Psychopathology

Chapter 1:

Please check all that apply

?Major Changes      ?Minor Changes      ?Changed Tables/Figures             

?Changes Data &Statistics    ?Changed References/Citation

Summary of Changes:

·       The chapter’s first section elaborates further on the use of the word psychopathology in the field and discusses language considerations such as person-first language and the stigma associated with slang words often used to describe mental illness.

·       Data in the text and figures on the impact and prevalence of mental disorders have been updated.

·       The chapter’s discussion of twenty-first-century treatment approaches now considers the importance of diversity and cultural competency within the context of evidence-based care.

·       A new paragraph and new citations have been added on the unified treatment model/unified protocol, also known as transdiagnostic therapy.

Chapter 2: “

Please check all that apply

?Major Changes      ?Minor Changes      ?Changed Tables/Figures             

?Changes Data &Statistics    ?Changed References/Citation

 

Summary of Changes:

·         A new paragraph and new citations have been added on evolving understandings of the function of passive and active dendrites.

·       The chapter now better clarifies the distinctions between biochemical substances considered neurotransmitters and those considered hormones.

·       A new extended section discusses the relationship between the brain and the microbiome with reference to a number of studies conducted in the past 5 years

·       New study citations are included on cortical networks.

·       The section Genetics and Psychopathology has been reorganized to consolidate discussions of epigenetics and genome-wide association studies. The discussion of GWAS studies has been updated and expanded to include recent research reflecting current approaches to these studies and new findings in the field that have emerged from these studies.

Chapter 3:

Please check all that apply

?Major Changes      ?Minor Changes      ?Changed Tables/Figures             

?Changes Data &Statistics    ?Changed References/Citation

 

Summary of Changes:

·       New study citations have been added on endophenotypes as they relate to schizophrenia.

·       The chapter now notes the increasing feasibility of GWAS studies; study citations have been added on the benefits of GWAS studies for understandings of schizophrenia.

·       An example has been added discussing a meta-analysis considering the efficacy of telehealth services during the COVID-19 pandemic.

Chapter 4:

Please check all that apply

?Major Changes      ?Minor Changes      ?Changed Tables/Figures             

?Changes Data &Statistics    ?Changed References/Citation

 

Summary of Changes: 

·       New information has been added on the newly released DSM-5-TR.

·       The discussion of the Cultural Formulation Interview has been updated to reflect updates in the DSM-5-TR, particularly related to consideration of cultural identity in migrants.

·       The discussion of MMPI has been updated to reflect the 2020 release of MMPI-3.

·       New study citations have been added on linking the Rorschach test to its neuroscience principles.

·       The section Comorbidity and Hierarchical Approaches to Psychopathology has been extensively revised, including new study citations, to consider recent work on the p factor and the emergence of the Hierarchical Taxonomy of Psychopathology (HiTOP).

·       A new figure has been added illustrating the HiTOP model.

·       The box Lens: Assessment, Classification, and Clinical Practice: The RDoC Alternative to the DSM has been thoroughly updated, including new citations and a new figure illustrating elements of the RDoC Framework.

·       The section Classification Systems for Mental Disorders now elaborates on the goal of reliability of diagnosis.

·       The section on DSM5-TR has been updated to reflect the latest changes and the effort to make the DSM–5 and ICD-11 more similar with each new edition.

Chapter 5:

Please check all that apply

?Major Changes      ?Minor Changes      ?Changed Tables/Figures             

?Changes Data &Statistics    ?Changed References/Citation

 

Summary of Changes:

·       New study citations have been added on the effects of genetic malfunctions and early environmental experiences on brain development.

·       Discussion of early life stress has been expanded with updated data from child protective services, considering the unequal distribution of this data by race and ethnicity. This section also includes recent study citations on early life adversity’s effect on the developing brain structure.

·       The box Cultural Lens: Romania Adoption Study has been updated to cite a follow up study published in 2020.

·       New study citations have been added on mirror neurons and imitation learning.

·       A new study citation has been added on gender differences in the rate of brain development.

·       The section Conduct Disorder includes a new consideration of the etiology and brain processes underlying CD.

·       New subheadings have been added throughout the section Characteristics of Autism Spectrum Disorder to facilitate easier reading.

·       Table 5.3 has been updated with the DSM-5-TR criteria for Autism Spectrum Disorder.

