DSM 5 CHANGES, CHALLENGES, CRITIQUES ANDREW PARRISH, LMFT CLINICAL SUPERVISOR LA FRONTERA NEW MEXICO
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1 DSM 5 CHANGES, CHALLENGES, CRITIQUES ANDREW PARRISH, LMFT CLINICAL SUPERVISOR LA FRONTERA NEW MEXICO
2 AGENDA CHANGES TO THE DSM 5 CHALLENGES OF THE DSM 5 STRENGTHS IN THE NEW MODEL LIMITATIONS IN THE NEW MODEL CRITIQUES OF THE DSM 5 DISCUSSION
3 CHANGES TO THE DSM 5 DSM 5 WAS INITIALLY PROPOSED IN 1999, SHORTLY AFTER DSM IV WAS COMPLETED DSM 5 IS DESIGNED TO MORE FLEXIBLY INCLUDE THE RESEARCH OF THE PAST TWO DECADES DSM 5 HAS ADDED MORE SPECIFIERS IN SOME CASES AND REMOVED DIAGNOSES IN OTHERS DSM 5 HAS THE SAME AMOUNT OF DIAGNOSES AVAILABLE AS DSM IV-TR
4 CHANGES TO DIAGNOSING IN DSM 5 INTELLECTUAL DISABILITY DISORDER PRIMARILY A LANGUAGE CHANGE PER LEGAL STATUTE AND INTERNATIONAL DESCRIPTORS AUTISM SPECTRUM DISORDER (299.00) COMBINED FOUR PREVIOUS DIAGNOSES: AUTISM, ASPERGER S, CHILD DISINTEGRATIVE DISORDER, AND PDD NOS ADHD CHANGE IN CONSIDERING SPAN OF LIFE, PARTICULARLY SPECIFYING ADULT ISSUES
5 CHANGES TO DIAGNOSING IN DSM 5 SCHIZOPHRENIA NO SUBTYPES, REQUIRE THAT ACTIVE SYMPTOMS INVOLVE EITHER DELUSIONS, HALLUCINATIONS OR DISORGANIZED SPEECH SCHIZOAFFECTIVE DISORDER MOOD INSTABILITY PRESENT DURING ACTIVE SYMPTOMS BIPOLAR DISORDER CHANGES IN REQUIRING THAT A CHANGE IN ACTIVITY AND ENERGY (AND NOT JUST MOOD BE PRESENT), MIXED FEATURES SPECIFIER, ANXIOUS DISTRESS SPECIFIER
6 CHANGES TO DIAGNOSING IN DSM 5 DEPRESSIVE DISORDERS INCLUDES DISRUPTIVE MOOD DYSREGULATION DISORDER, PERSISTENT DEPRESSIVE DISORDER MAJOR DEPRESSIVE DISORDER INVOLVING MIXED FEATURES THINKING ON BEREAVEMENT AND DEPRESSION ANXIETY DISORDERS REMOVAL OF THE REQUIREMENT TO NOTICE RESPONSE AS BEING OVERLY ANXIOUS SEPARATION OF PANIC DISORDER AND AGORAPHOBIA SEPARATION ANXIETY
7 CHANGES TO DIAGNOSING IN DSM 5 OBSESSIVE COMPULSIVE DISORDER TWO SUBTYPES: POOR INSIGHT AND LACKING INSIGHT/DELUSIONAL BODY DYSMORPHIC DISORDER HOARDING (MAY OR MAY NOT BE PART OF OCD) TRICHOTILLOMANIA, EXCORIATION STRESS DISORDERS ACUTE STRESS DISORDER EVENTS EXPERIENCED DIRECTLY, WITNESSED OR INDIRECTLY ADJUSTMENT DISORDER REQUIRES PRESENCE OF A DISTRESSING EVENT PTSD INVOLVING RE-EXPERIENCING, AVOIDING, NEGATIVE ALTERATIONS, AND AROUSAL
