Sunday, June 9, 2013

Revision of the Diagnostic and Statistical Manual of Mental Disorders

Excerpts From Education Week article by Christina Samuels: Click here to read the full Education Week article which goes into much more depth on the changes

The fifth revision of the Diagnostic and Statistical Manual of Mental Disorders, published by the American Psychiatric Association, is the standard classification of mental disorders used by mental-health professionals in the United States and contains a listing of diagnostic criteria for every psychiatric disorder recognized by the U.S. health-care system. The most recent edition includes several definitional changes to disorders that are often seen in school contexts.

Attention Deficit Hyperactivity Disorder
Definition: A pattern of behavior in multiple settings characterized by symptoms such as failure to pay close attention to details, difficulty organizing tasks and activities, fidgeting, excessive talking, and inability to stay seated.

What's Changed? “Several” symptoms must be present in more than one setting; symptoms must be present before age 12 instead of before age 7; examples have been included to illustrate the types of behaviors children, adolescents, and adults might experience.

Autism Spectrum Disorder
Definition: characterized by communication deficits, such as responding inappropriately in conversation; dependence on routines; high sensitivity to changes in environment; and intense focus on inappropriate items.

What's Changed? Four separate disorders, including Asperger’s syndrome and “pervasive developmental disorder-not otherwise specified,” have been folded into a single umbrella disorder.

Disruptive Mood Dysregulation Disorder
Definition: Children up to age 18 who exhibit persistent irritability and frequent episodes of extreme temper tantrums.

What's Changed? This disorder is new with the DSM-5 and is meant to address concerns about overdiagnosis and overtreatment of bipolar disorder in children.

Intellectual Disability
Definition: Impairment of general mental ability that affects adaptive functioning in three domains: conceptual (reading, writing, math, reasoning); social (empathy, judgment, interpersonal communications); and practical (money management, job responsibilities, personal care).

What's Changed? The term “mental retardation” has been removed; severity of impairment should be based on adaptive functioning and not IQ score alone.

Oppositional Defiant Disorder
Definition: An ongoing pattern of anger-guided disobedience, hostility, and defiant behavior toward authority.

What's Changed? The criteria explain how frequently the behaviors must occur to differentiate them from normal development in children; symptoms have been grouped into angry/irritable mood, argumentative/defiant behavior, and vindictiveness.

Social Communication Disorder
Definition: A persistent difficulty in social uses of verbal and nonverbal communication, such as greeting or exchanging information; following rules for conversation or storytelling, such as taking turns in conversation; and understanding what is not explicitly stated and nonliteral or ambiguous meanings of language.

What's Changed? The disorder is new to the DSM-5. It is meant to identify people who have some of the communication deficits associated with autism, but who do not have repetitive or restricted behavior patterns.

Specific Learning Disorder
Definition: Deficits that affect academic achievement in areas such as reading, writing or mathematical reasoning.

What's Changed? Specific diagnoses such as dyslexia or dyscalculia have been folded into this disorder. As part of the diagnosis, clinicians can provide greater detail as to the type of deficits present.

Source: American Psychiatric Association

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