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The Psychotherapy Curriculum

DSM-5: the Good, the Bad, and the Ugly

Program Description

In this program on the DSM-5, our speakers discuss the details and implications for practice of this new guideline which is going to change the way we view, diagnose and treat mental illness.

Learning Objectives

. The new structure of the DSM-5 diagnostic process and new classification system.
. Paradigm shifts represented in the DSM-5
. The relationship between DSM-5 and ICD-10.
. Describe and differentiate Binge-Eating. Disorder and Compulsive Overeating Disorder
. “New” diagnoses including Disruptive Mood Disregulation Disorder; Premenstrual Dysphoric Disorder; PTSD in children younger than 6 years old; and others
. The new approach to personality disorders
. Be able to recognize PTSD in children under age 6 and understand the most common faulty assumptions about PTSD in very young children.
. Understand the young child's experience of trauma.
. Accurate specifiers as they apply to the depressive disorders in the new manual
. The difference between grief and major depression
. The difference between depressive symptoms in men and women.
. Advantages and disadvantages of the new diagnostic system.
. How these changes and updates may affect your clinical practice.


Depressive Disorders in the DSM-5 - Melissa Perrin, Psy.D

Perhaps the most controversial change in the new DSM-5 has to do with the subject of grief and depression. Grief therapists, clinicians and researchers, as well as individuals who have suffered a loss because of the death of a loved one, have had extensive interest in the revision, which is significant, and which may lead to increased use of medication in treating individuals who have experienced a loss. the developers of the DSM-5 have recognized that while most people have grief reactions within a typical range, 10 to 15 percent of grievers have severe reactions to the loss of a loved one and thus may need treatment that includes prescription medication and therapy. So now, a person who is grieving a loss potentially may be diagnosed with depression or an adjustment disorder. Since the profound sadness that stems from grief can look a lot like the sadness depression brings, and this similarity can create a dilemma for mental health professionals, the bereavement exclusion from these diagnoses has become highly controversial.

Feeding and Eating Disorders - Greg Neimeyer, Ph.D.

When it comes to eating disorders, new knowledge has generated the single biggest change in the DSM-5: a move away from categorizing eating disorders by age, to a united system of feeding and eating disorders. By combining the symptomatology, it is more possible to study the links, avoiding the generational disconnects. Dr. Neimeyer fills us in.

Overview to the DSM-5 - Laura Groshong, LICSW

The arrival of a new DSM is always an awkward moment for psychiatry. It’s a rewriting of the rules of engagement with the human mind and a tacit admission of past errors, errors that have caused irreparable harm. This new manual, thirteen years in the making, while incorporating new understandings of diagnostic categories, may also require rediagnosis of patients whose long standing diagnoses simply disappear, or reassign diagnoses to categories with different reimbursement implications. Laura Groshong, LICSW, gives us an overview, highlighting the most significant changes and differences between the DSM-5 and the DSM IV-TR, the manual it replaces.

Personality Disorders in the DSM-5 - Melissa Perrin, Psy.D

Changes to the Personality Disorders section of DSM-5 have been a particular target for criticism. This is particularly distressing because personality disorders are frequently acknowledged to be the largest and fastest growing mental health issue. Few clinicians are trained to identify, assess and intervene is cases that involve personality disorders. Plus, these disorders are almost always the driving force behind stalled treatment. Clients are often referred to as confusing, resistive, unmanageable, difficult, stressful, and high risk, causing high levels of stress and frustration for their therapists. Prior to the DSM-5, personality disorders were coded on Axis II. But now the DSM-5 has done away with the use of “axes” for diagnostic coding, and the good news is there is a new conceptualization of personality disorders away from undesirable or negative personality features and towards a conceptualization of personality disorder as an impairment in both self organization and interpersonal relating.

PTSD in Pre-school Children - Toni Heineman, D.M.H

Historically, children have been under diagnosed with post-traumatic stress disorder (PTSD). This has been a serious omission, since trauma during childhood has been found to greatly increase the risk of an individual later having poor health, both mental and physical. Thus recognizing and treating children who have been traumatized can have a very positive impact. The DSM-5 includes a new developmental subtype of PTSD called “Posttraumatic stress disorder in preschool children.” This represents a significant step for the DSM taxonomy, and I am happy to be able to report that the general consensus is that the APA got something right. The sense is that regarding the entire PTSD category, the DSM-5 closes a lot of holes in the diagnosis, without cutting out legitimate trauma sufferers, while being expanded to now cover the subtype of Pre-school children age six and younger.

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