DSM-5 DIAGNOSTIC CATEGORIES

I - Neurodevelopmental Disorders
1) Intellectual Disabilities 4) Attention Deficit/ Hyperactivity Disorder
2) Communication Disorders 5) Specific Learning Disorders
3) Autism Spectrum Disorders 6) Motor Disorder
Intellectual Disability
 Intellectual disability (intellectual developmental disorder) is characterized by deficits in general
mental abilities
 The deficits result in impairments of adaptive functioning
o Conceptual
o Practical
o Social
 Onset of intellectual and adaptive deficits during the developmental period.

Communication Disorders
 Language disorder, speech sound disorder, social (pragmatic) communication disorder
characterized by deficits in the development and use of language, speech, and social
communication, respectively.
 Childhood-onset fluency disorder (stuttering) characterized by disturbances of the normal
fluency and motor production of speech

Autism Spectrum Disorder

 Characterized by persistent deficits in social communication and social interaction across
multiple contexts deficits in social reciprocity, nonverbal communicative behaviors used for social
interaction, and skills in developing, maintaining, and understanding relationships.
 Presence of restricted, repetitive patterns of behavior, interests, or activities.

ADHD
 Defined by impairing levels of inattention, disorganization, and/or hyperactivity-impulsivity.
 Inattention and disorganization entail inability to stay on task, seeming not to listen, and losing
materials, at levels that are inconsistent with age or developmental level.
 Hyperactivity-impulsivity entails overactivity, fidgeting, inability to stay seated, intruding into
other people's activities, and inability to wait—symptoms that are excessive for age or
developmental level.

Specific Learning Disorder

 Diagnosed when there are specific deficits in an individual's ability to perceive or process
information efficiently and accurately.
 Characterized by persistent and impairing difficulties with learning foundational academic skills in
reading, writing, and/or math.
 First manifests during the years of formal schooling

Motor Disorder
 Developmental coordination disorder
o Deficits in the acquisition and execution of coordinated motor skills and is manifested by
clumsiness and slowness or inaccuracy of performance of motor skills that cause
interference with activities of daily living.
 Stereotypic movement disorder
o Repetitive, seemingly driven, and apparently purposeless motor behaviors
 Tic disorders
o A tic is a sudden, rapid, recurrent, nonrhythmic motor movement or vocalization
o Onset is before age 18 years.
o The disturbance is not attributable to the physiological effects of a substance or another
medical condition

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 o Tourette’s Disorder
 Both multiple motor and one or more vocal tics have been present at some time
during the illness, although not necessarily concurrently.
o Persistent (Chronic) Motor or Vocal Tic Disorder
 Single or multiple motor or vocal tics have been present during the illness, but
not both motor and vocal.

II- Schizophrenia Spectrum and Other Psychotic Disorders

 A spectrum as it applies to mental disorder is a range of linked conditions, sometimes also
extending to include singular symptoms and traits
1) schizotypal personality disorder
2) schizophrenia
3) delusional disorder
4) schizoaffective disorder
5) schizophreniform disorder
Schizotypal Personality Disorder
 Pervasive pattern of social and interpersonal deficits
 Cognitive or perceptual distortions
 Eccentricities of behavior usually beginning by early adulthood but in some cases first
becoming apparent in childhood and adolescence.
 Abnormalities of beliefs, thinking, and perception are below the threshold for the diagnosis of a
psychotic disorder.
Delusional Disorder
 Characterized by at least 1 month of delusions but no other psychotic symptoms.
 The person has not met criteria for schizophrenia
 Functional impairment within the specific impact of the delusion
 The duration of manic and depressive episodes have been brief relative to the duration of
delusion.
Brief Psychotic Disorder
 One or more of the symptoms of schizophrenia that lasts more than 1 day and remits by 1 month
Schizophreniform Disorder
 Characterized by a symptomatic presentation equivalent to that of schizophrenia except for its
duration (less than 6 months) and the absence of a requirement for a decline in functioning.
Schizophrenia
 Two or more of the following symptoms for at least 1 month; one symptom should be either 1, 2,
or 3:
1) delusions
2) hallucinations
3) disorganized speech
4) disorganized (or catatonic) behavior
5) negative symptoms (diminished motivation or emotional expression)
 Functional impairment in one or more areas
 Signs of disorder for at least 6 months
Schizoaffective Disorder
 A mood episode and the active-phase symptoms of schizophrenia occur together and were
preceded or are followed by at least 2 weeks of delusions or hallucinations without prominent
mood symptoms.

