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Hockenbury & hockenbury Psychology, 6e: dsm-5 update supplement
The Diagnostic and Statistical Manual of Mental Disorders (DSM) is a comprehensive encyclopedia of psychological disorders first
published by the American Psychiatric Association in 1952. The DSM is used as a classification system in order to provide a common language for psychiatrists, psychologists, and other health-care professionals. It’s also used by insurance companies and legal
authorities. The fifth and most recent edition, popularly called DSM-5, was published in May 2013.
With each new edition, disorders are eliminated, relabeled, or added. Often, these changes reflect the progress of scientific research. In other cases, such as the 1973 removal of homosexuality from the DSM, they reflect changes in social and cultural understanding.
This table shows a chapter-by-chapter list of the DSM-5 changes that affect content in your textbook.
Chapter Chapter 7:
Thinking, Language, and
Intelligence
Chapter 10:
Gender and Sexuality
Chapter 14:
Psychological Disorders
Affected Terms
DSM–5 Change
Comment
Asperger’s syndrome and
autism (pp. 275-276; 302-303)
Both are now included in autism
spectrum disorder.
Asperger’s syndrome and autism are no
longer separate, distinct disorders, and
are differentiated only in terms of their
symptom severity. Individuals diagnosed
with autism spectrum disorder display
the two core symptoms of (1) deficits in
social communication and social interaction and (2) restricted, repetitive behaviors, interests, and activities. People with
autism spectrum disorder are diagnosed
according to three levels of symptom
severity: Level 1, “requiring support”; Level
2, “requiring substantial support”; or Level
3, “requiring very substantial support.”
Mental retardation (p. 302)
Now called intellectual disability
“Intellectual disability” is the currently
accepted term; severity is now determined
by adaptive functioning rather than primarily by IQ score.
Gender identity disorder
(p. 417)
Now called gender dysphoria
Both terms refer to psychological problems
caused by feelings of intense discomfort
(“dysphoria”) caused by a discrepancy or
mismatch between the gender one was
assigned at birth and the gender that one
expresses or experiences. However, the
change in terminology is meant to emphasize that it is the discomfort, and not
the discrepancy, that is considered to be a
psychological disorder.
Sexual aversion disorder
(p. 432)
Dropped from DSM-5
Disorder was dropped due to lack of research supporting its prevalence.
Vaginismus and dyspareunia
(p. 432)
Combined into a new disorder,
genito-pelvic pain/penetration
disorder
Both conditions frequently occurred together and were hard to distinguish.
Infancy, childhood, or adolescent disorders
(p. 566, Table 14.1)
Now called neuro-developmental
disorders
More accurately describes these disorders
as disorders of neural development.
Autistic disorder (p. 566,
Table 14.1)
Now called autism spectrum
disorder
Individuals diagnosed with autism
spectrum disorder display the two core
symptoms of (1) deficits in social communication and social interaction and (2)
restricted, repetitive behaviors, interests,
and activities. People with autism spectrum disorder are diagnosed according
to three levels of symptom severity: Level
1, “requiring support”; Level 2, “requiring
substantial support”; or Level 3, “requiring
very substantial support.”
Somatoform disorders
(p. 566, Table 14.1)
Now called somatic symptom and
related disorders
“Somatoform disorders” was confusing;
renamed for clarity.
Hypochondriasis (p. 566,
Table 14.1)
Dropped from DSM-5
Hypochondriasis eliminated partly because
of its negative connotations. Excessive
worry over one’s health is now split into
two separate disorders: somatic symptom
disorder, in which physical symptoms are
Chapter Affected Terms
DSM–5 Change
Chapter 14:
Psychological Disorders
(continued)
Comment
present but their significance is exaggerated; and illness anxiety disorder, in which
individuals worry excessively about being
ill despite an absence of physical symptoms.
Both disorders involve an anxious preoccupation or worry about health concerns.
Sexual and gender identity
disorders (p. 566, Table 14.1)
Split into three diagnostic classes:
sexual dysfunctions, gender dysphoria, and paraphilic disorders
In DSM-5, this class has been split into
three diagnostic classes: (1) sexual dysfunctions, which are clinically significant
disturbances in a person’s ability to
respond sexually or to experience sexual
pleasure; (2) gender dysphoria, which refers to the distress (“dysphoria”) that may
accompany the mismatch between one’s
experienced or expressed gender and one’s
assigned gender; and (3) paraphilic disorders, referring to intense and persistent
sexual interest in inappropriate objects or
people that causes distress or impairment
to the individual or harm to others.
Fetishism (p. 566, Table 14.1)
Now called fetishistic disorder
Change made to emphasize that a fetish is
only a disorder if it causes clinically significant personal distress or psychosocial
role impairment.