8 CHANGES TO DIAGNOSING IN DSM 5 EATING DISORDERS PICA, RUMINATION, RESTRICTIVE FOOD INTAKE DISORDER, ANOREXIA NERVOSA, BULIMIA NERVOSA, AND BINGE EATING CONDUCT DISORDERS OPPOSITIONAL DEFIANT DISORDER: THREE SUBTYPES ANGRY/IRRITABLE, ARGUMENTATIVE/DEFIANT, AND VINDICTIVE CONDUCT DISORDER CAN NOW INCLUDE HAVING POOR EMOTIONAL AWARENESS/EMPATHY INTERMITTENT EXPLOSIVE DISORDER INCLUDING PHYSICAL AND VERBALLY AGGRESSIVE BEHAVIOR
9 CHANGES TO DIAGNOSING IN DSM 5 GAMBLING ADDICTION DISORDER SUBSTANCE DISORDERS SUBSTANCE USE MILD MODERATE SEVERE SUBSTANCE INTOXICATION SUBSTANCE WITHDRAWAL
10 CHANGES TO DIAGNOSING IN DSM 5 PERSONALITY DISORDERS NEW FLAGS FOR WHEN TO TEST FOR PERSONALITY ISSUES DEFINING THE DIFFERENCE BETWEEN TRAITS AND DISORDER REMOVAL OF THE FIVE AXIS SYSTEM REMOVAL OF THE GAF SCORE INCLUSION OF V CODES
11 STRENGTHS OF THE NEW MODEL THE LABELS ARE MORE FLEXIBLE TO INCLUDE CHANGES THAT HAVE BEEN STUDIED IN THE PAST TWO DECADES INCLUSION OF THE VARIETIES OF SYMPTOMS IN DISORDERS TO CLARIFY ISSUES REMOVAL OF SUBJECTIVE INTERPRETATION ON PART OF DIAGNOSTICIAN
12 LIMITATIONS OF NEW MODEL HOW DO YOU DETERMINE FUNCTIONAL IMPAIRMENT? WHAT OCCURS WHEN YOU TAKE OUT THE 5 AXIS SYSTEM? WHAT HAS HAPPENED WITH THE GAF? HOW DOES THIS MODEL SUPPORT RECOVERY?
13 FUNCTIONAL IMPAIRMENT V CODES UTILIZED TO DESCRIBE IMPACTED AREAS OF FUNCTIONING FROM DIAGNOSES, OR FUNCTIONING THAT IMPACTS THE DIAGNOSIS INCLUDES THINGS SUCH AS V60.0 (HOMELESSNESS) V62.89 (VICTIM OF CRIME) V62.22 (EXPOSURE TO DISASTER) V62.3 (ACADEMIC OR EDUCATION PROBLEM)
14 CHANGE IN DIAGNOSTIC STRUCTURE AXIS I: (MDD, REC, MOD) AXIS II: (DEP. PERS. D/O) AXIS III: DIABETES, PER CLIENT REPORT AXIS IV: SEVERE PRIMARY SUPPORT, OCCUPATIONAL AXIS V: 48 DIAGNOSIS: CLIENT PRESENTS WITH (V 62.29, V62.3, IMPACTED STRONGLY BY LOSS OF JOB AND EDUCATIONAL CONCERNS); CLIENT IS ALSO STRUGGLING WITH (V61.20, V61.8 WITH RESULTING PROBLEMS WITH CHILDREN AND SIBLINGS)
15 GAF GLOBAL ASSESSMENT OF FUNCTIONING UTILIZED TO DETERMINE IF CLIENT MEETS SMI CRITERIA CURRENTLY GUIDANCE FROM DSM 5 RELIES MORE HEAVILY ON CLIENT SELF- REPORT DSM 5 CONTRIBUTORS NOT IN AGREEMENT ON HOW TO REPORT, HOW TO SCORE
16 RECOVERY AND DSM 5 WITH AFFORDABLE CARE ACT, DIAGNOSIS MAY BE MORE LASTING SUBJECTIVE REPORTING FROM CLIENT, NOT DIAGNOSTICIAN HOW DO YOU CREATE A STABLE THRESHOLD FOR IMPROVEMENT?
17 CRITICISMS OF DSM 5 EACH GROUP INVOLVED PHARMACEUTICAL COMPANIES IN SOME WAY GROUPS MAY NOT HAVE RELIED UPON RESEARCHERS IN THE FIELD MORE OR LESS DISORDERS?
18 DISCUSSION HOW DOES THIS IMPACT CLIENTS? HOW DOES THIS IMPACT CLINICIANS? HOW DOES THIS IMPACT THE MH SYSTEM IN NM?
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