The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) is used by clinical social workers and other health care professionals in the United States as the official reference for psychosomatic disorders. On March 18th, 2022, the American Psychiatric Association (APA) released the DSM-5-TR. The DSM-5-TR provides a more current and comprehensive view of mental disorders and their development.
Learn MoreDSM-5-TR Updates
On March 18, 2022, the American Psychiatric Association (APA) released the DSM-5-TR. Many exam candidates are wondering when this material will be included on their licensing exam.
DSM-5-TR Updates
On March 18, 2022, the American Psychiatric Association (APA) released the DSM-5-TR. Many exam candidates are wondering when this material will be included on their licensing exam.
DSM-5-TR Updates
On March 18, 2022, the American Psychiatric Association (APA) released the DSM-5-TR. Many exam candidates are wondering when this material will be included on their licensing exam.
DSM-5-TR Release Date
On March 18, 2022, the American Psychiatric Association (APA) released the DSM-5-TR.
This is a text revision to the DSM-5 that provides updated data for research published since 2013, the publication date of the DSM-5. As a result, many exam candidates are wondering when this material will be included on their licensing exam and how significant the DSM-5-TR updates may be.
DSM-5-TR Updates On Licensure Exams
The NBCC shared that they are making a deliberate transition to the DSM-5-TR which will take some time. New narratives and items written to the DSM-5-TR were added to the NCMHCE in November 2022 and new DSM-5-TR items will be incorporated into the NCE in 2023. In an individual inquiry made to the ASWB, the ASWB Director of Examination Development confirmed that ASWB exams will start including DSM-5-TR material in January of 2024.
AATBS strives to provide you with up-to-date exam prep materials that are closely aligned with the actual exam. Accordingly, our course materials will be revised to include DSM-5-TR material in alignment with the licensing exam boards. AATBS is also committed to providing you with the latest news and information about your licensing exam. We will continue to monitor communication from the boards so that we can update our exam prep community with new information as soon as it becomes available.
Now, let’s go over some of the updates included in the DSM-5-TR. These updates include revised language and criteria, a new disorder (Prolonged Grief Disorder), updated statistical information, new ICD-10-CM codes, and more.
| Disorder or Condition | DSM-5 | DSM-5-TR |
|---|---|---|
| Attenuated Psychosis Syndrome | Attenuated Psychosis Syndrome criterion A uses phrase "with relatively intact reality testing". | Attenuated Psychosis Syndrome criterion A has been modified: "relatively intact reality testing" has been removed and definitions for three symptoms (attenuated forms of delusion, hallucination, and disorganized speech) have been more clearly articulated. |
| Autism Spectrum Disorder | a) Criterion A uses phrase "as manifested by the following" b) wording instructs specification if autism is "assocated with another neurodevelopmental, mental or behavioral disorder". | a) Criterion A has been modified to read "as manifested by all of the following" in order to maintain a high standard for qualification of diagnosis b) specifier wording states, "associated with a neurodevelopmental, mental, or behavioral problem". This updae allows indication of co-occuring problems that do not meet criteria for a secondary diagnosis (e.g. self-injury). |
| Avoidant Restrictive Food Intake Disorder | "Criterion A uses phrase "as manifested by persistent failure to meet appropriate nutritional and/or energy needs"." | Criterion A has been modified to eliminate the statement, "as manifested by persistent failure to meet appropriate nutritional and/or energy needs", because of it's contradiction to A.4, which allowed Criterion A to be met by "marked interference with psychosocial functioning". In other words, failure to meet appropriate nutritional dificiency is no longer required in order to meet criteria for this diagnosis, although it is one of the four options listed under criterion A. |
| Bipolar and Related Disorders Due to Another Medical Condition | Criterion A reads, "A prominent and persistent period of abnormally elevated, expansive, or irritable mood and abnormally increased activity or energy that predominates in the clinical picture". | Criterion A has been reworded for clarification and consistency. It now matches the wording of "substance/medication-induced bipolar and related disorder" and "depressive disorder due to another medical condition". It now reads "A prominent and persistent disturbance in mood that predominates in the clinical picture and is characterized by abnormally elevated, expansive, or irritable mood and abnormally increased activty or energy." |
