Diagnostic and Statistical Manual of Mental Disorders Psychology DSM5
Preface
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Contents
Anxiety Disorders Autism Spectrum Disorder Catatonia Motor Disorders Obsessive-Compulsive and Related Disorders Autism-Deficit/ Hyperactivity Disorder Bipolar and Related Disorders Tic Disorders Disruptive, Impulse- Control and Conduct Disorders Specific Learning Disorder Depressive Disorders Schizophrenia Spectrum and Other Psychotic Disorders
Social Anxiety Disorder
Anxiety Disorders A. E. F. I. J. B.Marked fear or anxiety about one or more social situations in which the individual is exposed to possible scrutiny by others. Examples include social interactions (e.g., having a conversation, meeting unfamiliar people), being observed (e.g., eating or drinking), and performing in front of others (e.g., giving a speech). The fear or anxiety is out of proportion to the actual threat posed by the social situation and to the sociocultural context. The fear, anxiety, or avoidance is persistent, typically lasting for 6 months or more. The fear, anxiety, or avoidance is not better explained by the symptoms of another mental disorder, such as panic disorder, body dysmorphic disorder, or autism spectrum disorder. If another medical condition (e.g., Parkinson’s disease, obesity, disfigurement from burns or injury) is present, the fear, anxiety, or avoidance is clearly unrelated or is excessive. NOTE: In children, the anxiety must occur in peer settings and not just during interactions with adults. The individual fears that he or she will act in a way or show anxiety symptoms that will be negatively evaluated (i.e., will be humiliating or embarrassing; will lead to rejection or offend others). Social Anxiety Disorder
04 C. G. H. D.The social situations almost always provoke fear or anxiety. The social situations are avoided or endured with intense fear or anxiety. The fear, anxiety, or avoidance causes clinically significant distress or impairment in social, occupational, or other important areas of functioning. The fear, anxiety, or avoidance is not attributable to the physiological effects of a substance (e.g., a drug of abuse, a medication) or another medical condition. NOTE: In children, the fear or anxiety may be expressed by crying, tantrums, freezing, clinging, shrinking, or failing to speak in social situations. SPECIFY IF: Performance only: If the fear is restricted to speaking or performing in public.
Obsessive Compulsive Disorder
(OCD)
Obsessive-Compulsive and Related Disorders Presence of obsessions, compulsions, or both: Recurrent and persistent thoughts, urges, or images that are experienced, at some time during the disturbance, as intrusive and unwanted, and that in most individuals cause marked anxiety or distress. Repetitive behaviors (e.g., hand washing, ordering, checking) or mental acts (e.g., praying, counting, repeating words silently) that the individual feels driven to perform in response to an obsession or according to rules that must be applied rigidly. The individual attempts to ignore or suppress such thoughts, urges, or images, or to neutralize them with some other thought or action (i.e., by performing a compulsion). The behaviors or mental acts are aimed at preventing or reducing anxiety or distress, or preventing some dreaded event or situation; however, these behaviors or mental acts are not connected in a realistic way with what they are designed to neutralize or prevent or are clearly excessive. Obsessive Compulsive Disorder Obsessions are defined by (1) and (2): Compulsions are defined by (1) and (2): NOTE: Young children may not be able to articulate the aims of these behaviors or mental acts. (1) (1) (2) (2)
08 The obsessions or compulsions are time-consuming (e.g., take more than 1 hour per day) or cause clinically significant distress or impairment in social, occupational, or other important areas of functioning. The obsessive-compulsive symptoms are not attributable to the physiological effects of a substance (e.g., a drug of abuse, a medication) or another medical condition. The disturbance is not better explained by the symptoms of another mental disorder (e.g., excessive worries, as in generalized anxiety disorder; preoccupation with appearance, as in body dysmorphic disorder; difficulty discarding or parting with possessions, as in hoarding disorder; hair pulling, as in trichotillomania [hair-pulling disorder]; skin picking, as in excoriation [skin-picking] disorder; stereotypies, as in stereotypic movement disorder; ritualized eating behavior, as in eating disorders; preoccupation with substances or gambling, as in substance-related and addictive disorders; preoccupation with having an illness, as in illness anxiety disorder; sexual urges or fantasies, as in paraphilic disorders; impulses, as in disruptive, impulse-control, and conduct disorders; guilty ruminations, as in major depressive disorder; thought insertion or delusional preoccupations, as in schizophrenia spectrum and other psychotic disorders; or repetitive patterns of behavior, as in autism spectrum disorder). (OCD) B. C. D. SPECIFY IF: With good or fair insight: The individual recognizes that obsessive-compulsive disorder beliefs are definitely or probably not true or that they may or may not be true. With poor insight: The individual thinks obsessive-compulsive disorder beliefs are probably true. With absent insight/delusional beliefs: The individual is completely convinced that obsessive- compulsive disorder beliefs are true.
Conduct Disorder
Disruptive, Impulse-Control and Conduct Disorders A repetitive and persistent pattern of behaviour in which the basic rights of others or major age-appropriate societal norms or rules are violated, as manifested by the presence of at least three of the following 15 criteria in the past 12 months from any of the categories below, with at least one criterion present in the past 6 months: Often bullies, threatens, or intimidates others. Often initiates physical fights. Has used a weapon that can cause serious physical harm to others (e.g., a bat, brick, broken bottle, knife, gun). Has been physically cruel to people. Has been physically cruel to animals. Has stolen while confronting a victim (e.g., mugging, purse snatching, extortion, armed robbery). Has forced someone into sexual activity. Has deliberately engaged in fire setting with the intention of causing serious damage. Has deliberately destroyed others’ property (other than by fire setting). Has broken into someone else’s house, building, or car. Often lies to obtain goods or favors or to avoid obligations (i.e., “cons” others). Has stolen items of nontrivial value without confronting a victim (e.g., shoplifting, but without breaking and entering; forgery). 1. 2. Aggression to People and Animals Destruction of PropertyI. II. Destruction of Property Conduct Disorder
12 The disturbance in behaviour causes clinically significant impairment in social, academic, or occupational functioning. If the individual is age 18 years or older, criteria are not met for antisocial personality disorder. 3. 4. III. Often stays out at night despite parental prohibitions, beginning before age 13 years. Has run away from home overnight at least twice while living in the parental or parental surrogate home, or once without returning for a lengthy period. Is often truant from school, beginning before age 13 years. Serious Violations of Rules SPECIFY WHETHER: (F91.1) Childhood-onset type: Individuals show at least one symptom characteristic of conduct disorder prior to age 10 years. (F91.2) Adolescent-onset type: Individuals show no symptom characteristic of conduct disorder prior to age 10 years. (F91.9) Unspecified onset: Criteria for a diagnosis of conduct disorder are met, but there is not enough information available to determine whether the onset of the first symptom was before or after age 10 years. SPECIFY CURRENT SEVERITY: Mild: Few if any conduct problems in excess of those required to make the diagnosis are present, and conduct problems cause relatively minor harm to others (e.g., lying, truancy, staying out after dark without permission, other rule breaking). Moderate: The number of conduct problems and the effect on others are intermediate between those specified in “mild” and those in “severe” (e.g., stealing without confronting a victim, vandalism). Severe: Many conduct problems in excess of those required to make the diagnosis are present, or conduct problems cause considerable harm to others (e.g., forced sex, physical cruelty, use of a weapon, stealing while confronting a victim, breaking and entering).
Oppositional Defiant Disorder
(ODD)
Disruptive, Impulse-Control and Conduct Disorders A pattern of angry/irritable mood, argumentative/defiant behavior, or vindictiveness lasting at least 6 months as evidenced by at least four symptoms from any of the following categories, and exhibited during interaction with at least one individual who is not a sibling. Often loses temper. Is often touchy or easily annoyed. Is often angry and resentful. Often argues with authority figures or, for children and adolescents, with adults. Often actively defies or refuses to comply with requests from authority figures or with rules. Often deliberately annoys others. Often blames others for his or her mistakes or misbehaviour. Has been spiteful or vindictive at least twice within the past 6 months. 1. 2. 3. Oppositional Defiant Disorder Angry/Irritable Mood Argumentative/Defiant Behaviour Vindictiveness
16 The disturbance in behaviour is associated with distress in the individual or others in his or her immediate social context (e.g., family, peer group, work colleagues), or it impacts negatively on social, educational, occupational, or other important areas of functioning. The behaviours do not occur exclusively during the course of a psychotic, substance use, depressive, or bipolar disorder. Also, the criteria are not met for disruptive mood dysregulation disorder. 4. 5. (ODD) SPECIFY CURRENT SEVERITY: Mild: Symptoms are confined to only one setting (e.g., at home, at school, at work, with peers). Moderate: Some symptoms are present in at least two settings. Severe: Some symptoms are present in three or more settings.
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