III - Bipolar Disorders

1) Bipolar I
2) Bipolar II
3) Cyclothymic Disorder
Bipolar I
 At least one episode of mania or mixed episode in DSM-IV-TR
 More severe

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Bipolar II
 At least one episode of hypomania and one episode of major depression
Cyclothymic Disorder
 Cyclothymic Disorder
 At least two years (one year for children and adoloscents)
 Numerous periods with hypomanic symptoms that do not meet criteria for a hypomanic episode
 Numerous periods with depressive symptoms that do not meet criteria for a major depressive
episode.

IV- Depressive Disorders

1) Disruptive Mood Dysregulation Disorder
2) Major Depressive Disorder
3) Persistent Depressive Disorder (Dysthymia)
4) Premenstrual Dysphoric Disorder
Major Depressive Disorder
 Sad mood or loss of pleasure in usual activities. At least five symptoms (counting sad mood and
loss of pleasure):
 Sleeping too much or too little
 Psychomotor retardation or agitation
 Weight loss or change in appetite
 Loss of energy
 Feelings of worthlessness or excessive guilt
 Difficulty concentrating, thinking, or making decisions
 Recurrent thoughts of death or suicide
 Symptoms are present nearly every day, most of the day, for at least 2 weeks.
 Functional Impairment
Persistent Depressive Disorder (Dysthymia)
 Depressed mood for most of the day more than half of the time for 2 years (or 1 year for children
and adolescents). At least two of the following during that time:
 Poor appetite or overeating
 Sleeping too much or too little
 Poor self-esteem
 Low energy
 Trouble concentrating or making
 Decisions
 Feelings of hopelessness
Disruptive Mood Dysregulation Disorder,
 The core feature of disruptive mood dysregulation disorder is chronic, severe persistent irritability.
This severe irritability has two prominent clinical manifestations
o frequent temper outbursts.
o chronic, persistently irritable or angry mood that is present between the severe temper
outbursts.
Premenstrual Dysphoric Disorder
 The essential features of premenstrual dysphoric disorder are the expression of mood lability,
irritability, dysphoria, and anxiety symptoms that occur repeatedly during the premenstrual phase
of the cycle and remit around the onset of menses or shortly thereafter.
 These symptoms may be accompanied by behavioral and physical symptoms.
 The symptoms are associated with clinically significant distress or interference with work, school,
usual social activities, or relationships with others

V- Anxiety Disorders
1) Social Anxiety Disorder (Social Phobia) 5) Generalized Anxiety Disorder
2) Specific Phobia 6) Selective Mutism
3) Panic Disorder 7) Separation Anxiety Disorder
4) Agoraphobia

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Specific Phobia
 Marked and disproportionate fear consistently triggered by specific objects or situations
 The object or situation is avoided or else endured with intense anxiety
 Symptoms persist for at least 6 months
 The fear, anxiety, or avoidance causes clinically significant distress or impairment in social,
occupational, or other important areas of functioning.
 Not better explained by the symptoms of another mental disorder

Social Anxiety Disorder

 Marked and disproportionate fear consistently triggered by exposure to potential social scrutiny
 Exposure to the trigger leads to intense anxiety about being evaluated negatively
 Trigger situations are avoided or else endured with intense anxiety
 Symptoms persist for at least 6 months
 The fear, anxiety, or avoidance causes clinically significant distress or impairment in social,
occupational, or other important areas of functioning.
 Not better explained by the symptoms of another mental disorder
 If another medical condition is present, the fear, anxiety, or avoidance is clearly unrelated or is
excessive.
Panic Disorder
 Recurrent unexpected panic attacks
 At least 1 month of concern about the possibility of more attacks, worry about the
consequences of an attack, or maladaptive behavioral changes because of the attacks
Agoraphobia
 Disproportionate and marked fear or anxiety about at least 2 situations where it would be difficult
to escape or receive help in the event of incapacitation, embarrassing symptoms, or panic-like
symptoms
 such as being outside of the home alone; traveling on public transportation; being in open spaces
such as parking lots and marketplaces; being in enclosed spaces such as shops, theaters, or
cinemas; or standing in line or being in a crowd
 These situations consistently provoke fear or anxiety
 These situations are avoided, require the presence of a companion, or are endured with intense
fear or anxiety
 Symptoms last at least 6 months
Generalized Anxiety Disorder
 Excessive anxiety and worry at least 50 % of days about a number of events or activities
 The person finds it hard to control the worry
 The worry is sustained for at least 6 months
 The anxiety and worry are associated with at least three (or one in children) of the following:
restlessness or feeling keyed up or on edge; easily fatigued; difficulty concentrating or mind going
blank; irritability; muscle tension; sleep disturbance
Separation Anxiety Disorder
 Developmentally inappropriate and excessive fear or anxiety concerning separation from those
to whom the individual is attached
 The fear, anxiety, or avoidance is persistent, lasting at least 4 weeks in children and
adolescents and typically 6 months or more in adults.
 The disturbance causes clinically significant distress or impairment in social, academic,
occupational, or other important areas of functioning.
 The disturbance is not better explained by another mental disorder
Selective Mutism
 Characterized by a consistent failure to speak in social situations in which there is an
expectation to speak (e.g., school) even though the individual speaks in other situations.
 This interferes with normal social communication.
 The duration of the disturbance is at least 1 month

