What is the difference between dsm 4 and 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 Brainscape's GRE Psychology flashcards.

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.

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 details on PTSD Symptoms

Partly due to the wars in Iraq and Afghanistan, medical researchers have gained a great deal more insight into Post Traumatic Stress Disorder (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.

At the time of this writing, the discussions of the DSM-6 manual are already underway.  Please contact us if you'd like us to make a similar summary for that next update!

And if you're studying for the Psychology GRE yourself, be sure to check out Brainscape's GRE Psych flashcards. They're constantly updated with the latest changes in psychology research and for each new version of the DSM.

Best of luck on your psychology career explorations either way!