the clinician to specify the reason that the criteria for a specific disorder are not met; the second allows the clinician the option to forgo specification.

6284: 1553: 1261:(PD) previously belonged to a different axis than almost all other disorders, but is now in one axis with all mental and other medical diagnoses. However, the same ten types of personality disorder are retained. 772:

military personnel involved in combat, law enforcement officers and other first responders, did not meet criterion A2 in DSM-IV because their training prepared them to not react emotionally to traumatic events.

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The PTSD diagnostic clusters were reorganized and expanded from a total of three clusters to four based on the results of confirmatory factor analytic research conducted since the publication of DSM-IV.

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in all contexts requires 3 of a total of 12 symptoms. Catatonia may be a specifier for depressive, bipolar, and psychotic disorders; part of another medical condition; or of another specified diagnosis.

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Regier D, Narrow W, Clarke D, Kraemer H, Kuramoto S, Kuhl E, Kupfer D (2013). "DSM-5 Field Trials in the United States and Canada, Part II: Test-Retest Reliability of Selected Categorical Diagnoses".

2160:"Comparative efficacy and tolerability of 32 oral and long-acting injectable antipsychotics for the maintenance treatment of adults with schizophrenia: a systematic review and network meta-analysis" 1043: 3148: 3170: 1633:

The National Board of Medical Examiners (NBME) which is responsible for creating and publishing board exams for medical students around the United States conforms to the use of DSM-5 criteria.

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Organization's Disability Assessment Schedule is added to Section III (Emerging measures and models) under Assessment Measures, as a suggested, but not required, method to assess functioning.

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Disorders in this chapter were previously classified under disorders usually first diagnosed in infancy, childhood, or adolescence in DSM-IV. Now it is an independent classification in DSM 5.

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has been "reliability" – each edition has ensured that clinicians use the same terms in the same ways. The weakness is its lack of validity ... Patients with mental disorders deserve better.

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Krueger RF, Hopwood CJ, Wright AG, Markon KE (September 1, 2014). "DSM-5 and the Path Toward Empirically Based and Clinically Useful Conceptualization of Personality and Psychopathology".

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A new diagnosis is psychological factors affecting other medical conditions. This was formerly found in the DSM-IV chapter "Other Conditions That May Be a Focus of Clinical Attention".

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and hoarding disorder) to allow for good or fair insight, poor insight, and "absent insight/delusional" (i.e., complete conviction that obsessive-compulsive disorder beliefs are true).

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The introductory section describes the process of DSM revision, including field trials, public and professional review, and expert review. It states its goal is to harmonize with the

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Many authorities criticized the fifth edition both before and after it was published. Critics assert, for example, that many DSM-5 revisions or additions lack empirical support; that

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were moved to this new section and reconceptualized as stress-response syndromes. DSM-IV subtypes for depressed mood, anxious symptoms, and disturbed conduct are unchanged.

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co-authored a national letter for the Society for Humanistic Psychology that brought thousands into the public debate about the DSM. Approximately 13,000 individuals and

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Criteria were added to body dysmorphic disorder to describe repetitive behaviors or mental acts that may arise with perceived defects or flaws in physical appearance.

5375: 4044: 1240:(major NCD, or mild NCD). DSM-5 has a new list of neurocognitive domains. "New separate criteria are now presented" for major or mild NCD due to various conditions. 4635: 4531: 6238: 465: 5519: 4589: 4323: 1968:"Three Approaches to Understanding and Classifying Mental Disorder: ICD-11, DSM-5, and the National Institute of Mental Health's Research Domain Criteria (RDoC)" 589:

symptoms are a specifier (called "anxious distress") added to bipolar disorder and to depressive disorders (but are not part of the bipolar diagnostic criteria).

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Harold E (March 9, 2010). "APA Modifies DSM Naming Convention to Reflect Publication Changes". No. Release No. 10-17. The American Psychiatric Association.

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Sexual dysfunctions (except substance-/medication-induced sexual dysfunction) now require a duration of approximately 6 months and more exact severity criteria.

