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More Than Just Words and Numbers:: The Top 15 Fundamental Changes To The Dsm-5 & The Transition To Icd-10
More Than Just Words and Numbers:: The Top 15 Fundamental Changes To The Dsm-5 & The Transition To Icd-10
More Than Just Words and Numbers:: The Top 15 Fundamental Changes To The Dsm-5 & The Transition To Icd-10
PPA
WORDS AND
NUMBERS:
THE TOP 15 FUNDAMENTAL CHANGES TO
THE DSM-5 & THE TRANSITION TO ICD-10
DISCLAIMERS
• Suicidal Behavior
Disorder &
Nonsuicidal Self- • Hypersexual Disorder
injury • Attenuated Psychosis
• Coercive paraphilia Disorder
• Pedohebephilia • PD Dimensional Assessment
Disorder • Persistent Complex
#15:GAMBLING DISORDER JOINS
THE SUBSTANCE ABUSE SECTION
1) Needs to gamble with increasing amounts of money in
order to achieve desired excitement.
2) is restless or irritable when tr ying to cut down
gambling.
3) Has made repeated unsuccessful attempts to cut down
4) Is of ten preoccupied by gambling.
5) Of ten gambles when feeling distressed.
6) Af ter losing money , of ten returns the next day to get
even --“chasing” one’s losses.
7) Lies to conceal the extent of involvement in gambling.
8) Has jeopardized or lost a significant relationship, job,
or educational or career oppor tunity because of gambling.
9) Relies on others to provide money to relieve desperate
financial situations caused by gambling.
WHY IT MATTERS
Mild (1 setting)
Moderate (2 settings)
Severe (3 settings)
Nonconformity
to gender roles
Gender Transvestic
Schizophrenia Dysphoria disorder
Body Dysmorphic
disorder
WHY IT MATTERS
Anxious
Histrionic
Dependent
Other
Anankastic
#10: AGORAPHOBIA REDEFINED AND
PANIC SPECIFIER EXPANDED 2
needed
DSM IV DSM-5
A) Anxiety about being in A) Marked fear or anxiety
places or situations from about 2 or more of the
which escape might be five situations (listed on
difficult or embarrassing prior slide)
or in where help might not B) Person fears or avoids
be available from a these situations because
predisposed panic attack. of thoughts that escape
might be difficult or help
B) The situations are might not be available.
avoided or else endured C) The agoraphobic
with marked distress. situation almost always
provoke fear or anxiety
FROM SUBT YPES TO SPECIFIERS
Blood
Natural-
Animal Injection-
Environmental
Injury
Situational Other
PANIC ATTACK SPECIFIER
Depressive
Disorders
Medical Panic
Conditions Attacks PTSD
Substance
Use Disorder
WHY IT MATTERS
Paranoid
CLINICIAN-RATED DIMENSIONS OF
PSYCHOSIS SYMPTOM SEVERIT Y
DSM-5
D. Negative
A. Exposure B. Intrusion C. Avoidance Alterations in E. Increased
event Symptoms of Stimuli Moods and Arousal
Cognitions
1+ 1+ 2+ 2+
DSM-IV
1+ 3+ 2+
THIS NOT THAT
PTSD
SPECIFIERS
CONCEPTUAL Mild
Moderate
PRAGMATIC Severe
SOCIAL Profound
EXAMPLE SPECIFIER:
SOCIAL DOMAIN
Disorder of
Written
Expression
WHY IT MATTERS
Moderate
WHY IT MATTERS
Intellectual
Disability or
Language
Disorder
Social
(Pragmatic)
Communication Schizophrenia
Disorder
ASD
Stereotypic
Movement Rett
Disorder Syndrome
WHY IT MATTERS
Specify if:
Current: Not more than 12 months since past attempt
In early remission: 12-24 months since last attempt
DSM-5 ICD-10 CROSSWALK
MAJOR DEPRESSIVE DISORDER
ICD-10 and DSM-5 are ver y similar in their conceptualizations
of depression, but ICD-10 adds reduced energy into the
cardinal symptoms of depressed mood and loss of interest
and enjoyment.
