Exploring the DSM-5 and its New Diagnostic Criteria

The American Psychiatric Association recently released the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5).

The DSM-5 bears changes to the diagnostic criteria for a number of conditions. Although some criteria are now different, they should have little effect on the person-centered, strengths-based approach to care that CPI promotes. As such, they should also have little effect on how most Nonviolent Crisis Intervention^® and Dementia Capable Care Certified Instructors deliver their training programs.

The following changes are of note:

Autism Spectrum Disorder

The diagnosis of autism spectrum disorder in the DSM-5 now encompasses the DSM-IV diagnoses of autistic disorder, Asperger's disorder, childhood disintegrative disorder, and pervasive developmental disorder not otherwise specified (PDD-NOS). This change to the diagnosis of ASD attempts to broaden the definition of ASD, making it an umbrella term that's more inclusive of a variety of behaviors and severities.

The DSM-5 outlines two main criteria for the diagnosis of ASD:

• Differences in social communication and interaction.
• Restricted, repetitive patterns of behavior, interests, or activities.

The DSM-5 also outlines dimensional elements that indicate how much support an individual with ASD needs.

The updated manual also introduces a new diagnostic category, separate from ASD, called social communication disorder (SCD). The DSM-5 states that social communication is affected in an individual with SCD, but a person with SCD does not exhibit restricted, repetitive patterns of behavior, interests, or activities.

Post-Traumatic Stress Disorder

The updated manual features a new chapter on trauma- and stressor-related disorders. This chapter includes criteria for post-traumatic stress disorder (PTSD) and trauma- or stressor-related disorder not elsewhere classified. It now separates these conditions from anxiety disorders. Additionally, it outlines a diagnostic subtype for children who are affected with PTSD.

Alzheimer’s and Dementia

The DSM-5 replaces the term “dementia” with major neurocognitive disorder and mild neurocognitive disorder. The new terms focus on a decline, rather than a deficit, in function. The new criteria focus less on memory impairment, allowing for variables associated with conditions that sometimes begin with declines in speech or language usage ability.

According to the DSM-5’s criteria, individuals with major neurocognitive disorder exhibit cognitive deficits that interfere with independence. Persons with mild neurocognitive disorder may retain the ability to be independent.

The APA suggests that the addition of criteria for mild neurocognitive disorder is intended to promote early detection and treatment of cognitive decline. It also suggests that although the new terms are intended to help reduce the stigma associated with the term dementia, if you prefer, you can still use the term dementia to refer to neurocognitive disorder.

The Alzheimer’s Association outlines different diagnostic criteria for Alzheimer’s disease and retains the use of the word dementia.

Resources

The opinions expressed in these articles do not necessarily reflect the opinions of CPI.

• Learn more about the DSM-5 on the Autism Speaks website.
• Get the UK’s National Autistic Society’s take on the DSM-5.
• Read the APA’s fact sheet on ASD [PDF].
• Find out more about the new chapter on trauma.
• Read more about the changes to dementia terminology.
• Find out more about neurocognitive disorder.