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Mental disorder refers to “ a health condition characteriz ed by signi?cant dysf unction in an individua l’ s cognitions, em otions, or behavi ors that re?ects a disturbance in the psycholog- ical, biological, or developmental pr ocesses underlying mental functioning” (American Psychiatric Associa tion, 2012). Mental health pro- fessionals diagnose individuals based on the symptoms that they report experiencing and the signs of disorders with which they present. Whereas the DSM aid s professionals in u nder- standing, diag nosing, and communic ating about mental disorders through its pro vision of explicit d iagnostic crite ria and an o?cial classi?cation system, no information abou t treatmen t is included. Planning and Development of the DSM-5 ?e DSM-5 is the latest inc arnation of the manual in an evolving pro cess that began w ith ?e Encyclopedia of Clinical Psychology, First Edition. Mo re recently, the DSM-IV was published in 1994 and in 2000 a “text revision ” of the man ual ( DSM-IV-TR )w a sp u b l i s h e d,w h i c hs l i g h t l y updated some of the content in the manual. Empirical research and extensive li terature reviews have guided re?nements in the diag- nostic manual and its continued develo pment. In 1999, an initial DSM-5 research planning conference was convened, which set research priorities in an e?ort to expand the scienti?c basis for mental health diagnoses and classi?- cation. Between 2006 and 2008, the diagnostic workgroups were ass embled, comprising more than 160 clinicians and researchers fro m psy- chiatry, psy chology, social work, psy chiatric nursing, pediatrics, and neurology. In an e? ort to ensure broad perspectives were consid- ered, the work-group members represen ted more than 90 academic and mental health institutions throughout the world, and approx- imately 30 of t he work-group memb ers were fro m countries o ther than the U nit ed States. Addition ally, more than 300 advis- ers, known for their expertise in a particular.
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Each of the di agnostic wor kgroups con- ducted extensive literatur e reviews, performed secondary data an alyses, solici ted feedback from colleagues and professionals, and ulti- mately developed the new diag nostic criteria in their respective areas. Several general prin- ciples were established to guide the decisions made by the wor kgroups about w hat should be included, remo ved, or cha nged in the revised manual. ?ese principles included consid- eration of the clinical utility of and research evidence for the revisions, continuity wi th the previou s edition of the m anual when possible, and no predetermined constraints on the amount of change permitt ed. Addi- tionally, the workgroups were aske d to clarify the boundaries between mental disorders, Early dr a?s of th e DSM-5 were opened f o rp u b l i cr e v i e w;t h eA m e r i c a nP s y c h i a t r i c Association designated three time periods during which the general public was invited to comment o n the new diagnostic cri teria. Field trials were conducted between 2010 and 2011 to test the new diagnost ic criteria for feasibility, clinical utility, reliability, and validity in both academic and nonacademic clinical practice settings. ?e r elease of the ?n al, app roved DSM-5 occurred in May 2013. ?e manual is expected to become a living document, re?ecti ng more frequent rev isions. ?us, the traditional Roman numeral was dropped from the title so that fu ture cha nges prio r to the manual’ s next com plete revision will be sig- ni?ed as DSM-5.1, DSM-5.2,a n ds of o r t h. Although far fro m perfect, the DSM functions as one of the most comprehensive and thor- ough manuals used to classify and diagnose mental disorders. ?e only major competitor in the developed world is the W orld Health Organization ’ s Internationa l Classi ?cation o f Diseases ( ICD ), which is in its tenth edition. ?e ICD is also currently undergoing revision a n di se x p e c t e dt ob ew i d e l yc o m p a t i b l ew i t h the DSM-5.