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  The failure to speak is not attributable to a lack of knowledge of, or comfort with, the spoken
language required in the social situation
 The disturbance is not better explained by a communication disorder (e.g., childhoodonset
fluency disorder) and does not occur exclusively during the course of autism spectrum disorder,
schizophrenia, or another psychotic disorder.

VI- Obsessive Compulsive & Related Disorders

1) Obsessive-Compulsive Disorders
2) Body Dysmorphic Disorder
3) Hoarding Disorder
4) Hair-Pulling (Trichotillomania) Disorder
5) Skin-Picking (Excoriation) Disorder
Obsessive-Compulsive disorder
 characterized by obsessions or compulsions.
– Obsessions are intrusive and recurring thoughts, images, or impulses that are persistent
and uncontrollable
– Compulsions are repetitive, clearly excessive behaviors or mental acts that the person
feels driven to perform to reduce the anxiety caused by obsessive thoughts or to prevent
some calamity from occurring.
• Pursuing cleanliness and orderliness, sometimes through elaborate rituals
• Performing repetitive, magically protective acts, such as counting or touching a
body part
• Repetitive checking to ensure that certain acts are carried out
 The obsessions and compulsions are time consuming and cause significant distress and
impairment
 Not attributable to direct physiological effects of substances or any medical condition
 Not better explained by other mental disorder
Body Dysmorphic Disorder
 Preoccupation with one or more perceived defects in appearance
 The person has performed repetitive behaviors or mental acts (e.g., mirror checking, seeking
reassurance, or excessive grooming) in response
 The preoccupation with appearance can interfere with many aspects of occupational and social
functioning.
 Preoccupation is not restricted to concerns about weight or body fat
Hoarding disorder
 Persistent difficulty discarding or parting with possessions, regardless of their actual value
 Perceived need to save items and Distress associated with discarding
 The symptoms result in the accumulation of a large number of possessions that clutter active
living spaces to the extent that their intended use is compromised unless others intervene.
 Not attributable to any medical condition
 Not better explained by another mental disorder
Trichotillomania (Hair-Pulling Disorder)
 Recurrent pulling out of one’s hair, resulting in hair loss.
 Repeated attempts to decrease or stop hair pulling.
 Functional impairment and significant distress
 Not attributable to any medical condition
 Not better explained by the symptoms of another mental disorder
Excoriation (Skin-Picking) Disorder
 Recurrent skin picking resulting in skin lesions.
 Repeated attempts to decrease or stop skin picking.
 Functional impairment and significant distress
 Not attributable to any medical condition
 Not better explained by the symptoms of another mental disorder