·       New subheadings have been added throughout the section Causes of Autism Spectrum Disorder to facilitate easier reading.

·       New study citations have been added on genetic contributions to autism spectrum disorder.

·       Table 5.4 has been updated with the DSM-5-TR criteria for Attention Deficit/Hyperactivity Disorder.

·       The section Intellectual Development Disorder has been updated to reflect the ICD-11’s move away from the term “mental retardation.”

·       A new study citation has been added on the relationship between Down syndrome and Alzheimer’s disease.

Chapter 6:

Please check all that apply

?Major Changes      ?Minor Changes      ?Changed Tables/Figures             

?Changes Data &Statistics    ?Changed References/Citation

 

Summary of Changes:

·       The name of this chapter has been changed to “Mood Disorders”.

·       Figure 6.1 has been updated with more recent data on DALYs lost due to depression in countries around the world.

·       In the section Characteristics of Major Depressive Disorder, prevalence data has been updated, and new studies have been cited related to increases in depression in college students during the COVID-19 pandemic and the likelihood of recurrent depressive episodes.

·       Table 6.3 has been updated with the DSM-5-TR criteria for Major Depressive Disorder.

·       The box Understanding Changes in DSM-5 and DSM-5-TR has been updated to discuss the diagnostic category of prolonged grief disorder, new to the DSM-5-TR.

·       In the section Causes of Depression, new study citations have been added on models developed to map the pathway from stress to depression.

·       A new study citation has been added on the genetic connection between inflammation and symptoms of depression.

·       A new discussion and citations have been added on the potential of psilocybin to treat depression.

·       A new study citation has been added on vagal nerve stimulation treating depression by reducing inflammation.

·       The section Characteristics of Bipolar Disorder has been reorganized to facilitate easier reading and consolidate the discussions of Bipolar I, Bipolar II, and Cyclothymic Disorder.

·       Table 6.5 has been updated with the DSM-5-TR criteria for Bipolar I Disorder.

·       The section Causes of Bipolar Disorder includes new discussion and study citations on recent findings from GWAS research. This section also now discusses the correlation of Bipolar I with schizophrenia and of Bipolar II with major depressive disorder.

·       A study citation has been added on the efficacy of psychosocial family-based treatments for children and adolescents with bipolar disorder.

·       A new study citation has been added on the interpersonal-psychological theory of suicide.

·       Figure 6.12, Map of Suicide Rates Worldwide per 100,000 people, has been updated with 2019 data.

·       A new discussion and study citation has been added on gender differences in suicide attempts, including rates of mood disorders and suicide attempts among gender minorities.

·       Data in the box Lens: Suicide Among College Students have been updated.

·       The section Preventing Suicide has been updated with the new nationwide suicide hotline in the United States and a new discussion/study citation on the efficacy of machine learning in predicting who is at risk for suicide.

Chapter 7:

Please check all that apply

?Major Changes      ?Minor Changes      ?Changed Tables/Figures             

?Changes Data &Statistics    ?Changed References/Citation

 

Summary of Changes:

·       The title of this chapter has been changed to Stress, Trauma, and PTSD.

·       New study citations have been added on the relationships between childhood stress and trauma and the later development of physical and mental health problems.

·       New study citations have been added on the relationships among the immune system, inflammation, the gut microbiome, trauma, and psychopathology.

·       New study citations have been added on physiological reactions to stress and trauma.

·       A new study citation has been added on the nature of epigenetics as related to stress.

·       Table 7.1 has been updated with updated with the DSM-5-TR criteria for Acute Stress Disorder.

·       In the section Acute Stress Disorder, prevalence data have been updated.

·       A new section, Prolonged Grief Disorder, explains this new diagnostic category in DSM-5-TR.

·       The section Post-Traumatic Stress Disorder has been elevated to a major section in the chapter. This section has been reorganized to facilitate easier reading.

·       In the section Causes, Characteristics, and Prevalence of PTSD, new studies are cited on the development of PTSD among health care workers during the COVID-19 pandemic as well as the role of genetics in the development of PTSD. Prevalence data have also been updated.

·       Table 7.3 has been updated with updated with the DSM-5-TR criteria for Post-Traumatic Stress Disorder.

·       A new study citation has been added on examining the hippocampus in individuals with PTSD.

