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DSM-5 (Diagnostic Criteria)

Terms in this set (56)

A. Exposure to actual or threatened death, serious injury, or sexual violence in one (or more) of the following ways:
-1. Directly experiencing the traumatic event(s).
-2. Witnessing, in person, the event(s) as it occurred to others.
-3. Learning that the traumatic event(s) occurred to a close family member or close friend. In cases of actual or threatened death of a family member or friend, the event(s) must have been violent or accidental.
-4. Experiencing repeated or extreme exposure to aversive details of the traumatic event(s)
B. Presence of one (or more) of the following intrusion symptoms associated with the traumatic event(s), beginning after the traumatic event(s) occurred:
-1. Recurrent, involuntary, and intrusive distressing memories of the traumatic event(s).
-2. Recurrent distressing dreams in which the content and/or affect of the dream are related to the traumatic event(s).
-3. Dissociative reactions (e.g., flashbacks) in which the individual feels or acts as if the traumatic event(s) were recurring.
-4. Intense or prolonged psychological distress at exposure to internal or external cues that symbolize or resemble an aspect of the traumatic event(s).
-5. Marked physiological reactions to internal or external cues that symbolize or resemble an aspect of the traumatic event(s).
C. Persistent avoidance of stimuli associated with the traumatic event(s), beginning after the traumatic event(s) occurred, as evidenced by one or both of the following:
-1. Avoidance of or efforts to avoid distressing memories, thoughts, or feelings about or closely associated with the traumatic event(s).
-2. Avoidance of or efforts to avoid external reminders (people, places, conversations, activities, objects, situations) that arouse distressing memories, thoughts, or feelings about or closely associated with the traumatic event(s).
D. Negative alterations in cognitions and mood associated with the traumatic event(s), beginning or worsening after the traumatic event(s) occurred, as evidenced by two (or more) of the following:
-1. Inability to remember an important aspect of the traumatic event(s)
-2. Persistent and exaggerated negative beliefs or expectations about oneself, others, or the world
-3. Persistent, distorted cognitions about the cause or consequences of the traumatic event(s) that lead the individual to blame himself/herself or others.
-4. Persistent negative emotional state (e.g.,fear, horror, anger, guilt, or shame).
-5. Markedly diminished interest or participation in significant activities.
-6. Feelings of detachment or estrangement from others.
-7. Persistent inability to experience positive emotions (e.g., inability to experience happiness, satisfaction, or loving feelings)
E. Marked alterations in arousal and reactivity associated with the traumatic event(s), beginning or worsening after the traumatic event(s) occurred, as evidenced by two (or more) of the following:
-1. Irritable behavior and angry outbursts (with little or no provocation) typically expressed as verbal or physical aggression toward people or objects.
-2. Reckless or self-destructive behavior.
-3. Hyper-vigilance.
-4. Exaggerated startle response.
-5. Problems with concentration.
-6. Sleep disturbance (e.g.,difficulty falling or staying asleep or restless sleep).
F. Duration of the disturbance (Criteria B, C, D, and E) is more than 1 month.
G. Disturbance causes significant distress or impairment in social, occupational, or other areas of functioning.
H. Disturbance isn't attributable to physiological effects of a substance or another medical condition.
A. Exposure to actual or threatened death, serious injury, or sexual violation in one (or more) of the following ways:
-1. Directly experiencing the traumatic event(s).
-2. Witnessing, in person, the event(s) as it occurred to others.
-3. Learning that the event(s) occurred to a close family member or close friend.
-4. Experiencing repeated or extreme exposure to aversive details of the traumatic event(s)
B. Presence of nine (or more) of the following symptoms from any of the five categories of intrusion, negative mood, dissociation, avoidance, and arousal, beginning or worsening after the traumatic event(s) occurred:
--Intrusion Symptoms
-1.Recurrent, involuntary, and intrusive distressing memories of the traumatic event(s).
-2. Recurrent distressing dreams in which the content and/or affect of the dream are related to the event(s).
-3. Dissociative reactions (e.g., flashbacks) in which the individual feels or acts as if the traumatic event(s) were recurring.
-4. Intense or prolonged psychological distress or marked physiological reactions in response to internal or external cues that symbolize or resemble an aspect of the traumatic event(s).
--Negative Mood
-5. Persistent inability to experience positive emotions (e.g., inability to experience happiness, satisfaction, or loving feelings)
--Dissociative Symptoms
-6. An altered sense of the reality of one's surrounding or oneself
-7. Inability to remember an important aspect of the traumatic event(s)
--Avoidance Symptoms
-8. Efforts to avoid distressing memories, thoughts, or feelings about or closely associated with the traumatic event(s)
-9. Efforts to avoid external reminders (people, places, conversations, activities, objects, situations) that arouse distressing memories, thoughts, or feelings about or closely associated with the traumatic event(s)
--Arousal Symptoms
-10. Sleep disturbance (e.g. difficulty falling asleep or staying asleep, restless sleep)
-11. Irritable behavior and angry outbursts (with little or no provocation), typically expressed as verbal or physical aggression toward people or objects
-12. Hypervigilance
-13. Problems with concentration
-14. Exaggerated startle response
C. Duration of the disturbance (symptoms Criteria B) is 3 days to 1 month after trauma experience
D. The disturbance causes clinically significant distress or impairment in social, occupational, or other important areas of functioning.
E. The disturbance is not attributable to the physiological effects of a substance (e.g., medication or alcohol) or another medical condition (e.g., mild traumatic brain injury) and is not better explained by brief psychotic disorder.
Manic Episode
A. A distinct period of abnormally and persistently elevated, expansive, or irritable mood and abnormally and persistently increased goal-directed activity or energy, lasting at least 1 week and present most of the day, nearly every day
B. During the period of mood disturbance and increased energy or activity, three (or more) of the following symptoms (four if the mood is only irritable) are present to a significant degree and represent a noticeable change from usual behavior:
-1. Inflated self-esteem or grandiosity.
-2. Decreased need for sleep
-3. More talkative than usual or pressure to keep talking.
-4. Flight of ideas or subjective experience that thoughts are racing.
-5. Distractibility (i.e., attention too easily drawn to unimportant or irrelevant external stimuli), as reported or observed.
-6. Increase in goal-directed activity (either socially, at work or school, or sexually) or psychomotor agitation
-7. Excessive involvement in activities that have a high potential for painful consequences
C. The mood disturbance is sufficiently severe to cause marked impairment in social or occupational functioning or to necessitate hospitalization to prevent harm to self or others, or there are psychotic features.
D. The episode is not attributable to the physiological effects of a substance (e.g., a drug of abuse, a medication, other treatment) or to another medical condition.