| Bipolar I and Bipolar II Disorders | a) Criterion B in bipolar I disorder and criterion C in bipolar II disorder reads, "The occurence of the manic and major depressive episode(s) is not better explained by schizoaffective disorder, schizophrenia, schizophreniform disorder, delusional disorder, or other specified or unspecified schizophrenia spectrum and other psychotic disorder." b) Mood-congruent/mood incongruent psychotic features specifier, when applied to bipolar I or bipolar II disorders, is only applicable to psychotic manic episodes c) Severity specifiers only make sense if the current episode was a major depressive episode, not a manic episode. | a) Criterion B in bipolar 1 disorder now reads: "At least one manic episode is not better explained by schizoaffective disorder and is not superimposed on schizophrenia, schizophreniform disorder, delusional disorder, or other specified or unspecified schizophrenia spectrum and other psychotic disorder." b) Criterion C in bipolar II disorder now reads: "At least one hypomanic episode and at least one major depressive episode are not better explained by schizoaffective disorder and are not superimposed on schizophrenia, schizophreniform disorder, delusional disorder, or other specified or unspecified schizophrenia spectrum and other psychotic disorder." c) Change to mood-congruent/mood-incongruent psychotic features specifier to include different versions based on the type of episode. The manic version uses the wording of the bipolar and related disorders chapter and the depressive version uses the definition from the mood-congruent/mood-incongruent specifer from the depressive disorders chapter. d) Severity specifiers for a current manic episode (mild, moderate, severe) were added to bipolar and related disorders. |
| Delirium | Criterion A uses phrase, "A disturbance in attention (i.e., reduced ability to direct, focus, sustain, and shift attention) and awareness (reduced orientation to the environment)". | Criterion A has been modified to eliminate the parenthesized phrase "reduced orientation to the environment" and the second half of criterion A was changed to "accompanied by reduced awareness of the environment". |
| Depressive Disorder Due to Another Medical Condition | Criterion A reads, "A prominent and persistent period of depressed mood or markedly diminished interest or pleasure in all, or almost all, activities that predominates the clinical picture." | Criterion A now states, "A prominent and persistent disturbance in mood that predominates in the clinical picture and is characterized by depressed mood or markedly diminished interest or pleasure in all, or almost all, activities." |
| Functional Neurological Symptom Disorder (Conversion Disorder) | This disorder is listed as "Conversion Disorder (Functional Neurological Symptom Disorder)". | In DSM-5-TR, this disorder is now listed as "Functional Neurological Symptom Disorder (Conversion Disorder)". Functional neurological symptom disorder is the preferred term for researchers, clinicians, and with respect to etiology. |
| Gender Dysphoria | Specifiers for Gender Dysphoria include: "desired gender", "cross-sex medical procedure", "cross-sex hormone treatment", "natal male", "natal female". | Specifiers for Gender Dysphoria were changed to: "experienced gender", "gender-affirming medical procedure", "gender-affirming hormone treatment", "individual assigned male at birth", "invididual assigned female at birth". Additionally, “differences in sex development” is now noted to be an alternate term for “disorders of sex development". |
| Intellectual Development Disorder (Intellectual Disability) | Diagnosis reads, "Intellectual Disability (Intellectual Developmental Disorder). Diagnostic criteria "note" section explains that the term "intellectual disability" aligns with the ICD-11 diangosis of "intellectual developmental disorder" and that the term "mental retardation" has been replaced with "intellectual disability". | a) Diagnosis now reads "Intellectual Developmental Disorder (Intellectual Disability). The "note" section indicates that the term "intellectual developmental disorder" aligns best with the ICD-11 so it was given prominence. The equivalent term, "intellectual disability" is kept in parenthesis for contined common use. b) References to this diagnosis were updated in the following disorders to reflect the use of the new terminology: unspecified intellectual developmental disorder (intellectual disability), language disorder, social (pragmatic) communication disorder, autism spectrum disorder, developmental coordination disorder, and sterotypic movement disorder. |
| Major Depressive Disorder | Criterion D reads, "The occurrence of the major depressive episode is not better explained by schizoaffective disorder, schizophrenia, schizophreniform disorder, delusional disorder, or other specified and unspecified schizophrenia spectrum and other psychotic disorders." | Criterion D now states, "At least one major depressive episode is not better explained by schizoaffective disorder and is not superimposed on schizophrenia, schizophreniform disorder, delusional disorder, or other specified and unspecified schizophrenia spectrm and other psychotic disorders." |
