Dear Readers,
It seems like there is a lot going on in the addictions field these days, one of the most notable being the recently proposed draft diagnostic criteria for the fifth edition of Diagnostic and Statistical Manual of Mental Disorders (DSM).

As many of you know, the DSM-IV was published in 1994. Research investigators have began discussing revisions to the DSM in 2000, and in 2004 the American Psychiatric Association (APA) launched a website to invite questions, comments and research findings from a wider swath of research, clinical and consumer stakeholders.

From this, working groups made up of over 160 renowned clinicians and researchers were tasked with using information from scientific reviews and advisors to propose draft criteria for DSM-V. In addition to the working groups in diagnostic categories, there were study groups assigned to review gender, age and cross-cultural issues.

The proposed diagnostic criteria for DSM-V will be available for public comment until April 20, and will be reviewed and refined over the next two years, during which time the APA will conduct three phases of field trials to test some of the proposed diagnostic criteria in real-world clinical settings.

Among the draft revisions proposed for the DSM-V are several that focus on addictions.  Specifically, the APA is proposing eliminating the current categories substance abuse and dependence, and replacing them with the new category “addiction and related disorders.” This would include substance use disorders, with each drug identified in its own category.

“This will better differentiate between the compulsive drug-seeking behavior of addiction and normal responses of tolerance and withdrawal that some patients experience when using prescribed medications that affect the central nervous system,” APA notes.

Additionally, APA is proposing the creation of a new category of “behavioral addictions,” in which gambling will be the sole disorder. Although Internet addiction was considered for this category, the working group felt there was insufficient research data, and instead recommended it be included in the manual’s appendix instead, until additional research data was available.

While sex addiction is notably absent among the proposed revisions, the APA has proposed including hypersexual disorder in the DSM-V. It is defined as “recurrent and intense sexual fantasies, sexual urges and sexual behavior” in association with four or more of five named criteria.
Other notable proposed revisions to the DSM-V include: new suicide scales for adults and adolescents to help clinicians identify at-risk individuals; and a proposed new diagnostic category, temper dysregulation with dysphoria (TDD), within the Mood Disorders section of the manual, which may help clinicians better differentiate children with these symptoms from those with bipolar disorder or oppositional defiant disorder.

Based on the upcoming comments to the draft criteria and findings of the field trials, the work groups will propose final revisions to the diagnostic criteria in 2012. The final draft of DSM-V will be submitted to the APA’s Assembly and Board of Trustees for their review and approval, with a release of the final, approved DSM-V anticipated in May 2013.

So, I am interested in knowing what you, the addiction treatment professionals, think about the newly proposed criteria for the DSM-V. As always, I encourage you to contact me to share your thoughts on this and other issues facing the field, as well as any questions, comments or concerns regarding the content of Counselor. You can reach me by email at editor@counselormagazine.

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Colchess  - Counselor Magazine   |Registered |2011-03-29 07:44:34 I can write the editor, very cool. I know I am a subscriber: James R. Columbro, LICDC 24726 Meadow Lane Westlake, OHio 44145 olapiiii@ameritech.net 440-979-0233 could you verify? and I know there are capabilities for CE credits. here is my problem. I need to document for my certifying authority staff development in cultural competency. If there is an archived article that I might circulate and train staff in house you would be doing me an incredible service. feel free to correspond or forward to the relevant department within. very truly, James Reply 0   0

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