Re: (oops!) More about the new DSM-5 BPD Recommendations --> Temper Dysreg. D

[Guest guest]

Awesome--thanks for posting this!

BTW, I have to say this one item struck a chord in me:

" * Creating a new childhood disorder called " temper dysregulation disorder "

for children who are overly aggressive and tantrum-prone. Many children who

are now diagnosed with bipolar disorder would likely receive the new TDD

diagnosis instead. "

When I was a kid I was largely compliant, mellow, pretty light hearted [when not

absolutely terrified]--in spite of the chaos of nada. HOWEVER, when I broke, I

broke hard, albeit briefly, in the form of something that can only be described

as a tantrum: some examples are a burst of [profane] yelling at the top of my

lungs, or more likely striking an object--I remember punching a hole in one of

the hollow-core interior doors with a decorative wooden back-scratcher hanging

on the wall next to it. There were probably less than 7 of these episodes

during the ages of 6-17 (and it was always yelling and/or breaking something).

The point is: I was in a completely throttled existence where truth and being

myself were not an option, with no control over anything. Am I proud of those

episodes? Not hardly--I'm embarrassed even writing this now. But I think about

it now and think: Well yeah. There needed to be a vent for the pressure cooker

that nada built up in me. I didn't know what to do with it, so it came out in

that way.

So here's my concern: imagine diagnosing a KO a BP mom with something like the

newly proposed temper disregulation disorder, when mainly, they're just reacting

to their crazy FOO. I sure hope professionals are equipped with proper

techniques to truly elicit root causes of kids problems, cuz it spooks me when I

think about it. Especially when you couple it with the all too real possibility

of a nada dragging a kid into therapy and completely manipulating the

process--like we know already happens from the stories people have shared here.

Troubling. And it transcends just this new proposed disorder. Maybe the

standard practice of care should be that any parent that brings a kid in has to

undergo psychiatric evaluation and treatment (if necessary) first or in

parallel--or maybe that already is the standard practice? Poor kids.

-

>

> Sorry I didn't cut in and paste the text! How embarrassing.

>

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>

> Here you go:

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> ........................

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>

> You may know that borderline personality disorder is currently known as an

> " axis ll " disorder, a " permanent state " disorder and not a " temporary trait "

> disorder, and hence " not treatable " (i.e., insurance won't pay). A section

> of the DSM-5 site called " Classification Issues Under Discussion " says that

> a subgroup looking at the axis controversy has recommended subgroup has

> recommended that DSM-5 collapse Axes I and II (along with III, by the way)

> into one axis that contains all psychiatric and general medical diagnoses.

>

>

>

> This is from the site:

>

> There have been frequent and continued discussions about refining the

> classification of disorders in DSM-5, including the multi-axial system used

> by clinicians to document diagnoses and variables of clinical importance. A

> subgroup has been charged with examining the utility of Axis III, which is

> currently used in DSM-IV to record general medical conditions related to the

> patient's mental disorder. The subgroup has recommended that DSM-5 collapse

> Axes I, II, and III into one axis that contains all psychiatric and general

> medical diagnoses. This change would bring DSM-5 into greater harmony with

> the single-axis approach used by the international community in the World

> Health Organization's (WHO) International Classification of Diseases (ICD).

> Axis IV is currently where clinicians document psychosocial and

> environmental problems, such as whether a patient is having housing or

> economic problems or problems with his/her primary support group.

>

> The group working on Axis IV is examining the codes in the 10th edition of

> the ICD that might be comparable to the concepts presented in DSM-IV. Using

> these codes would allow DSM to more closely parallel the ICD as well.

>

> Finally, regarding Axis V, which allows clinicians to rate a patient's

> overall level of functioning, the

> <http://www.dsm5.org/MeetUs/Pages/ImpairmentandDisability.aspx> Impairment

> and Disability Study Group is discussing ways in which disability and

> distress can be better assessed in DSM-5. They have recommended that DSM-5

> more closely follow the concepts outlines in the WHO International Family of

> Classifications, in which disorders and their associated disabilities are

> conceptually distinct and assessed separately.

>

>

>

> See:

> http://www.dsm5.org/ProposedRevisions/Pages/ClassificationIssuesUnderDiscuss

> ion.aspx

>

>

>

> Here is something else:

>

> They are proposing to change the number of personality disorders from 10 to

> 5.

>

> DSM - IV ---------------------------------------------------

>

> Cluster A (odd or eccentric)

>

> * 301.0 Paranoid personality disorder

> * 301.20 Schizoid personality disorder

> * 301.22 Schizotypal personality disorder

>

> Cluster B (dramatic, emotional, or erratic)

>

> * 301.7 Antisocial personality disorder

> * 301.83 Borderline personality disorder

> * 301.50 Histrionic personality disorder

> * 301.81 Narcissistic personality disorder

>

> Cluster C (anxious or fearful)

>

> * 301.82 Avoidant personality disorder

> * 301.6 Dependent personality disorder

> * 301.4 Obsessive-compulsive personality disorder

>

>

> DSM - 5 ---------------------------------------------------

>

> Borderline,

> Antisocial/psychopathic (possibly with subtypes),

> Schizotypal,

> Avoidant, and

> Obsessive-compulsive.

