Tuesday, November 22, 2022


The DSM-5-TR

I'm not even sure how long the DSM-5-TR has been out (some of us haven't been paying attention) and honestly for me that's embarrassing. But the copyright is 2022 so if you're just tuning in, like me, you aren't that far behind. My copy is in the mail so I'll be referring to the TR in future posts beginning with a refresh of yesterday's (yesterday?) discussion about defining pedophilia. Over time we will review other disorders, too.

Usually TR means text revised and implies important changes. Why bother otherwise? The last DSM-5 is only 9 years old but academians have been busy, apparently. 

The American Psychiatric Association lists changes to the DSM. A glance tells me that those of us who have to diagnose had best go shopping. Totally rewritten there are, of course, even new codes. The APA boasts the following : 

  • Fully revised text for each disorder with updated sections on associated features, prevalence, development and course, risk and prognostic factors, culture, diagnostic markers, suicide, differential diagnosis, and more.
  • Addition of Prolonged Grief Disorder (PGD) to Section II—a new disorder for diagnosis
  • Over 70 modified criteria sets with helpful clarifications since publication of DSM-5
  • Fully updated Introduction and Use of the Manual to guide usage and provide context for important terminology
  • Considerations of the impact of racism and discrimination on mental disorders integrated into the text
  • New codes to flag and monitor suicidal behavior, available to all clinicians of any discipline and without the requirement of any other diagnosis
  • Fully updated ICD-10-CM codes implemented since 2013, including over 50 coding updates new to DSM-5-TR for substance intoxication and withdrawal and other disorders
  • Updated and redesigned Diagnostic Classification



DM said...

Random question related to the new diagnostic book you wrote about. Have you noticed a drift, or watering down when it comes to some of these issues? Culture as a whole (from my perspective) continues to drift away from traditional values...(ever heard of the Overton window) Here's a link to something I just pulled off the Internet https://en.psychologyinstructor.com/the-overton-window/

Just curious as to your thoughts. Thanks! DM

therapydoc said...

DM, this is a great topic. In my research, shaming 'perpetrators' for loving children in a sexual way has not always been tabu. Read Gay New York where the authors make it clear that historically, introducing children to sex in a very loving, paternal fashion, had been advanced in the highest of political circles (not exactly sure of that, read the book 25 years ago). Still, it wasn't taboo. Science has the investigatory 'power' to destigmatize 'pathological' behavior, but a proposed study must first pass an Institutional Review Board screening the research for harm to subject. My guess is that for cannibalism the harm might be thought to outweigh the good, but we live in a world where food is bountiful. Thanks for the comment! Fascinating.

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