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DSM-5-TR Summaries: Fourth Assignment
Aaron J. Harbaugh
School of Behavioral Sciences, Liberty University
FOURTH ASSIGNMENT 2
DSM-5-TR Summaries: Fourth Assignment
Disruptive, Impulse Control and Conduct Disorder / Feeding and Eating Disorders /
Sexual Disorder
Overview
Disruptive, Impulse Control, and Conduct Disorders, Feeding and Eating Disorders, and
Sexual Disorders as defined by the DSM-5-TR share common characteristics of significant
behavioral or psychological disturbances that impact daily functioning and well-being. These
disorders often involve patterns of behavior or thought that deviate from societal norms and
expectations, leading to distress or impairment. They typically require holistic information to
diagnose and a comprehensive treatment/approach that considers both psychological and
physiological factors. Additionally, these disorders can manifest early in life and persist into
adulthood, highlighting the importance of early intervention and ongoing support. Understanding
the underlying factors and symptoms is crucial for effective management and improving the
quality of life for those affected.
Disruptive, Impulse Control and Conduct
Overview
Disruptive, Impulse Control and Conduct Disorders are defined by the DSM-5-TR as a
group of disorders characterized by difficulties in controlling aggressive behaviors, self-control,
and impulses. Thus, the resulting behaviors or actions of the individual are typically considered a
threat primarily to others’ safety and societal norms, including fighting, destroying property,
defiance, stealing, lying, and rule-breaking. These disorders, which include Oppositional Defiant
Disorder, Intermittent Explosive Disorder, Conduct Disorder, Pyromania, Kleptomania, and
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others, are usually first observed in childhood and can persist into adulthood (DSM-5, 2022). It’s
important to note that these disorders involve a pattern of much more severe and longer-lasting
behaviors than what is developmentally appropriate (American Psychiatric Association, n.d.).
Disorders
Oppositional Defiant Disorder (ODD) is typified by a constellation of key characteristics
that include anger, irritability, argumentative or defiant behavior, and vindictiveness. The
manifestation of ODD symptoms often occurs in a singular setting, most commonly in the home
environment. The disorder is delineated by eight distinct symptom types and three diagnostic
criteria, with a diagnosis requiring the presence of at least six of the eight symptoms. Intermittent
Explosive Disorder (IED) is characterized by the abrupt onset of impulsive aggressive outbursts,
typically with minimal or absent prodromal period. It is critical to note that a diagnosis of IED
should not be assigned to children under the age of six, nor should the symptoms present within
the context of an adjustment disorder. Conduct Disorder is marked by repeated and persistent
violations of fundamental human rights or major age-appropriate societal norms or rules.
diagnosis of Conduct Disorder necessitates the presence of at least four symptoms. These
symptoms may encompass a range of behaviors, including but not limited to, altercations with
others, property destruction, involvement in criminal activities, and cruelty towards animals
which typically onset during childhood or adolescence.
Pyromania is characterized by multiple instances of intentional fire setting. The act of
setting fires is not a consequence of impaired judgment. The act of fire setting serves as a
mechanism to alleviate trauma, tension, anxiety, and/or arousal. Kleptomania is distinguished by
a defining characteristic: the inability to resist impulses to steal, even when the objects stolen do
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not serve the individual’s needs or possess monetary value. Typically, individuals with this
disorder avoid stealing when the probability of arrest is high, do not consider the likelihood of
apprehension, and commit thefts without the assistance of others. Other Specified Disruptive,
Impulse-Control and Conduct Disorder include disorders that can cause significant distress or
impairment in a person’s social, occupational, or other important areas of functioning but do not
meet the full criteria for any other disorder in this section. Unspecified Disruptive, Impulse-
Control, and Conduct Disorder includes disorders that can cause significant distress or
impairment in an individual’s social, occupational, or other important areas of functioning if they
are clinically significant. This category is assigned when the counselor/clinician elects not to
specify the reason that the criteria for the other diagnoses in this category are not met, often due
to insufficient information to make a specific diagnosis (DSM-5, 2022).
Risk and prognostic factors
Risk factors associated with Conduct Disorder encompass a variety of environmental and
genetic influences. Parental rejection and neglect, as well as other forms of child maltreatment,
including sexual abuse, have been identified as potential risk factors. Genetic predispositions
may also play a role, such as a parent having a diagnosis of Attention Deficit Disorder/Attention
Deficit Hyperactivity Disorder (ADD/ADHD) and Conduct Disorder (American Psychiatric
Association, 2022). A history of parental substance abuse and dependence, as well as parental
overindulgence, have also been identified as potential risk factors.