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VII - Trauma & Stressor Related Disorders
1) Post-Traumatic Stress Disorder
2) Acute Stress Disorder
3) Adjustment Disorders
4) Reactive Attachment Disorder
5) Disinhibited Social Engagement Disorder
Reactive Attachment Disorder
 Absence or grossly underdeveloped attachment between the child and putative caregiving
adults.
 A persistent social and emotional disturbance characterized
 The child has experienced a pattern of extremes of insufficient care
 The disturbance is evident before age 5 years.
 The child has a developmental age of at least 9 months.
Disinhiblted Social Engagement Disorder
 A pattern of behavior in which a child actively approaches and interacts with unfamiliar adults
 The behaviors are not limited to impulsivity
 The child has experienced a pattern of extremes of insufficient care
Posttraumatic Stress Disorder
 Exposure to actual or threatened death, serious injury, or sexual violence
 Presence of intrusion symptoms (1)
 Persistent avoidance of stimuli associated with the traumatic event/s (1)
 Negative alterations in cognitions and mood associated with the traumatic event/s (2)
 Marked alterations in arousal and reactivity associated with the traumatic event/s (2)
 Duration is more than one month
 Functional Impairment
 Not attributable to physiological effects of substance or any medical condition
Acute Stress Disorder
 Fairly similar to those of PTSD, but the duration is shorter.
 Symptoms occur between 3 days and 1 month after a trauma.
Adjustment Disorder
 The development of emotional or behavioral symptoms in response to an identifiable
stressor(s) occurring within 3 months of the onset of the stressor(s).
 These symptoms or behaviors are clinically significant, as evidenced by one or both of the
following:
 Marked distress that is out of proportion to the severity or intensity of the stressor
 Significant impairment in social, occupational, or other important areas of functioning.
 The stress-related disturbance does not meet the criteria for another mental disorder and is
not merely an exacerbation of a preexisting mental disorder.
 The symptoms do not represent normal bereavement.
 Once the stressor or its consequences have terminated, the symptoms do not persist for more
than an additional 6 months.

VIII - Dissociative Disorders

1) Dissociative Amnesia
2) Depersonalization/Derealization Disorder
3) Dissociative Identity Disorder
Dissociative Amnesia
 Inability to remember important personal information, usually of a traumatic or stressful nature,
that is too extensive to be ordinary forgetfulness
 Functional Impairment and significant distress
 The amnesia is not explained by substances or medical condition
 Not better explained another psychological conditions
 Specify dissociative fugue subtype if:

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 o the amnesia is associated with bewildered or apparently purposeful wandering
Depersonalization/Derealization Disorder
 Presence of persistent and recurrent experiences of depersonalization and derealization
o Depersonalization: Experiences of detachment from one’s mental processes or body, as
though one is in a dream, or
o Derealization: Experiences of unreality of surroundings
 Reality testing remains intact
 Significant distress and functional impairment
 Symptoms are not explained by substances, or by a medical condition
 Not better explained by another dissociative disorder, another psychological disorder another
dissociative disorder, another psychological disorder, or by a medical condition

Dissociative Identity Disorder

 Disruption of identity characterized by two or more distinct personality states (alters) or an
experience of possession. This disruption may be observed by others or reported by the patient.
 Recurrent gaps in recalling events or important personal information that are beyond ordinary
forgetting
 Functional impairment
 Symptoms are not part of a broadly accepted cultural or religious practice, and are not due to
drugs or a medical condition (In children, symptoms are not better explained by an imaginary
playmate or by fantasy play)
 Not attributable to physiological effects of substance or another medical condition

IX - Somatic Symptom and Related Disorders

1) Somatic symptom disorder
2) Illness anxiety disorder
3) Conversion disorder (functional neurological symptom disorder)
4) Factitious disorder
Somatic Symptom Disorder
 One or more somatic symptoms that are distressing or result in significant disruption in daily life
 Excessive thoughts, feelings or behaviors related to the seriousness of the somatic symptoms as
manifested in at least 1 of the ff:
o Persistent thoughts about the seriousness of the of one’s symptoms
o Persistently high level of anxiety about health or symptoms
o Excessive time or energy devoted to these symptoms
 Duration of at least 6 months
Illness Anxiety Disorder
 Preoccupation with fears of having a serious disease
 No significant somatic symptoms present
 High level of anxiety about health
 These fears must lead to excessive care seeking or maladaptive avoidance behaviors
 Duration of at least 6 months
 Not better explained by another mental disorder
Conversion Disorder
 One or more symptoms affecting voluntary motor or sensory function
o People may experience partial or complete paralysis of arms or legs; seizures and
coordination disturbances; a sensation of prickling, tingling, or creeping on the skin;
insensitivity to pain; or anesthesia
 The symptoms are incompatible with recognized medical disorder
o When a patient reports a neurological symptom, it is important to assess whether that
symptom has a true neurological basis.
 Not better explained by another medical condition
 Functional impairment and significant distress

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Factitious disorder
 People with this disorder fake or manufacture physical or psychological symptoms, but without
any apparent motive.
 The person presents himself to others as ill or injured
 Deceptive behavior is evident
 Not better explained by another mental disorder
o Factitious Disorder Subtypes
 Factitious disorder on self (Münchausen Syndrome)
 the person presents himself or herself to others as ill, impaired, or injured
 Factitious disorder imposed on another
 The person fabricates symptoms in another person and then presents
that person to others as ill, impaired, or injured
 NOTE: Factitious disorder is not the same as malingering. Because malingering is motivated by
external rewards or incentives, it is not considered a mental disorder within the DSM framework.