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Genera l Feat ure s of the DS M-5 Section 1 o f the DSM-5 pro vides an introduc- tion and includ es information on how to use the manual. In Section 2, mental disorders are grouped into 22 diagnos tic categories. ?e struc tural organizati on of the DSM-5 is revise d from the prev ious edition, such that the individual disorders within a category are arranged in a developmental lifestyle fashion, with disorders typically associated with child- hood presented ?rst. Additionally, the order o ft h ed i a g n o s t i cc a t e g o r i e si sd e s i g n e dt o closely position diagnostic areas that seem to be related to one anot her, re?ecting advanc es in the scienti?c understanding of mental disor- ders. Section 3 includes conditions that require further research, assessment measures, cultural formulations, a g lossary, and a descr iption of an alternative model for d iagnosing pers onality disorder (see below). According to the DSM-5,i n d i v i d u a l sw i t h a particular diagnosis (e.g., major depressive disorder) need not exhibit identical features, although they sh ould prese nt with certain ca r- dinal symptoms (e.g., either depres sed mood or anhedonia). In the DSM-5,t h ec r i t e r i af o r many mental disorders are polythetic, mean- ing that an individual must meet a minim um number of symptoms to be diagnose d, but not all symptoms need be present (e.g., ?ve of nine sy mptoms must b e prese nt to diag nose depression). U se of polythetic criteria allows for some variati on among people with t he same disorder. However, individuals with the same disorder should have a similar history in some areas, for example a typical age of o nset, prognosis, and common comorbid c onditions. Consistent with previous edition s, the DSM-5 primarily relies on a categorical ap proach to diagnosis so that individuals either have the disorder (i.e.
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, they meet criteria, they are diagnosable) or they do not (despite possibly having several s ymptoms but not enough to meet formal criteria). Notab ly abs ent fr om the DSM-5 is the use of the multiaxial system. Clinical disorders, personality disorders, and general medical conditions (formerly Axes I, II, an d III) are combined into a non axial documentation, with separat e notation s for psych osocial and contextual factors (formerly A xis IV) and disability (formerly Axis V). Regarding the former Axis V, the Global Assessmen t of Funct ioning s cal e has be en repla ced wi th the W orld Health Organizatio n Disability Assess- ment Schedule (WHODAS) whic h provides a global measure of disability. ?e WHOD AS is based on the International Classi?cation o f Funct ioning, Disa bility a nd Healt h (ICF) f or use across al l of medicine and h ealth care, and i sl o c a t e di nS e c t i o n3o ft h e DSM-5 with other An added feature in the DSM-5 i st h em o r ep r o m i n e n tu s eo f dimensional and crosscutting assessments. Dimensional assessments are pro posed for inclusion within some existing catego rical diagnoses, with the goal of providing addi- tional information that assists c linicians in assessment, treatment planning, and treatment monitoring. For exam ple, among individuals with schizoph renia, the severi ty of the prima ry symptoms of psychosis, inc luding delusions, hallucinations, disorganized speech, abno rmal psychomotor behavior, and negative symp- toms, may be rated on a dimensional ?ve-point scale ranging fr om 0 ( not present )t o4( present and seve re ). Cross-cutting assessment refers to the measu rement of import ant clinical are as that may be relevant beyond speci?c diagnos- tic areas, such as depres sed moo d, anxiety, substance use, or sleep problems. Suc h clinical areas may be rel evant for prognosi s, treatment p l a n n i n g,a s s e s s m e n to fo u t c o m e,o rr e.Clinical Disorders ?
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e bulk of the DSM-5 comprises 22 broad clusters under which speci?c clinical disorders are subsumed. Examples of clinical disorders include bipolar disorder, generalized anxiety disorder, schizophrenia, and anorexia nervosa. In gener al, many of t he main di agnost ic cate- gories remain largely the same in the DSM-5 as in the previ ous edition of the manu al, although some new categories were created (e.g., Neurodevelopmental Disorder s; Bipolar and Related Disorders, Gender Dysphoria, Obsessive-Compulsive and Relat ed Disorders). Other modi?cations included moving sev- eral disorders from one catego ry to another, renaming some disorders, and deleting some disorders that had questionable relia bility or validity, re?ecting advances in empirical research and unde rstanding of mental -health disorders. For examp le, disorders that were formally classi?ed as “Dementia” are now renamed “Mild Neur ocognitive Disorder” or “Major N eurocognitive Disorder,” with sub- types of each identifying the etiology of the cognitive dysfunction (e.g., Major N eurocog- nitive Disorder due to Alzheimer’ s Diseas e). Consisten t with the man ual’ s new dimen- sional approach, Asperg er’ s disorder has been subsumed in a new diagnosis called “ Autism Spectrum Disorder,” which allows for dimen- s i o n a lr a t i n g so fs e v e r i t yo ft h es y m p t o m so n a continuum from mi ld to severe. In add ition, there are a few newly classi?ed disorders, such as Hoarding Disorder, which fal ls under the “Obsessive-C ompulsive and Related Dis or- ders” categ ory. Finally, some clinical disorders such as Non-Suicidal Self Inj ury Disorder and Persistent Com plex Bereavement Dis- order are included in the manual under a section designated for disorders that require further study (in the previously mentioned Section 3 ). Personality Di sorders Personality disorders are in?exible a nd maladaptive patterns of behavior re?
