What Is DSM And How Is It Used To Identify Disorders?
The Diagnostic and Statistical Manual of Mental Disorders (DSM) is a tool used by mental health professionals for the official diagnosis and classification of mental disorders. The current definition of a mental disorder, as recognized by the APA, is:
“any condition characterized by cognitive and emotional disturbances, abnormal behaviors, impaired functioning, or any combination of these. Such disorders cannot be accounted for solely by environmental circumstances and may involve physiological, genetic, chemical, social, and other factors.”
Though controversial for many reasons, this tool has been helpful since its first publishing in 1952 by the American Psychiatric Association (APA). The APA has revised the manual five times (hence, the current version is the DSM-5) since its initial inception to accommodate the need for a standardized way of categorizing disorders that present symptoms in the population. With the field of psychology continually progressing, it needs constant revision to accommodate newly discovered disorders, phasing out of old disorders no longer classified as mental health issues, changes made in classification, and other influencing factors.
Mental health professionals use this text to rule out, determine, and examine disorders that a patient may have and narrow it down to an appropriate diagnosis. The DSM is also useful for explaining to patients their diagnosis and how it will influence and direct treatment.
Though the DSM helps in the classification of disorders, it does not offer treatment options for curious readers. Professionals use the tool only as a reference for diagnosis. Also, hospitals and insurance companies typically require a DSM diagnosis for their clients to pay for treatment.
The DSM also provides a basis for research and treatment to further the study of psychology. Using this tool, clinicians and researchers can develop new ways to combat symptoms and treat disorders.
How Is The DSM Organized?
The APA separates the DSM into three sections: the diagnostic classification, diagnostic criteria sets, and descriptions. The first section is a complete list of psychiatric disorders. (The DSM codes each one for health professionals for both diagnostic and billing purposes.)
The second section focuses on the methods of identifying psychological disorders. In this section, the clinician references how the patient's presenting symptoms match the criteria set forth in the manual regarding behaviors, feelings, and the time the symptoms present for a diagnosis to occur. This diagnosis assists the clinician in how they will proceed with treatment for the patient. The third section of the manual goes into a further description of each disorder and its subsets.
The DSM is only for use by trained professionals as a diagnostic tool in treating psychological disorders. While it is available to the public, professionals do not recommend its usage by lay people. Self-diagnosing and attempting to diagnose others can be detrimental; therefore, it is advisable to leave diagnosing to a trained mental health professional.
The disorders listed in the DSM-5 include, but aren’t limited to, depressive disorders, anxiety disorders, eating disorders, dissociative disorders, substance use disorders, and personality disorders.
Why So Many Revisions?
Due to the constant change of cultural norms and ever-evolving research, the DSM must evolve to account for these changes and to stay relevant. A hypothesis surrounding the reason for a disorder might change from its previous creation, requiring further testing and research to make sure it is accurate.
Since its inception, psychology continues to evolve from its beginnings. Researchers and psychologists understand that certain disorders need updating or eliminating due to being obsolete. Just as the techniques for treatment have expanded over the years (e.g., from the outdated use of lobotomies to current standards of medication), so must the criteria and classification of disorders.
Examples of DSM updates may include more concise and accurate descriptions, appropriately outlining criteria, creating unbiased descriptions of the cause of the disorder, and updating the descriptive language.
DSM Controversy
Because the APA has revised the DSM many times over the years, some professionals exercise caution when using it because the limited outlines of disorders may prevent the proper diagnosis of patients. Sometimes symptoms for disorders will overlap - such as for bipolar disorder and schizophrenia - and occasionally, symptoms will mask themselves as other disorders, making it difficult to confidently and accurately diagnosis a patient.
Schizophrenia, for example, has the most overlapping symptoms of all disorders and has been referred to by some in psychology as the "trashcan disorder" due to its inclusion of a surprising multitude of symptoms.
