Asperger’s, dyslexia and a host of other mental disorders are getting an official makeover.
The Diagnostic and Statistical Manual of Mental Disorders — published by the American Psychiatric Association — is being revised for the first time in almost 20 years. Known as the DSM, the manual is considered the main diagnostic tool among psychiatrists.
While some are touting the DSM’s new edition — its fifth — as necessary and beneficial, others are concerned that there will be consequences for students seeking assistance for mental disorders.
Many universities’ disabilities services are already preparing for the changes, which will be made public when the DSM-5 is published in May 2013.
Dorjes Jennette, a psychologist at the University of California – Davis’ Student Health and Counseling Services, wrote in an email that staff will be trained to recognize and treat disorders according to the DSM changes.
“Changes to the DSM have the potential to improve the identification of problems causing significant distress and difficulty functioning among college students,” she wrote. She added that this would help “expedite access to appropriate care.”
Lorraine Wolf, director of Boston University’s Disability Services, explained that she and her staff are already meeting more extensively with students.
“It’s an opportunity to talk to students with [diagnoses] that may have changed or been lost under [the] new system,” she said. “It’s a good opportunity to understand the impact for the individuals.”
Wolf added that, because the Americans with Disabilities Act is being revised in conjunction with the DSM, she doesn’t foresee major changes in care.
“The ADA has shifted scope to broaden the range of eligibility,” she said.
“We may come up with new forms for some of these changes. The main difference will be getting used to it, and getting used to new names,” she said.
“But the process will be same. Students will provide documentation of the condition and explain how the illness affects them on campus, and we’ll come up with services,” she added.
While some conditions will be lumped together into broader terms — the name Asperger’s will be dropped and the condition will become part of the autism spectrum disorder, while dyslexia will be one of several “specific learning disorders” — other conditions will be added to the list. Binge eating, hoarding and disruptive mood dysregulation are several of the new additions.
Still others, such as attenuated psychosis syndrome, will be dropped from the official list, at least until further research is completed.
The concern is that some students who initially qualified for care will no longer receive services under the DSM-5.
“The Asperger’s name will be eliminated. There’s a concern that mild Asperger’s patients may not meet the new criteria,” Wolf said.
Others are concerned that the elimination of attenuated psychosis syndrome, a condition used to describe young adults who have heard whispers in their heads, viewed objects as threatening or suffered other subtly psychotic symptoms, could put patients at risk.
“There were field trials for some of the disorders, but they failed trials,” said University of California – Los Angelos psychiatrist Helen Lavretsky of the conditions that were dropped. “A lot of technicians were involved and the field made huge efforts to come to a consensus.
“Awareness to families and college counselors will still be raised by including these conditions that need further research in Section III,” she added. Attenuated psychosis syndrome will be included in Section III.
But she said she believes that students “should, in general, benefit.”
“We’re on an upward slope — increasing number of students have been seeking services,” said Hilary Gerdes, senior director of the Accessible Education Center at the University of Oregon, “This trend will probably continue.”
Jennette agrees. “Students will get the recognition and validation of a more specific diagnosis, nudging students to access much-needed care,” she wrote.
“The social implications aren’t clear yet. Next year will be a test for this,” said Lavretsky.
But Gerdes highlights that a diagnosis is “important, but not critical” to treating students.
“It’s a labeling system. In the actual work we do, labeling is less important. What’s important is what the students’ barriers are,” she said.
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