DSM 5 Learnin'

My head is SPINNING!!! That typically happens after I go to trainings for a few reasons... 

1. I just learned a lot of new stuff that I'm all hyped up on and analyzing! 

2. Over the least few days I've had 4+ hours of alone drive time, plus alone time in the hotel and that much time alone with your thoughts is well... INTENSE! 

I will probably post a couple other blogs tonight. Seriously, that's how much thinking I'm doing on a billion different subjects. Or maybe I'll write them and spread them out. Who knows? BUT I thought I'd start with a blog about what I learned today. I know a lot of my friends are affected by the DSM-5. I learned A LOT about it today, but I just thought I'd highlight a few points. I think that if any of you have the opportunity for a training you should take it. 

You should know that I find this stuff insanely intriguing. You should also know I'm not a clinician. I only need/have a working knowledge of diagnoses. Meaning, if I have a juvenile in my care I need to know what the diagnostic symptoms might be and how to work with those symptoms. I at NO point can give those kinds of diagnoses at this time. Even though I like to mentally diagnose the people around me. None of them are official... Though maybe accurate. :) Also, you should know that this training may have grazed some of the discussions around the changes, but did not talk about it in depth. It was only a 6 hour training and it was specifically on why the changes were made from APA's perspective, what the changes are, and how they might affect clients and clinicians in practice. I am in no way informed about the debates surrounding the DSM-5. I just know that it will be used, I need to know what the new diagnoses are referring to, and how it might affect my juveniles. That being said here are some highlights... (And when I say high lights, I mean highlights. Maybe "Fun Facts" might be more accurate.)

WHY: First of all, it took 13 YEARS for APA to publish a new DSM. Well technically the most recent DSM was published in 1994, and only an update (DSM IV-TR) was published in 2000. That is a long freaking time to work on a book. There have also be MANY developments in the way of neuroscience, biology, psychology, genetics, etc. We know so much more then we did then, so it was most certainly time for a change. APA worked to make the DSM align itself with ICD-10 (the tool used by medical professionals), ADA, Public Laws, and World Health Association. By aligning with all of these groups diagnoses are better understood across cultures and in different settings. When people see diagnoses now, they will all be on the same page. This is VERY important when it comes to making sure that people receive adequate care and have access to adequate resources. 

INTERESTING CHANGES: There is no longer a section specifically for children. All of those diagnoses have been distributed throughout the DSM-5. 

They will be using DSM-5 rather than DSM-V. Also, all updates will be DSM-5.1, DSM-5.2, etc. This is to ease in international use because most other countries don't recognize Roman Numerals. Psh, most of this country can't read them anymore! 

The DSM-5 focuses  a lot on genetic research/findings, neuroscience links, and attachment! There was a lot of focus on revising related diagnoses. 

(The Controversial One) Autism Spectrum Disorder now is an umbrella for Autism Spectrum Disorder, Pervasive Developmental Disorder, Childhood Disintegrative Disorder, Asperger's Syndrome, and Rhetts (I believe, but I'm not sure...). All of those diagnoses have gone away and all people with diagnoses are diagnosed with Autism. The reason for this is because the neuroscience between all 5 of these is very similar even though the symptoms are not. The controversy comes in (to my understanding) primarily with people who were previously diagnosed with Asperger's syndrome. I have not done research on their side of the story, but my assumption is they fear the social stigma related with Autsim and possible loss of identity. I guess the good news is that clinicians and the DSM-5 still recognize the symptomatic differences. For that reasons there are 3 Levels of Severity within the Autism Spectrum Disorder. With Level 1 referring to the higher functioning people or people previous diagnosed with Asperger's. I'm assuming that this is really exciting for people who have kids on the who teeter between Asperger's and Autism, because now their kids will comfortably fit in the 2nd Level. Also, there are 3 specifiers that could be used. This means that while there aren't the other diagnoses there are 27 (if I did my math right) different ways that Asperger's can be represented in a diagosis. This really gives potential care providers a good idea of what kind of symptoms to expect and can really improve the quality of care given to these individuals. Also, across the country families who had children with Asperger's have struggled in IEP meetings, because it's always been a discussion as to what category Asperger's fell into. Now that it is Autism IEPs will more adequately provide resources for these kids, and additional resources may be available for employment as well. This change makes the DSM-5 more compatible with the ADA and laws surrounding IEP. 

Children who mothers smoke while pregnant are more likely to develop ADHD, Oppositional Defiant Disorder, or Conduct Disorder. (Note: Those are probably the most prevalent diagnoses in the juvenile justice system.) Now their not 100% sure if it's the smoke or if it's because people who smoke while pregnant are more likely to have the genetic markers for ADHD, ODD, or CD. (Yup, there are genetic markers for those kinds of things!). Either way... DON'T SMOKE! 

Reactive Attachment Disorder was split into two different diagnoses. 

Gender identity disorder is GONE and Gender Dsyphoria is in! 

There's a new diagnosis called Disruptive Mood Dysregulation Disorder which will eliminate the Bipolar diagnosis in most kids. Giving a kid a diagnosis of Bipolar is scary, because it sticks for life. This gives them a stepping stone prior to that diagnosis. 

There is no hierarchy to diagnoses. This is in attempt for Mental Health diagnoses to be recognized on the same level of medical diagnoses.

Also, it has been proven that vaccinations do not cause Autism. The journal that, that was published in has removed that article, and the doctor who made that claim has been suspended. Most kids with Autism will start showing very noticeable symptoms at 18 months, the same time a certain vaccination was given. The doctor did not take into account that prior to that the children who had Autism struggled to latch on with nursing and other early warning signs. 

Ummm... I learned a lot more but those I found most interesting. Again, this is about the limit of my knowledge. I'm would love to hear thoughts. I know that I have a lot of informed parents and professionals on the old FB. However, at this point the DSM-5 isn't really up for debate, and I don't have the knowledge to debate. It's all about moving forward and dealing with what we have. (Know that many clinicians are not all thrilled with changes either).