Mental Notes

Rethinking and rewriting the psychiatric rulebook

| November-December 2011

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.