DSM-5 Category Summaries Introductions

Over the past two decades, professionals in the field of Psychology have underscored the importance of making accurate diagnoses of mental disorders during practice. The general consensus hails precise identification of a mental health disorder for ultimately leading to correct treatment options on offer thus bolstering chances of effective case management. Pursuant to this premise, the American Psychological Association (APA) went on to produce its handbook containing criteria necessary for diagnosis, popularly referred to as the Diagnostic and Statistical Manual of Mental Disorders (DSM). Now in its fifth edition, DSM-5 is an updated version of the manual penned by a committee of experts to be used as an analytical and taxonomic tool when making psychiatric diagnoses. The purpose of this research paper is, therefore, to provide introductions to DSM-5 category summaries of schizophrenia spectrum and other psychotic disorders, bipolar and related disorders, trauma and stressor-related disorders, dissociative disorder, and paraphilic disorders.

Read Also Changes Made From DSM IV to DSM-5

Schizophrenia Spectrum and Other Psychotic Disorders

The medical term “schizophrenia” was introduced by the Swiss psychiatrist E. Bleur to refer to an apparent splitting of the mind and personality. It was noted that the subjects exhibited a break up in their psychic functioning that went on to impact their perceptions of reality. Today, DSM-5 uses a gradient when making diagnoses of persons with psychotic indicators(Association &American Psychiatric, 2013, p.87). It holds the idea that this condition occurs as a component of a continuum of other related mental conditions with similar predisposing factors. The characterization of schizophrenia is done using two categories: negative and positive. Negative symptoms manifest in the form of delusions, a disorganized manner of thinking, unsystematic behavior and hallucinations.  In other instances, patients may, at times, experience anomalous thoughts, discernments and behavior that may be unusual but positive. The condition’s sub-types include schizotypal personality disorder, delusional disorder, brief psychotic disorder, schizophreniform disorder, schizoaffective disorder, and schizophrenia.  According to In Luhrmann & In Marrow (2016), an estimated 0.3-07 % of the American population is afflicted by schizophrenia and its adverse effects (43). Men and women are affected by the disorder in equal measure, with long-term infirmity beginning during childhood and persisting through to adulthood.

Bipolar and Related Disorders

Changes in mood are part normal human life. Nevertheless, if one happens to suffer from bipolar and other related disorders mood changes may occur more frequently and for extended periods. A bipolar episode is punctuated by two contrasting mood states where individual in question periodically slips from mania to depression. Manic episodes are charged by a sudden burst of energy attributed to the euphoria that one may be experiencing. In this state, patients typically spend most of their time awake with racing thoughts and accelerated speech. A feeling of invincibility pervades them, which also explains why those with this disorder may feel overly confident. Conversely, depressive episodes are characterized by long periods of low energy where the individual is quite pessimistic. As a result, their sleep pattern changes and may alternate between excessive sleeping and sleeplessness(Kring & Kring, 2014). Unexplained emotional outbursts are common, with the sufferer opting to withdraw completely from active social life. DSM-5 applies anxious distress, rapid cycling, melancholic features, mood reactivity, catatonia, and psychotic features as specifiers during the classification process(Association &American Psychiatric, 2013, p.124).  Episodes may last anywhere from a week to several months. For this reason, it can remain undetected throughout a person’s life only to be diagnosed at a later stage.

Trauma and Stress-Related Disorders

Trauma and stress-related disorders represent a host of grave psychological reactions that afflicts select individuals after exposure to traumatic or high-stress situations. These events may range from combat, torture, accidents, natural calamities, sexual assault or even childhood neglect. Evidence of this spectrum of conditions was first recorded in 1648 by Swiss Military doctors during routine check-ups at the frontlines. Subjects exhibited nostalgia, melancholy, stupor, weakness and an incessant bout of anxiety. Nearly 300 years later horrors of conflict linked to The Great War (1914-18) and The Second World War (1939-45) led researchers to the thorough investigation of psychological reactions that result from trauma. It is from this premise that the most recent edition of DSM-5 groups all shock-related conditions in a single group: trauma and stress-related disorders. The main disorders in this category are post-traumatic stress disorder (PTSD), adjustment disorders, reactive attachment disorder, and stressor-related disorders(Association &American Psychiatric, 2013, p.266).Characteristics include intrusion symptoms, hyper-arousal, deleterious alterations in cognition and avoidance. Nevertheless, it is important to note that determining the prevalence of disorders in this category presents a challenge since they only occur after contact with a specific stressful event.

Dissociative Disorders

The mental health conditions grouped in this category all involve glitches with memory, perception and the subject’s sense of self. Typically, symptoms are often so adverse that they practically interfere with all aspects of the subject’s cognitive function. Sufferers may experience a sense of detachment from reality and even claim to have out-of-body experiences. The three most common types of dissociative disorders are amnesia, dissociative identity disorder, and depersonalization disorder. Those with these conditions admit to experiencing an intermittent lack of continuity in thoughts, environment, and actions. It is for this very reason that patients would seek to escape reality in unhealthy and unconventional ways that may ultimately exacerbate their present condition. Essentially, the development of dissociative disorders is a response to trauma and, therefore, meant to keep troubling recollections at bay. In classifying these conditions, DSM-5 has made notable changes including the inclusion of de-realization

(Association &American Psychiatric, 2013, p.292).Formerly referred to as depersonalization disorder, both the name and structure have been tweaked to be in tandem with the variations effected in the field. Formerly known as dissociative fugue, dissociative amnesia has now been designated as a specifier and is no longer a detached diagnosis. Persons who have experienced emotional and sexual abuse are more likely to develop dissociative disorders owing to trauma than their counterparts who have led what is considered a normal life.

Paraphilic Disorders

The psychiatric conditions grouped in this category are characterized by intense sexual urges and fantasies that may cause severe distress to the individual in question. These recurrent behaviors may involve children, inert objects or the humiliation of non-consenting adults with the aim of causing them considerable harm. These atypical and pathological demeanors may be termed as paraphilic when they are persistent or cause significant impairment on their normal day to day functioning. The pattern of disturbance leading to these disorders begins with early emotional trauma, a realignment of the pattern of arousal and the inclusion of conditioning elements. DSM-5 lists pedophilia, transvestic disorder, voyeurism and exhibitionism as the common forms of paraphilia that medical practitioners are likely to encounter (Association &American Psychiatric, 2013, p.699). Some forms of paraphilia such as pedophilia are criminal in nature and those found to have committed them being subjected to imprisonment in correctional facilities. In addition to this, they may also be registered in the sex offender’s list for the safety of those who might be around them. Most recently psychologists have suggested the use of behavior therapy and psychoanalysis as practical treatment options to alter the conditions. Others have suggested the use of medication, even though it is vital to acknowledge the level of sex drive is not always related to a paraphiliac’s actual behavior.

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