Hypomanic Episode
A. A distinct period of abnormally and persistently elevated, expansive, or irritable mood
and abnormally and persistently increased activity or energy, lasting at least 4 consecutive days and present most of the day, nearly every day.
B. During the period of mood disturbance and increased energy and activity, three (or more) of the following symptoms (four if the mood is only irritable) have persisted, represent a noticeable change from usual behavior, and have been present to a significant degree:
-1. Inflated self-esteem or grandiosity.
-2. Decreased need for sleep
-3. More talkative than usual or pressure to keep talking.
-4. Flight of ideas or subjective experience that thoughts are racing.
-5. Distractibility (i.e., attention too easily drawn to unimportant or irrelevant external stimuli), as reported or observed.
-6. Increase in goal directed activity (either socially, at work or school, or sexually) or psychomotor agitation.
-7. Excessive involvement in activities that have a high potential for painful consequences
C. The episode is associated with an unequivocal change in functioning that is uncharacteristic of the individual when not symptomatic.
D. The disturbance in mood and the change in functioning are observable by others.
E. The episode is not severe enough to cause marked impairment in social or occupational functioning or to necessitate hospitalization. If there are psychotic features, the episode is, by definition, manic.
F. The episode is not attributable to the physiological effects of a substance

Major Depressive Episode
A. Five (or more) of the following symptoms have been present during the same 2-week period and represent a change from previous functioning; at least one of the symptoms is either (1) depressed mood or (2) loss of interest or pleasure.
-1. Depressed mood most of the day, nearly everyday, as indicated by either subjective report (e.g., feels sad, empty, or hopeless) or observation made by others
-2. Markedly diminished interest or pleasure in all, or almost all, activities most of the day, nearly every day
-3. Significant weight loss when not dieting or weight gain (e.g., a change of more than 5% of body weight in a month), or decrease or increase in appetite nearly every day.
-4. Insomnia or hypersomnia nearly everyday.
-5. Psychomotor agitation or retardation nearly every day
-6. Fatigue or loss of energy nearly everyday.
-7. Feelings of worthlessness or excessive or inappropriate guilt (which may be delusional) nearly every day
-8. Diminished ability to think or concentrate, or indecisiveness, nearly every day
-9. Recurrent thoughts of death (not just fear of dying), recurrent suicidal ideation with-out a specific plan, or a suicide attempt or a specific plan for committing suicide.
B. The symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.
C. The episode is not attributable to the physiological effects of a substance or another medical condition.