Feeding and Eating Disorders
Overview
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Feeding and Eating Disorders, as characterized by the DSM-5-TR, are persistent
disturbances of eating or eating-related behavior that result in altered consumption or absorption
of food (DSM-5, 2022). These disorders significantly impair physical health or psychosocial
functioning (Kenny et al., 2014). The disorders include anorexia nervosa, avoidant/restrictive
food intake disorder, binge eating disorder, bulimia nervosa, other specified feeding and eating
disorders, unspecified feeding and eating disorders, pica, and rumination disorders. Diagnostic
criteria are defined in the DSM-5-TR, which divides eating disorders into mutually exclusive
categories based on observed symptoms (DSM-5, 2022). Furthermore, body mass index is a new
measurement to determine the severity of certain diagnoses such as Anorexia nervosa (Kenny et
al., 2014).
Disorders
Pica is a disorder characterized by the consumption of objects not typically considered
food. The ingestion of non-food substances must persist for at least a month and be severe
enough to warrant clinical attention. These substances can include paper, soap, cloth, hair, string,
wool, soil, chalk, talcum powder, paint, gum, metal, pebbles, charcoal or coal, ash, clay, starch,
or ice. The minimum age for diagnosis is two years old. Rumination Disorder involves the
repeated regurgitation of food after feeding or eating over at least one month. Regurgitation is
frequent, occurring several times per week, typically daily. Previously swallowed food may be
brought up into the mouth without nausea, involuntary retching, or disgust. Avoidant/Restrictive
Food Intake Disorder is characterized by avoidance or restriction of food intake, resulting in
significant weight loss, nutritional deficiency, dependence on enteral feeding or nutritional
supplements, and interference with psychosocial functioning. This disorder includes food
avoidance based on the sensory characteristics of food and is also described as restrictive eating,
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selective eating, choosy eating, perseverant eating, chronic food refusal, and food neophobia.
This also includes the refusal to eat certain brands of foods and the inability to tolerate the smell
of food being eaten by others.
Anorexia Nervosa is characterized by low body weight, intense fear of gaining weight,
and persistent energy intake restriction. It can be classified by restricting type (F50.01), binge-
eating/purging type (F50.02) with specifiers of partial remission or in full remission and severity
including mild, moderate, severe, extreme. Bulimia Nervosa involves recurrent episodes of binge
eating, recurrent inappropriate compensatory behaviors to prevent weight gain, and self-
evaluation that is influenced by body shape and weight. Triggers include dietary restraint,
negative feelings related to body weight, body shape, food, and boredom. Individuals with this
disorder are typically ashamed of their eating problems and attempt to conceal them Binnge-
Eating Disorder is characterized by recurrent episodes of binge eating that must occur, on
average, at least once per week for three months. The amounts of food consumed are larger than
most people would eat in a similar period of time. This disorder is evident by marked distress,
including eating much more rapidly than normal, eating until feeling uncomfortably full, eating
large amounts of food when not feeling physically hungry, eating alone due to feeling
embarrassed by the amount of food being eaten, and feeling disgusted with oneself, depressed,
and guilty. Other Specified Feeding or Eating Disorder and Unspecified Feeding or Eating
Disorders are categories used when disorders cause significant distress or impairment in a
person’s social, occupational, or other important areas of functioning but do not meet the full
criteria for any other disorder in this section. These categories are used when the clinician
chooses to communicate the specific reason that an individual does not meet the other criteria for
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the named diagnosis in this category, or when the clinician decides not to specify the reason that
other criteria for other diagnoses in this section are not me (DSM-5, 2022).
Risk and Prognostic Factors
Anorexia nervosa is influenced by a range of risk and prognostic factors. Genetic
predisposition is significant, with studies indicating a higher risk among individuals with a
family history of eating disorders (DSM-5, 2022). According to Charrat et al. (2023),
psychological factors such as perfectionism, obsessive-compulsive traits, and high levels of
anxiety are critical contributors. Moreover, sociocultural influences, including societal pressure
to be thin and exposure to media promoting thinness, play a substantial role (Charrat et al.,
2023). Childhood trauma and abuse have also been linked to an increased risk of developing
anorexia nervosa (DSM-5, 2022).
Sexual Disorders
Overview
In the DSM-5-TR there are two main categories of sexual disorders; sexual dysfunctions
and paraphilic disorders. Sexual dysfunctions are characterized by an individual’s ability (or
inability) to respond sexually or to experience sexual pleasure. Disorders in this category include
but are not limited to Delayed Ejaculation, Erectile Disorder, and Female Orgasmic Disorder.
