What to Know About the DSM-5-TR

Table of ContentsView AllTable of ContentsCultural ChangesUpdated Criteria for ChildrenUpdated Criteria for AdultsChanges Within Existing Diagnoses

Table of ContentsView All

View All

Table of Contents

Cultural Changes

Updated Criteria for Children

Updated Criteria for Adults

Changes Within Existing Diagnoses

Close

The Diagnostic and Statistical Manual of Mental Disorders Fifth Edition Text Revision (DSM-5-TR) substantially updates theDSM-5, which was originally published in 2013.

The Major ChangesThe new text revision incorporates some significant changes. It adds Prolonged Grief Disorder and specific coding for suicidal and self-harming behavior, updates language around sex and gender, and changes the criteria for more than 75 diagnoses.

The Major Changes

The new text revision incorporates some significant changes. It adds Prolonged Grief Disorder and specific coding for suicidal and self-harming behavior, updates language around sex and gender, and changes the criteria for more than 75 diagnoses.

The changes can be classified into four categories: cultural, criteria for children’s diagnoses, addition of new disorders, and changes to existing criteria.

Cultural Changes to the DSM-5-TR

Members of theAmerican Psychiatric Association—which publishes the DSM—as well as other mental health professionals were calling for race, racism, and discrimination to be handled more appropriately in the DSM.

Particular attention was paid tomisdiagnosis in socially oppressed racial groupsas well as variations of symptom expression across races and possible causes for disorders.

The Cross-Cutting Review Committee on Cultural Issues and an Ethnoracial Equity and Inclusion Work Group collaborated on the following changes:

Gender and Sexuality Updates

It was as recent as 1973 that the DSM removed homosexuality as a diagnosis, but the DSM-5-TR has now updated some of its vocabulary for gender and sexuality.

For example, in entries related togender dysphoria, “desired gender,” used in the DSM-5, is now written as “experienced gender.”

Similarly, the DSM-5 used “cross-sex medical procedure,” but the TR has updated this term to “gender-affirmingmedical procedure.”

Updated DSM-5-TR Criteria for Children

The DSM criteriaupdates for children are largely semantical. Clarifying language is used to reduce confusion for the following disorders:

Signs Your Child May Be Struggling With Mental Health Issues

Updated DSM-5-TR Criteria for Adults

The updates in the entries for adult disorders fall into two categories: additions and changes within existing diagnoses.

Additions

Several disorders or conditions have been added in this edition to reflect a continued understanding of their possible impact on one’s mental health. Many of these diagnoses had previously been in a section of the DSM reserved for conditions that “may be a focus of clinical attention.”

Inclusion of a topic in this section means that it is recognized that they are significant enough to have a clinical impact but the DSM may not yet have enough information to consider it a full-blown disorder.

Prolonged Grief Disorder

Prolonged grief disorder(removes persistent complex bereavement) is one of the major additions to the DSM-TR. This diagnosis is used when someone close to you has died—at least six months ago for children and a year ago or more for adults.

While it is common to feelgrieflong after a loved one is gone, major criteria of the disorder include that the reactions must occur most of the day, nearly every day, for at least a month. Additionally, these reactions must cause “clinically significant distress,” which means that the reactions and symptoms lead to an impairment or social, occupational or other key areas of functioning.

The diagnosis was addedto address the kind of enduring struggle that leads a total inability to move forward and a heightened risk forself-harmand suicide. While this diagnosis has been criticized for pathologizing grief (i.e., implying that grief is not normal), it separates grief symptoms from depression or PTSD symptoms in order to observe patterns and design treatment.

If you are having suicidal thoughts, contact theNational Suicide Prevention Lifelineat988for support and assistance from a trained counselor. If you or a loved one are in immediate danger, call 911.For more mental health resources, see ourNational Helpline Database.

If you are having suicidal thoughts, contact theNational Suicide Prevention Lifelineat988for support and assistance from a trained counselor. If you or a loved one are in immediate danger, call 911.

For more mental health resources, see ourNational Helpline Database.

Unspecified Mood Disorder

This diagnosis is used when symptoms are predominantly in line with a depressive disorder’s diagnosis but they do not meet the full diagnostic criteria of any of the depressive oradjustment disorders.

It may be used either in situations where a mental health provider decides not to specify the reason criteria aren’t met—or in a situation such as in anemergency roomwhere there isn’t enough information to accurately give a full diagnosis because a provider has only met with someone once and for a short amount of time.

Stimulant-Induced Mild Neurocognitive Disorder

In the DSM-5, there is already a section forsubstance-induced mild neurocognitive disorders. That designation included alcohol, inhalants, sedative, hypnotic andanxiolyticsubstances.

This addition comes following ongoing research showing the lingering neurocognitive effectsthat the chronic use of stimulants can cause.

An Overview of Stimulants and How They’re Used

Suicidal Behavior and Nonsuicidal Self-Injury (NSSI)

Non-suicidalself-injuryis defined as the purposeful self-inflicted destruction of one’s body without the goal of suicide. Research shows that the incidence of these behaviors may be as high as 40% among adolescents, absolutely warranting clinical attention.

The designation of this gives clinicians the ability to flag these behaviors independent of a specific diagnosis so that one may get the proper care. Additionally, these behaviors have been isolated clinically and diagnostically to encourage research on treating them specifically, rather than just addressing their manifestation in other disorders.

NSSI, specifically, had previously only been included as a symptom inborderline personality disorder, which means that it failed to capture those with other disorders or no diagnosable disorder who engaged inself-mutilation. This may also help clinicians to estimate risk factors forfuture suicide attemptsor death.

An Overview of Self-Harm and Cutting

Attenuated Psychosis Syndrome (APS)

This is a state where one is not in full-blownpsychosis,butsomepsychotic criteria may exist, known as meeting the subclinical threshold for a full diagnosis.

