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Using the DSM-5: Try It, You'll Like It - by Jason King, …

The Americanization of Mental Illness - The New York …

how about the koro syndrome? It is a culturally specific disorder found in asia where they believe that their penis is shrinking and will go inside of their body and actually kill them

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RAD differs from disinhibited social engagement disorder in that “the former is expressed as an internalizing disorder with depressive symptoms and withdrawn behavior, while the latter is marked by disinhibition and externalizing behavior” (APA, 2013, p. 265). RAD is characterized by avoidant and disturbed attachment behaviors and a marked absence of seeking comfort from primary caretakers. Disinhibited social engagement disorder is characterized by indiscriminant behaviors that violate social boundaries of the child’s culture, yet it can be common for the child not to have any signs of disturbed attachment.

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In 2013, Cosgrove and Suppes published “Informing DSM-5: Biological boundaries between bipolar I disorder, schizoaffective disorder and schizophrenia”. For the DSM-5, existing nosological boundaries between bipolar disorder and schizophrenia were retained. In addition, schizoaffective disorder was preserved as an independent diagnosis because the biological data are not yet compelling enough to justify a move to a more neurodevelopmentally continuous model of psychosis. The authors also noted that family studies suggest a clear genetic link between all three disorders. Most important, hallucinations and delusions are typically considered the hallmark of schizophrenia, but mood fluctuations are central to bipolar disorder.

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Clients presenting with psychotic and schizophrenia spectrum disorders are challenging and diagnostically complex. To assist with these difficulties, the DSM-5 presents a new conceptualization to facilitate clinical utility and to streamline diagnostic formulations (Bruijnzeel & Tandon, 2011). Similar to autism, schizophrenia has been referenced as a spectrum disorder since 1995 (Kendler, Neale, & Walsh, 1995) and the DSM-5 marks the official recognition of this spectrum conceptualization by embedding the word in the diagnostic title. Essential to competent practice in this area is reading the on pages 87-88 of the DSM-5 (e.g., delusions, hallucinations, disorganized thinking, grossly disorganized or abnormal motor behavior, and negative symptoms). Further critical reading is the new on the DSM-5 pages 89-90. These pages describe the heterogeneity of psychotic disorders and the dimensional framework for the assessment of primary symptom severity within the psychotic disorders. This spectrum conceptualization differs from the DSM-IV-TR categorical and mutually exclusive diagnostic system that assumed “mental disorders are discrete entities, with relatively homogeneous populations that display similar symptoms and attributes of a disorder” (Jones, 2012, p. 481).

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In the DSM-5, the multiaxial system of previous editions is eliminated, and chapters are now arranged according to a lifespan or developmental approach (which fits the paradigm of counseling). Disorders affecting children appear first, and those more common in older individuals appear later. The intention throughout is to group disorders that are similar to one another across a range of validators, including symptoms; neurobiological substrates; familiarity; course of illness; and treatment response. With all of these changes, it is imperative that clinicians remember this mantra: The DSM-5 does not make diagnoses; clinicians, by systematically and objectively using standardized and non-standardized testing, specialized clinical assessment techniques, and case conceptualization procedures, make diagnoses that are developmentally and culturally sensitive.

Using the DSM-5: Try It, You'll Like It - by Jason King, Ph.D.

A growing body of scientific evidence favors dimensional concepts in the diagnosis of mental disorders, as opposed to categorical concepts used in prior DSM versions. Excessive comorbidity, boundary disputes, and disproportionate use of the NOS categories undermine the hypothesis that DSM-defined disorders represent distinct entities (see Jones, 2012)