What ’ s New in the DSM-5-TR ? Here ’ s What You Need to Know About the Four Major Areas of Change
In March 2022 , the American Psychiatric Association ( APA ) released its first major revision of the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders ( DSM-5 )— the DSM-5-Text Revision . Believe it or not , it has been almost 10 years since the publication in 2013 of DSM-5 . I remember being at the American Psychiatric Association ’ s Convention in San Francisco when the DSM-5 was released with great fanfare ( and controversy ).
The hope then was that updates would be rolled out more regularly than with past editions . In fact , that is one reason why the APA changed its system of numbering the manual , from using Roman numerals ( e . g ., DSM-IV ) to using Arabic numbers ( 1 , 2 , 3 , etc .). The plan was for updates to be noted by indicating DSM-5.1 , etc .
Well , that didn ’ t happen . Instead , APA ’ s DSM committee opted to revert to the way changes were noted in previous editions of the DSM , by indicating it with the “ Text Revision ” moniker . However , DSM-5-TR is much more than a simple text revision , as was the case with DSM-IV-TR .
Gary G . Gintner , PhD , LPC-S , NCC , is the program coordinator of the Counseling Program at Louisiana State University . He has published numerous articles on topics such as DSM-5 , differential diagnosis , and mood disorders . He is a nationally recognized trainer on the DSM-5 and best-practice guidelines . His 30 years of clinical experience include inpatient care , substance abuse counseling , and outpatient mental health . He was the 2007 – 2008 president of the American Mental Health Counselors Association .
In this article , I review the major updates , and pay special attention to the rationale behind these changes .
The process of updating DSM-5 has really been ongoing since its release . APA ’ s DSM-5 Steering Committee , which continued working after the release of the fifth edition in 2013 , released a major update in 2015 that primarily clarified language and corrected oversights , along with making some other changes . In addition , the APA has released an annual updating of codes to reflect ICD-10-CM ’ s code updates each October . APA has also created an online portal for clinicians to submit proposals for changes and new disorders in the manual , bit . ly / 3T8TDJ8 . The site outlines procedures for these submissions , which require significant documentation and data support . All of the code changes and yearly updates have been included in the new manual .
A second set of updates began in 2019 with the appointment of a DSM-5 Revision Committee co-chaired by Michael B . First , MD , and Philip S . Wang , MD , DrPH . This committee focused primarily on updating the background text for each disorder ( e . g ., prevalence , risk factors , development and course , differential diagnosis , etc .). Special attention was also paid to revising the manual ’ s refence to culture , racism , discrimination , and sex and gender issues ( discussed below ).
Overall , four major areas of change appear in the DSM-5-TR :
• Addition of new disorders and codes ,
• Changes to criteria and specifiers ,
• Updated terminology , and
• A comprehensive update of background text .
NEW DISORDERS AND CODES
Three new disorders are now included in the revised manual : Prolonged Grief Disorder , Unspecified Mood Disorder , and Stimulant-Induced Mild Neurocognitive Disorder .
Prolonged Grief Disorder
Of the three new disorders , Prolonged Grief Disorder is the most significant . Its essential feature is a sustained maladaptive grief reaction that has persisted for 12 months or longer ( six months for children and adolescents ) after the death of a loved one . The clinical picture is
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