ecting extreme variants of normal personality traits that have become rigid and dysfunctional. Ten prototypical personality disorders wer e listed in the DSM-IV-TR,i n c l u d i n gt h ea n t i s o c i a l, avoidant, borderline, dependent, histrionic, narcissistic, obsessive-compulsive, para noid, schizoid, a nd schizotypal per sonality diso r- ders. Substantial comorb idity and overlap exist among the pers onality dis orders. ?e DSM-5 Personality an d Personality Dis orders Work Group proposed subst antial changes in the way clinicians assess and diagnose personality pathology. H owever, a?er extensive debate and critique of the proposed changes, the DSM-5 included the 10 standard personality disorders in the main text o f the manual an d relega ted most of the p roposed cha nges to the la tter portion of the m anual so tha t the chang es can be studied m ore fully. Nonetheless, the pro- posal is available for current use if the clinician wishes. ?e workgroup initially recommended the previous 10 categories be red uced to six spe- ci?c personality disorder types, including One additional type, Personality Disorder T rait Speci?ed (PDTS) was suggested t o replace the former Personality Disorder N ot Oth- erwise Speci?ed diagnosis. ?e wo rkgroup also proposed tha t the DSM-5 criteria should incorporate a dimensional appr oach, such that in order to be diagnosed with a personality disorder an individual must hav e impairment in two areas of pe rsonality f unctioning: self and interpers onal. Impairment of self is related to identity and self-directedness, whereas interpersonal impairment is related to o ne’ s capacity for empa thy and intimacy. L evels of impairment in these areas are supposed to be rated along a c ontinuum from 0 ( healthy functio nin g )t o4( extreme impairmen t ). Finally, the workgroup pro posed and de?ned ?ve broad person ality trait do mains, inc luding negative a?
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ectivity, detachment, antagonism, disinhibition versus compulsivity, and psy- choticism. Within these ?ve br oad domains are component trait facets, which vary by disorder. It was sugg ested that th e personality do main in DSM-5 be used to describe th e personalit y characteri stics of all patie nts, whether o r not they have a clinically signi?cant personality disorder. ?e workgroup ’s full proposal is a v a i l a b l ef o ru s ei nS e c t i o n3. In response to these suggested major changes to the Personality Disorders ca tegory in DSM-5, there has been substantial and some- times contentious debate in the literature regarding many of thes e modi?cat ions. Most of the criticisms center around questions a bout the empirical basis for many of the chan ges, the perceived ar bitrariness of the change s, and the perceived limited clinical utility and unnecessar y complexity of t he changes (e.g., Livesley, 2012; Zimmerman, 2011). Although no major change s in the personality disorders were formally adopted in DSM-5,i ti sl i k e l yt h a tm a n yo f the propose d changes will b e revisited in future editio ns of the man ual especially as the researc h base contin ues to clarify whe ther the proposed modi?cations increase diagnostic utility and validity. Mult ic ultu ra l and D iver sit y Issu es in the DSM-5 During the DSM-5 developmen t process, study groups on gender and cross-cultur al issues and on lifespan developmental ap proaches were included. In addition, there was an e?ort to include international experts in the revision process, as well as a variety of clinical settings during the ?e ld trials, to ensu re a wide pool of information on cultural facto rs in psy- chopatholog y and diagnosi s. Such information is necessar y to help clinicians and re searchers diagnose individuals outside the majority cul- ture. ?e DSM-5 provides an up dated version of the Outli ne for Cultural Formulat ion that was introduced in DSM-IV.?
