The Diagnostic and Statistical Manual of Mental Disorders (DSM), published by the American Psychiatric Association (APA), provides the criteria for and classifications of mental disorders. It is generally considered to be definitive although not without controversy. Originally published in 1952, the DSM has been through several versions – DSM-4 is the current edition. Over the years, the criteria of some disorders have changed, some conditions considered to be mental disorders no longer appear, and new mental disorders have been added.
While the DSM may seem irrelevant or unimportant to us in our day to day lives with our children with Reactive Disorder (RAD), it is well worth our while to understand the DSM or at least be aware of it. It is used by psychotherapists to make diagnoses and by insurance companies to approve coverage as well as by others who are involved in mental health.
Today DSM-5, scheduled to be published in May 2013, is under consideration. Two provisions pertain to us and our children. First, as of March 16, the description of RAD has been changed (before the 16th the DSM-5 proposal did not differ from the DSM-4 description of RAD). Second, a new provision, Posttraumatic Stress Disorder (PTSD) in Preschool Children, has been proposed. You can go to the DSM-5 web site, http://www.dsm5.org, to view all proposals for DSM-5. RAD is here and PTSD is here. DSM-4 included only generalized PTSD, not necessarily applicable to young children.
The provisions for DSM-5 are drafts. Nothing is yet final. The APA is accepting comments on the proposals. If you have concerns about the provisions and want to make comments you can. Yes, lay people like you and I, can make our views known, and we who are in the trenches with children who have RAD and PTSD are best qualified to comment. To comment all you have to do is go to the DSM-5 home page and register at the upper right corner under “Participate.” I strongly encourage you to do so. Comments will be accepted only until April 20, 2010, so act quickly.
Have you had any encounters with therapists who don’t understand RAD? Has any therapist told you that your child doesn’t have RAD because the behaviors don’t fit in with the DSM-4 description of RAD? Have you had any insurance coverage problems because your insurance company feels that DSM-4 RAD doesn’t apply to your child? What do you think is right or wrong with the DSM-5 proposals for RAD and PTSD? Please share your experiences and thoughts in the comment box below.
{ 2 comments… read them below or add one }
I am in general pleased that attachment styles and attachment disorders are separated, and the criteria is now based on strong studies.
But where were the studies at this time which looked at the DSM-IV criteria of the time?
And it is good to see attachment behaviours and social behaviours more generally be separated.
Thank you for your thoughts, Adelaide. It is a tremendous development, as well, that PTSD for preschoolers is being proposed. The therapists I know already find PTSD in almost every one of the kids they see.