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Key TakeawaysThe DSM-5, a diagnostic manual for mental health professionals, was updated in early March.A new condition added to the DSM-5, prolonged grief disorder, has sparked debate among mental health experts.While some consider the addition unnecessary and stigmatizing, others feel it will increase access to care.

Key Takeaways

The DSM-5, a diagnostic manual for mental health professionals, was updated in early March.A new condition added to the DSM-5, prolonged grief disorder, has sparked debate among mental health experts.While some consider the addition unnecessary and stigmatizing, others feel it will increase access to care.

Whileeditorsdescribe these changes as vital to clinicians and researchers, some mental health professionals are in disagreement as to whether all the changes were necessary.

Prolonged Grief Disorder

One major point of contention is the addition of prolonged grief disorder, a longer-lasting and more disruptive form of grief that extends beyond a year after a death or loss for adults and six months for children. Clinical psychologistNoël Hunter, PsyD, who specializes in trauma and grief, strongly disagrees with the addition.

“This is yet another disgusting display of overreach, pharmaceutical influence and an inability as a society to tolerate painful emotions,” Hunter says. “The updates to the DSM are, sadly, representative of a process that has been troubled from the start.”

Noël Hunter, PsyD

The “trouble” Hunter is referring to is the financial conflict surrounding the DSM-5 and its task force members. According to reporting from the time of the DSM-5’s release in 2012, 69 percent of the DSM-5’s task force members reported financial relationships with pharmaceutical companies.

Disorders Missing in the DSM-5

“On the other hand, everyone reacts to loss differently,” Weill says. “I worry with having this new diagnosis that it will be misdiagnosed for someone who is going through a natural process—that of missing a dearly departed loved one.”

The New Experience of Grief

The timing of this addition is also important to consider. After two years of an ongoing pandemic, perhaps the most intense and extended period of loss some of us have ever experienced, many people are still in the process of grieving. AndIris Waichler, MSW, LCSW, who specializes in grief and loss, notes that the pandemic took away the opportunity to hold certain rituals and services that typically help us move forward in coping with loss.

Joseph Stern, MDWhen a bereaved person is in a vulnerable state and an expert tells them they are ‘disordered’ or ‘abnormal’, they may begin to mistrust themselves or their emotions.

Joseph Stern, MD

When a bereaved person is in a vulnerable state and an expert tells them they are ‘disordered’ or ‘abnormal’, they may begin to mistrust themselves or their emotions.

Understanding the impact of these constraints will take time. And to now establish a “normal” timeframe to for this process could be dangerous, points out neurosurgeon and nationally recognized grief specialistJoseph Stern, MD.

“Critics fear that it will lead to more false positives and encourage pharmaceutical companies to jump at the opportunity to develop new medications and to convince the public that they need medical treatment to cope with the universal life experience of bereavement or mourning,” Stern says. “This can be especially harmful because, when a bereaved person is in a vulnerable state and an expert tells them they are ‘disordered’ or ‘abnormal’, they may begin to mistrust themselves or their emotions.”

Understanding Grief in the Age of the COVID-19 Pandemic

Other Important Updates

While prolonged grief disorder has garnered the most attention, other important updates were made to the DSM-5, as well. Diagnostic criteria was revised for several conditions, including autism spectrum disorder, substance- or medication-induced mental disorders,post-traumatic stress disorder (PTSD) in children, major depressive disorder, andbipolar disorder, among others.

New symptoms codes were also added that allow mental health professionals to indicate the history or presence of suicidal behavior, non-suicidal self-injury, or dangerous behavior that could lead to injury. These codes don’t indicate mental disorders in themselves but help clinicians track and document symptoms and behavior if further attention is required.

Caitlin Weese, LMSWI think these reflect a larger push to see dysphoria through a medical lens versus a mental health condition that needs to be ‘treated.’

Caitlin Weese, LMSW

I think these reflect a larger push to see dysphoria through a medical lens versus a mental health condition that needs to be ‘treated.’

Caitlin Weese, LMSW, finds some of the updates refreshing. For example, the entry forgender dysphoriacontains new wording that updates “desired gender” to “experienced gender” and “cross-sex medical procedure” to “gender-affirming medical procedure.”

“I think these reflect a larger push to see dysphoria through a medical lens versus a mental health condition that needs to be ‘treated,'” Weese says.

Overall, the updates to the DSM-5 cover more than 70 disorders.Some of these are praised for affirmation and inclusivity, and others are viewed as unnecessary or even harmful. While its contents may be the subject of debate among clinicians and researchers, the DSM-5 continues to be a useful tool in understanding mental health.

What This Means For You

Advantages and Disadvantages of the Diagnostic Statistical Manual

2 SourcesVerywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Cosgrove L, Krimsky S.A comparison of DSM-IV and DSM-5 panel members’ financial associations with industry: A pernicious problem persists.PLoS Med. 2012;9(3):e1001190. doi:10.1371/journal.pmed.1001190American Psychiatric Association.Diagnostic And Statistical Manual Of Mental Disorders, Text Revision: DSM-5-TR.5th ed. 2022.

2 Sources

Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Cosgrove L, Krimsky S.A comparison of DSM-IV and DSM-5 panel members’ financial associations with industry: A pernicious problem persists.PLoS Med. 2012;9(3):e1001190. doi:10.1371/journal.pmed.1001190American Psychiatric Association.Diagnostic And Statistical Manual Of Mental Disorders, Text Revision: DSM-5-TR.5th ed. 2022.

Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

Cosgrove L, Krimsky S.A comparison of DSM-IV and DSM-5 panel members’ financial associations with industry: A pernicious problem persists.PLoS Med. 2012;9(3):e1001190. doi:10.1371/journal.pmed.1001190American Psychiatric Association.Diagnostic And Statistical Manual Of Mental Disorders, Text Revision: DSM-5-TR.5th ed. 2022.

Cosgrove L, Krimsky S.A comparison of DSM-IV and DSM-5 panel members’ financial associations with industry: A pernicious problem persists.PLoS Med. 2012;9(3):e1001190. doi:10.1371/journal.pmed.1001190

American Psychiatric Association.Diagnostic And Statistical Manual Of Mental Disorders, Text Revision: DSM-5-TR.5th ed. 2022.

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