Discussion Board #1: DSM-5-TR Improvements
The Diagnostic and Statistical Manual (DSM) of Mental Disorders is updated every five
to seven years to be more specific in certain diagnoses and to help guide providers in
differentiating between similar conditions. First et al. (2022) note that the current manual, the
DSM-5-TR, added four main aspects, including more diagnostic conditions, free symptoms
codes, diagnostic criteria changes, and revised terminology. I believe the text revisions for the
DSM-5 have improved the diagnostic process. First et al. (2022) write that the revision has added
three new conditions: prolonged grief disorder, unspecified mood disorder, and stimulantinduced neurocognitive disorders. These disorders may have previously been overlooked or
grouped with other disorders. For example, in the DSM editions prior to the 5-TR, grief and/or
bereavement may have fallen under the categories of bereavement disorders, post-traumatic
stress disorder (PTSD), acute stress disorder, or adjustment disorders, as these disorders can
share some of the same characteristics (Boelen & Lenferink, 2022). Categorization can be based
on the time frame of the event in relation to the patient’s mental status during the incident. In
general most grieving usually lasts between 6-12 months. However, what if the condition is
prolonged due to the individual’s experience and lasts for more than 12 months? The DSM text
revisions added this new diagnostic condition to allow mental health providers to more
accurately diagnose patients with prolonged grief disorder. A new diagnosis category does not
mean the treatment plan will change. Mental health providers can decide to keep the treatment
the same if the patient is progressively doing better.
The text revisions also make it more specific to diagnose conditions such as autism. In
previous versions, the DSM stated that fulfilling Criterion A of autism requires the patient to
meet a set of conditions. However, the manual did not suggest the patient should meet one or
more, or all of the conditions to satisfy criterion A. The text revisions made it clearer that to
fulfill the A criteria of autism, the patient must meet all of the conditions noted. The revision also
includes new codes to classify suicidal behaviors and non-suicidal self-injury (First et al., 2022).
I believe this is important as it can help track these two conditions instead of them previously
being just a specifier.
In addition to clarifying diagnostic criteria, the DSM-5-TR has been revised to include
more culturally acceptable terminology that may help reduce stigma in healthcare. In an example
of gender dysphoria, First et al. (2022) write that the description of this condition is noted to be
“experienced gender.” In prior manuals, the DSM referred to these patients as having the
dysphoria based on a desired gender. I believe this change is more accurate as the condition is
not merely just the patient wanting to change his or her physical body parts. It is the “dysphoria”
that the patient is feeling that mental health providers can address to help support the patient.
Another example is the removal of “phobia” from social phobia and classifying the condition as
social anxiety disorder (American Psychiatric Association, 2022). The term “phobia” may have a
negative connotation as it can signify that the patient has an intense fear of social situations
instead of clarifying that the fear can cause extreme anxiety, which is the mental condition itself.
The examples noted above are just a few out of many that suggest why the revisions to
the DSM-5 have made the manual more specific to help providers diagnose mental health
conditions. I believe the language has been made clearer to differentiate different diagnoses that
may have very similar characteristics. This may help reduce interpretations of specific conditions
and lead to a better treatment plan for the patient’s well-being.
References
American Psychiatric Association. (2022). Diagnostic and statistical manual of mental
disorders (5th ed., text rev.). https://doi.org/10.1176/appi.books.9780890425787
Boelen, P. A., & Lenferink, L. I. (2022). Prolonged grief disorder in DSM-5-TR: Early predictors
and longitudinal measurement invariance. Australian & New Zealand Journal of
Psychiatry, 56(6), 667–674. https://doi.org/10.1177/00048674211025728
First, M. B., Yousif, L. H., Clarke, D. E., Wang, P. S., Gogtay, N., & Appelbaum, P. S. (2022).
DSM‐5‐TR: Overview of what’s new and what’s changed. World Psychiatry, 21(2), 218–
219. https://doi.org/10.1002/wps.20989