Bipolar I Disorder
A. Criteria have been met for at least one manic episode (Criteria A-D under "Manic Episode" above).
B. The occurrence of the manic and major depressive episode(s) is not better explained by schizoaffective disorder, schizophrenia, schizophreniform disorder, delusional disorder, or other specified or unspecified schizophrenia spectrum and other psychotic disorder.
Hypomanic Episode
A. A distinct period of abnormally and persistently elevated, expansive, or irritable mood
and abnormally and persistently increased activity or energy, lasting at least 4 consecutive days and present most of the day, nearly every day.
B. During the period of mood disturbance and increased energy and activity, three (or more) of the following symptoms have persisted (four if the mood is only irritable), represent a noticeable change from usual behavior, and have been present to a significant degree:
-1. Inflated self-esteem or grandiosity.
-2. Decreased need for sleep
-3. More talkative than usual or pressure to keep talking.
-4. Flight of ideas or subjective experience that thoughts are racing.
-5. Distractibility (i.e., attention too easily drawn to unimportant or irrelevant external stimuli), as reported or observed.
-6. Increase in goal-directed activity (either socially, at work or school, or sexually) or psychomotor agitation.
-7. Excessive involvement in activities that have a high potential for painful consequences
C. The episode is associated with an unequivocal change in functioning that is uncharacteristic of the individual when not symptomatic.
D. The disturbance in mood and the change in functioning are observable by others.
E. The episode is not severe enough to cause marked impairment in social or occupational functioning or to necessitate hospitalization. If there are psychotic features, the episode is, by definition, manic.
F.The episode is not attributable to the physiological effects of a substance

Major Depressive Episode
A. Five (or more) of the following symptoms have been present during the same 2-week period and represent a change from previous functioning; at least one of the symptoms is either (1) depressed mood or (2) loss of interest or pleasure.
-1. Depressed mood most of the day, nearly everyday, as indicated by either subjective report (e.g., feels sad, empty, or hopeless) or observation made by others
-2. Markedly diminished interest or pleasure in all, or almost all, activities most of the day, nearly every day
-3. Significant weight loss when not dieting or weight gain (e.g., a change of more than 5% of body weight in a month), or decrease or increase in appetite nearly every day.
-4. Insomnia or hypersomnia nearly everyday.
-5. Psychomotor agitation or retardation nearly every day
-6. Fatigue or loss of energy nearly everyday.
-7. Feelings of worthlessness or excessive or inappropriate guilt (which may be delusional) nearly every day
-8. Diminished ability to think or concentrate, or indecisiveness, nearly every day
-9. Recurrent thoughts of death (not just fear of dying), recurrent suicidal ideation without a specific plan, a suicide attempt, or a specific plan for committing suicide.
B. The symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.
C. The episode is not attributable to the physiological effects of a substance or another medical condition.

