The DSM-5

The medical community relies on the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) to diagnose all things mental. It is put out by the American Psychiatric Association (APA) and is used as a classification and diagnostic tool. Since its updated version, in 2013, when some changes were made regarding ADHD, there continues to be some confusion regarding its diagnosis.

 1 Disorder     2 Presentations   3 Degrees

The term “on the spectrum” has many people feeling that ADHD is a part of Autism Spectrum Disorder (ASD). It is not, although there is some brain functioning overlap of certain traits. Simply, the term “spectrum” is used to describe the broad array of symptoms and their degrees of severity, not the disorder. ADHD is a distinct condition and while it is not on the same spectrum as Autism, individuals with Autism can also have ADHD.

 

The DSM-5 no longer presents different “types” of ADHD. By this, I mean the previous distinction made between ADD and ADHD. This reflects how our collective understanding has evolved over the years. We used to think of hyperactivity (the H in ADHD) as a symptom that not everyone shared and those who had it generally outgrew it. Now we know it simply presents differently in adults. Hyperactivity in adults shows up less outwardly as physical restlessness and more inwardly as a racy mind. The DSM-5 has given us the single designation, ADHD, for now, but it’s subject to change in future editions as we continue to advance our knowledge.

 

The DSM-5 describes two presentations, three when combining the first two:

 

  1. Inattention
  2. Impulsivity and Hyperactivity
  3. Combination of inattention, impulsivity, and hyperactivity

 

People can present as one or the other or as a combination and they may switch from one to the other and even back and forth between them in varying areas during their lifetime. Symptoms have three degrees of severity, mild, moderate, and severe. This depends on the extent to which the symptoms interfere with daily tasks. 

The DSM-5 continues by listing traits and giving parameters for diagnosis, such as age of onset and number of environments where ADHD symptoms are causing difficulty. There are 18 symptoms from which to choose, including “Often loses things necessary for tasks and activities” and “Is often ‘on the go’ acting as if ‘driven by a motor’.” The criteria which must be met includes six or more of those symptoms within the category of either inattention or hyperactivity-impulsivity, for children up to age 16, or five or more for adolescents 17 and older and adults. These symptoms must also have been present for at least six months, and are inappropriate for the individual’s developmental level. In addition, the symptoms were present before age 12, experienced in two or more different settings, interfere with normal functioning, and are not better explained by another mental disorder.

Adaptation based on: Symptoms and Diagnosis. (2014, September 29). Retrieved November 11, 2014, from http://www.cdc.gov/ncbddd/adhd/diagnosis.html

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