X - Feeding and Eating Disorders

1) Pica Disorder
2) Rumination disorder
3) Avoidant/restrictive Food Intake Disorder
4) Anorexia nervosa
5) Bulimia nervosa
6) Binge-eating disorder
Pica Disorder
 Persistent eating of nonnutritive, nonfood substances over a period of at least 1 month.
 Inappropriate to the developmental level of the individual (A minimum age of 2 years is
suggested for a pica diagnosis)
 The eating behavior is not part of a culturally supported or socially normative practice.
 If the eating behavior occurs in the context of another mental disorder it is sufficiently severe to
warrant additional clinical attention.
Rumination Disorder
 Repeated regurgitation of food over a period of at least 1 month. Regurgitated food may be re-
chewed, re-swallowed, or spit out.
 The repeated regurgitation is not attributable to an associated gastrointestinal or other medical
condition (e.g., gastroesophageal reflux, pyloric stenosis).
 The eating disturbance does not occur exclusively during the course of other eating disorders
 If the symptoms occur in the context of another mental disorder they are sufficiently severe to
warrant additional clinical attention.
Avoidant/Restrictive Food Intake Disorder
 Avoidance or restriction of food intake manifested by clinically significant failure to meet
requirements for nutrition or insufficient energy intake through oral intake of food.
 The disturbance is not better explained by lack of available food or by an associated culturally
sanctioned practice.
 The eating disturbance does not occur exclusively during the course of other eating disorders
 The eating disturbance is not attributable to a concurrent medical condition or better
explained by other mental disorder
Anorexia Nervosa
 Restriction of food that leads to very low body weight body weight is significantly below
normal
 Intense fear of weight gain or persistent behavior that interferes with weight gain, even
though at a significantly low weight.
 Body image disturbance or persistent lack of recognition of the seriousness of the current low
body weight.

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Bulimia Nervosa
 Recurrent episodes of binge eating
 Recurrent compensatory behaviors to prevent weight gain, for example, vomiting
 The binge eating and inappropriate compensatory behaviors both occur, on average, at least
once a week for 3 months.
 Body shape and weight are extremely important for self-evaluation
 The disturbance does not occur exclusively during episodes of anorexia nervosa.
Binge Eating Disorder
 Recurrent binge eating episodes
 Binge eating episodes include at least three of the following:
o eating more quickly than usual
o eating until over full
o eating large amounts even if not hungry
o eating alone due to embarrassment about large food quantity
o feeling bad (e.g., disgusted, guilty, or depressed) after the binge
o No compensatory behavior is present
 Marked distress regarding binge eating is present.
 The binge eating occurs, on average, at least once a week for 3 months.
 The binge eating is not associated with the recurrent use of inappropriate compensatory
behavior as in bulimia and does not occur exclusively during the course of bulimia nervosa or
anorexia nervosa.

XI - Sexual Dysfunctions
1) Disorders Involving Sexual Interest, Desire, and Arousal
 Female Sexual interest/arousal disorder
 Male Hypoactive sexual desire disorder
 Erectile disorder
2) Orgasmic Disorders
 Female orgasmic disorder
 Early ejaculation
 Delayed Ejaculation Disorder
3) Genito-pelvic pain/penetration disorder
Disorders Involving Sexual Interest, Desire, and Arousal
Female Sexual interest/arousal disorder
 Diminished, absent, or reduced frequency of at least three of the following for 6 months
or more:
– Interest in sexual activity
– Erotic thoughts or fantasies
– Initiation of sexual activity and responsiveness to partner’s attempts to initiate
– Sexual excitement/pleasure during 75 percent of sexual encounters
– Sexual interest/arousal elicited by any internal or external erotic cues
– Genital or nongenital sensations during 75 percent of sexual encounters
Male Hypoactive sexual desire disorder
 Persistently or recurrently deficient (or absent) sexual/erotic thoughts or fantasies and desire
for sexual activity. The judgment of deficiency is made by the clinician.
 The symptoms in Criterion A have persisted for a minimum duration of approximately 6
months.
 The symptoms in Criterion A cause clinically significant distress in the individual.
 The sexual dysfunction is not better explained by a nonsexual mental disorder or as a
consequence of severe relationship distress or other significant stressors and is not
attributable to the effects of a substance/medication or another medical condition

