Download DSM 5

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DSM - 5
What you need to know for the ASWB license
exams.
Idelle Datlof, MSW, LISW-S
PassItPro.com May 2015
DSM - 5: Introduction
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DSM - 5 replaces DSM IV on all the ASWB license
exams on July 1, 2015.
DSM - 5 is organized across the life span. Diagnoses
that begin during childhood are not separated.
Emphasis is on the impact on functioning. More than one
diagnosis can occur at the same time.
Listed here are the basic changes in diagnostic
categories: Diagnoses that have been removed, brandnew diagnoses (additions) and renaming or grouping of
diagnoses. Brief descriptions are included.
Changes: Deletions:
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Multi-Axial format; Axes I – V Gone.
Distinction between “substance abuse” and
“substance dependence” has been dropped.
“Bereavement exclusion” in major depression has
been removed. Bereavement is recognized as a
severe psychosocial stressor that can precipitate a
major depressive episode in a vulnerable
individual, and may therefore be a factor in the
development of an episode of major depression.
New Diagnoses: Summary
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Autism Spectrum Disorder
Disinhibited Social Engagement Disorder
ADHD
Disruptive Mood Dysregulation Disorder
Premenstrual Dysphoric Disorder
Gender Dysphoria Disorder
Hoarding Disorder
Excoriation Disorder
New Diagnoses: Summary (cont’d)
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Binge-Eating Disorder
Major Neurocognitive Disorder
Mild Neurocognitive Disorder
Changes in Diagnostic Categories: New
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Autism Spectrum Disorder
ASD now encompasses and replaces the previous DSM-IV
autistic disorder (autism), Asperger’s disorder, childhood
disintegrative disorder, and pervasive developmental disorder.
ASD is characterized by 1) deficits in social communication and
social interaction and 2) restricted repetitive behaviors, interests,
and activities (RRBs). Because both components are required for
diagnosis of ASD, social communication disorder is diagnosed if no
RRBs are present.
Disinhibited Social Engagement
Disorder
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A pattern of behavior in which a child actively
approaches and interacts with unfamiliar adults.
Overly familiar verbal and physical behavior with
strangers.
Willingness to go off with strangers.
Limited checking back with adult caregivers.
Social neglect or deprivation (which may be caused
by living in an institution).
ADHD
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Attention deficit hyperactivity disorder. ADHD now
allows that this disorder can continue into adulthood.
You can be diagnosed with ADHD as an adult if you
meet one less symptom than if you are a child.
Children: Symptoms now have to appear before
age 12, instead of before age 7.
Disruptive Mood Dysregulation
Disorder
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Childhood bipolar disorder has a new name. This
can be diagnosed in children up to age 18 years
who exhibit persistent irritability and frequent
episodes of extreme behavioral dyscontrol (e.g.,
they are out of control).
Symptoms include: Severe, recurrent temper
outbursts (verbal or behavior) 3 times per week.
Persistent angry and/or irritable mood.
Premenstrual Dysphoric Disorder
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Minimum of #5 symptoms during majority of
menstrual cycles present in final week before the
start of menses which become minimal or absent in
the week post-menses.
Symptoms: marked irritability or anger, mood
swings, depressed mood or anxiety. Problems with
concentration, low energy, disturbed sleep patterns,
changes in appetite, decreased interest in normal
activities.
Gender Dysphoria Disorder
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Children: 6 months of age +
Symptoms: Marked incongruence between assigned
gender and one’s experience or expression of
gender. Strong desire to be the other gender.
Significant distress or impairment in functioning.
Adolescents and Adults:
Symptoms: As above, plus strong desire for
characteristics of preferred gender, and to be rid
of characteristics of other gender.
Hoarding Disorder
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Symptoms:
Persistent difficulty discarding possessions.
Accumulation of possessions resulting in congestion
and cluttering of living areas.
Results in significant distress or impairment in social,
occupational or other functioning.
Excoriation Disorder
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Symptoms:
Recurrent skin picking which results in lesions or
sores.
Inability to stop behavior despite frequent attempts.
Causes significant distress or impairment in social,
occupational or other important areas of
functioning.
Binge-Eating Disorder
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Recurrent episodes of binge-eating: overeating,
inability to control amounts of food ingested.
Eating faster than normal until uncomfortable,
eating large quantity of food when not hungry.
Experiencing distress during and after these events
and not being able to refrain from repeated
episodes.
Occurring at least once per week for 3 months.
Major Neurocognitive Disorder
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Significant cognitive decline affecting: (one or more)
memory, learning, attention, language, judgment,
decision-making.
Deficits interfere with independence in activities of
daily living.
Individual has awareness/concern about these
changes.
Replaces DSM IV diagnoses of dementia and
amnestic disorders.
Mild Neurocognitive Disorder
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Modest cognitive decline.
Awareness and concern on part of individual.
Deficits do not interfere with capacity for
independence in everyday activities.
Renaming: Summary
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Somatic Symptom Disorder – new grouping
Hypochondriasis is now “Illness Anxiety Disorder”
Social Phobia is now “Social Anxiety Disorder”
Factitious disorder is now “Imposed on Self” or
“Imposed on Another”
Dysthymia is now “Persistent Depressive Disorder”
“Mental Retardation” is now “Intellectual Disability”
“Stuttering” is now “Childhood-onset fluency
disorder
Somatic Symptom Disorder
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Duration: 6 months + Preoccupation with:
One or more somatic (body/physical) symptoms
that results in significant disruption of daily life.
 Excessive attention, fear, and/or anxiety, use of
significant time and energy.
 Replaces “Somatization” and “Undifferentiated
Somatoform” disorders.
Illness Anxiety Disorder
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Preoccupation with having or acquiring a serious
illness.
Somatic (physical symptoms are absent or minimal.)
High anxiety about health status.
Social Anxiety Disorder
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Marked fear or Anxiety in social situations where
individual is exposed to scrutiny.
Fear of falling short, of being negatively
evaluated.
Social situations are avoided or endured with
intense discomfort.
Cause significant distress.
Duration: 6 months+
Factitious Disorders
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Falsification of physical or psychological
symptoms/injuries or disease with intent to deceive.
Two sub-types: “Imposed on Self” or “Imposed on
Another”.
Persistent Depressive Disorder
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Consolidates Major Depressive Disorder with
Dysthymic Disorder.)
Depressed mood for at least 2 years (adults).
Depressed mood for at least 1 year (children and
adolescents).