Additionally, ICD-10 does not seem to endorse some of the
atypical symptoms of DSM-5 depression (increased appetite
and hypersomnia) and instead suppor ts diminished appetite
and disturbed sleep.
While DSM-5 suggests that clients can have recurrent
thoughts of death (as well as suicidal thoughts and actions),
ICD-10 elevates the threshold with self-harm or suicide action
as the star t point of such symptomology.
ICD-10 also adds bleak and pessimistic views of the future to
their diagnostic profile, well-suppor ted by Beck’s negative
cognitive triad, but interestingly absent from DSM-5.
#1: PSYCHOPATHY SPECIFIERS ARE
ADDED TO CONDUCT DISORDER
ASPD Dissocial PD
1. Failure to conform to social norms with -Irresponsibility & disregard for social
respect to lawful behaviors norms, rules, and obligations
2. Deceitfulness, as indicated by repeated Incapacity to maintain enduring
lying, etc. relationships, though having no difficulty in
3. Impulsivity or failure to plan ahead. establishing them
I II III IV V
5-AXES DSM-IV VS. N0 AXES DSM-5
DSM IV-TR Example DSM-5 Example
A m e r ic a n P s yc hia t r i c A s s o c ia t io n. ( 2 0 0 0 ) . Di a g n os t i c a n d s t a t i s t i c a l
m a n u a l of m e n t a l d i s or d e r s ( 4 t h e d . , tex t r ev. ) . Was hing to n, D C : A u t h o r.
C ap lan , P. J . ( 1 9 91 ) . H ow d o t h ey d e c id e w ho i s no r m al? T h e b iz ar r e , b u t t r ue , tale o f
t h e D S M p r o c e s s . C ana d ian P s yc ho lo g y, 3 2 : 2 , 16 2 - 17 0
Fo r t h, A . E . , Ko s s o n, D . S . , & Har e , R. ( 2 0 0 3 ) . P s yc ho p athy C he c k l i s t . Yo u t h ve r s io n. M H S .
Fr anc e s , A lle n. ( 2 01 2 , D e c 2 ) . D S M- 5 is g uid e no t b ib l e — ig no r e i t s te n w o r s t c han g e s .
P s yc h ol o g y To d ay.
Fr anc e s , A . ( 2 0 0 9 , N ov 1 ) . A d v ic e to D S M- V: I nte g r ate w it h I C D - 1 1 . P s yc h i a t r i c T i m e s .
Ret r ieve d f r o m : h t t p : / / w w w.p s yc hia t r i c t im e s . c o m / ar t i c l e s / a d v ic e - d s m - v - in te g r at e - i c d -
11
A m e r ic a n P s yc hia t r i c A s s o c ia t io n ( 2 01 3 ). I ns ur anc e I m p lic a t io ns f o r D S M- 5 .
Wo r ld H e alt h Or g ani z at io n ( 1 9 9 2) I nte r nat io nal S t at is t ic a l C la s s if ic a t io n o f D is e as
e s and Re l ated H ealt h P r o b le m s , 1 0 t h r ev is io n ( I C D - 1 0 ) . G e neva: W HO.
Re d d y, L . A . , & A t am anof f , T. ( 2 0 0 5 ) . Ame r i c a n J our n a l of P s yc h i a t r y . B ook Review S
e c t io n: f r om A to Z on c h il d a nd ad ole s c e nt b ip o lar d is or d e r. S c h o ol P s yc h o l og y
Qu a r te r l y, 21 ( 1 ) , 1 1 2 - 1 17.
We lc h , S . , K las s e n, C . , B o r i s ova, O, C lo t hie r, H. ( 2 01 3) . T he D S M- 5 c o nt r ove r s ie s : H ow
s ho u ld p s yc ho lo g is t s r e s p o nd ? C a n a d i a n P s yc h o l og y, 5 4 ( 3 ) , 16 6- 17 5 .