Also, outdated information and information based on social and cultural biases can be harmful. Issues of homosexuality and gender beliefs provide a good example of how, if it weren’t for evolving research, patients would still receive “treatment” for a diagnosed mental disorder that is not a disorder at all. In the early years of the DSM, homosexuality was listed as a disorder without empirical evidence to determine it as such until it was finally removed in 1973.
Some critics believe the DSM promotes the use of psychotropic medications as treatment for many mental health disorders for the financial gain of pharmaceutical companies. Many critics presume that the descriptions and requirements for diagnosis are deliberately broad for pharmaceutical companies to take advantage of potential patients. Considering that there have been authors of the DSM involved financially with these institutions, this issue has emerged as a conflict of interest and is under constant scrutiny.
Despite these controversies, the DSM remains a trusted tool in aiding researchers and clinicians looking for updated ways to diagnose and treat illnesses. The breadth and scope of research and contributions from mental health professionals worldwide make it a resource unparalleled by anything else in the field of behavioral science.
Takeaway
Diagnosing a mental disorder is a multi-step process. First, the professional psychologist or psychiatrist will likely evaluate your physical health and any history of illnesses from you or your family. They will present you with a questionnaire and, for your first visit, ask you questions about your symptoms, background, and any thoughts you may have about your condition. They’ll then use the information gathered from this process and information from the DSM-5 to determine a diagnosis and treatment plan.
If you believe you are experiencing symptoms of a mental disorder, it is imperative to seek treatment from a mental health professional. Symptoms can present themselves differently from person to person, and they can change with time. Self-diagnosis is not only often inaccurate, but it can also be harmful if you’re facing a more serious mental health condition.
Online therapy makes it easy to consult with a psychologist about your symptoms and receive an accurate, professional diagnosis. Platforms like BetterHelp connect patients with licensed, accredited therapists experienced in diagnosing mental health challenges. You choose the right therapist for you, and they’ll work with you to develop a treatment plan on your own schedule via text, online messaging, video chat, or over the phone.
BetterHelp offers easy, affordable mental health care for individuals at all stages of treatment, whether it’s just for support or to receive a diagnosis and long-term treatment plan.
Frequently Asked Questions (FAQs)
What does DSM mean?
“DSM” refers to the Diagnostic and Statistical Manual of Mental Disorders. It’s used for the official diagnosis and classification of mental disorders. In news releases, when reading psychology information only, and when learning about mental disorders, it’s likely that you’ve seen the DSM referenced on multiple occasions.
What is the DSM 5 definition of mental disorder?
A mental disorder is a mental illness. The american psychiatric association apa website defines mental illness by saying, “Mental illnesses are health conditions involving changes in emotion, thinking or behavior (or a combination of these). Mental illnesses are associated with distress and/or problems functioning in social, work or family activities.”
What is the difference between DSM 4 and DSM 5?
The revisions made to the DSM-5 were largely made to improve the classification of mental disorders. The DSM-5 includes terminology and diagnoses that weren’t present in the DSM-4, allowing more people to get an accurate diagnosis and receive the help that they need. Two notable differences, for example, are that obsessive compulsive disorder (OCD) is no longer considered an anxiety disorder in the DSM and that gender dysphoria is listed in the new edition. The frequently asked questions page on the american psychiatric association (APA) website explains the need for the changes made in the DSM-5 by saying, “Many of the changes in DSM–5 were made to better characterize symptoms and behaviors of groups of people who are currently seeking clinical help but whose symptoms are not well defined by DSM–IV (meaning they are less likely to have to treatment). Our hope is that by more accurately defining disorders, diagnosis and clinical care will be improved and new research will be facilitated to further our understanding of mental disorders.”
What are the 5 DSM categories?
The categories included in the Diagnostic and Statistical Manual of Mental Disorders DSM 5 include:
- Neurodevelopmental Disorders
- Schizophrenia spectrum and other psychotic disorders
- Bipolar and related disorders
- Depressive disorders
- Anxiety disorders
- Obsessive-compulsive and related disorders
- Trauma and stressor-related disorders
- Dissociative disorders
- Somatic symptom and related disorders
- Feeding and eating disorders
- Elimination disorders
- Sleep-wake disorders
- Sexual dysfunctions
- Disruptive, impulse-control, and conduct disorders
- Substance-related and addictive disorders
- Neurocognitive disorders
- Personality disorders
- Paraphilic disorders
- Other mental disorders
What does the DSM 5 stand for?
