Recent Changes Diagnostic and Statistical Manual of Mental Disorders DSM 5

Running head: DSM

DSM 5

Diagnostic and Statistical Manual of Mental Disorders (DSM-5): Recent Changes

Diagnostic and Statistical Manual of Mental Disorders (DSM-5): Recent Changes

The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) is considered the gold standard of how mental illness is diagnosed and treated within the psychiatric community of the United States. Although laypersons may think of mental illness or sanity versus insanity as stable classifications, the DSM has, in fact, undergone a number of significant changes over the years. For example, in much earlier editions of the DSM, homosexuality was classified as a mental illness. This is fortunately no longer the case. Changes from the DSM-IV to the DSM-V are far more recent and less extreme, although there have been some notable shifts that are clinically and culturally relevant.

Perhaps the most significant of these is the elimination of Asperger’s syndrome as a separate classification and its classication as part of a spectrum of autism disorder. According to Grohol (2013), autism spectrum disorder (ASD) now subsumes Asperger’s disorder, childhood disintegrative disorder, and pervasive developmental disorder not otherwise specified. The elimination of ASD, however, may be considered particularly significant given that many people proudly wore their status as an Aspie with pride, viewing themselves as nerdy rather than disorder. Persons who may have been diagnosed with Asperger’s in the past are now likely to be diagnosed as high-functioning ASD.

For a diagnosis of ASD, social problems and repetitive behaviors, interests, and activities (RRBs) must both be present for a diagnosis (Grohol, 2013). This change occurred because significant enough differences were not found between individuals with Asperger’s and autism to warrant separate categories. On the other hand, hording disorder (excessive hoarding of possessions) is not classified as a separate disorder rather than subsumed into OCD (obsessive compulsive disorder), given that it is deemed to have enough unique features to warrant its own diagnosis (Grohol, 2013).

The DSM frequently changes to reflect concerns expressed within the professional community as well as changes in society. For example, there has been concern that child bipolar disorder, once a very rare diagnosis, has becoming increasingly overused and misused as a diagnosis, due to aggressive use of off-label antipsychotic drugs. The new diagnosis of disruptive mood dysregulation disorder is to ensure that there is greater caution in treating very young children with powerful psychotropic medications that have not been studied on children and whose long-term developmental effects are not well known (Grohol, 2013). While bipolar disorder in adults must almost under all circumstances be controlled with medication, it is hoped that greater diagnostic caution will be shown with disruptive mood dysregulation disorder diagnoses.

The diagnostic criteria has also been changed for attention deficit hyperactivity disorder (ADHD), making it somewhat easier to be diagnosed as an adult but also increasing the cross-situational requirement; in other words, now several symptoms must be shown in multiple contexts (Grohol, 2013). Greater sensitivity towards gendered disorders is also manifested in the new DSM. Eating disorders, which are more common in women, now include binge eating disorder (eating without purging) as well as premenstrual dysphoric disorder (Grohol, 2013). Again, these reflect changes in understanding and social perceptions of these disorders.