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Schneider-Thoma J, Chalkou K, Dörries C, Bighelli I, Ceraso A, Huhn M, Siafis S, Davis JM, Cipriani A, Furukawa TA, Salanti G, Leucht S (February 26, 2022).

1437: 250:) was published. In the United States, the DSM serves as the principal authority for psychiatric diagnoses. Treatment recommendations, as well as payment by 234: 82: 38: 1204:

threshold of the number of criteria that must be met was changed and severity from mild to severe is based on the number of criteria endorsed. Criteria for

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Somatic symptom and related disorders are defined by positive symptoms, and the use of medically unexplained symptoms is minimized, except in the cases of

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The DSM-IV specifier "with obsessive-compulsive symptoms" moved from anxiety disorders to this new category for obsessive-compulsive and related disorders.

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Hathaway LM, Boals, A., Banks, J. B. (2010). "PTSD symptoms and dominant emotional response to a traumatic event: An examination of DSM-IV criterion A2".

707:, substance-/medication-induced obsessive-compulsive and related disorder, and obsessive-compulsive and related disorder due to another medical condition. 254:, are often determined by DSM classifications, so the appearance of a new version has practical importance. However, some providers instead rely on the 6211: 4291: 3334: 366:

Anxiety Disorders says that the "sequential order" of at least some DSM-5 chapters has significance that reflects the relationships between diagnoses.

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Criteria for conduct disorder are unchanged for the most part from DSM-IV. A specifier was added for people with limited "prosocial emotion", showing

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Adler AB, Wright, K. M., Bliese, P. D., Eckford, R., Hoge, C. W. (2008). "A2 diagnostic criterion for combat-related posttraumatic stress disorder".

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Cosgrove L, Krimsky S, Vijayaraghavan M, Schneider L (April 2006), "Financial Ties between DSM-IV Panel Members and the Pharmaceutical Industry",

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which involved different clinicians doing independent evaluations of the same patient—a common approach to the study of diagnostic reliability.

713:(hair-pulling disorder) moved from "impulse-control disorders not elsewhere classified" in DSM-IV, to an obsessive-compulsive disorder in DSM-5. 2107:

Bandelow B, Reitt M, Röver C, Michaelis S, Görlich Y, Wedekind D (July 2015). "Efficacy of treatments for anxiety disorders: a meta-analysis".

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Beginning with the fifth edition, it is intended that diagnostic guideline revisions will be added incrementally. The DSM-5 is identified with

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Subtypes for all disorders include only "lifelong versus acquired" and "generalized versus situational" (one subtype was deleted from DSM-IV).

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The DSM-IV specifier for a physiological subtype has been eliminated in DSM-5, as has the DSM-IV diagnosis of polysubstance dependence.

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Two subtypes were deleted: "sexual dysfunction due to a general medical condition" and "due to psychological versus combined factors".

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a major revision of the DSM-IV-TR, but the two have significant differences. Changes in the DSM-5 include the re-conceptualization of

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and binge eating disorder were changed from "at least twice weekly for 6 months" to "at least once weekly over the last 3 months".

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in DSM-5. Separate criteria for children, adolescents and adults that are appropriate for varying developmental states are added.

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is low for many disorders; that several sections contain poorly written, confusing, or contradictory information; and that the

957:"Sleep disorders related to another mental disorder, and sleep disorders related to a general medical condition" were deleted. 6363: 6311: 6181: 5442: 5191: 5089: 5035: 4618: 3819: 3637: 3572: 3092: 2741: 2569: 2215:

Gartlehner G, Crotty K, Kennedy S, Edlund MJ, Ali R, Siddiqui M, Fortman R, Wines R, Persad E, Viswanathan M (October 2021).

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DSM-5 includes a section on how to conduct a "cultural formulation interview", which gives information about how a person's

1286:, and paraphilic disorders. All criteria sets were changed to add the word disorder to all of the paraphilias, for example, 6306: 6051: 3535: 3365: 3312: 2787: 2761: 1813:. The name, the diagnostic criteria for, and description of, borderline personality disorder remain largely unchanged from 857: 5371: 3234: 2813: 2618: 2592: 5867: 4642: 4393: 1876: 1607: 1351: 1002: 700: 497: 5730: 4413: 1802: 5695: 5523: 4707:"What's 'normal' sex? Shrinks seek definition: Controversy erupts over creation of psychiatric rule book's new edition" 1892:(RDoC), currently for research purposes only. Insel's post sparked a flurry of reaction, some of which might be termed 1677: 1376:, such as holding stock in pharmaceutical companies, serving as consultants to industry, or serving on company boards. 4584: 4316: 3896: 3672:

Regier DA, Narrow WE, First MB, Marshall T (2002). "The APA classification of mental disorders: future perspectives".

