DSM-5-TR Summaries: Second Assignment
Brittany Phillips
Department of Counselor Education and Family Studies, Liberty University
Author Note
Brittany Phillips
I have no known conflict of interest to disclose
Correspondence concerning this article should be addressed to Brittany Phillips
Email: bnphillips8@liberty.edu
Substance-Related and Addictive Disorders
The topic of substance-related disorders covers 10 different classes of drugs; alcohol,
caffeine, cannabis, hallucinogens, inhalants, opioids, sedatives, hypnotics, stimulants, tobacco,
and other. These drugs all implement a feeling of being “high”, or feeling pleasure. When it
comes to substances, there are two groups: substance use disorders and substance-induced
disorders. The latter would be considered intoxication, withdrawal, and substances induced
mental disorders.
There is a higher prevalence for drug usage in almost every substance in individuals aged
18-24. It’s also important to note that when it comes to substance use, there is often times a
high comorbidity with other substances.
Anyone who uses drugs from any of the 10 classes can be diagnosed with substance use
disorder. In these individuals, we see that there are symptoms which are caused by use. It’s
important to note that individuals with substance use disorder will likely struggle with it forever,
even after they’ve detoxed. This is due to chemical alterations in the brain which cannot be
repaired. As a counselor, it’s important to note the drug type along with the class.
Substance-induced disorders come when an individual is partaking in substance use or
actively withdrawing. In this instance, we see the problematic behaviors occur while in these
states. Using or withdrawing from substances can cause impairment in social and occupational
functioning as well as other symptoms such as psychosis. Counselors should be aware that while
recording withdrawal, usage, and comorbidity, there are different codes.
Substance-induced mental disorders occur when a substances causes, what appears to
be, a mental disorder such as depression or psychosis. We see this when symptoms do not
occur prior to medication or substance use.
Gambling use disorder is the final disorder, which is not substance related, that is in the
substance-related and addictive disorders section of the DSM-5-TR. It consists of a need to
gamble, irritability when attempting to stop, has been unsuccessful in stopping, is preoccupied
with gambling, uses it as a coping mechanism, returns after losing, lies to conceal gambling, has
suffered consequences due to gambling, and relies on others to provide due to lack of money.
Trauma- and Stressor -Related Disorders
In the instance of trauma- and stressor -related disorders, there has to be a traumatic
event or stressful experience. Disorders that fall under this category are: reactive attachment
disorder, disinhibited social engagement disorder, posttraumatic stress disorder (PTSD), acute
stress disorder, adjustment disorders, and prolonged grief disorder. It’s important to note that
there are differences between anxieties or fears and traumas.
In reactive attachment disorder, a child does not developmentally attach to a caregiver
and does not seek them out for comfort. These individuals do not show happiness often but
readily portray unexplained irritability, sadness, or fearfulness. In this case, the child has also
experienced extreme insufficient care. This disorder is more prevalent in children who have
been severely neglected and then placed into foster care or other facilities.
Disinhibited social engagement disorder occurs when a child actively approaches
strangers with no hesitation, without checking with an adult, using familiar language, or
reduced thoughts in approaching. Extremes in insufficient care are prevalent within this
disorder as well. This disorder is rare and typically occurs in minorities but stems from severe
neglect.
Posttraumatic stress disorder can occur in individuals in all ages but has different criteria
for those aged 6 an older than it does for those under the age of 6. PTSD requires exposure to a
traumatic even whether it be it happening to them or witnessing it happen. PTSD can also
come from learning of someone else’s trauma or repeated exposure to a traumatic event. An
individual must have recurrent and intrusive memories or dreams of the event, flashbacks,
prolonged psychological distress, or physiological reactions. There must be an avoidance of
stimuli regarding the event. There must be at least two negative alterations in cognition and
mood. Finally, there has to be alterations in reactivity such as hypervigilance or self-destructive
behavior. All of these behaviors must occur for more than one month. It’s important to note
that anyone can be diagnosed with PTSD.
Acute stress disorder is similar to PTSD but in this situation, symptoms only occur for as
little as 3 days up to 1 month.
Adjustment disorders is the development of symptoms in response to a stressor within 3
months of the stressor but must resolve within 6 months of the end of the stressor. It’s
important that the symptoms do not meet criteria for any other disorder such as prolonged
grief disorder. This is a common disorder which is higher in women than men.
Prolonged grief disorder is only diagnosed 12 months, 6 in children, after someone has
passed away that they had a close relationship with.
Obsessive-compulsive and Related Disorders
The chapter of obsessive-compulsive and related disorders consists of obsessive-
compulsive disorder (OCD), body dysmorphia disorder, hoarding disorder, trichotillomania,
excoriation disorder, substance/medication induced obsessive-compulsive and related disorder,
obsessive-compulsive and related disorder due to another medical condition, other specified
obsessive-compulsive and related disorders, and other unspecified obsessive-compulsive and
related disorders. Obsessions are intrusive and recurrent thoughts while compulsions are
repetitive behaviors.
OCD varies in its degrees depending on self-awareness. Within this disorder, time must
be taken up and/or cause impairment. Obsessions must not be something that the individual
find pleasure in, typically causing distress or anxiety. Obsessions can be something like the
house burning down or violent like having the urge to stab someone. Compulsions are a
response to an obsession, so if a person obsesses over the house burning down, they may check
the coffee pot 3 times before they leave. Individuals with OCD don’t need obsessions and
compulsions but most times they have both.
Body dysmorphia has more than one type and people can think different things about
themselves while still having the disorder. These individuals get stuck on a physical flaw that
others may not see and hate their bodies for it. These individuals are often comparing
themselves to others or doing things to make themselves look or feel better/fix the problem.
This disorder is more prevalent in women than men but only by .3%.
Hoarding disorder occurs when an individual has an influx of items and cannot bare to
part with any items. There is a distress associated with throwing away items, even items as
simple as newspapers. These individuals may be living in a home that they are unable to really
live in due to clutter. Hoarding is a disorder that starts early in life and stays with an individual
until late in life, if not until they die.
Trichotillomania is a disorder in which an individual pulls their hair out, the hair can be
from the head, arms, eyebrows, eyelashes, etc. Hair pulling can fluctuate due to anxiety or just
different times of the day. This disorder required hair loss, though this can be tricky due to
patterned pulling by the individual or hiding with makeup, wigs, or long clothing.
Excoriation disorder exists when an individual picks their skin and creates lesions. Picking
can take up several hours of an individuals day and can occur on any area of skin; new or
blemished. Picking must cause impairment and in order to be diagnosed, the individual must
have repeated attempts to stop. Picking can be triggered by anxieties, boredom, or pleasure.
When it comes to obsessions and compulsions, it’s important to note that they can be
onset by substance/medication-induced. Drugs like methamphetamines and cocaine can make a
person pick at their skin, this could be considered a substance-induced obsessive-compulsive
related disorder. In these cases, the obsessive-compulsive and related disorder symptoms must
occur after drug use and not be prevalent prior to.
References
American Psychiatric Association. (2022). Diagnostic and statistical manual
of mental disorders (5th ed., text
rev.). https://doi.org/10.1176/appi.books.9780890425787