>

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> Now, something from PBS web site:

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>

>

> " The update will be the fifth iteration of a manual first published in 1952.

> It will likely have far-reaching consequences for doctors, patients,

> insurers and pharmaceutical companies, among others, affecting how people

> are diagnosed with mental illness and the drugs and therapies used to treat

> them.

>

> " Anything you put in that book, any little change you make, has huge

> implications not only for psychiatry but for pharmaceutical marketing,

> research, for the legal system, for who's considered to be normal or not,

> for who's considered disabled, " First, a professor of psychiatry at

> Columbia University.

>

>

>

> For more, see:

> http://www.pbs.org/newshour/rundown/2010/02/psychiatrists-to-revise-mental-i

> llness-manual.html

>

>

>

> Other proposed changes include:

>

>

>

> * Creating a new childhood disorder called " temper dysregulation disorder "

> for children who are overly aggressive and tantrum-prone. Many children who

> are now diagnosed with bipolar disorder would likely receive the new TDD

> diagnosis instead.

>

>

>

> * Creating a new category of " behavioral addictions, " which for the moment

> includes only gambling addiction. Working group members considered adding

> " Internet addiction " to the manual but decided there was not enough research

> evidence; instead they included it in an appendix.

>

>

>

> * Adding a new eating disorder, " binge eating disorder, " which is regularly

> eating abnormally large amounts of food with a sense of loss of control and

> guilt. In a press release, the group says it is important to distinguish the

> new disorder from the common phenomenon of simply overeating.

>

>

>

> * The new manual would eliminate the separate categories of autistic

> disorder and Asperger's disorder, and classify them under a new, broader

> category of autism spectrum disorders -- a term that's already in everyday

> use.

>

>

>

> Other areas with changes include:

>

>

>

> <http://www.dsm5.org/ProposedRevisions/Pages/Adjustment%20Disorders.aspx>

> Adjustment Disorders

> <http://www.dsm5.org/ProposedRevisions/Pages/AnxietyDisorders.aspx> Anxiety

> Disorders

>

> <http://www.dsm5.org/ProposedRevisions/Pages/Delirium,Dementia,Amnestic,Othe

> rCognitive.aspx> Delirium, Dementia, Amnestic, and Other Cognitive Disorders

>

> <http://www.dsm5.org/ProposedRevisions/Pages/InfancyChildhoodAdolescence.asp

> x> Disorders Usually First Diagnosed in Infancy, Childhood, or Adolescence

> <http://www.dsm5.org/ProposedRevisions/Pages/DissociativeDisorders.aspx>

> Dissociative Disorders

> <http://www.dsm5.org/ProposedRevisions/Pages/EatingDisorders.aspx> Eating

> Disorders

> <http://www.dsm5.org/ProposedRevisions/Pages/FactitiousDisorders.aspx>

> Factitious Disorders

>

> <http://www.dsm5.org/ProposedRevisions/Pages/Impulse-ControlDisordersNotElse

> whereClassified.aspx> Impulse-Control Disorders Not Elsewhere Classified

>

> <http://www.dsm5.org/ProposedRevisions/Pages/MentalDisordersDuetoaGeneralMed

> icalConditionNotElsewhereClassified.aspx> Mental Disorders Due to a General

> Medical Condition Not Elsewhere Classified

> <http://www.dsm5.org/ProposedRevisions/Pages/MoodDisorders.aspx> Mood

> Disorders

>

> <http://www.dsm5.org/ProposedRevisions/Pages/OtherClinicalConditionsThatMayB

> eaFocusofClinicalAttention.aspx> Other Clinical Conditions That May Be a

> Focus of Clinical Attention

>

> <http://www.dsm5.org/ProposedRevisions/Pages/PersonalityandPersonalityDisord

> ers.aspx> Personality and Personality Disorders

>

> <http://www.dsm5.org/ProposedRevisions/Pages/SchizophreniaandOtherPsychoticD

> isorders.aspx> Schizophrenia and Other Psychotic Disorders

>

> <http://www.dsm5.org/ProposedRevisions/Pages/SexualandGenderIdentityDisorder

> s.aspx> Sexual and Gender Identity Disorders

> <http://www.dsm5.org/ProposedRevisions/Pages/SleepDisorders.aspx> Sleep

> Disorders

> <http://www.dsm5.org/ProposedRevisions/Pages/SomatoformDisorders.aspx>

> Somatoform Disorders

>

> <http://www.dsm5.org/ProposedRevisions/Pages/Substance-RelatedDisorders.aspx

> > Substance-Related Disorders

>

> Info is at http://www.dsm5.org/ProposedRevisions/Pages/Default.aspx

>

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> Randi @BPDCentral.com

>

> Author, " The Essential Family Guide to Borderline Personality Disorder: New

> Tips and Tools to Stop Walking on Eggshells "

>

> (Available at www.BPDCentral.com)

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