5977: 5783: 4806:"A comparison of DSM-iv and DSM-5 panel members' financial associations with industry: A pernicious problem persists" 4685:(May 30, 2008). "Activists alarmed over APA: Head of psychiatry panel favors 'change' therapy for some trans teens". 1649:, the head of the DSM-III task force, publicly criticized the APA for mandating that DSM-5 task force members sign a 696: 461: 5944: 4554: 4051: 3762: 3728: 3629: 3597: 2533: 1418: 734: 243: 63: 3623: 1801:

reported that "the name BPD is confusing, imparts no relevant or descriptive information, and reinforces existing

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graduated from DSM-IV's "Appendix B -- Criteria Sets and Axes Provided for Further Study" into a proper diagnosis.

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disorder (behaviors like nail biting, lip biting, and cheek chewing, other than hair pulling and skin picking) or

675:(formerly, social phobia) changed in favor of a performance only (i.e., public speaking or performance) specifier. 6384: 6044: 5972: 5967: 5962: 5898: 5740: 4962: 4960: 4855:

Davis LC, Diianni AT, Drumheller SR, Elansary NN, D'Ambrozio GN, Herrawi F, Piper BJ, Cosgrove L (January 2024).

4706: 4166:"Supplemental Material for Same Name, Same Content? Evaluation of DSM-5-TR and ICD-11 Prolonged Grief Criteria". 2315:

Welch S, Klassen C, Borisova O, Clothier H (2013). "The DSM-5 controversies: How should psychologists respond?".

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First M, Rebello T, Keeley J, Bhargava R, Dai Y, Kulygina M, Matsumoto C, Robles R, Stona A, Reed G (June 2018).

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A survey of nearly 5,000 international psychiatrists ... DSM-IV use was nearly universal in the United States.

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Epistemological reflections about the crisis of the DSM-5 and the revolutionary potential of the RDoC project

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These conditions and criteria are set forth to encourage future research and are not meant for clinical use.

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Specifiers were added for mixed symptoms and for anxiety, along with guidance to physicians for suicidality.

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that 60% of the American physicians contributing to the revised edition received payments from industry.

678: 5522:. National Institute of Mental Health and American Psychiatric Association. May 13, 2013. Archived from 3200: 1564:

diagnostic codes for specifying levels of suicidality and nonsuicidal self-injury for mental disorders.

6368: 4772:"Task Force questions critical appointments to APA's Committee on Sexual and Gender Identity Disorders" 4134:"Prolonged grief disorder recognized as official diagnosis. Here's what to know about chronic mourning" 2217:"Pharmacological Treatments for Borderline Personality Disorder: A Systematic Review and Meta-Analysis" 545: 527: 5581: 5059: 1019:

are each a disorder, instead of both being listed under "dyssomnia not otherwise specified" in DSM-IV.

6098: 5626: 3674: 3340:. American Psychiatric Publishing. American Psychiatric Association. 2013. p. 16. Archived from 1743: 931: 573: 572:, bipolar disorder NED (not elsewhere defined, previously called "NOS", not otherwise specified) and 290: 1781:

for pathologizing an unhelpful number of people that a psychiatric diagnosis is not beneficial for.

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A revision of DSM-5, titled DSM-5-TR, was published in March 2022, updating diagnostic criteria and

930:"Feeding disorder of infancy or early childhood", a rarely used diagnosis in DSM-IV, was renamed to 6110: 6093: 5243: 3028:

Karam EG, Andrews, G., Bromet, E., Petukhova, M., Ruscio, A. M., Salamoun, M., et al. (2010).

