By Umesh Jain
Rosemary Tannock wrote a brilliant paper called “Rethinking ADHD and LD in DSM-5: Proposed Changes in Diagnostic Criteria” published just recently in the J Learning Disabilities online November 9th, 2012 and can be found here: http://ldx.sagepub.com/content/early/2012/11/07/0022219412464341
It is one of clearest articles that describes ADHD that I have read and it is very well referenced. Since she is on the DSM-5 Committee, she has an insiders view of the process.
Now, I have ranted about the DSM-5 and the problems related to the categorizing of diagnoses concocted by psychiatrists but one gets to appreciate the challenges of coming up with some sort of consensus from this article. (See other blogs here: The DSM-IV-TR And Why It Sucks! and Best Before Date) I was disappointed that the DSM-5 will not go far enough to explain the lifespan model and the connection of symptoms threading from childhood to adulthood. We knew the age of diagnosis was going to change from age 7 to 12 which will make it easier to make the adult ADHD diagnosis.
There continues to be some controversy around the Inattentive Subtype (the more shy quiet internalizing individual) in that ADHD will be classified on the current presentation not the evolution of the disorder. But the fact that ADHD will likely be pulled out of the Disruptive Behavior Disorders group and put into a section called Neurodevelopmental Disorders is an achievement.
The implication of this could be good. ADHD finally gets to be seen as a true biological disorder and can be accommodated the same way. However, it is still hidden deep inside the book and not in the adult section so adult psychiatrists may still not know where to find the diagnostic criteria. Worse, they may not know how to handle the new placement. Do they have to get psychometric testing on their subjects? If they interpret the diagnosis too narrowly, they may reject it’s application altogether.
One thing is for sure, there will be controversy after the DSM-5 will be published. I am not sure it will lead us to the etiological understanding of the disorder and it will certainly not make it easier for us to diagnosis the condition.
If you would like me to explain each of the sections of the paper in lay person language, let me know. This is the most educated version of the future I have seen and it is really important you understand it.
If you would like to know more about what the DSM-5 is and the process to create it, The American Psychiatric Association released the following on December 1, 2013:
Leave a Reply
You must be logged in to comment