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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

Passitpro.com

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DSM - 5: Introduction

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, brand-new diagnoses (additions) and renaming or grouping of diagnoses. Brief descriptions are included.

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Changes: Deletions:

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.

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New Diagnoses: Summary

Autism Spectrum Disorder Disinhibited Social Engagement Disorder ADHD Disruptive Mood Dysregulation Disorder Premenstrual Dysphoric Disorder Gender Dysphoria Disorder Hoarding Disorder Excoriation Disorder

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New Diagnoses: Summary (cont’d) Binge-Eating Disorder Major Neurocognitive Disorder Mild Neurocognitive Disorder

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Changes in Diagnostic Categories: New

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.

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Disinhibited Social Engagement Disorder

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).

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ADHD

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.

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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.

Disruptive Mood Dysregulation Disorder

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Premenstrual Dysphoric Disorder 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.

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Gender Dysphoria Disorder

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.

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Hoarding Disorder

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.

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Excoriation Disorder

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.

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Binge-Eating Disorder

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.

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Major Neurocognitive Disorder 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.

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Mild Neurocognitive Disorder Modest cognitive decline. Awareness and concern on part of

individual. Deficits do not interfere with capacity for

independence in everyday activities.

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Renaming: Summary

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

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Somatic Symptom Disorder

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.

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Illness Anxiety Disorder

Preoccupation with having or acquiring a serious illness.

Somatic (physical symptoms are absent or minimal.)

High anxiety about health status.

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Social Anxiety Disorder

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+

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Factitious Disorders

Falsification of physical or psychological symptoms/injuries or disease with intent to deceive.

Two sub-types: “Imposed on Self” or “Imposed on Another”.

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Persistent Depressive Disorder 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).