Analysis Of Improvements From Dsm Iv To Dsm 5

3612 words - 14 pages

The Diagnostic and Statistical Manual for Mental Disorders (DSM) provides standard criteria for diagnosing mental disorders. It serves numerous purposes and delineates a common language for researchers, clinicians, educators and students. The APA released the fifth edition of its Diagnostic and Statistical manual of mental disorders in May 2013 after 12 years of research involving a diverse range of 400 experts from 12 countries worldwide (Kuhl, Kupfer, & Reiner, 2013). While the release of the new DSM 5 has caused much controversy in the field of psychiatry, specifically for its changes in specific diagnosis and new disorders, the structural changes that have been made seem to be an improvement from the previous DSM IV and will help clinicians diagnose and treat patients in a more straightforward and precise way.
One of the most debated proposals for the DSM 5 was a proposal to re-structure the DSM into five clusters of mental disorders that shared certain external validating factors. While this proposal was not entirely adopted in the actual DSM 5, many concepts and ideas from this proposed idea were used. The idea behind this metastructure originated from advances in the field of psychiatry since the DSM IV that demonstrated that many disorders share external validating factors such as genetic risk factors, rates of co-morbidity, and likely course (Andrews, Goldberg, Krueger, Carpenter, Hyman, Sachdev, & Pine, 2009). These ideas were backed up by twin studies that showed how important genetic and environmental risk factors are and raised concerns about the current structure of the DSM IV, because it focused more on excluding false-positive results in diagnosis. Consequently, categorical groups were too limited and this resulted in the over-use of NOS diagnosis (American Psychiatric Association 2013). Because of this, experts working on the DSM 5 proposal came up with five groups of clusters composed of disorders that share certain characteristics and risk factors. These include an emotional cluster that includes disorders like anxiety, depressive, and somatic disorders because research has shown that they often co-occur. Other clusters were defined as a neurocognitive cluster, neurodevelopmental cluser, psychosis cluster, and externalizing cluster (Andrews et al., 2009). The main goals of this metastructure were increased utility by simplifying the current system to make it less complex for routine care and primary care physicians, increased validity by moving away from symptomatology to the current understanding of mutual underlying risk, and increased homogeneity within clusters, which emphasize similarities rather than differences between diagnoses (Wittchen, Beesdo, & Gloster, 2009). The clusters could be very useful to clinicians because they could view their patient’s disorders within a broader context and better understand the epidemiology of risk factors to come up with treatment plans that minimize these shared risk factors...

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