DSM-5-TR SUMMARIES 2
DSM-5-TR Summaries: Fourth Assignment
Sexual Dysfunctions
Overview
Sexual dysfunctions include: delayed ejaculation, erectile disorder, female orgasmic
disorder, female sexual interest/arousal disorder, Genito-pelvic pain/penetration disorder, mal
hypoactive sexual desire disorder, premature (early) ejaculation, substance/medication induced
sexual dysfunction, other specified sexual dysfunction, other specified sexual dysfunction, and
unspecified sexual dysfunction. Sexual dysfunctions are characterized by a significant
disturbance in a person’s ability to respond sexually or to experience sexual pleasure. Those
diagnosed with a sexual dysfunction may have multiple at one time. They have to have had
symptoms for at least six months and cause significant distress to the person.
Disorders
Delayed ejaculation can be diagnosed by an individual’s inability to achieve, delayed or
infrequency of ejaculation in all or almost all sexual occasions of partnered sexual activity
despite having the desire to ejaculate. Erectile disorder is when an individual has difficulty in
getting and maintaining an erection. Female orgasmic disorder is when there is difficulty
experiencing an orgasm or a decrease in intensity of an orgasm. Female sexual interest/arousal
disorder is when there is an absence or significant reduction in frequency of three or more of the
six indicators. Genito-pelvic pain/penetration disorder can be diagnosed by one or more of the
following persisten or recurrent difficulties: vaginal penetration during intercourse, marked
vulvovaginal or pelvic pain during vaginal intercourse or penetration attempts, marked fear or
anxiety about pain as a result of vaginal penetration, marked tensing or tightening of the pelvic
floor muscles during attempted vaginal penetration. Male hypoactive sexual desire disorder can
DSM-5-TR SUMMARIES 3
be diagnosed by an individual having both low desire for sex and deficient sexual thoughts or
fantasies. To diagnose premature early) ejaculation the individual will have persistent or
recurrent pattern of ejaculation occurring during partner3d sexual activity within one minute of
vaginal penetration and before the individual would like to ejaculate. Substances/medication-
induced sexual dysfunction is caused using substances or medications, where there may not have
been problems before. Other specified sexual dysfunction and unspecified sexual dysfunctions
are sexual dysfunctions not caused by one of the more specific diagnoses.
Risk and Prognostic Factors
Female sexual interest/arousal disorder risk can include temperamental factors that
include negative cognitions and attitudes about sexuality and past history of mental disorders, as
well as environmental factors that can include relationship difficulties, partner sexual functioning
and developmental history. Genetic and physiological factors can include medical conditions
such as diabetes mellitus and thyroid dysfunction. Low desires have been reported across the
world, so this is not specific to one culture. By definition this disorder affects women only. This
disorder has also been associated with decrease in relationship satisfaction.
DSM-5-TR SUMMARIES 4
Feeding and Eating Disorders
Overview
Feeding and eating disorders include the following symptoms: a continuous disruption of
ingesting or ingesting-related actions, whose outcome is adjustable eating or consumption of
food that notably stifles physical wellness or psychological functionality. Of the feeding and
eating disorders there are pica, rumination disorder, avoidant/restrictive food intake disorder,
anorexia nervosa, bulimia nervosa, binge-eating disorder, and other specified feeding or eating
disorder.