1889: 1622: 1598: 1571: 1545: 1339: 1138:

moved to this chapter from the DSM-IV chapter "Impulse-Control Disorders Not Otherwise Specified".

1119: 1057: 861: 832: 717: 534: 449: 5582:"DSM-5 Update: Supplement to Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition" 5569: 3590:"A Research Agenda for DSM-V: Summary of the DSM-V Preplanning White Papers Published in May 2002" 3256: 442:), and a new condition characterized by impaired social verbal and nonverbal communication called 5768: 3952:"Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision (DSM-5-TR™)" 1682: 1650: 1373: 1366: 672: 408: 377: 341: 337: 5183: 5177: 3754: 3564: 3558: 3084: 3078: 6088: 6067: 2733: 2727: 1275:

New specifiers "in a controlled environment" and "in remission" were added to criteria for all

1016: 481:"Specific Learning Disorder" encompasses shortcomings in academic skill development, including 415: 5025: 2561: 2555: 1943:

Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision (DSM-5-TR)

3511: 906: 853: 768: 435: 431: 304: 1729:, can be treated by encouraging gender expression in line with their anatomy." According to 1967: 1839: 1372:

About 68% of DSM-5 task-force members and 56% of panel members reported having ties to the

1328: 1276: 1258: 1200: 1190: 810: 786: 738: 530:, catatonic, undifferentiated, and residual) in favor of a severity-based rating approach. 8: 6345: 4597: 4372: 4257: 2835:

Friedman MJ, Resick, P. A., Bryant, R. A., Strain, J., Horowitz, M., Spiegel, D. (2011).

1612: 1580: 1355: 1287: 1216:

along with new specifiers for "in a controlled environment" and "on maintenance therapy".

980: 900: 882: 868: 569: 541: 251: 31: 4883: 4856: 4500: 1220:

There are no more polysubstance diagnoses in DSM-5; the substance(s) must be specified.

758:(PTSD) is now included in a new section titled "Trauma- and Stressor-Related Disorders." 6358: 6075: 5489: 5143: 5001: 4968: 4931: 4832: 4805: 4779: 4559: 4262: 4187: 4110: 4077: 4026: 3699: 3486: 3054: 3029: 3010: 2918: 2866: 2674: 2641: 2297: 2249: 2216: 2197: 2140: 2084: 2059: 2034: 2009: 1702: 1576: 1237: 806: 565: 239: 212: 5595: 3477: 2176: 2159: 2075: 6294: 5187: 5135: 5031: 5006: 4988: 4951: 4923: 4888: 4837: 4682: 4614: 4191: 4179: 4141: 4115: 4097: 4030: 4018: 4010: 3867: 3779: 3691: 3643: 3633: 3568: 3491: 3439: 3171:"DSM-5 redefines hypochondriasis — For Medical Professionals — Mayo Clinic" 3088: 3059: 3002: 2967: 2910: 2858: 2737: 2679: 2661: 2565: 2359: 2301: 2289: 2254: 2236: 2201: 2189: 2181: 2132: 2124: 2089: 2039: 1987: 1946: 1920: 1900: 1487: 1186: 838:

Patients that present with chronic pain can now be diagnosed with the mental illness

704: 604: 509: 457: 419: 278: 144: 132: 4935: 3703: 3014: 2922: 2870: 2144: 1879:

director Thomas R. Insel, MD, wrote in an April 29, 2013 blog post about the DSM-5:

1680:

divisions endorsed the petition. In a November 2011 article about the debate in the

5147: 5131: 5127: 4996: 4980: 4915: 4878: 4868: 4857:"Undisclosed financial conflicts of interest in DSM-5-TR: cross sectional analysis" 4827: 4817: 4687: 4238: 4171: 4105: 4089: 4002: 3982: 3857: 3771: 3755:"Somatic Presentations of Mental Disorders: Refining the Research Agenda for DSM-V" 3683: 3481: 3473: 3431: 3049: 3045: 3041: 3030:"The Role of Criterion A2 in the DSM-IV Diagnosis of Posttraumatic Stress Disorder" 2994: 2959: 2900: 2848: 2669: 2653: 2355: 2351: 2324: 2281: 2244: 2228: 2171: 2116: 2079: 2071: 2029: 2021: 1979: 1584: 1518: 1123: 1107: 1083: 1076: 920: 710: 682: 299: 170: 5346:"Federal institute for mental health abandons controversial 'bible' of psychiatry" 3621: 1791:

