Changes in Psychology Diagnostic Manual Effective May 2013

DSM-5 updates diagnosis of autism, other disorders

The American Psychiatric Association (APA) announced changes to the Diagnostic and Statistical Manual of Mental Disorders (DSM) in early December 2012. The new guidelines go into effect May 2013, leaving many people questioning how they or their loved ones will be affected.

Asperger’s, Autism Seeing Major Changes in New Version

The Centers for Disease Control and Prevention (CDC) reports that one in 110 children are diagnosed with autism spectrum disorder under current diagnostics; however, this number may change after the new DSM-5 updates go into effect later this year. Perhaps the most scrutinized update after APA’s December announcement is the dropping of the specific diagnosis of Asperger’s syndrome from DSM-5.

Asperger’s is typically recognized as a high-functioning form of autism. Children with the disorder are known to have high intelligence and a wide knowledge of narrow subjects; however, they often lack basic social skills. Under the new provisions, Asperger’s, along with similar disorders, will be reorganized under a broader categorization of autism spectrum disorder. The change would alter the current diagnostic criteria for autism and potentially re-diagnose tens of thousands of people in the process. The APA has issued a statement assuring that this and similar changes were made to add accuracy and consistency to diagnosing children with autism; however, skeptics worry the revised diagnostic standards could phase many autistic children out of much-needed health care benefits.

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Other Notable Changes Coming to DSM-5

Revisions to the DSM-5 help illustrate changing times and the evolution of human psychology. Other notable changes to the revised DSM-5 include:

  • Hoarding has been added to the DSM-5 as a disorder characterized by the inability to part with material possessions despite their actual value.
  • Binge eating has been classified as a mental disorder in the new manual.
  • Disruptive mood dysregulation disorder (DMDD) – a new diagnosis – has been added to the manual to classify children with frequent temper tantrums.
  • A skin-picking disorder – excoriation – has been classified as a new obsessive-compulsive disorder in the updated DSM-5.
  • The bereavement exclusion has been removed from the upcoming manual. Bereavement is now classified as a severe psychosocial stressor that can cause intense depression soon after the death of a family member or loved one.
  • The term “gender identity disorder” has been eliminated from the upcoming manual and replaced with “gender dysphoria” to recognize emotional distress in children and adults over their gender.
  • The diagnostic clusters for post-traumatic stress disorder (PTSD) have been expanded from three to four in the revised DSM-5. The DSM-5 has added a new chapter on trauma- and stress-related disorders and will be more developmentally sensitive for children and adolescents.
  • The creation of specific learning disorder has broadened the previous manual’s criteria to identify distinct disorders that inhibit the attainment and use of one or more of the following academic skills: reading, written language, oral language or mathematics.
  • Substance abuse and substance dependence has been combined under substance use disorder in the DSM-5. The criteria for this disorder have been strengthened, now requiring two or three symptoms to be present for diagnosis.

How New Changes Could Affect You

Autism support groups have kept a close eye on the changing manual in an effort to stay on top of how changes would affect their community. For adults with autism or parents of autistic children, it is important to note that the DSM-5 committee has stated that those individuals with a diagnosis on the autism spectrum under the terms in previous manuals will retain their ASD diagnosis going forward. However, future cases will be measured under the new diagnostic criteria established by the DSM-5. This is important as it protects potential health care benefits and government support currently received by ASD patients under old guidelines.

People with other disorders that are newly classified or altered by the DSM-5 could also be adversely affected by its update. Health care providers often use this manual to determine methods of treatment and patient care. Insurance companies often use the diagnostic manual to determine coverage options, while schools and government agencies depend on it to help allocate benefits and create special programs and provisions for people with mental or developmental disorders. People whose disorders have been adjusted or reclassified may experience a change in benefits. It is important to stay updated on changes and your or your child’s status to ensure you don’t lose or miss out on key benefits and support programs.

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