Disorders
Pica can be diagnosed by incessant consumption of unhealthy, inedible items over a
period of one month or more. Rumination disorder can be diagnosed by repeated regurgitation of
food over a period of at least one month, regurgitated may be re-chewed, re-swallowed, or spit
out. Avoidant/restrictive food intake disorder can be diagnosed by an eating or feed disturbance
(lack of interest in eating or food, avoidance based on a sensory issue with the food, or concern
about aversive consequences of eating) associated with on or more of the following: significant
weight loss, significant nutritional deficiency, dependence on enteral feeding or oral nutritional
supplements, and/or marked interference with psychosocial functioning. Anorexia nervosa can
be diagnosed by the intense fear of gaining weight or of becoming fat, or persistent behavior that
interferes with weight gain, even though the individual is at a significantly low weight. Bulimia
nervosa can be diagnosed by an individual’s recurrent inappropriate compensatory behaviors in
order to prevent weight gain, such as self-induced vomiting, misuse of laxatives, diuretics, or
other medications, fasting or excessive exercise. Binge-eating disorders are recurrent episodes of
eating more rapidly than normal, until feeling uncomfortably full, eating large amounts of food
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when not feeling physically hungry, feeling disgusted with oneself, depressed, or very guilty
afterwards. Other specified feed or eating disorders are diagnosed by significant distress or
impairment in social, occupational, or other important areas of life that are not met due to eating
or feeding disorders.
Risk and Prognostic Factors
Anorexia nervosa risk and prognostic factors include temperamental issues such as
anxiety disorder or display obsessional traits in childhood. Environmental factors include issues
where thinness is valued in a person. There is an increased risk for anorexia nervosa in a person
that has relatives that have been diagnosed with eating and other psychiatric disorders. Anorexia
nervosa is a worldwide problem, it does not stay with one culture more than another.
DSM-5-TR SUMMARIES 6
Sleep-Wake Disorders
Overview
Sleep-wake disorders include insomnia disorder, hypersomnolence disorder, narcolepsy,
breathing-related sleep disorders, circadian rhythm sleep-wake disorders, non-rapid eye
movement (NREM) sleep arousal disorders, nightmare disorders, rapid eye movement (REM)
sleep behavior disorder, restless legs syndrome, and substance/medication-induced sleep
disorder.
Disorders
Individuals with these disorders typically have complaints about the quality, timing and
amount of sleep resulting in daytime distress and impairment. For insomnia disorder the
individual will be dissatisfied with the quantity or quality of sleep due to either difficulty
initiating or maintaining sleep. Hypersomnolence disorder the individual will have symptoms of
excessive quantity of sleep (such as extended nocturnal sleep or long naps), sleepiness, and sleep
inertia (period of impaired performance and reduced vigilance following awakening from regular
sleep episodes). Narcolepsy can be diagnosed by an individual experiencing recurrent daytime
naps or lapses into sleep that occur typically during the day and have one or more of the
following: cataplexy, hypocretin deficiency, or characteristic abnormalities on a nocturnal
polysomnogram. Breathing-related sleep disorders involve an individual that show evidence by
polysomnography of at least five obstructive apneas or hypopneas per hour of sleep with the
following symptoms: nocturnal br3athing disturbances, snoring, snorting/gasping, or breathing
pauses during sleep, daytime sleepiness, fatigue, or unrefreshing sleep despite sufficient time to
sleep that is not better explained by another mental disorder or medical condition. Circadian
rhythm sleep-wake disorder the individual will have a persistent or recurrent pattern of sleep
DSM-5-TR SUMMARIES 7
disruption that is primarily due to an alteration of the circadian system. NREM sleep arousal
disorder the individual will experience recurrent episodes of incomplete awakening from sleep.
Nightmare disorder can be diagnosed by an individual experiencing repeated occurrences of
extended, extremely dysphoric, and well-remembered dreams usually involving efforts to avoid
threats. REM sleep behavior disorder the individual will experience repeated episodes of arousal
during sleep associated with vocalization. Restless legs syndrome the individual will have an
urge to move the legs usually accompanied by or in response to uncomfortable and unpleasant
sensations in the legs. Lastly substance or medication-induced sleep disorder occurs after the use
of substances or medications when there was not previously issues.
Risk and Prognostic Factors
Insomnia disorder risks and prognostic factors include anxiety or worry-prone personality
or cognitive styles. Environmental factors include noise, light, uncomfortably high or low
temperatures. Female sex and advancing ages are associated with vulnerability to insomnia.
Excessive use of caffeine and irregular sleep schedule can also cause insomnia. Insomnia is a
universal human experience. Females are more prone to insomnia especially following the birth
of a child or menopause.