Treatment and Research Advancements National Association for Personality Disorders

5552: 5545: 4822: 4593: 4417: 4397: 4379: 4303: 4295: 3775: 2120: 1752: 1726: 1706: 1385: 1205: 1196: 984: 969: 913: 896: 282: 267: 259: 4969:"Mental Health Challenges Related to Neoliberal Capitalism in the United States" 3531: 3361: 3308: 2783: 2757: 2272:

Wakefield JC (May 22, 2013). "DSM-5: An Overview of Changes and Controversies".

1350:

In 1999, a DSM-5 Research Planning Conference, sponsored jointly by APA and the

371:

International Statistical Classification of Diseases and Related Health Problems

256:

International Statistical Classification of Diseases and Related Health Problems

6262: 6120: 4984: 4242: 4076:

First MB, Yousif LH, Clarke DE, Wang PS, Gogtay N, Appelbaum PS (May 7, 2022).

3230: 2886: 2809: 2614: 2588: 2232: 1893: 1718: 1389: 975:

There are now three breathing-related sleep disorders: obstructive sleep apnea

685:

are now classified as anxiety disorders (rather than disorders of early onset).

658: 493: 453: 354: 263: 4390: 4006: 2998: 2285: 1102:

Some of these disorders were formerly part of the chapter on early diagnosis,

1089:

Subtypes of gender identity disorder based on sexual orientation were deleted.

6399: 6278: 4992: 4410: 4183: 4145: 4101: 4014: 3443: 2665: 2293: 2240: 2185: 2128: 1991: 1983: 1722: 1673: 1669: 1654: 864:, a diagnosis which no longer requires a specific number of somatic symptoms. 523: 286: 4873: 4611:

The DSM-5 in Perspective: Philosophical Reflections on the Psychiatric Babel

4432:"A Warning Sign on the Road to DSM-V: Beware of Its Unintended Consequences" 4175: 3647: 2834: 1888:

Insel also discussed an NIMH effort to develop a new classification system,

1762: 6226: 5182:(Fifth ed.). Arlington, VA: American Psychiatric Publishing. pp. 5139: 5010: 4927: 4892: 4841: 4299: 4119: 4022: 3888: 3871: 3783: 3695: 3563:(Fifth ed.). Arlington, VA: American Psychiatric Publishing. pp. 3495: 3063: 3006: 2971: 2914: 2862: 2732:(Fifth ed.). Arlington, VA: American Psychiatric Publishing. pp. 2683: 2560:(Fifth ed.). Arlington, VA: American Psychiatric Publishing. pp. 2363: 2258: 2193: 2136: 2093: 2043: 872: 652: 505: 3083:(Fifth ed.). Arlington, VA: American Psychiatric Publishing. p. 2947: 1868:, an alternative, dimensional framework for classifying mental disorders. 151: 6036: 3862: 3845: 1748: 1676:

professionals signed a petition in support of the letter. Thirteen other

1212:

withdrawal were added. New specifiers were added for early and sustained

1135: 1051: 662: 486: 27:

2013 edition of the Diagnostic and Statistical Manual of Mental Disorders

1513: 668:

Specific types of phobias became specifiers but are otherwise unchanged.

3846:"Developing Unbiased Diagnostic and Treatment Guidelines in Psychiatry" 3435: 3027: 1291: 1283: 1047: 965: 924: 516: 439: 308: 307:

as a discrete eating disorder; the renaming and reconceptualization of

5443:"Mental Health Researchers Reject Psychiatry's New Diagnostic 'Bible'" 4949:"Toward Credible Conflict of Interest Policies in Clinical Psychiatry" 4919: 4905: 4093: 3687: 2963: 2657: 2025: 1082:

DSM-IV's gender identity disorder is similar to, but not the same as,

537:(for a majority of the disorder's duration after criterion A is met). 6321: 6176: 5655: 4714: 3622:

Kupfer, David J., First, Michael B., Regier, Darrel A., eds. (2002),

2905: 2853: 2836: 2328: 2157: 1899:

In May 2013, Insel, on behalf of NIMH, issued a joint statement with

1814: 1602: 1537: 1131: 1097: 627: 551: 186: 4342:"DSM-V Task Force Member Disclosure Report: Darrel Alvin Regier M.D" 3951: 2888: 1966:

Clark LA, Cuthbert B, Lewis-Fernández R, Narrow WE, Reed GM (2017).