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 Erectile disorder
 On at least 75 percent of sexual occasions for 6 months:
– Inability to attain an erection, or
– Inability to maintain an erection for completion of sexual activity, or
– Marked decrease in erectile rigidity interferes with penetration or pleasure
Orgasmic Disorders
Female orgasmic disorder
 On at least 75 percent of sexual occasions for 6 months:
– Marked delay, infrequency, or absence of orgasm, or
– Markedly reduced intensity of orgasmic sensation
Early ejaculation
 Tendency to ejaculate during partnered sexual activity within 1 minute of sexual activity on at
least 75 percent of sexual occasions for 6 months
Delayed Ejaculation Disorder
 Marked delay, infrequency, or absence of orgasm on at least 75 percent of sexual occasions
for 6 months
Genito-Pelvic Pain/Penetration Disorder
 Persistent or recurrent difficulties for at least 6 months with at least one of the following:
 Inability to have vaginal/ penetration during intercourse
 Marked vulvovaginal or pelvic pain during vaginal penetration or intercourse attempts
 Marked fear or anxiety about pain or penetration
 Marked tensing of the pelvic floor muscles during attempted vaginal penetration

XII - Paraphilic Disorders

Exhibitionistic Disorder
 Over a period of at least 6 months, recurrent and intense sexual arousal from the exposure of
one’s genitals to an unsuspecting person, as manifested by fantasies, urges, or behaviors.
 The individual has acted on these sexual urges with a nonconsenting person, or the sexual
urges or fantasies cause clinically significant distress or impairment in social, occupational,
or other important areas of functioning.
Voyeuristic Disorder
 Over a period of at least 6 months, recurrent and intense sexual arousal from observing an
unsuspecting person who is naked, in the process of disrobing, or engaging in sexual activity, as
manifested by fantasies, urges, or behaviors.
 The individual has acted on these sexual urges with a nonconsenting person, or the sexual urges
or fantasies cause clinically significant distress or impairment in social, occupational, or other
important areas of functioning.
 The individual experiencing the arousal and/or acting on the urges is at least 18 years of age.

Sexual Masochism Disorder

 Over a period of at least 6 months, recurrent and intense sexual arousal from the act of being
humiliated, beaten, bound, or otherwise made to suffer, as manifested by fantasies, urges, or
behaviors.
 The fantasies, sexual urges, or behaviors cause clinically significant distress or impairment
in social, occupational, or other important areas of functioning.
Sexual Sadism Disorder
 Over a period of at least 6 months, recurrent and intense sexual arousal from the physical or
psychological suffering of another person, as manifested by fantasies, urges, or behaviors.
 The individual has acted on these sexual urges with a nonconsenting person, or the sexual
urges or fantasies cause clinically significant distress or impairment in social, occupational,
or other important areas of functioning.

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Fetishistic Disorder
• Over a period of at least 6 months, recurrent and intense sexual arousal from either the use of
nonliving objects or a highly specific focus on nongenital body part(s), as manifested by
fantasies, urges, or behaviors.
• The fantasies, sexual urges, or behaviors cause clinically significant distress or impairment in
social, occupational, or other important areas of functioning.
• The fetish objects are not limited to articles of clothing used in cross-dressing (as in
transvestic disorder) or devices specifically designed for the purpose of tactile genital stimulation
(e.g., vibrator).
Frotteuristic Disorder
 Over a period of at least 6 months, recurrent and intense sexual arousal from touching or
rubbing against a nonconsenting person, as manifested by fantasies, urges, or behaviors.
 The individual has acted on these sexual urges with a nonconsenting person, or the sexual
urges or fantasies cause clinically significant distress or impairment in social, occupational,
or other important areas of functioning.
Transvestic Disorder
 Over a period of at least 6 months, recurrent and intense sexual arousal from crossdressing,
as manifested by fantasies, urges, or behaviors.
 The fantasies, sexual urges, or behaviors cause clinically significant distress or impairment in
social, occupational, or other important areas of functioning
Pedophilic Disorder
 Over a period of at least 6 months, recurrent, intense sexually arousing fantasies, sexual
urges, or behaviors involving sexual activity with a prepubescent child or children
(generally age 13 years or younger).
 The individual has acted on these sexual urges, or the sexual urges or fantasies cause marked
distress or interpersonal difficulty.
 The individual is at least age 16 years and at least 5 years older than the child or children in
Criterion A.

