What Is the DSM? - Definition & Characteristics

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  • 0:00 The DSM
  • 2:15 Diagnosis
  • 5:42 Types of Disorders
  • 10:43 Lesson Summary
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Lesson Transcript
Instructor: Natalie Boyd

Natalie is a teacher and holds an MA in English Education and is in progress on her PhD in psychology.

How do mental health workers keep track of the hundreds of mental disorders in existence? When looking up and diagnosing psychological disorders, they refer to the DSM, or the Diagnostic and Statistical Manual of Mental Disorders.

The DSM

Imagine that you are a psychologist, and Pat comes to your office. He says he feels like he's going crazy. He sometimes feels like he's having heart attacks, but the doctor says there's nothing wrong with his heart. During these attacks, he sweats a lot, his heart pounds, and he feels like he his choking. Sometimes, he feels dizzy and thinks he might be dying. How do you decide what's wrong with Pat, and how do you treat him?

The Diagnostic and Statistical Manual of Mental Disorders, or DSM for short, is a text that provides the requirements to diagnose a mental disorder, along with statistics and suggested course of treatment for different psychological disorders. The DSM has gone through many revisions, and the most current version is the DSM-5.

Think of it like a cookbook, except instead of looking for a recipe, you are eating something and trying to figure out what it is. In this case, you are going to look through the cookbook to match up the ingredients with the name of the recipe. Maybe you are eating something with macaroni pasta, and it tastes pretty cheesy. It's creamy, too - maybe it has milk or cream in it? When you look through the cookbook, you notice that mac and cheese has all of those ingredients, and you decide that's what you're eating.

That's kind of what psychologists do with the DSM. The book acts as a guide to help them find the diagnosis, or name, of a mental disorder, such as schizophrenia, bipolar disorder, or autism. Each diagnosis is also given a number to help separate it and speed up referencing another professional's work. For example, 315.1 is dyscalculia, or mathematics disorder, which is a type of neurodevelopmental disorder in which a person has trouble with math and numbers.

As we mentioned, the text also has informative statistics, or the mathematical description of a disorder's cultural, familial, and gender prevalence. For example, about 1% of the population has schizophrenia, but if your twin sibling has it, your chances go up to about 50%.

Let's look a little closer at how psychologists use the DSM to make diagnoses.

Diagnosis

Think back to Pat. He's got symptoms, like ingredients, and you've got to put the symptoms together to diagnose what's wrong with him, like choosing the recipe from the cookbook. Mental disorders and their symptoms are found in the DSM, but as the psychologist, it is your job to determine which diagnosis is correct.

You start by looking at all of Pat's symptoms: feeling like he is going crazy, feeling like he is having heart attacks, sweating, heart pounding, sensation of choking, dizziness, feeling like he is dying, and no medical issues with his heart. Together, these symptoms make up a constellation, or group of symptoms. It's called a constellation because it's as if each symptom is a star, and you, as the psychologist, need to identify the correct constellation (or disorder) the star (or symptom) belongs to.

Pat's constellation of symptoms has a lot to do with anxiety, such as the feeling of going crazy or dying and the physical sensation of a pounding heart. Luckily, the DSM divides disorders into groups. Some of these include: neurodevelopmental, depressive, personality, anxiety, and sleep-wake disorders. They are all very broad categories and in each section are the individual disorders and how to diagnose someone with them.

You open your copy and find the anxiety section. It opens with a short paragraph of the many anxiety conditions. You find that a brief description of panic attacks is very similar to your client's symptoms, so you go to the full text to learn more. The section for panic attacks says that you need four symptoms that begin abruptly and end within 10 minutes. Your client has seven physical symptoms, and they are not caused by a medical condition with their heart. Your client is having panic attacks, but as you continue to read the criteria, you see that panic attacks themselves aren't actually a disorder. They are a symptom of a different anxiety disorder.

But which one? When you look closely, you notice that Pat has some of the symptoms of an anxiety disorder called panic disorder, which involves regularly and suddenly feeling terror. You flip to the page that describes panic disorder to see if Pat meets the criteria.

To be diagnosed with panic disorder, a patient must have panic attacks (expected or unexpected), followed by at least 1 month of:

  1. worry about panic attacks; or
  2. significant maladaptive behavioral changes tied to the attack

We know that Pat has had panic attacks, so he fits the first part of the description. But, what about the second part, at least one month of worrying or changing his behavior for the worse? Well, as you talk to Pat, you realize that he has changed his life all around because he's scared that he might get another panic attack. He goes out much less often in case he has a panic attack in public, and even at home, he refuses to watch the news or certain television shows in case they trigger an attack.

Clearly, Pat is worried about his panic attacks. But, he's also engaging in 'significant maladaptive behavior,' by withdrawing from his friends and family and avoiding the news and other television programs. Thus, you diagnose Pat as having panic disorder. You write this in his patient chart and have successfully used the DSM to make a diagnosis.

Types of Disorders

Ok, Pat has panic disorder. But, what about your other patients? As we mentioned before, Pat's panic disorder is grouped with several other disorders under the heading of 'anxiety disorders.' There are several different groupings like this one in the DSM-5. They include:

1. Neurodevelopmental disorders: These are disorders that are often diagnosed in childhood and have to do with the way children develop. They include things like intellectual disabilities, ADHD, and autism spectrum disorders.

2. Schizophrenia spectrum and other psychotic disorders: Besides schizophrenia, this group also includes delusional disorder and catatonic disorder, among others.

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