225:

Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition

18:

Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition

5793: 5110: 4462: 3732: 3651: 1914: 1810: 1229: 1209: 1032:

For females, sexual desire and arousal disorders are combined into

976: 961: 764:

Separate criteria were added for children six years old or younger.

482: 247: 199: 4493:"Professor co-authors letter about America's mental health manual" 3601: 2837:"Classification of trauma and stressor-related disorders in DSM-5" 2642:"Changes in the Definition of ADHD in DSM-5: Subtle but Important" 1965: 1712: 1407: 1333:

Neurobehavioral disorder associated with prenatal alcohol exposure

1171:

People over the disorder's minimum age of 6 may be diagnosed with

6316: 5113:"The case for shifting borderline personality disorder to Axis I" 2887:

Friedman MJ, Resick, P. A., Bryant, R. A., Brewin, C. R. (2011).

2810:"A Guide to DSM-5: Disruptive Mood Dysregulation Disorder (DMDD)" 2784:"A Guide to DSM-5: Removal of the Bereavement Exclusion From MDD" 1698: 1233: 1006: 645: 586: 5295:. National Institute of Mental Health. June 2011. Archived from 5175: 3556: 3076: 2725: 2553: 1940: 620:

moved from an appendix for further study, and became a disorder.

6325: 6149: 6144: 5679: 5514: 5512: 4317:"DSM-V Task Force Member Disclosure Report: David J Kupfer, MD" 2056: 1864:

Many of the same criticisms also led to the development of the

1717:

The appointment, in May 2008, of two of the taskforce members,

1657:, chair of the DSM-IV task force, expressed a similar concern. 1557: 641: 370: 255: 5591:. American Psychiatric Association Publishing. September 2016. 5485:"Psychiatry's Guide Is Out of Touch With Science, Experts Say" 4854: 1784: 52: 6335: 6171: 6154: 3141:"Diagnostic Ethics: Harms/Benefits, Somatic Symptom Disorder" 2984: 2214: 689: 600: 452:

is a new diagnosis that incorporates the former diagnoses of

145: 5509: 3985:, Kendler KS (November 1, 2021). "Iterative Revision of the 2314: 1793:(TARA-APD) campaigned to change the name and designation of 1705:. The goal is to make more reliable and valid diagnoses for 1298: 1180: 396: 5555:

Dialogues in Philosophy, Mental and Neuro Sciences 7: 11-20

5051: 4237:. Vol. 49, no. 22. November 21, 2014. p. 1. 2106: 1213: 5111:

New A, Triebwasser Joseph, Charney Dennis (October 2008).

3980: 3421: 2007: 1556:. Prolonged grief disorder, which had been present in the 844:

psychological factors that affect other medical conditions

775:

Two new disorders that were formerly subtypes were named:

171: 3671: 2341: 1820: 1763:

Financial Conflicts of Interest and Perverse Dependencies

749: 731:

other specified obsessive-compulsive and related disorder

5372:"National Institute of Mental Health abandoning the DSM" 3843: 3532:"A Guide to DSM-5: Paraphilias and Paraphilic Disorders" 1945:. Washington, DC, USA: American Psychiatric Publishing. 885:(functional neurological symptom disorder) were changed. 825: 630:

now also would be called persistent depressive disorder.

466:

pervasive developmental disorder not otherwise specified

5625: 5573: 5398:"Psychiatry divided as mental health 'bible' denounced" 3715: 3713: 1282:

A distinction is made between paraphilic behaviors, or

4666: 3813:"Reliability and Prevalence in the DSM-5 Field Trials" 1871: 564:

New specifier "with mixed features" can be applied to

6406: