Here's what's coming
'round the mountain. Posting today at dsmv.org,
a new draft of the DSM. Don't worry, it's not on the test till it's
out of draft and between shiny covers. But, FYI, here's a little
bit of what's new:
* The recommendation of new
categories for learning disorders and a single diagnostic category,
"autism spectrum disorders" that will incorporate the current
diagnoses of autistic disorder, Asperger's disorder, childhood
disintegrative disorder and pervasive developmental disorder (not
otherwise specified). Work group members have also recommended that
the diagnostic term "mental retardation" be changed to
"intellectual disability," bringing the DSM criteria into alignment
with terminology used by other disciplines.
* Eliminating the current categories
substance abuse and dependence, replacing them with the new
category "addiction and related disorders." This will include
substance use disorders, with each drug identified in its own
* Eliminating the category of
dependence will better differentiate between the compulsive
drug-seeking behavior of addiction and normal responses of
tolerance and withdrawal that some patients experience when using
prescribed medications that affect the central nervous system.
* Creating a new category of
"behavioral addictions," in which gambling will be the sole
disorder. Internet addiction was considered for this category, but
work group members decided there was insufficient research data to
do so, so they recommended it be included in the manual's appendix
instead, with a goal of encouraging additional study.
* New suicide scales for adults and
adolescents to help clinicians identify those individuals most at
risk, with a goal of enhancing interventions across a broad range
of mental disorders; the scales include research-based criteria
such as impulsive behavior and heavy drinking in teens.
* Consideration of a new "risk
syndromes" category, with information to help clinicians identify
earlier stages of some serious mental disorders, such as
neurocognitive disorder (dementia) and psychosis.
* A proposed new diagnostic
category, temper dysregulation with dysphoria (TDD), within the
Mood Disorders section of the manual. The new criteria are based on
a decade of research on severe mood dysregulation, and may help
clinicians better differentiate children with these symptoms from
those with bipolar disorder or oppositional defiant disorder.
* New recognition of binge eating
disorder and improved criteria for anorexia nervosa and bulimia
nervosa, as well as recommended changes in the definitions of some
eating disorders now described as beginning in infancy and
childhood to emphasize that they may also develop in older