DSM-5 Summaries
Author Note
DSM-5 Summaries: Disruptive, Impulse Control, and Conduct Disorders,
Sexual Dysfunctions, and Gender Dysphoria
School of Behavioral Sciences, Liberty University
1
DSM-5 Summaries2
DSM-5 Summaries: Disruptive, Impulse Control, and Conduct Disorders,
Sexual Dysfunctions, and Gender Dysphoria
All the following information was taken from the Diagnostic and Statistical Manual 5th
Edition (American Psychiatric Association, 2013) unless otherwise noted.
Disruptive, Impulse Control, and Conduct Disorders
Overview
These disorders are characterized emotional and behavioral problems that involve social
conflicts and the violation of others’ rights. All the disorders listed in this section either violate
social norms or the rights of others.
Disorders
Oppositional Defiant Disorder
This is diagnosed when an individual meets four or more of the criteria within 6 months,
and the symptoms surpass normative behavior for the person’s age, gender, and culture. For this
disorder, there are patterns of angry/irritable mood, argumentative/defiant behavior, or
vindictiveness.
Intermittent Explosive Disorder
The individual displays uncontrolled behavioral outbursts of either verbal (minimum
twice weekly for 3 months) or physical (three occurrences in 12 months) aggression. It is
characterized by an inability to control aggression in response to a minor provocation.
Conduct Disorder
For this disorder, there is a consistent and repeating pattern of behavior that violates the
rights of others. This could include behaviors of aggression against people or animals,
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nonaggressive but destructive behavior toward property, deceit or theft, and violation of rules.
Diagnosis is divided into subtypes and specifiers based on age, emotional affect, and severity.
Antisocial Personality Disorder
Listed under personality disorders, this disorder is associated with features of disregard
and violation for the rights of others. The behaviors are present in childhood or adolescence and
continue into adulthood. For diagnosis, the individual must be at least 18 and have a history of
conduct disorder present prior to 15. The patterns displayed in behavior for diagnosis are also
referred to as psychopathy, sociopathy, or dyssocial personality disorder.
Pyromania
This is characterized by multiple, deliberate instances of purposefully setting fires
accompanied by feelings of tension or arousal prior to setting the fires. Individuals are fascinated
with all aspects of fire and experience relief or pleasure after seeing one set. The fire setting is
not done for reasons extending beyond the gratification felt when the act is performed.
Kleptomania
This is characterized by repeatedly and impulsively stealing things that the individual
does not need or want for monetary gain. The thefts are accompanied by feelings of tension prior
to the act and gratification post-theft. The thievery is not done for reasons extending beyond the
relief, pleasure, or gratification felt when the act is performed.
Other Specified Disruptive, Impulse-Control, and Conduct Disorder
The symptoms for a disruptive, impulse-control, and conduct disorder are present but do
not fully meet any of the criteria for any diagnosis in this category. The clinician specifies the
reason the criteria are not met for a definitive diagnosis.
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Unspecified Disruptive, Impulse-Control, and Conduct Disorder
The symptoms for a disruptive, impulse-control, and conduct disorder are present by do
not fully meet any of the criteria for a specific diagnosis. The clinician does not specify the
reason a diagnosis cannot be achieved.
Risk and Prognostic Factors
The risk and prognostic factors for conduct disorder include the individual’s
temperament, environment, genetics, and physiology. Persons who displayed difficult
temperaments as infants, low intelligence, and low verbal IQ are higher risk. As are children with
biological parents who suffer from disorders like alcohol use, depression, bipolar, schizophrenia,
ADHD, or conduct. Environmental factors include parental rejection/neglect, inconsistent
parenting, harsh discipline, physical/sexual abuse, lack of supervision, institutionalization,
frequent changes in caregivers, large families, criminal history of parents, and having parents
with substance-related disorders. Experiencing rejection by peers or exposure to violence and
delinquent relationships also increases one’s risk of conduct disorders.
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Sexual Dysfunctions
Overview
These disorders are classified as disturbances that effect a person’s ability to respond to
or experience sexual pleasure. Dysfunctions in this category can be categorized as lifelong,
acquired, generalized, or situational.
Disorders
Delayed Ejaculation
This is characterized by a reported delay or infrequency of ejaculation occurring in 75%-
100% of partnered sexual activity with a persistence lasting at least 6 months. Specifiers are
added concerning whether the dysfunction is lifelong, acquired, generalized, or situational and
according to severity.
Erectile Disorder
This disorder is marked by the individual’s inability to obtain or maintain erections
during at least 75%-100% of sexual activity for at least 6 months. The specifiers are for
whether the disorder is lifelong, acquired, generalized, or situational and according to severity.
