Mental Notes

Image Gallery Image by Flickr user: Patrick Hoesly / Creative Commons

Lee Anna Clark, a University of Notre Dame psychology professor, jumped at the chance to be involved in crafting the fifth edition of the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM-5), due to be published in 2013.

“I saw this as a possible opportunity to see my research have real-world applications,” says Clark, who studies personality disorders and impairment assessment. Clark is one of several psychologists helping with the revision—the first since 1994.

Since the process began in 1999, the DSM-5 task force—and more than a dozen work groups, many of which include practicing psychologists—has been reviewing the current manual’s strengths and weaknesses, perusing the literature, and analyzing data. A draft of the DSM-5 proposes changes to the following categories:

Mood disorders. Add a new category called “temper dysregulation with dysphoria” to help clinicians distinguish between children with symptoms of severe mood dysregulation and those who have bipolar disorder or oppositional defiant disorder.

Suicide. Include new scales for adults and adolescents that may help clinicians identify patients at greatest risk.

Risk syndromes. Add a new diagnostic category called “risk syndromes,” which may help clinicians identify earlier stages of serious mental disorders such as dementia and psychosis.

Addiction. Replace the current categories of substance abuse and dependence with a new category called “addiction and related disorders” and add a new category called “behavioral addictions,” with gambling as its sole disorder.

Eating disorders. Change the criteria for diagnosing anorexia and bulimia. The proposed criteria for anorexia include a heightened focus on behavior, for example. While the DSM-IV’s diagnostic criteria include “refusal” and “fear of weight gain,” the eating disorders work group points out that “refusal” is difficult to assess and that some people with anorexia deny fear of weight gain. Additionally, make binge-eating disorder a freestanding diagnosis.

Learning disorders. Change the names of certain categories within the learning disorders section to bring them in line with international usage. Thus, the reading disorder and mathematics disorder categories become dyslexia and dyscalculia. The draft also recommends the creation of a single diagnostic category—autism spectrum disorders—to replace current diagnoses of autistic disorder, Asperger’s disorder, childhood disintegrative disorder, and pervasive developmental disorder.