XIII - Gender Dysphoria

 A marked incongruence between one’s experienced/expressed gender and assigned
gender, of at least 6 months’ duration
 Strong desire to be a member of the other gender or strongly expressing the belief that one is
a member of the other gender
 Strong preferences for playing with members of the other gender and for toys, games, and
activities associated with the other gender
 Strong feelings of disgust and personal distress about one’s sexual anatomy
 Strong desires to have physical characteristics associated with one’s experienced gender
 Strong preferences for assuming roles of the other gender in make believe or fantasy play
 Strong preferences for wearing clothing typically associated with the other gender and
rejection of clothing associated with one’s own gender

XIV - Disruptive, Impulse Control and Conduct Disorders

1) Oppositional defiant disorder
2) Intermittent explosive disorder
3) Conduct disorder,
4) Antisocial personality disorder (which is described in the chapter ''Personality Disorders")
5) Pyromania
6) Kleptomania

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Oppositional Defiant Disorder
 A pattern of angry/irritable mood, argumentative/defiant behavior, or vindictiveness lasting at least 6
months
 The disturbance in behavior is associated with distress
 The behaviors do not occur exclusively during the course of a psychotic, substance use, depressive, or
bipolar disorder. Also, the criteria are not met for disruptive mood dysregulation disorder.
Intermittent Explosive Disorder
 Recurrent behavioral outbursts representing a failure to control aggressive impulses
 The magnitude of aggressiveness expressed during the recurrent outbursts is grossly out of
proportion to the provocation
 The recurrent aggressive outbursts are not premeditated and are not committed to achieve
some tangible objective
Conduct Disorder
 A repetitive and persistent pattern of behavior in which the basic rights of others or major age-
appropriate societal norms or rules are violated, as manifested by the presence of the following
criteria in the past 12 months; 6 months duration
– Aggression to People and Animals
– Destruction of Property
– Deceitful ness or Theft
– Serious Violations of Rules
 Functional impairment
 If the individual is age 18 years or older, criteria are not met for antisocial personality disorder
Pyromania
 Deliberate and purposeful fire setting on more than one occasion
 Tension or affective arousal before the act
 Fascination with, interest in, curiosity about, or attraction to fire and its situational contexts
 Pleasure, gratification, or relief when setting fires or when witnessing or participating in their
aftermath.
Kleptomania
 Recurrent failure to resist impulses to steal objects that are not needed for personal use or for
their monetary value.
 Increasing sense of tension immediately before committing the theft.
 Pleasure, gratification, or relief at the time of committing the theft.
 The stealing is not committed to express anger or vengeance and is not in response to a delusion
or a hallucination.
 The stealing is not better explained by conduct disorder, a manic episode, or antisocial
personality disorder

XV - Substance-Related and Addictive Disorders

Substance Use Disorder
 A maladaptive pattern of substance use leading to clinically significant impairment or distress
 Recurrent substance use in situations in which it is physically hazardous (e.g., driving an
automobile or operating a machine when impaired by substance use)
 Continued use leading to impairment in school or work
 Development of tolerance
 Characteristic withdrawal syndrome depending on substance
 Persistent desire to cut down or decrease substance use
 Drug-seeking behavior
Gambling Disorder
 Persistent and recurrent problematic gambling behavior leading to clinically significant impairment
or distress, as indicated by the individual exhibiting four (or more) of the symptoms
 The gambling behavior is not better explained by a manic episode.

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XV - Personality Disorders
Cluster A. Odd/Eccentric
1) Paranoid
2) Schizoid
3) Schizotypal
Cluster B. Dramatic/Erratic
1) Antisocial
2) Borderline
3) Histrionic
4) Narcissistic
Cluster C. Fearful/Anxious
1) Avoidant
2) Dependent
3) Obsessive-Compulsive

Cluster A (odd/eccentric)
Paranoid
 Presence of four or more of the following signs of distrust and suspiciousness, beginning by
early adulthood and shown in many contexts:
– Unjustified suspiciousness of being harmed, deceived, or exploited
– Unwarranted doubts about the loyalty or trustworthiness of friends or associates
– Reluctance to confide in others because of suspiciousness
– The tendency to read hidden meanings into the benign actions of others
– Bears grudges for perceived wrongs
– Angry reactions to perceived attacks on character or reputation
– Unwarranted suspiciousness of the fidelity of partner
Schizoid
 Presence of four or more of the following signs of interpersonal detachment and restricted
emotion are present from early adulthood across many contexts:
– Lack of desire for or enjoyment of close relationships
– Almost always prefers solitude to companionship
– Little interest in sex
– Few or no pleasurable activities
– Lack of friends
– Indifference to praise or criticism
– Flat affect, emotional detachment
Schizotypal
 Presence of five or more of the following in many contexts beginning in early adulthood:
– Ideas of reference
– Odd beliefs or magical thinking, e.g., belief in extrasensory perception
– Unusual perceptions, e.g., distorted feelings about one’s body
– Odd patterns of thought and speech
– Suspiciousness or paranoia
– Inappropriate or restricted affect
– Odd or eccentric behavior or appearance
– Lack of close friends
– Anxiety around other people, which does not diminish with familiarity

