DSM - 5 What you need to know for the ASWB license exams. Idelle Datlof, MSW, LISW-S PassItPro.com May Passitpro.com

DSM - 5: Introduction 2  DSM - 5 replaces DSM IV on all the ASWB license exams on July 1,  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.

Changes: Deletions: 3  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.

New Diagnoses: Summary 4  Autism Spectrum Disorder  Disinhibited Social Engagement Disorder  ADHD  Disruptive Mood Dysregulation Disorder  Premenstrual Dysphoric Disorder  Gender Dysphoria Disorder  Hoarding Disorder  Excoriation Disorder

New Diagnoses: Summary (cont’d) 5  Binge-Eating Disorder  Major Neurocognitive Disorder  Mild Neurocognitive Disorder

Changes in Diagnostic Categories: New 6  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.

Disinhibited Social Engagement Disorder 7  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).

ADHD 8  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.

9  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

Premenstrual Dysphoric Disorder 10  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.

Gender Dysphoria Disorder 11  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.

Hoarding Disorder 12  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.

Excoriation Disorder 13  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.

Binge-Eating Disorder 14  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.

Major Neurocognitive Disorder 15  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.

Mild Neurocognitive Disorder 16  Modest cognitive decline.  Awareness and concern on part of individual.  Deficits do not interfere with capacity for independence in everyday activities.

Renaming: Summary 17  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

Somatic Symptom Disorder 18 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.

Illness Anxiety Disorder 19  Preoccupation with having or acquiring a serious illness.  Somatic (physical symptoms are absent or minimal.)  High anxiety about health status.

Social Anxiety Disorder 20  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+

Factitious Disorders 21  Falsification of physical or psychological symptoms/injuries or disease with intent to deceive.  Two sub-types: “Imposed on Self” or “Imposed on Another”.

Persistent Depressive Disorder 22  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).