DSM Changes to Help Clinical Social Workers Transition

Fall     I S S U E     2 0 1 4

Mirean Coleman, LICSW, CT

Senior Practice Associate

mcoleman@naswdc.org

There are changes in the Diagnostic and Statistical Manual for Mental Disorders (DSM) clinical social workers should familiarize themselves with as the mental health industry transitions from the DSM-IV to the DSM-5. NASW has prepared the following list of 10 key changes to help clinical social workers transition.

• Substance abuse with substance dependence was consolidated into a single disorder called substance use disorder which is measured on a continuum from mild to severe. Drug craving was added to the list of symptoms and law enforcement problems were eliminated.

• Hoarding Disorder is a new diagnosis in the DSM and reflects persistent difficulty discarding or parting with possessions due to a perceived need to save the items and distress associated with discarding them.

• Premenstrual Dysphoric Disorder was moved to the main body of the DSM.

• Binge Eating Disorder was elevated to the main body of the DSM. Criteria was changed to an average frequency of at least once weekly over the last three months

• Attention Deficit Hyperactivity Disorder (ADHD) must now appear by age 12. Research indicated that ADHD occurs after age 7 when a child may be challenged by school requirements.

• Intellectual Disability replaces the term mental retardation. Intelligent Quotients (IQs) scores and adaptive functioning are both germane factors in determining a person’s ability.

• The bereavement exclusion was eliminated in the DSM which applied to a major depressive episode that lasted less than two months following the death of a loved one. Bereavement is listed in the DSM-5 Section III, “Conditions for Further Study.”

• Major Neurocognitive Disorder replaces the term dementia. Mild Neurocognitive Disorder was added with support from evidence-based literature that this population could benefit from diagnosis and treatment.

• Neurodevelopmental Disorder is a new chapter which combines the following different disorders:

‣ Intellectual Disability

‣ Communication Disorder

‣ Autism Spectrum Disorder

‣ Attention Deficit Hyperactivity Disorder

‣ Specific Learning Disorder

‣ Motor Disorder

• Suicidal Behavior Disorder is a new category listed in the DSM-5 Section III, “Conditions for Further Study” and identifies the risk factors associated with suicide attempts including depression, substance use or lack of impulse control. Patient must have attempted suicide within the last two years.

Products

• NASW has a Webinar training on the DSM-5 which may be access at the following Web link: DSM-5 Depressive and Grief Disorders: Mastering the Changes, Understanding the Controversies: www.socialworkers.org/sections/teleconferences/tcourses/Default.aspx?courseID=ab867e40-8a2b-4a41-838a-c0acf5313210&header=OFF

• A Practice Perspectives, DSM-5 Frequently Asked Questions by Clinical Social Workers, is available online at: www.socialworkers.org/assets/secured/documents/practice/clinical/dsm5faq.pdf

• NASW members can receive a 15 percent discount when purchasing the DSM-5 from the American Psychiatric Association when using the discount code NASWMEM at 800.368.5777 or online at www.appi.org.

Resources

American Psychiatric Association. 2013.

Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition.
Arlington, VA: Washington DC.