DSM V - What's the Difference Part I

Autism Spectrum Disorder vs. Social (Pragmatic) Disorder

1: Merged with Autism, Asperger’s & ASD with different levels of severity.

• 0 to 5 age of development

• Deficiency in social communication & interaction (ie- baby is making no eye contact)

• Stereotyped behavior (repetitive speech/ hand flapping) (fixation with specific subject)

• Difficult time with transitions (prefers stability)

2.

• Impaired social communication & only this

• Stereotyped repetitive behavior is NOT present for this diagnosis

Specific Learning Disorder vs. ADHD

1

• Difficulty learning basic skills the way most people learn on the basis of child’s IQ & age (ie- dyslexia)

2

• Rule out a learning disorder (FIRST)

• Symptoms need to be present BEFORE the age of 12

• Behavior needs to be present in 2 environments (ie- school & home)

• Problems consist of inattention and/ or hyperactivity

Pica vs. Rumination Disorder

Pica: Persistent eating of non-food substances

• Eating dirt/ tissue paper

Rumination: Repeat regurgitation of food that is not related to any other disorder

• (ie- Person will eat, but they will regurgitate the food)

Language Disorder vs. Childhood-Onset Fluency Disorder

1.

• Time time building vocabulary (typically w/ children)

• Simple sentence structure is limited and the child will drop words leading to broken sentences

2.

• Stuttering (broken-words; “long pause” when speaking to others) (repetition of the first word)

**Both the disorders appear BEFORE the age of 5

Tourette’s Disorder vs. Persistent Motor/ Vocal Tic Disorder

1.

• Person has both motor (hand movement/ facial movement) and vocal (person shouts out words uncontrollably) tics

2.

• Person will have EITHER motor or vocal tics, NOT both

Encopresis vs. Enuresis

1

• (poop); someone soils their pants past the age of 5

2

• (pee); someone urinates their pants past the age of 5

**Warning sign for sexual abuse or some kind of trauma

**Both these people should be “potty-trained” by now

Separation Anxiety Disorder vs. Generalized Anxiety Disorder

1: Person has anxiety when they are not near or attached to the caregiver

• Common with children; Symptoms need to be present for 4 weeks

• Anticipatory anxiety from not being with the caregiver

2: Worrying about various subjects at any given moment

• Symptoms: Tension, problem sleeping/ eating, issues with concentrating

• Symptoms have to be PRESENT for 6 months with children & adults

Selective Mutism vs. Social Anxiety Disorder

1: individuals fail to speak in a particular situation

• Kid doesn’t speak at school, but at home they speak with family

2: Specific context around the social situation

• Fear of engagement in social situations due to fear of being observed, judged or rejected

• Person will avoid these events & remain WITHDRAWN from social gatherings

Reactive Attachment Disorder vs. Disinhibited Social Engagement Disorder

**Both are a result of persistent neglect & abuse or changing of caregivers (common with foster care)

**Early age; (9 months to 5 years of age)

RAD (the quiet ones):

• “failure to thrive"; withdrawn and don’t react to the comfort of the caregiver

• Sit in the corner & avoid seeking attention

DSED (the loud ones):

• Very social and engages well with strangers

• Attaches to people and strangers very easily

• Seeks attention and comfort from others

Oppositional Defiant Disorder vs. Conduct Disorder vs. Disruptive Mood Dysregulation Disorder

ODD: Someone who is DEFIANT TO OTHERS

• Issues with authority, argumentative, refuse to comply with any form of directions & don’t want to complete tasks other people request

CD: Violation in the Rights of Others

• Stealing, vandalism, property destruction, pricking fights, or breaking the law

• Leads to Antisocial Personality Disorder

DMDD: (bipolar in children) People who are chronically irritable, mood & reoccurring tantrums

• Typically 6-10 year old; may go up to 16 yr old

• Outbursts need to occur at least 3x per week

• Mood typically negative; even when outburst isn’t present

Brief Psychotic Disorder vs. Schizophreniform Disorder vs. Schizophrenia

**All have the same symptoms, but the TIMELINE IS DIFFERENT

BPD: symptoms are present UP TO A MONTH

Schizophreniform: symptoms are present 1 MONTH TO 6 MONTHS

Schizophrenia: symptoms are present MORE THAN 6 MONTHS

Brief Psychotic Disorder vs. Schizophreniform Disorder vs. Schizophrenia: Five Categories for Symptology

