DSM-5=TR
“All of the following information was taken from the Diagnostic and Statistical Manual 5th
Edition, Text Revision (American Psychiatric Association, 2022) unless otherwise noted.”
Substance-related and Addictive Disorders
Overview
Substance-related and Addictive Disorders involve problematic or addictive use of
alcohol, drugs, and medications. According to the DSM-5, common features include impaired
control, cravings, and negative consequences resulting from substance use. Tolerance, which
requires more substance to have the desired effect, indicates abstinence-related withdrawal
symptoms and more time spent on getting, using, and recovering from drugs (APA, 2022).
Maintaining substance use amid relationship problems is also a common feature for all SUDs.
Due to substance use missing important social and leisure activities (APA, 2022). Using the
DSM-5, physicians can group SUDs into three categories depending on the symptoms; if the
patient experiences less than 3 symptoms, they have mild SUD; 4 to 5 symptoms, then they have
moderate SUD; while for severe cases, the patient must exhibit at least six symptoms (APA,
2022).
Disorders
Alcohol Use Disorder: Physical and psychological dependence on alcohol results from this
disorder. Tolerance, withdrawal, and unsuccessful attempts to cut down or control drinking (APA,
2022).
Opioid Use Disorder: This illness involves problematic opioid use, including prescription
medications and heroin (APA, 2022). Strong cravings, tolerance, and withdrawal are key
characteristics among individuals with opioid use disorder.
Cannabis Use Disorder: This disorder is characterized by excessive and problematic cannabis use,
poor functioning, withdrawal symptoms, and failed attempts to quit (APA, 2022).
Stimulant Use Disorder: People with Stimulant Use Disorder overuse cocaine or
methamphetamine. Cravings, abandonment of important tasks, and recurrent usage in dangerous
settings are among this disorder's most common and unique symptoms (APA, 2022).
Risk and Prognostic Factors for OUDs
Risk factors for Opioid Use Disorder include a family history of substance abuse, a prior history
of addiction, and the availability of opioids. Comorbid mental health disorders and evidence-
based treatments are prognostic variables (APA, 2022). Opioids may also increase the risk of
overdose in patients with certain medical problems; examples are advanced age (65+) and
respiratory disorders, including Sleep Apnea, Asthma, and COPD (APA, 2022).
Trauma and stressor-related disorders
Overview
Trauma and Stressor Related Disorders involve psychological reactions to traumatic or stressful
events. This event can be directly experienced, witnessed, or learned about happening to a close
family member or friend (APA, 2022). Some common features across these disorders, as
highlighted in the DSM-5, include unwanted thoughts that make the patient uneasy, avoiding
others, negative changes in mood and cognition, and increased arousal (APA, 2022). These
symptoms should start during or shortly after the trauma and last up to four weeks before
reassessing the diagnosis, per the DSM-5. They should last three days to four weeks before
reevaluation.
Disorders:
Post-Traumatic Stress Disorder (PTSD): After a traumatic experience, PTSD symptoms include
flashbacks, nightmares, avoidance of reminders, and hyperarousal (APA, 2022).
Acute Stress Disorder: This disorder can continue two to four weeks after a severe experience and
is akin to PTSD. For an individual to be diagnosed with ASD, they must experience nine or more
symptoms from five categories: intrusion, mood problems, dissociation with people, avoidance of
people, and arousal appearing or worsening after a traumatic event (APA, 2022). Intrusion
symptoms refer to the recurring, painful memories of the trauma (APA, 2022). The memories
unavoidably invade one's thoughts and cause mental distress.
Adjustment Disorders: Emotional and behavioral symptoms appear three months after a stressor.
These symptoms are more severe than expected and cause significant distress (APA, 2022). These
symptoms, including work and social relationships, must seriously impair the patient's daily life
(APA, 2022). Daily life disturbance should be worse than predicted from the triggering event.
Clinicians may be subjective about this element of diagnosis since cultural and external variables
affect how people cope with and respond to such situations.
Risk and Prognostic Factors for PTSD
PTSD risk factors include earlier trauma, childhood experiences, severity, lack of social
support, and preexisting mental health disorders. Early intervention, effective therapy, and social
support contribute to prognosis (APA, 2022). Women are more likely than men to develop PTSD,
and genetics may play a role (APA, 2022). However, it is vital to emphasize that PTSD patients
are not weak or deficient (APA, 2022). The primary factor influencing the likelihood of
developing PTSD is the nature and frequency of exposure to traumatic events.
Obsessive-compulsive and Related Disorders
Overview
Obsessive-compulsive and Related Disorders involve intrusive, unwanted thoughts and repetitive
mental acts/behaviors (compulsions) to reduce distress. Common features include time-
consuming behaviors and the interference of obsessions and compulsions in daily life (APA,
2022). To diagnose any of these disorders, the DSM-5 requires severe symptoms that cause
considerable discomfort or challenges in handling social and occupational activities or other vital
areas of functioning. A mental health professional must evaluate the patient to diagnose and treat
them (APA, 2022). Treatment for these problems usually involves CBT, medication, or both.
Disorders
Obsessive-Compulsive Disorder (OCD): OCD is characterized by recurrent, distressing
obsessions leading to ritualistic compulsions (APA, 2022). OCD individuals utilize repetitive
routines to calm their anxieties.
Body Dysmorphic Disorder: Body Dysmorphic Disorder (BDD) is a mental illness that causes an
obsessive obsession with physical flaws. BDD individuals obsess over this imagined fault, which
may not exist (APA, 2022). They may spend hours a day trying to fix or hide this perceived fault,
frequently with cosmetic surgeries or excessive exercise (APA, 2022). BDD individuals often
obsess about their appearance in mirrors, compare themselves to others, and avoid social
situations and photos due to their perceived defect (APA, 2022). Counseling or psychotherapy to
address body image issues and antidepressants to reduce anxiety and obsessive thoughts are
typical BDD treatments.
Hoarding Disorder: Difficulty discarding items causes clutter and functional impairment.
Hoarders typically attach strong sentimental value to their belongings (APA, 2022).
Risk and Prognostic Factors for OCD
A family history of OCD, early symptom onset, and associated mental health problems are
risk factors for OCD. A first-degree relative (parent, sibling) with OCD increases the likelihood of
getting OCD (APA, 2022). Research suggests that orbitofrontal cortex, anterior cingulate cortex,
and basal ganglia anomalies may produce obsessive-compulsive symptoms (APA, 2022).
Childhood trauma, abuse, and other stressors may raise OCD risk. Trauma can worsen symptoms
in vulnerable people. Prognostic factors involve the type and intensity of treatment, willingness to
engage in therapy, and the presence of a strong social support system.