Gender identity disorder
(p. 566, Table 14.1)
Now called gender dysphoria
Gender identity disorder, previously defined
as the strong and persistent desire to be
the other sex, has been replaced by gender
dysphoria, now defined as distress that accompanies the discrepancy between one’s
experienced and expressed gender and one’s
assigned gender. The change in terminology is meant to emphasize that it is the
discomfort, and not the discrepancy, that is
considered to be a psychological disorder.
Impulse-control disorders
(p. 566, Table 14.1)
These disorders are now included
in a new diagnostic class called
disruptive, impulse-control, and
conduct disorders.
The definition is essentially the same but
the classification has been expanded to
include additional disorders.
Agoraphobia (p. 568)
Panic attacks are no longer a
requirement for the diagnosis.
Because not all people with agoraphobia
have panic attacks, criteria have been
expanded to include fear of panic-like
symptoms or of other incapacitating or
embarrassing symptoms, such as fear
of getting lost, fear of falling, or fear of
incontinence.
Social phobia (p. 570)
Posttraumatic stress
disorder (PTSD) (pp. 571–572)
Renamed social anxiety disorder
Name changed for clarity.
Now included in new diagnostic
class, trauma- and stressorrelated disorders
PTSD is no longer classified as an anxiety
disorder. Instead, it falls under a new classification in DSM-5, called trauma- and
stressor-related disorders. Although
anxiety is still an important symptom
in posttraumatic stress disorder, the
new classification recognizes that some
sufferers of trauma-related disorders
experience symptoms other than fear
and anxiety. Thus, to the three symptom
clusters described in your text (frequent
and intrusive recollections of the traumatic
event, avoidance, and hyperarousal), DSM5 adds a fourth cluster: negative alterations
in cognition and mood. Examples include
angry outbursts, exaggerated negative
beliefs about the self or the world, negative
emotions, irritable behavior, reckless or
self-destructive behavior, and so forth.
Continued on the next page.
Chapter Chapter 14:
Psychological Disorders
(continued)
Affected Terms
DSM–5 Change
Comment
Obsessive-compulsive
disorder (pp. 544-545)
Now included in new diagnostic
class, obsessive-compulsive and
related disorders
Although anxiety is still an important symptom in obsessive-compulsive disorder, the
disorder is no longer classified as an anxiety
disorder. Instead, it’s included in a new DSM5 category called obsessive-compulsive
and related disorders with other disorders
involving compulsive behavior, such as
hoarding, trichotillomania (hair-pulling),
and excoriation (skin-pulling).
Mood disorders (pp. 575–581)
Now split into two diagnostic
classes, depressive disorders and
bipolar and related disorders
In previous editions of DSM, the classification mood disorders included both depression and bipolar disorder. In DSM-5, these
disorders are split into two new diagnostic
classes: depressive disorders, and bipolar
and related disorders.
“The bereavement exclusion”
(p. 577)
Bereavement is no longer excluded
as a criterion for major depressive
disorder
One key difference in DSM-5, and a controversial one, was the removal of what has
been termed “the bereavement exclusion,”
which we discuss on page 577 (paragraph
2). In DSM-IV-TR, despondency following
the death of a loved one was not considered to be a case of major depression unless the ability to function was still severely
impaired for 2 months or longer after
the death. In DSM-5, recent bereavement
no longer disqualifies someone for the
diagnosis of major depression, although
the point is made that it is important to
distinguish true depression from normal
grief symptoms.
Eating disorders
(pp. 582–584)
Included in a new, expanded
diagnostic class called feeding and
eating disorders
Feeding and eating disorders is a new
diagnostic class that includes anorexia
nervosa, bulimia nervosa, a new disorder
called binge-eating disorder, and feeding/
eating disorders of infancy and childhood,
such as pica (eating nonfood substances).
Anorexia nervosa
(p. 582)
Change in criteria: diagnosis
requires only “significantly low
weight” rather than “less than 85%
of normal weight”; absence of menstrual cycles has been dropped.
Recognition that many women with
anorexia nervosa did not experience a loss
of menstrual periods, and that some people
with symptoms of anorexia nervosa have
an unhealthy body weight but do not meet
the 85% criterion.
Schizophrenia (pp. 594–596,
including Table 14.9)
The paranoid, catatonic, disorganized, and undifferentiated
subtypes of schizophrenia have
been dropped in DSM-5.
Instead of differentiating schizophrenia
“subtypes” on the basis of distinct clusters
of symptoms, clinicians now diagnose
clients in terms of symptom severity. Note
that the symptoms themselves are still
present in schizophrenia, but they do not
seem to be organized according to the subtypes described in earlier editions of DSM.
Reference:
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.).
Washington, DC: Author.