| Narcolepsy | a) Subtypes are: "(G47.419) Narcolepsy without cataplexy but with hyopcretin deficiency" "(G47.411) Narcolepsy with cataplexy but without hyopcretin deficiency" "(G47.419) Autosomal dominant cerebellar ataxia, deafness, and narcolepsy" "(G47.419) Autosomal dominant narcolepsy, obesity, and type 2 diabetes" "(G47.429) Narcolepsy secondary to another medical condition". b) Coding note for ICD-9 included. | a) Narcolepsy subtypes were updated to better align with the International Classification of Sleep Disorders, 3rd edition (ICSD 3) and International Classification of Diseases, 11th edition (ICD-11). The subtypes now are: "G47.411 Narcolepsy with cataplexy or hypocretin deficiency (type 1)" "G47.419 Narcolepsy without cataplexy and either without hyopcretin deficiency or hypocretin unmeasured (type 2)" "G47.421 Narcolepsy with cataplexy or hypocretin deficiency due to a medical condition" "G47.429 Narcolepsy without cataplexy and without hypocretin deficiency due to a medical condition". b) Coding note about ICD-9 eliminated. Coding notes for how to record underlying medical conditions included. |
| Other Specified Obsessive-Compulsive and Related Disorder | The specifer "olfactory reference disorder (olfactory reference syndrome)" is included in DSM-5 under the term “Jikoshu-kyofu", a term used in traditional Japanese psychiatry. | The specifier term has been updated to "olfactory reference disorder (olfactory reference syndrome)" to reflect the fact that it is not a Japanese culture-bound syndrome and to better align with the ICD-11. |
| Other Specified Bipolar and Related Disorder | Example #3, "Hypomanic episode without prior major depressive episode" has a qualifying sentence stating, "If this occurs in an individual with an established diagnosis of persistent depressive disorder (dysthymia), both diagnoses can be concurrently applied during the periods when the full criteria for a hypomanic episode are met". | a) The qualifying sentence in Example #3, "Hypomanic episode without prior major depressive episode" was eliminated. Now the example reads, "One or more hypomanic episodes in an individual whose presentation has never met full criteria for a major depressive episode or a manic episode". This was done to resolve a conflict with criterion E for persistent depressive disorder b) A 5th example, "manic episode superimposed" was added. |
| Other Specified Delirium Disorder | Has an example of "attenuated delirium syndrome" that does not reflect the current terminology accepted in the field. | Updated the terminology of the example to the more widely used and accepted "subsyndromal delirium". |
| Other Specified Depressive Disorder | The DSM-5 does not include the 4th example, "major depressive episode superimposed", which has been added to the DSM-5-TR. | A fourth example, "major depressive episode superimposed", has been added. It reads, "Major depressive episode superimposed on schizophrenia, schizophreniform disorder, delusional disorder, or other specified and unspecified schizophrenia spectrum and other psychotic disorder. Note: Major depressive episodes that are part of schizoaffective disorder do not merit an additional diagnosis of other specified depressive disorder". |
| Other Specified Feeding Or Eating Disorder | Ayptical anorexia nervosa example reads, "All of the criteria for anorexia nervosa are met, except that despite significant weight loss, the individual's weight is within or above the normal range." | The phrase, "individuals with atypical anorexia nervosa may experience many of the physiological complications associated with anorexia nervosa", was added as a second sentence to the description of the atypical anorexia nervosa. |
| Other Specified Schizophrenia Spectrum and Other Psychotic Disorder | Example #4 In DSM-5 includes the phrasing, "delusional symptoms in partner of individual with delusional disorder". | Terminology was updated to say, "delusional symptoms in the context of relationship with an individual with prominent delusions". This change eliminates the use of the term "partner," which could infer a romantic relationship. |
| Persistent Depressive Disorder | a) Called "Persistent Depressive Disorder (Dysthymia)" b) Specifiers are: "with anxious distress", "with mixed features", "with melancholic features", "with atypical features", "with mood-congruent psychotic features", "with mood-incongruent psychotic features", "with peripartum onset". | a) Called "Persistent Depressive Disorder" The term "dysthymia" is removed. b) Specifiers now only include: "with anxious distress" and "with atypical features". Specifiers about remission, onset, etc. remain the same. |
| Prolonged Grief Disorder | This diagnosis is not present in DSM-5. DSM-5 does include a category of persistent complex bereavement disorder as a "condition for further study". | Prolonged grief disorder has been added to the trauma and stressor related disorders chapter. Prolonged grief disorder is defined as "intense yearning or longing for the deceased (often with intense sorrow and emotional pain), and preoccupation with thoughts or memories of the deceased (in children and adolescents, this preoccupation may focus on the circumstances of the death)". |
| PTSD | Criterion A.2 for posttraumatic stress disorder in children includes a note stating, "witnessing does not include events that are witnessed only in electronic media, television, movies, or pictures". | The note included in criterion A.2 stating, "witnessing does not include events that are witnessed only in electronic media, television, movies, or pictures" has been removed for children 6 years and younger, because criterion A.2 already indicates that the events occurring to others must be witnessed in person. |
