7 of the Biggest Changes from DSM-IV to DSM-5

Modified on by Max Wilbert

7 Biggest Changes from DSM-IV to DSM-5

In 2013, a new version of the DSM was released by the American Psychiatric Association. The DSM, or the Diagnostic and Statistical Manual of Mental Disorders, is a listing of officially recognized mental disorders. It is intended to assist researchers, healthcare providers, insurance providers, regulatory institutions, and other parties in the medical field in guiding treatment of mental health issues.

The new version, called DSM-5 (yes, they swapped from Roman numerals to standard Arabic) represents the largest change to the DSM in many years. It contains an extremely wide variety of clinical diagnoses for mental disorders, and generally reflects changes in the scientific understanding of such issues and their treatment. The changes in the DSM-5 have huge impacts on the work of medical practitioners across a wide variety of fields — including those who are studying GRE Psychology using Brainscape.

In this article, we’re going to go over some of the biggest changes in the DSM-5, and their implications. Let’s get to it.

7 Biggest Changes from DSM-IV to DSM-5

1. Modification of Artificial Categorization

The DSM-IV used an “axial” system to group disorders into five broad categories, or groups:

  1. All psychological diagnostic categories except mental retardation and personality disorder
  2. Personality disorders and mental retardation
  3. General medical condition; acute medical conditions and physical disorders
  4. Psychosocial and environmental factors contributing to the disorder
  5. Global Assessment of Functioning or Children’s Global Assessment Scale for children and teens under the age of 18

No longer. With the release of the DSM-5, this categorization has been simplified to clarify relationships between different disorders. Criticisms of the previous system include that it made it more difficult for providers to draw linkages between issues that crossed these artificial boundaries, and that it disassociated disorders that shared very similar characteristics. Now these links are clearer.

2. The Autism Spectrum

In the DSM-5, four separately classified issues—that are unfortunately very common—have been unified under the header of autism spectrum disorder. The previous categories of autism, Asperger’s, childhood disintegrative disorder, and pervasive developmental disorder are no longer in use.

3. Elimination of Childhood Bipolar Disorder

In response to an observed trend of harmful over-diagnosis and over-treatment of childhood bipolar disorder, the DSM-5 removes childhood bipolar disorder and replaces it with Disruptive Mood Dysregulation Disorder (DMDD). While not all children who were formerly diagnosed with bipolar disorder will fall under DMDD, it does provide a new diagnosis that more accurately matches a set of symptoms characterized by extreme temper outbursts.

4. Revisions to ADHD Diagnosis

The new DSM-5 broadens the ADHD diagnosis, allowing for adult-onset and relaxing the strictness of the criteria to more accurately reflect new research on this disorder. Given that adults have more developed brains and generally greater impulse control, adults can now be diagnosed with ADHD if they have fewer signs and symptoms than children do.

5. Increasing Detail on PTSD Symptoms

Partly due to the wars in Iraq and Afghanistan, medical researchers have gained a great deal more insight into PTSD in the last 15 years. The DSM-5 reflects this increased understanding, adds nuance for children with PTSD, and describes four main types of symptoms:

  1. Arousal
  2. Avoidance
  3. Flashbacks
  4. Negative impacts on thought patterns and mood

6. Reclassification of Dementia

In the DSM-5, both dementia and the category of memory/learning difficulties called amnestic disorders have been subsumed into a new category, Neurocognitive Disorder. The DSM-5 splits this disorder into two broad severities (major and mild) to encourage early detection and treatment of these issues.

7. Intellectual Disability

To reflect common language, the issues previously referred to as “mental retardation” are now classified as “intellectual disability.” This term is already falling out of favor, however, and thus the DSM-5 also uses the term Intellectual Development Disorder, which is the next evolution of the phrase in international medical parlance. The diagnostic criteria for this disorder have also been updated to more strongly focus on adaptive functioning, rather than IQ score.

Of course, this is just a sampling of the changes in the DSM-5. After all, this revision took nearly 15 years and over 400 professionals to complete. But if you’re new to the subject, this is a good intro. Any important points we missed? Let us know in the comments. Thanks for reading!

Brainscape is a web & mobile education platform that helps you learn anything faster, using cognitive science. Join the millions of students, teachers, language learners, test-takers, and corporate trainees who are doubling their learning results. Visit brainscape.com or find us on the App Store .


Sigint 12 months ago

Took 400 professional 15 years to change. Would have taken 10 professionals only 2 years.....

....but the manual would have really WANTED to be changed.

visehood 1 year ago

(Substance Abuse & Substance Dependence) --> Substance Use Disorders
Pretty key change in my opinion!

R. 3 years ago

M. 3 years ago

Caitlin Jenner is transgender, that's different from being a transvestite.

Sigint 12 months ago

Either of those conditions is a mental disorder....

Ashley Boros 11 months ago

Definitley NOT a mental disorder

R. 3 years ago


comments powered by Disqus