i sO u t l i n ep r o - vides a fr amework for assess ing informati on a b o u tt h er o l eo fc u l t u r ei na ni n d i v i d u a l ’ s mental health p roblems. Speci?cally, the Out- line calls for a thorough assessment of ?ve content areas, incl uding the cultural identity of the individual, cultural conceptualization s of distress, psychosocia l stressors and cul- tural features of vulnerability a nd resiliency, cultural features of the relatio nship between clinician and client, and an o verall cultural assessment. ?e DSM-5 Outline also p resents a n approach to ass essment using t he Cultural Formulation I nterview (CFI). ?e CFI con- tains a set of 16 questions that clinician s may use during a clinical intake assessment to elicit information from a client abou t the possible impact of culture on di.It is des igned to be used rega rdless of th e client’s cultural background or the clin ician’ s cultural backgr ound or theo retical orien tation. ?e CFI emphasize s four main domains: (a) cultural de?nition of the problem; (b) cultural percepti ons of cause, context, an d support; Although culture p urportedly refers to all aspects of one’s mem bership in diverse social groups (e.g., ethnic groups, the military, faith communities), the CFI appears to em phasize t h ei m p a c to fr a c ea n de t h n i c i t yo no n e ’ s understanding of one’ s di?culties. Additional modules have been d eveloped for pop ulations with unique needs, such as children, older adults, and immigrants and refugees, which can be used to supplement the standard CFI. D e s p i t es o m ea p p a r e n ti m p r o v e m e n t s,t h e relevance of criteria for some mental disorders among older adults is addressed in a limited fashion in the DSM-5.F i n a l l y,aG l o s s a r yo f Cultural Concepts of Distress is located in the Appendix, and includes informa tion about culture-bound syndromes, the cultures in which they occur, and a description of the main psychopathological features.
Limitations and Criticisms of DSM-5 Although an ticipated to im prove u pon its predecesso rs and pro vide a state-o f-the-art manual for the diagnosis and classi?cation of mental disorders, the DSM-5 has received some signi?cant criticisms. A major criticism is the dramatic exp ansion of the bound aries of some categories, for exam ple attention de?ci t hyper- activity disorder (ADHD), potentially resulting in numerous “false positive ” diagnoses. A related controver sy regards the ex pansion in the number of diagnosable mental disorders, potentially p romp ting unneces sary stigmatiza- tion, intervention, and expense. Indeed, across editions of the DS M, more mental disorders have been included in each successive versio n as new disorders have been de?ned to ?ll in the gaps between existing disorders. Such pro- liferation of ne wly minted dis orders raises t he question whether they truly represent distinct forms of psychopatholo gy or are merely vari- ations of existing disorders. Other criticisms include the American Psychiatric As sociation ’ s lack of inclusiveness and transparenc y in the revision process; the adoption of a dimen- sional approach to diagnosis without su?cient empirical support; the use of newly developed dimensional and cross-cutting assessments in the absence of evidence of reliability and valid- ity; and limited attention to careful risk-bene?t analyses rega rding many of the changes. For a more complete disc ussion of strengths an d criticisms of the DSM-5, interested readers are referred to Frances an d Widiger (2012), Kamens (2012), and Widiger a nd Gore (2012). SEE ALSO: D e?nition of Men tal Disorder; DS M-I and DSM-II; DSM-III and DSM-III-R; DSM-IV; Medical Model of Men tal Disorders; Rei?cation References American Psychiatric Association. (2012). De?nition of a mental disorder.