“DSM 5” stands for or refers to the fifth version of the Diagnostic and Statistical Manual of Mental Disorders. It was released in 2013, where the DSM 4 was released in 1994.
Is DSM IV still used?
The DSM-IV isn’t used in clinical settings and is no longer used for diagnosing mental disorders. When diagnosing mental disorders, providers now use the DSM-V. When using common language, however, some people still reference diagnoses and terms used in the DSM-IV. In fact, common language sometimes includes terms from versions of the DSM that existed prior to the DSM-IV. An example of outdated terms being used in common language would be the use of the term “manic depression,” which we now know as bipolar disorder.
What is a DSM category?
Categories in the DSM are used to group mental health conditions. For example, eating disorders are listed under the DSM category called “feeding and eating disorders,” and post traumatic stress disorder PTSD is under the category called “trauma and stressor-related disorders.” Therapists, psychiatrists, general doctors, and those in the field of social work may reference the DSM. Patients families and clients seeking general or basic mental health information do not necessarily need to know all of the details of the DSM categories, but should patients families and clients want to, much of this information is available online in a PDF format.
What disorders are in the DSM 5?
Disorders that fall under the categories listed under the question, “What are the 5 DSM categories?” are all listed in the DSM-5. These disorders include but aren’t limited to depressive disorders anxiety disorders, eating disorders, dissociative disorders, substance use disorders, and personality disorders. The development of DSM categories and revisions to terminology, criteria, and so on, have served as a way to better categorize and diagnose people living with mental health conditions.
Is the DSM reliable?
The DSM is reliable. While future revisions will occur as we continue to gain knowledge about mental health and mental disorders, the DSM is used for diagnosing mental disorders in the United States. It is compatible with billing codes used for insurance companies, which is one of the reasons why an accurate diagnosis can help people living with mental health conditions. On the psychiatry.org website, there is a frequently asked questions page regarding the DSM-5 that explains the importance of the DSM and how it’s used. According to the APA, “DSM-5’s Task Force and 13 Work Groups include more than 160 mental health and medical professionals who are leaders in their respective fields.” In addition to these work groups, the World Health Organization (WHO) was involved in the development of the DSM-5. Click here to learn more about the development of DSM criteria for the new edition as well as the organizations and providers involved. The rights reserved statement of the DSM-5 reads, “DSM-5 is a registered trademark, and all of its content is by copyright held by the American Psychiatric Association. All rights are reserved, and written permission is required from the American Psychiatric Association for use in any way, commercial or noncommercial.”
What are the 5 axis in psychology?
In the DSM-4, the 5 axis were Axis I (mental health and substance use disorders), Axis II (personality disorders and mental retardation), Axis III (coding general medical conditions), Axis IV (psychosocial and environmental problems), and Axis V (assessment of overall functioning via the GAF scale, which has since been dropped).
How many disorders are in DSM IV?
297 disorders were included in the DSM-IV.
What does multiaxial mean?
The APA dictionary of psychology defines multiaxial classification as, “a system of classifying mental disorders according to several categories of factors (e.g., social and cultural influences) as well as clinical symptoms.”
What is the difference between Axis I and Axis II disorders?
While the multi axial system has been eliminated, Axis I disorders previously consisted of “mental health and substance use disorders,” where Axis II consisted of “personality disorders and mental retardation.” (Source).
What does the DSM 5 say about ADHD?
The changes made to the DSM-5 reflect the increased knowledge that we have surrounding ADHD and other disorders. In the DSM-5, ADHD is classified under the category of Neurodevelopmental Disorders. The changes in the DSM-5 regarding ADHD were most notable in the sense that they have allowed more people to gain an accurate diagnosis. News releases on ADHD continue to provide emerging information about ADHD and other disorders.