Literature on DSM-5 and ICD-11

Although it’s been more than a year since the fifth edition of the American Psychiatric Association’s (APA) Diagnostic and Statistical Manual (DSM-5) has been published, articles regarding the new criteria have been appearing since 2011. This is because, any revisions of the DSM-IV criteria for PTSD (whether removal, addition or modification of specific symptoms) had to be supported by strong empirical evidence. As a result, review articles and position papers were undertaken to synthesize all relevant empirical findings in order to guide final decisions regarding the diagnostic criteria. This process was true for all DSM-5 diagnoses, not just for PTSD (Kupfer, Kuhl, & Regier, 2013) Given the strong empirical approach and the high burden of proof required for changing any diagnostic criterion, the DSM-5 process was essentially conservative. Therefore, it should come as no surprise, that except for Criterion A2 (which was removed), all 17 DSM-IV PTSD criteria were retained although, in some cases, greatly modified. In addition three new symptoms were added. Other major changes in DSM-5 were: 1) establishing a new DSM-5 diagnostic category, “Trauma and Stressor-Related Disorders” for PTSD (and acute stress disorder, adjustment disorders, and others) so that PTSD is no longer classified as an anxiety disorder, 2) reconceptualizing PTSD broadly to include posttraumatic anhedonic/dysphoric, externalizing and dissociative clinical presentations along with the original fear-based anxiety disorder, and 3) establishment of preschool and dissociative subtypes.