Shared characteristics of these disorders include distress and interpersonal difficulty related to
sexual dysfunction if the dysfunction is not better explained by a nonsexual mental disorder,
medical condition, or as a result of severe relationship distress or other significant stressors.
Paraphilic disorders, on the other hand, involve sexual interests that are considered to be atypical
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or extreme. This category includes but is not limited to Exhibitionistic Disorder, Fetishistic
Disorder, and Pedophilic Disorder. These disorders often involve sexual arousal from fantasies,
urges, or behaviors that are atypical and involve inanimate objects, children, nonconsenting
individuals, or the suffering or humiliation of oneself or the partner (DSM-5, 2022).
Disorders
Under the sexual dysfunctional category, there are several disorders in the DSM-5-TR
such as Delayed Ejaculation which involves a significant delay or absence of ejaculation during
sexual activity. Erectile Disorder is characterized by difficulty in achieving or maintaining an
erection. Female Orgasmic Disorder refers to a delay, infrequency, or absence of orgasm in
women. Female Sexual Interest/Arousal Disorder involves a lack of sexual interest or arousal in
women. Genito-Pelvic Pain/Penetration Disorder includes pain during intercourse or fear of pain,
leading to avoidance of sexual activity. Male Hypoactive Sexual Desire Disorder is marked by a
persistent lack of sexual thoughts or desire in men. Premature (Early) Ejaculation is when
ejaculation occurs within a minute of penetration and before the individual wishes it.
Substance/Medication-Induced Sexual Dysfunction involves sexual dysfunctions caused by
substance use or medication other Specified Sexual Dysfunction and Unspecified Sexual
Dysfunction are categories for sexual dysfunctions that do not fit into the other specific
categories.
The DSM-5-TR lists several paraphilic disorders, each with distinct characteristics.
Exhibitionistic Disorder involves intense sexual arousal from exposing one’s genitals to an
unsuspecting person. Fetishistic Disorder is characterized by sexual arousal from non-living
objects or specific non-genital body parts. Frotteuristic Disorder involves sexual arousal from
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touching or rubbing against a non-consenting person. Pedophilic Disorder is marked by
recurrent, intense sexual fantasies, urges, or behaviors involving sexual activity with a
prepubescent child. Sexual Masochism Disorder involves sexual arousal from being humiliated,
beaten, bound, or otherwise made to suffer. Sexual Sadism Disorder is characterized by sexual
arousal from the physical or psychological suffering of another person. Transvestic Disorder
involves sexual arousal from cross-dressing, which causes significant distress or
impairmentVoyeuristic Disorder is marked by sexual arousal from observing an unsuspecting
person who is naked, in the process of disrobing, or engaging in sexual activity
Risk and Prognostic Factors
Delayed ejaculation can be influenced by several risk and prognostic factors. According
to Rowland (2017), age is a significant factor, with older men more likely to experience this
condition due to natural declines in sexual function. Medical conditions such as diabetes,
multiple sclerosis, and spinal cord injuries are also associated with an increased risk
Psychological factors, including anxiety, depression, and high levels of stress, play a crucial role
in the development of delayed ejaculation (DSM-5, 2022). Certain medications, particularly
antidepressants and antipsychotics, can interfere with ejaculation (Rowland, 2017). Additionally,
lifestyle factors such as excessive alcohol consumption and smoking may contribute to the
condition.
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References
American Psychiatric Association. (2022). Diagnostic and Statistical Manual of Mental
Disorders (5th ed., text rev.)
American Psychiatric Association. (n.d.). What are disruptive, Impulse Control and conduct
disorders?. Psychiatry.org - What are Disruptive, Impulse Control and Conduct
Disorders? https://www.psychiatry.org/patients-families/disruptive-impulse-control-and-
conduct-disorders/what-are-disruptive-impulse-control-and-conduct
Charrat, J.-P., Massoubre, C., Germain, N., Gay, A., & Galusca, B. (2023). A systematic review
of prospective studies assessing risk factors to predict anorexia nervosa onset. Journal of
Eating Disorders, 11(1). https://doi.org/10.1186/s40337-023-00882-0
Kenny, M. C., Ward-Lichterman, M., & Abdelmonem, M. H. (2014). The expansion and
clarification of feeding and eating disorders in the DSM-5. The Professional Counselor,
4(3), 246–256. https://doi.org/10.15241/mck.4.3.246
Rowland, D. L. (2017). Evaluation of delayed ejaculation. The Textbook of Clinical Sexual
Medicine, 241–254. https://doi.org/10.1007/978-3-319-52539-6_16
