New Edition of Manual Will Be Known as DSM-5-TR
It has been nine years since the American Psychiatric Association (APA) issued the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). At the time of publishing, DSM-5 made sweeping changes to the way autism spectrum disorder (ASD) was diagnosed when it consolidated four labels – autistic disorder, Asperger’s Syndrome, childhood disintegrative disorder and pervasive developmental disorder, not otherwise specified – under the umbrella diagnosis of ASD. Earlier this month, the APA released the newest revision of the manual, which is referred to as the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision (DSM-5-TR). This new version includes small changes to the definitions of both autism and intellectual disability. These adjustments were made to help further clarify both diagnoses. Two changes were included for autism. The first allows clinicians to describe related behaviors that are not severe enough to be recognized as a separately diagnosable condition (e.g., self-jury). The earlier DSM-5 referred to these circumstances as “associated with another neurodevelopmental, mental or behavioral disorder.” Now, the DSM-5-TR refers to the same situation as, “associated with a neurodevelopmental, mental, or behavioral problem.” The second change revolves around clarifying diagnostic criteria for social interactions. The DSM-5 required an ASD diagnosis to include “persistent deficits in social communication and social interaction across multiple contexts, as manifested by the following: deficits in social-emotional reciprocity, in nonverbal communicative behaviors used for social interaction, and in developing, maintaining and understanding relationships.” DSM-5-TR revised that wording. It now reads, “as manifested by all of the following.” This change was made to remove confusion over the inclusion of one, two or three of the deficits. The new manual also includes a name change. Intellectual disability will now be labeled “intellectual developmental disorder (intellectual disability)” which aligns more closely to the World Health Organization’s disease classification system that uses the term “disorders of intellectual development.” Additionally, intellectual developmental disorder will include revised language which clarifies that the diagnosis “should not be bound narrowly to the 65-75 IQ score range, the diagnosis would not be appropriate for those with substantially higher IQ scores.” Moving forward, advocates do not view any of these changes as having a significant impact on diagnoses.
