Tuesday, August 13, 2013

Changes in the DSM V: part three

On we go with our dissection of the new DSM 5. The next category up is Anxiety Disorders. Here we have some important changes.

For one thing, Obsessive-Compulsive patients are no longer in a subdivision of Anxiety, but now have a category of their own. And Post Traumatic Stress Disorder has been moved as well, to be placed under the Trauma Related Disorders rubric.

There is also a substantive recognition of our world view. It is no longer required that the Anxiety patient label their own fears as excessive and unreasonable. There is acceptance of the fact that what you are afraid of is, to you, truly dangerous. In the rest of the world’s eyes, maybe the danger is overestimated. But to you, it is quite real, and as far as you are concerned your fear is entirely rational. The requirement is now merely that the Anxiety be out of proportion to the danger - NOT that the patient agrees that her fears are ‘silly’ or ‘crazy.’ To me, this demonstrates respect for the patient’s reality.

The other new requirement is that the Anxiety be of at least 6 months’ duration, to distinguish it from passing fears.

The Panic Attack category also shows some changes. A set of previously complex terms have now been boiled down to a simple choice between “expected” and “unexpected.” This label can be added as a specifier across various disorders.

Also, Panic Disorder and Agoraphobia have now been unlinked. If a person displays both, then he gets two diagnoses.

The former “social phobia” is now renamed Social Anxiety Disorder and can be typified as “performance only” if necessary. It is no longer “generalized.”

Lastly for Anxiety Disorders, Separation Anxiety is now recognized as occurring in adults as well as children. And Selective Mutism has now come under the Anxiety Disorder heading.

Next post: Obsessive Compulsive Disorders, including the new Hoarding Disorder.

Deborah is the author of Is There Room for Me, Too? 12 Steps & 12 Strategies for Coping with Mental Illness, available at Amazon and other major vendors. Visit her web page at www.lafruche.net, or see her catalog at www.lastlaughproductions.net.

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