Continuing our series of quick
posts highlighting big diagnostic changes that appear in DSM-5. Up
next: Alcohol Use Disorder (AUD). Again, let's let the net do what
it does and answer the question. What is AUD? How is it different
from what appeared in DSM-IV-TR?
Changes Disorder Terminology
DSM-IV described two distinct disorders, alcohol abuse and
alcohol dependence, with specific criteria for each.
DSM-5 integrates the two DSM-IV disorders, alcohol abuse and
alcohol dependence, into a single disorder called alcohol use
disorder (AUD) with mild, moderate, and severe
Changes Diagnostic Thresholds
Under DSM-IV, the diagnostic criteria for abuse and dependence
were distinct: anyone meeting one or more of the "abuse"
criteria...would receive the "abuse" diagnosis. Anyone with three
or more of the "dependence" criteria during the same 12-month
period would receive a "dependence" diagnosis.
Under DSM-5, anyone meeting any two of the 11 criteria during
the same 12-month period would receive a diagnosis of AUD. The
severity of an AUD-mild, moderate, or severe-is based on the number
of criteria met.
Here are those 11 criteria and how to score them, also from
Scoring for symptoms 1 through 11. The presence of at
least 2 of these symptoms indicates an Alcohol Use Disorder
The severity of the AUD is defined as: Mild: The presence of 2
to 3 symptoms; Moderate: The presence of 4 to 5 symptoms; Severe:
The presence of 6 or more symptoms
In the past year, have you:
1 Had times when you ended up drinking more, or longer, than you
2 More than once wanted to cut down or stop drinking, or tried
to, but couldn't?
3 A great deal of time is spent in activities necessary to
obtain alcohol, use alcohol, or recover from its effects.
4 Spent a lot of time drinking? Or being sick or getting over
other aftereffects? (**This is new to DSM-5**)
5 Found that drinking-or being sick from drinking-often
interfered with taking care of your home or family? Or caused job
troubles? Or school problems?
6 Continued to drink even though it was causing trouble with
your family or friends?
7 Given up or cut back on activities that were important or
interesting to you, or gave you pleasure, in order to drink?
8 More than once gotten into situations while or after drinking
that increased your chances of getting hurt (such as driving,
swimming, using machinery, walking in a dangerous area, or having
9 Continued to drink even though it was making you feel
depressed or anxious or adding to another health problem? Or after
having had a memory blackout?
10 Had to drink much more than you once did to get the effect
you want? Or found that your usual number of drinks had much less
effect than before?
11 Found that when the effects of alcohol were wearing off, you
had withdrawal symptoms, such as trouble sleeping, shakiness,
restlessness, nausea, sweating, a racing heart, or a seizure? Or
sensed things that were not there?
And there are the basics. If an exam answer specifies "alcohol
dependence" or "alcohol abuse," be wary. With DSM-5, it's
alcohol use disorder.
For questions about AUD and much more, sign up for SWTP