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Autism spectrum disorder (ASD) is a serious neurodevelopmental disorder that starts in early childhood and is characterized by social communication barriers, restricted interests, repetitive stereotyped behaviors, and abnormalities in perception (1). In recent years, epidemiological survey data on the incidence of ASD showed that the prevalence rate increased from 0.07 to 1.8 in China (2)... According to the 2013 version of the Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5), ASD symptoms are usually present in young children at the age of 1-2 years. Occasionally, initial symptoms often involve delayed language development, accompanied by a lack of social interest or unusual social interactions, quirky play modes and unusual communication patterns (1). A study by Barbaro and Dissanayake on family videos and parental reports revealed early warning signs in social interactions of children with ASD aged 12 to 24 months old (5), which included lack of joint attention, lack of eye contact, lack of social smiling, lack of social interest and sharing, no response to calling name, lack of gestures, and communication impairments (5)(6)(7)(8)(9).. Application of the Still-Face Paradigm in Early Screening for High-Risk Autism Spectrum Disorder in Infants and Toddlers Article Full-text available Jun 2020 Nana Qiu Chuangao Tang Mengyao Zhai Xiaoyan Ke Background: Although autism spectrum disorder (ASD) can currently be diagnosed at the age of 2 years, age at ASD diagnosis is still 40 months or even later. In order to early screening for ASD with more objective method, behavioral videos were used in a number of studies in recent years. The HR group was follow-up until they were 2 years old to confirm final diagnosis. Machine learning methods were used to establish models for early screening of ASD.
Results: During the face-to-face interaction (FF) episode of the SFP, there were statistically significant differences in the duration and frequency of eye contact, social smiling, and active social engagement between the two groups. During the still-face (SF) episode, there were statistically significant differences in the duration and frequency of eye contact and active social engagement between the two groups. The 45 children in the HR group were reclassified into two groups after follow-up: five children in the N-ASD group who were not meet the criterion of ASD and 40 children in the ASD group. The results showed that the accuracy of Support Vector Machine (SVM) classification was 83.35 for the SF episode. Conclusion: The use of the social behavior indicator of the SFP for a child with HR before 2 years old can effectively predict the clinical diagnosis of the child at the age of 2 years. The screening model constructed using SVM based on the SF episode of the SFP was the best. This also proves that the SFP has certain value in high-risk autism spectrum disorder screening. In addition, because of its convenient, it can provide a self-screening mode for use at home. Trial registration: Chinese Clinical Trial Registry, ChiCTR-OPC-17011995. View Show abstract. Bulimia nervosa comprises binge eating with compensatory behaviours aimed at reducing weight, such as vomiting or excessive exercise, while binge eating disorder includes binge eating but without compensatory behaviours. Internet addiction has become a major global concern and a burden on mental health. However, there is a lack of consensus on its link to mental health outcomes.Most of these metrics in the group with mild internet addiction were similar to or slightly higher than the average rates; however, these rates sharply increased in the moderate and severe internet addiction groups.
This finding supports the illness validity of moderate and severe internet addiction in contrast to mild internet addiction. These results are important for informing health policymakers and service suppliers from the perspective of resolving the overall human health burden in the current era of “Internet Plus” and artificial intelligence. The behavior involves deliberate tissue damage that is usually performed without suicidal intent. The term self-mutilation is also sometimes used, although this phrase evokes connotations that some find worrisome, inaccurate, or offensive. The diagnostic study of this behavior is controversial, and it needs to be further discussed with the definition criteria of suicide and borderline personality disorder. The pathologic mechanism of nssi behavior is proposed by several theoretical models, including the functional model, developmental pathologic model, and integrative model. In the future research, the research on the psychological evaluation intervention of nssi behavior should be widened, the factors affecting nssi can be further classified, and the cross-cultural research on nssi behavior and the applicability of existing foreign research achievements in China will also become the focus of future research. Classical Measurement Theory (CTT) and Item Response Theory (IRT) were applied to the collected data. All the patients were individually diagnosed by an experienced associated professor gynecologist.. Altered fractional amplitude of low frequency fluctuation in Women with Premenstrual Syndrome Via Acupuncture at Sanyinjiao(SP6) Preprint Full-text available Mar 2020 Gaoxiong Duan Ya Chen Yong Pang Demao Deng Background: Premenstrual Syndrome(PMS) is a prevalent gynecological disease and is significantly associated with abnormal neural activity. Acupuncture is an effective treatment on PMS in clinical practice.