Bipolar II Disorder
A.Criteria have been met for at least one hypomanic episode (CriteriaA-F under" Hypomanic Episode" above) and at least one major depressive episode (Criteria A-C under "Major Depressive Episode" above).
B. There has never been a manic episode.
C. The occurrence of the hypomanic episode(s) and major depressive episode(s) is not better explained by schizoaffective disorder, schizophrenia, schizophreniform disorder, delusional disorder, or other specified or unspecified schizophrenia spectrum and other psychotic disorder.
D. The symptoms of depression or the unpredictability caused by frequent alternation between periods of depression and hypomania causes clinically significant distress or impairment in social, occupational, or other important areas of functioning.
A. Five (or more) of the following symptoms have been present during the same 2-week period and represent a change from previous functioning; at least one of the symptoms is either (1) depressed mood or (2) loss of interest or pleasure.
-1. Depressed mood most of the day, nearly everyday, as indicated by either subjective report (e.g., feels sad, empty, hopeless) or observation made by others
-2. Markedly diminished interest or pleasure in all, or almost all, activities most of the day, nearly every day
-3. Significant weight loss when not dieting or weight gain (e.g.,a change of more than 5% of body weight in a month), or decrease or increase in appetite nearly every day.
-4. Insomnia or hypersomnia nearly everyday.
-5. Psychomotor agitation or retardation nearly every day
-6. Fatigue or loss of energy nearly everyday.
-7. Feelings of worthlessness or excessive or inappropriate guilt (which may be delusional) nearly every day
-8. Diminished ability to think or concentrate, or indecisiveness, nearly every day
-9. Recurrent thoughts of death (not just fear of dying), recurrent suicidal ideation without a specific plan, or a suicide attempt or a specific plan for committing suicide.
B. The symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.
C. The episode is not attributable to the physiological effects of a substance or to another medical condition.
D. The occurrence of the major depressive episode is not better explained by schizoaffective disorder, schizophrenia, schizophreniform disorder, delusional disorder, or
other specified and unspecified schizophrenia spectrum and other psychotic disorders.
E. There has never been a manic episode or a hypomanic episode.
A. Two (or more) of the following, each present for a significant portion of time during a 1-month period (or less if successfully treated). At least one of these must be (1), (2), or (3):
-1. Delusions.
-2. Hallucinations.
-3. Disorganized speech
-4. Grossly disorganized or catatonic behavior.
-5. Negative symptoms
B. For a significant portion of the time since the onset of the disturbance, level of functioning in one or more major areas, such as work, interpersonal relations, or self-care, is markedly below the level achieved prior to the onset
C. Continuous signs of the disturbance persist for at least 6 months. This 6-month period must include at least 1 month of symptoms (or less if successfully treated) that meet Criterion A (i.e., active-phase symptoms) and may include periods of prodromal or residual symptoms. During these prodromal or residual periods, the signs of the disturbance may be manifested by only negative symptoms or by two or more symptoms listed in Criterion A present in an attenuated form
D. Schizoaffective disorder and depressive or bipolar disorder with psychotic features have been ruled out because either 1) no major depressive or manic episodes have occurred concurrently with the active-phase symptoms, or 2) if mood episodes have occurred during active-phase symptoms, they have been present for a minority of the total duration of the active and residual periods of the illness.
E. The disturbance is not attributable to the physiological effects of a substance (e.g., a drug of abuse, a medication) or another medical condition.
F. If there is a history of autism spectrum disorder or a communication disorder of child- hood onset, the additional diagnosis of schizophrenia is made only if prominent delusions or hallucinations, in addition to the other required symptoms of schizophrenia, are also present for at least 1 month (or less if successfully treated).
A. A problematic pattern of alcohol use leading to clinically significant impairment or distress, as manifested by at least two of the following, occurring within a 12-month period:
-1. Alcohol is often taken in larger amounts or over a longer period than was intended.
-2. There is a persistent desire or unsuccessful efforts to cut down or control alcohol use.
-3. A great deal of time is spent in activities necessary to obtain alcohol, use alcohol, or recover from its effects.
-4. Craving, or a strong desire or urge to use alcohol.
-5. Recurrent alcohol use resulting in a failure to fulfill major role obligations at work, school, or home.
-6. Continued alcohol use despite having persistent or recurrent social or interpersonal problems caused or exacerbated by the effects of alcohol.
-7. Important social, occupational, or recreational activities are given up or reduced because of alcohol use.
-8. Recurrent alcohol use in situations in which it is physically hazardous.
-9. Alcohol use is continued despite knowledge of having a persistent or recurrent physical or psychological problem that is likely to have been caused or exacerbated by alcohol.
-10. Tolerance, as defined by either of the following:
--a. A need for markedly increased amounts of alcohol to achieve intoxication or desired effect.
--b. A markedly diminished effect with continued use of the same amount of alcohol.
-11. Withdrawal, as manifested by either of the following:
--a. The characteristic withdrawal syndrome for alcohol
--b. Alcohol (or a closely related substance, such as a benzodiazepine) is taken to relieve or avoid withdrawal symptoms.