Female Orgasmic Disorder
Individuals with this disorder experience either a delay, infrequency, or absence of
orgasm or a reduction of intensity in orgasmic sensations for 75%-100% of sexual activity for
at least 6 months. There are specifiers for context, situation, and severity.
Female Sexual Interest/Arousal Disorder
A diagnosis of this disorder requires an absence or reduced frequency/intensity of sexual
interest or arousal indicated by at least three of six indicators lasting a minimum of 6 months.
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Additionally, there must be the existence of clinical distress because of the symptoms. Specifiers
are included to note situation, context, and severity.
Genito-Pelvic Pain/Penetration Disorder
Typically, in this diagnosis, four symptoms are present: difficulty having intercourse,
genito-pelvic pain, fear of pain or penetration, and tension of the pelvic floor muscles. However,
a diagnosis can be made from one symptom. The symptom(s) must be present for at least 6
months and cause the individual distress. There are specifiers for whether the disorder is lifelong
or acquired and to note the severity.
Male Hypoactive Sexual Desire Disorder
Individuals with this diagnosis have both a low/absent desire for sex and a lack of sexual
thoughts or fantasies that lasts for a minimum of 6 months. It is accompanied by specifiers that
address context, situation, and severity.
Premature (Early) Ejaculation
Criteria for this dysfunction are established specifically related to vaginal penetration. It
involves repeated patterns of ejaculation within 1 minute of vaginal penetration, before the
individual wishes to ejaculate. It occurs with 75%-100% of partnered sexual activity and has
lasted a least 6 months. Specifiers include context, situation, and severity.
Substance/Medication Induced Sexual Dysfunction
Marked by a disturbance in sexual function that is related to substance/medication
initiation, discontinuation, or dosage change. Specifiers note whether the dysfunction occurs
during intoxication, withdrawal, or after medication use and mark the severity.
Other Specified Sexual Dysfunction
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The symptoms for a sexual dysfunction are present by do not fully meet the criteria for
diagnosis. The clinician specifies that reason that a diagnosis was not made.
Unspecified Sexual Dysfunction
The symptoms for sexual dysfunction are present but do not fully meet the criteria for
diagnosis. The clinician does not specify the reasons that a diagnosis was not made.
Risk and Prognostic Factors
The risk and prognostic factors for men experience hypoactive sexual desire disorder
include temperament, environment, genetics, and physiology. Decreased desire is associated with
mood, anxiety, self-esteem, perceived understanding of his partner’s sexual desire toward him,
and emotional connection. Environmental factors may include alcohol use, trauma, lack of sex-
education, internalized homophobia for gay men, and interpersonal problems. Genetics and
physiology like endocrine disorders, age, and testosterone levels can also predict risk.
Gender Dysphoria
Overview
Gender dysphoria is categorized by the feeling of incongruence with one’s assigned
gender and their expressed/experienced gender. The diagnostic criteria are separated based on
age, with different criteria for children, adolescents, and adults.
Disorders
Gender Dysphoria in Children
Individuals experiencing this have feelings of conflict concerning their birth gender and
their experienced/expressed gender. The feelings must persist for at least 6 months and are shown
through the expression of at least six of eight listed criteria. If the individual also has a disorder
of sex development, that is specified with the diagnosis.
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Gender Dysphoria in Adolescents and Adults
For a diagnosis of gender dysphoria in this age group, the individual has conflicting
feelings concerning their birth gender and expressed gender that persist for at least 6 months.
These feelings are manifested by at least two of six listed criteria. If there is a disorder of sex
development, that is coded along with the diagnosis. Other specifiers include whether the
individual is posttransition.
Other Specified Gender Dysphoria
The symptoms of gender dysphoria are present but not to the extent needed to meet the
criteria for a diagnosis. The clinician specifies the reason a diagnosis cannot be met.
Unspecified Gender Dysphoria
The symptoms of gender dysphoria are present but do not meet the full criteria for the
diagnosis. The clinician does not provide a reason.
Risk and Prognostic Factors
Risk and prognostic factors for gender dysphoria include individual temperament,
environment, genetics, and physiology. If there is not a sex development disorder, there is
typically a display of atypical behavior beginning in early preschool age. Environmentally, males
with older brothers are more likely to exhibit gender dysphoria than those without. Additionally,
individuals who fetishize transvestism are higher risk for developing gender dysphoria.
Genetically, there is evidence of some heritability of gender dysphoria but not enough to label it
as a genetic form of intersexuality. Physiologically, there are higher rates of gender dysphoria for
individuals who initiated gender change than individuals with a disorder of sex development.
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References
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders:
DSM-5™ (5th ed.). American Psychiatric Publishing, Inc. https://doi-
org.ezproxy.liberty.edu/10.1176/appi.books.9780890425596