However, few studies have been performed to investigate whether acupuncture might modulate the abnormal neural activity in patients with PMS. Thereby, the aim of the study was to assess alterations of the brain activity induced by acupuncture stimulation in PMS patients. Methods: 20 PMS patients were enrolled in this study. All patients received a 6-min resting-state functional magnetic resonance imaging(rs-fMRI) scan before and after electro-acupuncturing stimulation (EAS) at Sanyinjiao (SP6) acupoint in the late luteal phase of menstrual. Applied the fractional amplitude of low frequency fluctuation(fALFF) method to examine EAS-related brain changes in PMS patients. Results: Compared with pre-EAS at SP6, increased fALFF value in several brain regions induced by SP6, including brainstem, right thalamus, bilateral insula, right paracentral lobule, bilateral cerebellum, meanwhile, decreased fALFF in the left cuneus, right precuneus, left inferior temporal cortex. Conclusions: Our findings provide imaging evidence to support that SP6-related acupuncture stimulation may modulate the neural activity in patients with PMS. This study may partly interpret the neural mechanisms of acupuncture at SP6 which is used to treat PMS patients in clinical. Finally, since the purpose of the study was to detect post-traumatic stress symptomatology without making a diagnosis of post-traumatic stress disorders (PTSD), we used the wellknown, validated IES scale 47). This measure embraces criteria for PTSD as defined by DSM-IV 61) and showed good reliability in the present study. However, in order to make a more comprehensive diagnosis of post-traumatic stress symptoms, it would be useful to include clinical examinations in future studies..
The moderating effect of exposure to robbery on the relationship between post-traumatic stress and job satisfaction Article Jan 2020 IND HEALTH Francesco Montani Valentina Sommovigo Ilaria Setti Piergiorgio Argentero Research has disregarded the boundary conditions of the effects of post-traumatic stress symptoms (PTSS) at work. Addressing this issue, the present study examines the moderating impact of the (shared vs isolated) exposure to robbery on the relationship between PTSS and employee job satisfaction. Drawing on the conservation of resources theory, we argue that PTSS would positively affect employee job satisfaction when the robbery is experienced collectively. Results from hierarchical regression analyses supported our prediction: the exposure to robbery moderated the relationship between PTSS and job satisfaction. While within the “isolated exposure” group the job satisfaction score was higher among less symptomatic victims, within the “shared exposure” group those with high PTSS reported higher job satisfaction levels than those with low PTSS. We discuss the implications of these findings for theory and practice. View Show abstract SOCIAL PHOBIA AND AGORAPHOBIA: AN EMPIRICAL REVIEW AND ANALYSIS Presentation Mar 2020 Chidiebere Obioha The purpose of this work is to discuss the concept of social phobia and agoraphobia, and their treatment modalities. The work will explain the general statistics surrounding social phobia and agoraphobia, noting the following; the percentage population that meet the criteria for social phobia and agoraphobia, the prevalent rates of social phobia and agoraphobia across the lifespan (which category of people are usually affected by social phobia and agoraphobia, and what rates-children, adolescence, adults, elderly?), the onset of the development of social phobia and agoraphobia (at what stage of life do social phobia and agoraphobia develop?
), the development and cause of social phobia, the gender mostly associated with social phobia and agoraphobia and reasons, and lastly, the percentage of population that seek social phobia and agoraphobia treatment. The word iagnosis itself comes from the Greek words dia, meaning apart, and gnosis, meaning to know, thus promoting the idea that to know or understand a condition one must be able to discriminate it from other conditions. The earliest roots of the diagnosis and classification of abnormal behavior, no doubt, stretch back into the very dawn of human consciousness and the rise of societal behavior. Acculturation processes and their evolutionary advantages over solitary existence probably served as a major impetus for the necessity of humans to decide who was capable of following the rules of society, who might be excused from them (perhaps the very young or very old), and who would not. For example, the contemporary Inuit North Americans describe, in their own language, a kind of antisocial personality disordered individual as “his mind knows what to do but he does not do it” (Murphy, 1976). In this introductory chapter, the major issues regarding the diagnosis and classification of abnormal behavior are analyzed. We first discuss the purposes of diagnosis and then provide a historical overview of diagnosis and classification. Next, we describe the current classification system and conclude with a discussion of criticisms and limitations of diagnosis and classification. View Show abstract Controversial issues for the future DSM-V Article Full-text available Jan 2010 Sarah Kamens View Revising the Personality Disorder Diagnostic Criteria for the Diagnostic and Statistical Manual of Mental Disorders?Fifth Edition (DSM?