DSM-5 Wins APA Board Approval

DSM-5 Wins APA Board Approval

So it's almost time to toss all the data on the DSM IV - the DSM 5 is underway!

Article
The American Psychiatric Association's board of trustees has approved the fifth edition of its influential diagnostic manual, dubbed DSM-5, the group announced Saturday.

The board vote is the last step before the manual is formally released at the APA's annual meeting next May. The association's Diagnostic and Statistical Manual of Mental Disorders was last revised in 1994; that edition is known colloquially as DSM-IV.

more...
http://www.medpagetoday.com/Psychiatry/DSM-5/36206

I was surprised to read that the DSM hasn't been revised for almost 20 years!

I'll be interested to read the finalised version of version 5 and see how much it might impact people potentially being diagnosed with dissociative disorders...

Very interesting Thank you for sharing

From what I understand most things with DID are set in the proposed DSM 5, but some of the wording is likely to change.

Here is what is up so far:

H 02 Dissociative Identity Disorder

Proposed Revision
Rationale
Severity
DSM-IV
Updated April-30-12


Disruption of identity characterized by two or more distinct personality states or an experience of possession. This involves marked discontinuity in sense of self and sense of agency, accompanied by related alterations in affect, behavior, consciousness, memory, perception, cognition, and/or sensory-motor functioning. These signs and symptoms may be observed by others or reported by the individual.
Recurrent gaps in the recall of everyday events, important personal information, and/or traumatic events that are inconsistent with ordinary forgetting.
The symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.
The disturbance is not a normal part of a broadly accepted cultural or religious practice. (Note: In children, the symptoms are not attributable to imaginary playmates or other fantasy play.)
The symptoms are not attributable to the direct physiological effects of a substance (e.g., blackouts or chaotic behavior during Alcohol Intoxication) or another medical condition (e.g., complex partial seizures).
Specify if:

With prominent non-epileptic seizures and/or other sensory-motor (functional neurologic) symptoms
http://www.dsm5.org/ProposedRevisions/P ... spx?rid=57

These signs and symptoms may be observed by others or reported by the individual.

This should make the process of diagnosis a bit easier. The wording in the DSM-4 never made much sense to me. If the point of the system is to hide, I can imagine how many people go undiagnosed with DID bc the "two distinct personality states" aren't witnessed by who ever's assessing.

I know my T has seen a few possible switches, but probably not hard enough evidence for a diagnosis by how the DSM-4 is currently worded.

**trigger warning**
Someone on here mentioned that DDNOS-1 and DID will now be under the same dx. Is this true? Does this mean time loss for personal information or traumatic events will no longer be a criteria for DID? I would assume it to be a relatively important distinguishing factor between DDNOS-1 and DID? I may be way off though

lifelongthing wrote:**trigger warning**
Someone on here mentioned that DDNOS-1 and DID will now be under the same dx. Is this true? Does this mean time loss for personal information or traumatic events will no longer be a criteria for DID? I would assume it to be a relatively important distinguishing factor between DDNOS-1 and DID? I may be way off though

No! But they are trying to soften the boundaries between the DX for the 2. The last I read on it was that they are going to allow a patient to report time loss rather than the Doc having to actually notice it.

Ah, makes sense. Time loss is still required for it to be DID then. Just trying to get my facts straight so I don't say nothing wrong

If anyone feels like venting today...

Here is a good place to do it!
http://news.nationalpost.com/2012/12/09 ... -in-dsm-v/

In the proposed DSM-V, the criteria for DID is to be broadened in criteria A and B and adding a new diagnostic criterion: "C.

Criterion C - Causes clinically significant distress or impairment in social, occupational, or other important areas of functioning." This phrase, which occurs in several other diagnostic criteria, is proposed for inclusion in 300.14 as part of a proposed merger of dissociative trance disorder with DID. Criterion C would be included to "help differentiate normative cultural experiences from psychopathology". For example, professionals would be able to take shamanism, which involves voluntary possession trance states, into consideration, rather than diagnosing those who report it as having a mental disorder.

This has been added: Specify if with prominent non-epileptic seizures and/or other sensory-motor (functional neurologic) symptoms

Actual version of the DSM-5 (but some wording may still be changed)

A. Disruption of identity characterized by two or more distinct personality states or an experience of possession. This involves marked discontinuity in sense of self and sense of agency, accompanied by related alterations in affect, behavior, consciousness, memory, perception, cognition, and/or sensory-motor functioning. These signs and symptoms may be observed by others or reported by the individual.

B. Recurrent gaps in the recall of everyday events, important personal information, and/or traumatic events that are inconsistent with ordinary forgetting.

C. The symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.

D. The disturbance is not a normal part of a broadly accepted cultural or religious practice. (Note: In children, the symptoms are not attributable to imaginary playmates or other fantasy play.)

E. The symptoms are not attributable to the direct physiological effects of a substance (e.g., blackouts or chaotic behavior during Alcohol Intoxication) or another medical condition (e.g., complex partial seizures).

Specify if:

With prominent non-epileptic seizures and/or other sensory-motor (functional neurologic) symptoms

http://www.dsm5.org/ProposedRevisions/P ... spx?rid=57


The Rationale they give:
A. Clarification of language, including indicating that different states can be reported or observed, reducing use of Dissociative Disorder Not Otherwise Specified. Including Trance and Possession Disorder by mentioning “experience of possession” increases global utility.

B. Noting that amnesia for everyday events is a common feature.

C. This criterion is included in DSM-IV Dissociative Trance Disorder. Including it may help differentiate normative cultural experiences from psychopathology.

D. Addition from DSM-IV Dissociative Trance Disorder to increase cross-cultural applicability

Specifier: a) A substantial proportion of patients with Dissociative Identity Disorder have conversion symptoms, which are related to their dissociative disorder and require special clinical attention and treatment. b) Some Dissociative Identity Disorder patients have dissociative variations in somatic symptoms that require clarification for differential medical diagnosis and treatment.

Reference: Spiegel D et al: Dissociative Disorders in DSM-5. Depression & Anxiety, 2011; 28: 824-852
PDF: http://www.dsm5.org/Documents/Anxiety,% ... orders.pdf

Compared to the DSM-IV TR
Dissociative Identity Disorder (formerly Multiple Personality Disorder)

A. The presence of two or more distinct identities or personality states (each with its own relatively enduring pattern of perceiving, relating to, and thinking about the environment and self).

B. At least two of these identities or personality states recurrently take control of the person's behavior.

C. Inability to recall important personal information that is too extensive to be explained by ordinary forgetfulness.

D. The disturbance is not due to the direct physiological effects of a substance (e.g., blackouts or chaotic behavior during Alcohol Intoxication) or a general medical condition (e.g., complex partial seizures). Note: In children, the symptoms are not attributable to imaginary playmates or other fantasy play.