1. Delusion (bizarre or non-bizarre)

2. Hallucinations (visual or auditory)

3. Disorganized Speech (rambling/ incoherent)

4. Disorganized Behaviors (randomly moving item)

5. Negative Symptoms (flat affect/ lost in own world)

Major Depressive Disorder vs. Unspecified Depressive Disorder vs. Persistent Depressive Disorder

MDD:

• Symptoms need to be present for 2 WEEKS

• Dark mood, can’t enjoy things, lack of motivation, under/ over sleeping, change in appetite; suicidal ideations/ feel worthless

UDD:

• Does not meet full criteria of MDD

• Mild signs of MDD; No suicidal thoughts

PDD:

• Depressed mood for 2 years as an adult or 1 year as a child

• ie- Depressed mood for 2-3 years and no change in biological functioning with previous history of depression

Bipolar I vs. Bipolar II vs. Cyclothymic Disorder

BPD I: Needs a Manic Phase

• Manic Phase: having elevated mood that leads to significant social impairment for at least 1 WEEK

• ie- excessive spending, high risk behavior, grandiose behavior, lack of need for sleep, high risk sexual behavior

BPD II: Needs a Hypo-Manic Phase

• Hypo-manic Phase: only lasts 4 days with an elevated mood and not social impairment

• Needs to have an episode of MDD

• **Both these things need to occur

CD:

• Present for 2 WEEKS

• Hypomanic state & low MDD episode

Schizoaffective Disorder vs. Bipolar I Disorder w/ Psychotic Features

SD: Presence of psychotic features and mood disorder is present (mood disorder comes in-and-out)

BD I: mood disorder is constant, while the psychotic features come in-and-out

Bereavement vs. Major Depressive Disorder vs. Adjustment Disorder w/ Depressed Mood

Bereavement: Someone who is GRIEVING something, someone or an animal (normal grief reaction)

MDD: Can be present with diagnosis of bereavement. **MDD look for the symptoms for the answers: Dark mood, can’t enjoy things, lack of motivation, under/ over sleeping, change in appetite; suicidal ideations/ feel worthless

AD w/ DM: A recent life stressor that has an impact on client’s mood

• Symptoms have to be 3 MONTHS within the STRESSOR event and persist less than 6 MONTHS since the time of the event

Prolonged Grief Disorder

Grieving last longer than a 12-month period

• Children & adolescent symptom timeline is 6 months or more

• Severity of grief need to oversee cultural and religious norms

Panic Disorder vs. Agoraphobia

PD: Recurrent unexpected panic attacks and the fear that the panic attacks will return causing an impairment in daily functioning

Agoraphobia: The fear of “going out” in public

• This needs to precipitate at least two times and impairment of functioning is affected

Obsessive-Compulsive Disorder vs. Obsessive-Compulsive Personality Disorder

OCD: Both obsessive thoughts & obsessive behaviors (Joe from church)

• intrusive thoughts: (constant worry of germs)

• compulsive actions: (excessive hand washing)

OC Personality Disorder:

• Perfectionist, controlling, rigid, organized and have no awareness of this present in their own lives

PTSD vs. Acute Stress Disorder vs. Adjustment Disorder w/ Anxiety

**all the symptoms are the same, but the difference is the timeline that the symptoms occurred

**Both occur from an incident that is life threatening or be in the presence of the incident (child sees mother get beaten by father) (war veterans)

PTSD: Symptoms present AFTER 1 month

Acute Stress: Symptoms present BEFORE 1 month

Adjustment: Event is non-life threatening

PTSD & Acute Stress Disorder Symptomology

1. Intrusive Elements (flashbacks/ memories)

2. Negative Mood (shame/ irritable/ depressed)

3. Behavioral (ppl avoid situations that remind them of the incident)

4. Arousal (jumpy/ aware of surroundings)

Generalized Anxiety Disorder vs. Anxiety Disorder Unspecified

GAD: Symptoms present for 6 months or MORE

• Problems with biological functioning (eating/ sleeping)

ADU: Symptoms present for LESS than 6 months

• Someone who’s symptoms don’t tag along with any other anxiety disorder