DSM-5-TR Updates and Changes for Therapists
As the field of mental health continues to evolve, so too does the understanding of various disorders and conditions that affect individuals' psychological well-being. In this dynamic landscape, the Diagnostic and Statistical Manual of Mental Disorders (DSM) plays a pivotal role. This widely recognized classification system provides a framework for diagnosing and understanding mental health conditions, serving as a cornerstone for clinicians, researchers, and policymakers alike.
The DSM-5-TR: A Collaborative Text Revision Process
The American Psychiatric Association (APA), custodian of the DSM, has diligently been working on the forthcoming release of the updated edition. Dubbed the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision (DSM-5-TR), this revision is a collaborative effort, drawing upon insights from over 200 subject matter experts and incorporating the latest scientific research in the field. The text revision process was guided by the DSM Steering Committee, alongside the Equity and Inclusion Work Group and various review groups dedicated to ensuring accuracy and inclusivity.
Changes in DSM-5-TR and New Disorders
As the release date draws closer, a sense of anticipation envelops the mental health community. The APA has provided a sneak peek into the changes that will be unveiled on March 18. According to their statements, a substantial portion of disorder texts underwent revision, with about three-quarters of them experiencing significant updates. These changes to criteria sets and text updates are expected to reflect the latest advancements in mental health research and clinical understanding.
One of the most notable changes includes the diagnosis of prolonged grief disorder, marking a significant shift in how mental health practitioners address grief-related conditions. Additionally, specified bipolar and related disorder has been updated to enhance diagnostic clarity. The inclusion of new research and revisions in criteria and text further bolster the manual’s role as a comprehensive diagnostic tool.
The Role of Subject Matter Experts and Review Committees
The dynamic nature of mental health necessitates a continuous process of reevaluation and refinement. Disorders that were once understood in a specific context may evolve as new research emerges, shedding light on previously unknown factors that contribute to their development and manifestation. The board of trustees of the APA ensures that all revisions were approved with careful consideration, incorporating feedback from experts in cultural psychiatry and mental health practitioners from diverse ethnic and racialized backgrounds. Their collective expertise in disparity-reduction practices and international classification of diseases ensures that the latest edition is both accurate and inclusive.
What’s Next for the DSM?
While changes in the DSM signify progress, it's important to remember that certain aspects of the manual will likely remain consistent. The APA carefully balances the need for continuity with the desire to incorporate new knowledge. This equilibrium ensures that both experienced clinicians and new practitioners can rely on the manual as a trustworthy guide, even as it evolves.
While full details are yet to be released, we already have key insights into DSM-5-TR revisions and updates to ICD-10-CM codes since its last edition. Future DSM revisions will be shaped by subject matter experts and ongoing research, ensuring that it remains the leading diagnostic tool in psychiatry and mental health.
The Broader Implications of DSM-5-TR for Mental Disorders
The DSM-5-TR updates for therapists not only refine diagnostic criteria but also have a significant impact on clinical practice. With the addition of prolonged grief disorder, clinicians must now assess when grief reactions extend beyond cultural and societal norms, ensuring they meet the criteria for prolonged grief disorder rather than typical bereavement. This distinction is crucial in guiding interventions and treatment planning.
Recognizing and Addressing High-Risk Behaviors
Similarly, the introduction of suicidal behavior codes and nonsuicidal self-injury codes provides a more nuanced approach to assessing risk. By formally coding these behaviors, clinicians can better track patterns, identify at-risk individuals, and tailor interventions accordingly. This change also has implications for insurance coverage and treatment documentation.
The reinstatement of unspecified mood disorder acknowledges that not all individuals fit neatly into established diagnostic categories. This flexibility allows for a more individualized approach to treatment while maintaining the integrity of the diagnosis of mental disorders framework.
Ensuring Inclusivity and Future Adaptations
Beyond specific diagnostic shifts, the revision of DSM-5 reflects a broader commitment to inclusivity and accuracy. The cross-cutting review committee on cultural issues played a key role in ensuring that mental health conditions are understood within diverse social and cultural contexts. By integrating expertise from clinicians of racialized backgrounds with expertise in disparity reduction, the APA board of trustees has approved updates that align with contemporary understandings of psychiatric conditions.
As we look toward future revisions, it is likely that enough advances in the field will lead to further refinements. The ongoing collaboration between researchers, clinicians, and cultural experts ensures that the development of DSM-5 remains an evolving process, reflecting the latest psychiatric knowledge while prioritizing equity and inclusion.
Keep reading to learn more about the changes in DSM-5-TR and how they may impact clinical practice.
What are the changes to the DSM-5-TR?
A preview of the specific changes coming to the DSM-5-TR include:
✔ The addition of prolonged grief disorder
This is a notable development that highlights the evolving understanding of grief and its impact on mental health. This addition reflects the ongoing effort within the mental health community to comprehensively address the complexities of grief experiences and their potential long-term effects.
✔ The inclusion of symptom codes for suicidal behavior and nonsuicidal self-injury
This reflects a crucial advancement in the field of mental health assessment and diagnosis. This addition demonstrates the growing recognition of the importance of accurately identifying and addressing behaviors related to suicide risk and self-injury.
✔ The return of unspecified mood disorder
This re-introduction reflects a recognition of the complexities and nuances within mood disorders that may not fit neatly into specific diagnostic criteria. This category allows clinicians to acknowledge and classify mood-related symptoms and experiences that do not precisely align with existing mood disorder categories.
✔ Intellectual disability is now intellectual developmental disorder
This change reflects a more accurate and respectful terminology. It promotes the understanding that intellectual disabilities are not static conditions but rather developmental in nature. The updated terminology also aligns more closely with the language used in other fields, such as education and psychology.
✔ Conversion disorder is now functional neurological symptom disorder
The change in terminology reflects a shift in understanding towards the disorder's underlying mechanisms.
✔ Updates to the terminology to describe gender dysphoria, including “desired gender” is now “experienced gender,” the term “cross-sex medical procedure” is now “gender-affirming medical procedure,” and the term “natal male”/“natal female” is now “individual assigned male/female at birth"
Language and terminology around gender-related topics have evolved over time to be more respectful and inclusive of diverse gender identities. Changes reflect an effort to use more sensitive and accurate language when discussing matters related to gender identity and transition. These changes aim to reduce stigma and discrimination while acknowledging the diversity of gender experiences.
✔ Revised diagnostic criteria for several diagnoses, including autism spectrum disorder, manic episode, bipolar I and bipolar II disorders, cyclothymic disorder, major depressive disorder, persistent depressive disorder, PTSD in children, avoidant-restrictive food intake disorder
Criteria were refined to improve diagnostic accuracy.
✔ Comprehensive review of the impact of racism and discrimination on the diagnosis and manifestations of mental disorders.
Discussions around the intersection of racism, discrimination, and mental health have been growing in importance in recent years. Researchers and mental health professionals have increasingly recognized that systemic racism and discrimination can have significant effects on mental health, influencing not only the prevalence and presentation of mental disorders but also access to appropriate care and treatment.
When will the DSM-5-TR be released?
As of right now, the new DSM-5-TR is set to be released on March, 18th 2022. You can pre-order your copy of the DSM-5-TR on Amazon here.
How can I learn more about the DSM-5-TR?
You can read more about the upcoming changes to the DSM-5-TR from the American Psychiatric Association here, or join us on the Therapist Network for unlimited consultation groups, masterclasses and community support.
Mar 7, 2022
