The document outlines the specific aims of understanding changes from DSM-IV to DSM-5, appreciating changes to diagnostic criteria for disorders common in veterans, and reviewing new cross-cutting and severity measures. It discusses criticisms of DSM-IV including high comorbidity rates and outdated criteria. The development process included task forces, workgroups, and over 200 publications. DSM-5 has three sections and changes the framework by removing Roman numerals and consolidating some disorders.

1. Specific Aims
• To understand the changes in framework from DSM-IV to
DSM-5
• To appreciate specific changes in diagnostic criteria for
commonly occurring disorders in the Veteran population
• To review the new cross-cutting symptom measures and
disease severity measures found in DSM-5

2. Criticisms of DSM-IV
•
•
•
•
High rates of comorbidity
High use of “Not Otherwise Specified” (NOS) category
Lack of laboratory markers
DSM-IV criteria are a decade old. Neuroscience has moved
very quickly in that time span.
• Criteria lack validity/not based in etiology
• American document

3. DSM-5 Development
•
•
•
•
•
2006-2007 DSM-5 Task Forces
2007-2013 DSM-5 Workgroups
Cross-cutting study groups
>50% of participants from outside US
13 conferences, 10 monographs, and >200 journal articles
published prior to release of DSM-5
3

4. Three Sections of DSM-5
•
•
•
Section I: Preamble, definitions, cautionary statements
Section II: 20 Mental disorder chapters
Section III: Items requiring further research
– Emerging diagnoses
– Dimensional model of personality disorders
– Emerging measures
• Cross-cutting
• Symptom severity
• Appendix
4

5. Changes in Framework
• Abandon Roman numerals!
– DSM, DSM-II, DSM-III, DSM-IV… and now DSM-5
• Fewer total disorders (15 new, 2 discarded, and 28 combined)
• Not Otherwise Specified now called Unspecified or Other
Specified
5

6. Specific Aims
To understand the changes in framework from DSMIV to DSM-5
To appreciate specific changes in diagnostic criteria
for commonly occurring disorders in the Veteran
population
To review the new cross-cutting symptom measures
and disease severity measures found in DSM-5

7. Criticisms of DSM-IV
High rates of comorbidity
High use of “Not Otherwise Specified” (NOS) category
Lack of laboratory markers
DSM-IV criteria are a decade old. Neuroscience has
moved very quickly in that time span.
Criteria lack validity/not based in etiology
American document

8. DSM-5 Development
2006-2007 DSM-5 Task Forces
2007-2013 DSM-5 Workgroups
Cross-cutting study groups
>50% of participants from outside
US
13 conferences, 10 monographs,
and >200 journal articles published
prior to release of DSM-5

9. Three Sections of DSM-5
Section I
• Preamble, definitions, cautionary statements
Section II
• 20 Mental disorder chapters
Section III
• Items requiring further research
• Emerging diagnoses
• Dimensional model of personality disorders
• Emerging measures
• Cross-cutting
• Symptom severity
Appendix

10. Changes in Framework
Abandon Roman numerals!
Fewer total disorders
Not Otherwise Specified
now called Unspecified
or Other Specified