Child and Adolescent
Psychopathology
Project report
Submitted To: Ma’am Momina Fatima
Submitted By: Syeda Tehsheema Zubair
(09-279251-006)
Rahima Kiran (09-279251-004)
AD in IC&AMH
Semester 1
Date: 5/2/2025
DSM-5TR Classification of Disorders
1. Introduction to DSM-5-TR
The DSM-5-TR (Diagnostic and Statistical Manual of Mental Disorders – 5th Edition, Text
Revision) is a core resource for the classification and diagnosis of mental disorders. Published by
the American Psychiatric Association (APA), this manual reflects decades of research and
clinical consensus and is widely used by mental health professionals globally, especially in the
United States.
The “TR” in DSM-5-TR indicates that it is a Text Revision of DSM-5 (originally released in
2013), not a full new edition. This update includes revised text descriptions, clarified diagnostic
criteria, updated prevalence data, and increased emphasis on cultural and contextual
considerations. It enhances the clarity and clinical utility of the DSM without altering its
fundamental structure.
2. Purpose and Use of DSM-5-TR
A. Standardized Criteria
DSM-5-TR provides explicit diagnostic criteria for each disorder, such as required
symptoms, duration, and exclusion rules. This standardization promotes diagnostic
reliability—ensuring that different clinicians can arrive at the same diagnosis under
similar conditions.
B. Consistent Terminology
The manual introduces and reinforces consistent language across the field of mental
health, facilitating collaboration among diverse professionals and enhancing research
comparability.
C. Diagnostic Precision
Specificity in symptom thresholds and clinical descriptions helps in distinguishing
between similar disorders, reducing both overdiagnosis and underdiagnosis.
D. Guiding Treatment Plans
By clearly defining each disorder, DSM-5-TR helps clinicians develop targeted
interventions and select evidence-based treatments tailored to the individual’s condition.
E. Broad Professional Utilization
The DSM-5-TR is used by a wide range of practitioners—psychiatrists, psychologists,
counselors, social workers, psychiatric nurses, and researchers. Its interdisciplinary
relevance supports comprehensive care planning and team-based decision-making.
3. Style of Classification in DSM-5-TR
A. Categorical Approach
DSM-5-TR maintains a categorical model, where mental disorders are seen as distinct
clinical entities. Each disorder is either “present” or “absent” based on whether the
diagnostic criteria are met. This structure allows for clarity in clinical practice and
insurance coding.
B. Shift from Multiaxial System
In DSM-IV, a multiaxial system assessed patients across five domains (clinical
disorders, personality/intellectual disorders, medical conditions, psychosocial stressors,
and global functioning). DSM-5-TR removed this system, integrating all diagnostic
information into a single, unified framework to improve usability.
C. Merging of Axes
Elements from the previous axes are now embedded within the disorder descriptions or
are documented through supplemental notes. This holistic view allows for greater clinical
flexibility and reduces redundancy.
4. Dimensional Assessments
A. Introduction to Measurement
DSM-5-TR introduces dimensional assessments that supplement categorical diagnoses.
These include rating scales to measure the severity and impact of symptoms.
B. Severity Ratings
For example, depression and anxiety disorders now include severity specifiers (e.g., mild,
moderate, severe) which allow clinicians to track progress and tailor interventions more
accurately.
C. Increased Specificity
Dimensional assessments capture subtle variations in symptom expression. Rather than
a binary diagnosis, clinicians can document symptom intensity, enhancing precision in
both clinical and research contexts.
5. Organizational Structure of DSM-5-TR
The DSM-5-TR is organized into broad diagnostic categories, reflecting major domains of
mental functioning. Each category includes clearly defined disorders, their criteria, and
associated features.
A. Broad Categories
1. Neurodevelopmental Disorders – Includes Autism Spectrum Disorder, ADHD,
Intellectual Disability; typically appear early in life.
2. Schizophrenia Spectrum and Other Psychotic Disorders – Covers schizophrenia,
schizoaffective disorder, and related psychoses.
3. Depressive Disorders – Includes major depressive disorder, dysthymia (persistent
depressive disorder), and premenstrual dysphoric disorder.
B. Other Categories
Anxiety Disorders – Generalized anxiety, panic disorder, specific phobias, social
anxiety.
Trauma- and Stressor-Related Disorders – PTSD, Acute Stress Disorder, and
Adjustment Disorders; all linked to stressful life events.
Substance-Related and Addictive Disorders – Includes alcohol, drug, and gambling-
related conditions.
C. Diagnostic Criteria
Each disorder is associated with:
Symptom Requirements (number/type)
Duration Thresholds
Impairment Criteria For instance, PTSD requires exposure to trauma and persistent re-
experiencing, avoidance, and negative mood alterations for at least one month.
6. Key Changes in DSM-5-TR (2022)
A. Text Revision
DSM-5-TR is not a full edition but a refinement of DSM-5. It retains the same chapter
structure and layout, making it easy for clinicians to adapt.
B. Incremental Updates
Terminology clarifications to reduce ambiguity.
Updated statistics and prevalence rates.
Improved descriptions of diagnostic features.
C. New Diagnoses
Prolonged Grief Disorder (PGD) was added as an official diagnosis under Trauma-
and Stressor-Related Disorders. It defines grief that extends beyond culturally
accepted timeframes and causes significant distress or impairment.
D. Revisions in Existing Conditions
Gender Dysphoria: Updated to use more inclusive and accurate terminology.
Neurocognitive Disorders: Refined to better reflect contemporary scientific
understanding.
Suicidal Behavior: Provided enhanced guidance for clinical assessment and
introduced codable descriptors to improve recognition and treatment.
E. Cultural Considerations
DSM-5-TR places greater emphasis on cultural and contextual factors. It integrates
cross-cultural concepts and encourages clinicians to assess sociocultural background
when diagnosing.
7. Dimensional vs. Categorical Classification
A. Retaining Categorical Model
The primary framework of DSM-5-TR remains categorical, with disorders grouped into
distinct categories for clinical clarity and utility.
B. Benefits of the Categorical System
Enables quick identification of disorders.
Facilitates standardized diagnostic coding.
Supports communication across disciplines and health systems.
C. Introduction of Dimensional Measures
Provides quantitative scores for symptom severity.
Offers dynamic assessment that reflects the complexity of real-life cases.
D. Acknowledging Spectrum Nature
DSM-5-TR acknowledges that many disorders exist on a spectrum (e.g., Autism
Spectrum Disorder), recognizing wide variability in symptom expression, intensity, and
functional impact.
E. Personalized Approaches
This hybrid model allows clinicians to individualize treatment and better understand
patients’ unique presentations.
Conclusion
The DSM-5-TR represents a significant advancement in the classification of mental disorders,
balancing structure with flexibility. By combining categorical clarity with dimensional depth,
and updating content to reflect current research and cultural awareness, it equips mental health
professionals with a more accurate, inclusive, and practical diagnostic tool.
