Ten Things for Counselors to Consider when reviewing the DSM-5 draft
Dimensional assessments have been included and represent one of the biggest and most extensive changes to the DSM-5. Although these vary considerably across the diagnostic categories, the overall purpose of this approach is to allow counselors to evaluate symptom severity as well as account for cross-cutting symptoms (e.g., an individual with schizophrenia reporting symptoms of insomnia, depression, or anxiety). Other dimensional assessments may be used prior to a formal diagnostic evaluation and may help counselors identify levels of, for example, suicidal ideation or depression or rate specific personality traits. Other assessments may record common symptoms that are not addressed within the diagnostic criteria later allowing counselors to evaluate any change in the condition. This is an extensive modification within the proposed diagnostic criteria and overall content of the DSM. Counselors are encouraged to investigate and comment on areas of interest. New scales for adults and adolescents to help assess suicide risk have been added.
New categories for learning disorders and a single diagnostic category-"Autism Spectrum Disorders"- has been proposed. In this proposal, Autism Spectrum Disorder will incorporate the DSM-IV-TR diagnoses of autistic disorder, Asperger's disorder, childhood disintegrative disorder and pervasive developmental disorder (not otherwise specified). It is also recommended that the diagnostic term "intellectual disability" as opposed "mental retardation" be used.
The current categories of substance abuse and dependence have been eliminated and replaced with the new category "addiction and related disorders." This change will include substance use disorders with each drug identified in its own category.
A new category of "behavioral addictions" has been created in which gambling will be the only disorder included. For information regarding Internet addiction, strongly considered for inclusion, see the manual's appendix.
Other categories and proposed diagnoses that Counselors may want to consider:
A new "risk syndromes" category which includes information to help clinicians identify earlier stages of some serious mental disorders, such as neurocognitive disorder (known as dementia in the current DSM) and psychosis have been added.
A proposed new diagnostic category-"temper dysregulation with dysphoria (TDD)"- has been added to the Mood Disorders section. The new criteria are proposed to help clinicians better differentiate children with these symptoms from those with bipolar disorder or oppositional defiant disorder.
Inclusion of binge eating disorder and modified criteria for anorexia nervosa and bulimia nervosa. Many changes have been recommended in the definitions of some eating disorders which are currently classified under Disorders Usually First Diagnosed in Infancy, Childhood, or Adolescence. This change is intended to emphasize that some eating and feeding disorders may develop in older individuals.
Considerations of gender, race and ethnicity are being highlighted in an effort to include the various ways in which gender, race and culture affect the expression of symptoms.
Numerous conditions have been recommended by outside sources which are still be considered by the DSM-5 Task Force. These-not currently contained in the proposed draft-include:
Body Integrity Identity Disorder
Complicated Grief Disorder
Developmental Trauma Disorder
Disorders of Extreme Stress Not Otherwise Specified