APA proposed several changes for DSM V
In February, the American Psychiatric Association (APA) officially released the changes that are expected in to take place in the 5th version of the Diagnostic and Statistical Manual of Mental Disorder (DSM V). The DSM is often referred to as the Bible to mental health professionals, and is seen as the gold standard used when diagnosing mental illness.
APA has proposed several changes for DSM V. Some of the major changes include how Addiction is classified. Three notable changes are being proposed.
- First, drug addiction and alcoholism as well as pathological gambling are typically categorized under Substance-Related Disorder. However to better account for the addictions that do not involve substances such as gambling, the internet, or pornography, the category will be changed to Addiction and Related Disorders.
- Second, the concepts of dependence in terms of withdraw and tolerance have been drastically reconceptualized; this is such that in the case of Alcohol Use Disorder (alcoholism) for example, withdraw and tolerance are only 2 of the possible 11 symptoms associated with this disorder rather than the hallmarks of the diagnosis.
- Third, all of the individual diagnostic categories have been drastically changed as to have a more behavior focus. All of the diagnoses proposed under Addiction and Related Disorders category in the DSM have a major focus on “maladaptive pattern of substance use leading to clinically significant impairment or distress”1
It is in this last change that most of the controversy will arise. The intention of the APA in focusing on more behavioral aspects of addiction is to hopefully better capture the true essence of addiction. However DSM V will not be released until 2013, so we have lots of time to think it over.
What do you think? Do you think that focusing on the behaviors of addiction are good or is it addiction so amorphous it is a slippery slope?
Keep checking for the next post when I break down the specific changes proposed for the diagnosis of Alcoholism.
1: Proposed Revisions for DSM V from APA’s website on DSM V: http://www.dsm5.org/ProposedRevisions/Pages/proposedrevision.aspx?rid=452