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Cluster B (dramatic/erratic)
Antisocial
 Age at least 18
 Evidence of conduct disorder before age 15
 Pervasive pattern of disregard for the rights of others since the age of 15 as shown by at least
three of the following:
– Repeated lawbreaking
– Deceitfulness, lying
– Impulsivity
– Irritability and aggressiveness
– Reckless disregard for own safety and that of others
– Irresponsibility as seen in unreliable employment or financial history
– Lack of remorse
Borderline
 Presence of five or more of the following in many contexts beginning by early adulthood:
– Frantic efforts to avoid abandonment
– Unstable interpersonal relationships in which others are either idealized or devalued
– Unstable sense of self
– Self-damaging, impulsive behaviors in at least two areas, such as spending, sex,
substance abuse, reckless driving, and binge eating
– Recurrent suicidal behavior, gestures, or self-injurious behavior (e.g., cutting self)
– Marked mood reactivity
– Chronic feelings of emptiness
– Recurrent bouts of intense or poorly controlled anger
– During stress, a tendency to experience transient paranoid thoughts an dissociative
symptoms
Histrionic
 Presence of five or more of the following signs of excessive emotionality and attention
seeking shown in many contexts by early adulthood:
– Strong need to be the center of attention
– Inappropriate sexually seductive behavior
– Rapidly shifting expression of emotions
– Use of physical appearance to draw attention to self
– Speech that is excessively impressionistic and lacking in detail
– Exaggerated, theatrical emotional expression
– Overly suggestible
– Misreads relationships as more intimate than they are
Narcissistic
 Presence of five or more of the following shown by early adulthood in many contexts:
– Grandiose view of one’s importance
– Preoccupation with one’s success, brilliance, beauty
– Belief that one is special and can be understood only by other high-status people
– Extreme need for admiration
– Strong sense of entitlement
– Tendency to exploit others
– Lack of empathy
– Envious of others
– Arrogant behavior or attitudes

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Cluster C (anxious/fearful)
Avoidant
 A pervasive pattern of social inhibition, feelings of inadequacy, and hypersensitivity to criticism as
shown by four or more of the following starting by early adulthood in many contexts:
– Avoidance of occupational activities that involve significant interpersonal contact,
because of fears of criticism or disapproval
– Unwilling to get involved with people unless certain of being liked
– Restrained in intimate relationships because of the fear of being shamed or ridiculed
– Preoccupation with being criticized or rejected
– Inhibited in new interpersonal situations because of feelings of inadequacy
– Views self as socially inept or inferior
– Unusually reluctant to try new activities because they may prove embarrassing
Dependent
 An excessive need to be taken care of, as shown by the presence of at least five of the following
beginning by early adulthood and shown in many contexts:
– Difficulty making decisions without excessive advice and reassurance from others
– Need for others to take responsibility for most major areas of life
– Difficulty disagreeing with others for fear of losing their support
– Difficulty doing things on own or starting projects because of lack of self-confidence
– Doing unpleasant things as a way to obtain the approval and
– support of others
– Feelings of helplessness when alone because of fears of being unable to care for self
– Urgently seeking new relationship when one ends
– Preoccupation with fears of having to take care of self
Obsessive-compulsive
 Intense need for order, perfection, and control, as shown by the presence of at least four of the
following beginning by early adulthood and evidenced in many contexts:
– Preoccupation with rules, details, and organization to the extent that the point of an
activity is lost
– Extreme perfectionism interferes with task completion
– Excessive devotion to work to the exclusion of leisure an friendships
– Inflexibility about morals and values
– Difficulty discarding worthless items
– Reluctance to delegate unless others conform to one’s standards
– Miserliness
– Rigidity and stubbornness

Reference:

American Psychiatric Association (2013). Diagnostic and statistical manual of mental disorders. (5 th ed.).
Washington, DC: American Psychiatric Association.

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