The purported reasoning behind this is to eliminate over/misdiagnosis, which could lead to harmful use ofanti-psychotic medicationfor people who would not develop psychosis. This diagnosis is meant to capture and treat a person’s current state, not what statemaydevelop.

One of the key differences is that someone with APS is aware that their perceptions are altered, whereas someone in full-blown psychosis meeting all diagnostic criteria is not. APS is new to this version of the DSM and classified as a condition for further study.

Changes were made in diagnostic criteria for a handful of disorders, generally to provide a bit more clarity in the language. These revisions affect the following disorders:

List of Psychological Disorders

A Word From Verywell

The last time the DSM was updated was 2013—nearly ten years ago—so, many things have shifted both culturally and scientifically in our understanding of the mind. Updates like this are meant to reflect improved cultural and scientific understanding. If you’re seekingmental health treatment, these updates help to ensure that you receive the most accurate diagnosis possible so that you can receive the treatment most appropriate for your needs.

7 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.DSM-5-TR fact sheets. Psychiatry.org - DSM-5-TR Fact Sheets.DSM-5-TR fact sheets. Psychiatry.org - DSM-5-TR Fact Sheets.Prigerson HG, Kakarala S, Gang J, Maciejewski PK.History and status of prolonged grief disorder as a psychiatric diagnosis. Annu Rev Clin Psychol. 2021;17(1):109-126. doi:10.1146/annurev-clinpsy-081219-093600DSM-5-TR fact sheets. Psychiatry.org - DSM-5-TR Fact Sheets.Spronk DB, van Wel JHP, Ramaekers JG, Verkes RJ.Characterizing the cognitive effects of cocaine: a comprehensive review. Neurosci Biobehav Rev. 2013;37(8):1838-1859. doi:10.1016/j.neubiorev.2013.07.003Zetterqvist M.The DSM-5 diagnosis of nonsuicidal self-injury disorder: a review of the empirical literature. Child and Adolescent Psychiatry and Mental Health. 2015;9(1):31. doi:10.1186/s13034-015-0062-7DSM-5-TR fact sheets. Psychiatry.org - DSM-5-TR Fact Sheets.

7 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.DSM-5-TR fact sheets. Psychiatry.org - DSM-5-TR Fact Sheets.DSM-5-TR fact sheets. Psychiatry.org - DSM-5-TR Fact Sheets.Prigerson HG, Kakarala S, Gang J, Maciejewski PK.History and status of prolonged grief disorder as a psychiatric diagnosis. Annu Rev Clin Psychol. 2021;17(1):109-126. doi:10.1146/annurev-clinpsy-081219-093600DSM-5-TR fact sheets. Psychiatry.org - DSM-5-TR Fact Sheets.Spronk DB, van Wel JHP, Ramaekers JG, Verkes RJ.Characterizing the cognitive effects of cocaine: a comprehensive review. Neurosci Biobehav Rev. 2013;37(8):1838-1859. doi:10.1016/j.neubiorev.2013.07.003Zetterqvist M.The DSM-5 diagnosis of nonsuicidal self-injury disorder: a review of the empirical literature. Child and Adolescent Psychiatry and Mental Health. 2015;9(1):31. doi:10.1186/s13034-015-0062-7DSM-5-TR fact sheets. Psychiatry.org - DSM-5-TR Fact Sheets.

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.

DSM-5-TR fact sheets. Psychiatry.org - DSM-5-TR Fact Sheets.DSM-5-TR fact sheets. Psychiatry.org - DSM-5-TR Fact Sheets.Prigerson HG, Kakarala S, Gang J, Maciejewski PK.History and status of prolonged grief disorder as a psychiatric diagnosis. Annu Rev Clin Psychol. 2021;17(1):109-126. doi:10.1146/annurev-clinpsy-081219-093600DSM-5-TR fact sheets. Psychiatry.org - DSM-5-TR Fact Sheets.Spronk DB, van Wel JHP, Ramaekers JG, Verkes RJ.Characterizing the cognitive effects of cocaine: a comprehensive review. Neurosci Biobehav Rev. 2013;37(8):1838-1859. doi:10.1016/j.neubiorev.2013.07.003Zetterqvist M.The DSM-5 diagnosis of nonsuicidal self-injury disorder: a review of the empirical literature. Child and Adolescent Psychiatry and Mental Health. 2015;9(1):31. doi:10.1186/s13034-015-0062-7DSM-5-TR fact sheets. Psychiatry.org - DSM-5-TR Fact Sheets.

DSM-5-TR fact sheets. Psychiatry.org - DSM-5-TR Fact Sheets.

Prigerson HG, Kakarala S, Gang J, Maciejewski PK.History and status of prolonged grief disorder as a psychiatric diagnosis. Annu Rev Clin Psychol. 2021;17(1):109-126. doi:10.1146/annurev-clinpsy-081219-093600

Spronk DB, van Wel JHP, Ramaekers JG, Verkes RJ.Characterizing the cognitive effects of cocaine: a comprehensive review. Neurosci Biobehav Rev. 2013;37(8):1838-1859. doi:10.1016/j.neubiorev.2013.07.003

Zetterqvist M.The DSM-5 diagnosis of nonsuicidal self-injury disorder: a review of the empirical literature. Child and Adolescent Psychiatry and Mental Health. 2015;9(1):31. doi:10.1186/s13034-015-0062-7

Meet Our Review Board

Share Feedback

Was this page helpful?Thanks for your feedback!What is your feedback?HelpfulReport an ErrorOtherSubmit

Was this page helpful?

Thanks for your feedback!

What is your feedback?HelpfulReport an ErrorOtherSubmit

What is your feedback?