| Social Anxiety Disorder | The disorder is listed as "Social Anxiety Disorder (Social Phobia)". | The parenethtical term "(social phobia)" has been removed from this term and "Social Anxiety Disorder" has been adopted as the correct and widely adopted clinical term. |
| Substance/Medication Induced Bipolar and Related Disorder | a) Criterion A reads, "A prominent and persistent disturbance in mood that predominates in the clinical picture and is characterized by elevated, expansive, or irritable mood, with or without depressed mood, or markedly diminished interest in pleasure in all, or almost all, activities." b) Criterion B.1 states, "The symptoms in Criterion A developed during or soon after substance intoxication or withdrawal or after exposure to a medication." | a) Criterion A now states, "A prominent and persistent disturbance in mood that predominates in the clinical picture and is characterized by abnormally elevated, expansive, or irritable mood and abnormally increased activity or energy." b) Criteria B.1 states, "The symptoms in Criterion A developed during or soon after substance intoxication or withdrawal or after exposure to or withdrawal from a medication." |
| Unspecified Mood Disorder | DSM-5 does not include the category, "unspecified mood disorder". | "Unspecified mood disorder" is once more included in the DSM. It will be applied to presentations that do not meet criteria for any specific mood disorder and in which it is difficult to choose between an unspecified depressive disorder and an unspecified bipolar disorder. This makes DSM-5-TR align more closely with ICD-10-CM and ICD-11, both of which also include this category. |
Additional Changes:
- In section 2 of the DSM-5-TR, diagnostic codes have been included for suicidal behavior and suicidal self-injury in the chapter titled, "other conditions that may be a focus of clinical attentionquot;. This chapter includes conditions, behaviors, and psychosocial or environmental problems that may effect diagnosis, course, prognosis, or treatment of an invidual's mental disorder. These codes have been added to bring attention to additional conditions, behaviors, and problems so that clinicians to improve documentation, research, and clinicial focus of these issues. These other conditions are not mental disorders.
- The DSM-5-TR includes changes in terminology used to discuss culture, racism, and discrimination. The changes are as follows: the term "racialized" is used instead of "race/racial" "ethnoracial" is used to indicate the U.S. Census categories, such as Hispanic, White, or African American, that include both ethnic and racialized identifiers; the terms "non-white" and "minority" are no longer used; "Latinx" is used in place of "Latino/a" the term "Caucasian" is no longer used. Additionally, prevalence data on specific ethnoracial groups has been included, as well as information on variations in symptom expression, attributions for disorder causes or precipitants, and factors associated with differential prevalence across demographic groups.
- The DSM-5-TR includes changes to more accurately capture the experiences and symptoms of children. These changes include: Criterion A for Autism Spectrum Disorder has been revised to read, "as manifested by all of the followingquot;, rather than "as manifested by the following" the "Development and Course" section for Disruptive Mood Dysregulation Disorder has been updated to reflect "6 - 18 years" as the age range for diagnosis; the statement, “witnessing does not include events that are witnessed only in electronic media, television, movies, or pictures” was removed from criterion A.2 for Posttraumatic Stress Disorder in children 6 years or younger; specific language was added to the criteria for Prolonged Grief Disorder to define the difference between children and adolescents versus adults.
- DSM-5-TR will now include only ICD-10-CM codes because they are the only official coding system in the United States at this time.
- Section 3 of DSM-5-TR includes sets of criteria for conditions that require future research. These conditions may influence a person's functioning and/or level of distress but will require more research before they are recognized as diagnosable disorders.
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The DSM is a mental health disorder classification system that was created by the American Psychiatric Association (APA). It is used by clinicians and researchers to diagnose and study mental disorders. The DSM-5-TR is improtant because it is a revision to the DSM 5.
Learn MoreThis is a text revision to the DSM-5 that provides updated data for research published since 2013, the publication date of the DSM-5.
Learn More
References:
The information provided in this resource is referenced from the DSM-5-TR and the DM-5-TR Fact Sheets provided by the American Psychiatric Association.
American Psychiatric Association. (2022). Diagnostic and Statistical Manual of Mental Disorders (5th ed., TR). https://doi.org/10.1176/appi.books.9780890425787
American Psychiatric Association. (2021). DSM-5-TR Fact Sheets. https://www.psychiatry.org/psychiatrists/practice/dsm/educational-resources/dsm-5-tr-fact-sheet