The section Treatment for Post-Traumatic Stress Disorder includes new study citations on cognitive and behavioral therapies and exposure therapy for people with PTSD

Chapter 8:

Please check all that apply

?Major Changes      ?Minor Changes      ?Changed Tables/Figures             

?Changes Data &Statistics    ?Changed References/Citation

 

Summary of Changes:

·       A new study citation has been added on the brain networks underlying anxiety.

·       New study citations have been added on temperament research among infants and models of anxiety development.

·       Table 8.6 has been updated with updated with the DSM-5-TR criteria for Generalized Anxiety Disorder.

·       New study citations have been added on the most effective treatments for GAD.

·       The box Lens: Anxiety and the Prescribing of Benzodiazepines has been updated with new data.

·       Table 8.6 has been updated with updated with the DSM-5-TR criteria for Social Anxiety Disorder.

·       New study citations have been added on the brain networks and regions underlying social anxiety, particularly research related to the amygdala.

·       The chapter’s discussion of Phobias and Panic Disorder has been elevated to a major section.

·       Table 8.8 has been updated with updated with the DSM-5-TR criteria for Specific Phobia.

·       Table 8.8 has been updated with updated with the DSM-5-TR criteria for Panic Disorder.

·       Table 8.12 has been updated with updated with the DSM-5-TR criteria for Obsessive-Compulsive Disorder.

·       A new study citation has been added on the relationship between OCD and autoimmune disorders.

·       In the section Neuroscience Aspects of OCD, new study citations have been added related to the genetic components of OCD.

Chapter 9:

Please check all that apply

?Major Changes      ?Minor Changes      ?Changed Tables/Figures             

?Changes Data &Statistics    ?Changed References/Citation

 

Summary of Changes:

·       The heading structure and learning objectives in this chapter have been streamlined and realigned to facilitate easier reading.

·       A new study citation has been added on the origins of dissociative symptoms.

·       A new study citation has been added on depersonalization as the result of difficulty integrating external stimuli with internal experiences.

·       Prevalence rates of depersonalization have been updated.

·       Table 9.3 has been updated with the DSM-5-TR criteria for Dissociative Identity Disorder.

A new study citation has been added on neurofunctional biomarkers of pathological dissociation.

Chapter 10:

Please check all that apply

?Major Changes      ?Minor Changes      ?Changed Tables/Figures             

?Changes Data &Statistics    ?Changed References/Citation

 

Summary of Changes:

    

·       The heading structure and learning objectives in this chapter have been streamlined and realigned to facilitate easier reading.

·       The section Obesity has been retitled, and it begins with a new paragraph both clarifying that obesity is not a mental disorder and explaining why it is considered alongside feeding and eating disorders. The section includes a revised framing of the causes of obesity and discussion of different connections between genetics, physiological processes, and the foods we eat.

·       Prevalence data on obesity and data on caloric intake worldwide have been updated.

·       The discussion of BMI has been nuanced to reflect current thinking about its utility in discussions of obesity and health.

·       A new study citation has been added on weight perception among transgender and nonbinary young adults.

·       Prevalence data for eating disorders has been updated.

·       A new study citation has been added on the association between childhood experiences and eating disorders.

·       Table 10.3 has been updated with the DSM-5-TR criteria for Anorexia Nervosa.

·       A new study citation has been added on brain networks as they relate to anorexia nervosa.

·       A new study citation has been added on cardiovascular measures in adult women who were treated for anorexia as adolescents.

·       A new study citation has been added on GWAS research into eating disorders.

·       Table 10.6 has been updated with the DSM-5-TR criteria for Bulimia Nervosa

Chapter 11:

Please check all that apply

?Major Changes      ?Minor Changes      ?Changed Tables/Figures             

?Changes Data &Statistics    ?Changed References/Citation

 

Summary of Changes:

    

·       Data on sexual orientation and behaviors of Americans have been updated.

·       The section Normal Sexual Functioning includes a new discussion of intersex individuals.

·       The section Pedophilic Disorder has been nuanced to clarify the distinction between the mental disorder pedophilia and the criminal behavior that results from acting on these urges.

·       The section Transvestic Disorder has been nuanced to better distinguish among people with transvestic disorder, transgender individuals, and individuals who engage in drag performance.

·       A new study citation has been added on the efficacy of Lupron as a treatment for paraphilic disorders.

·       Language throughout the section Gender Dysphoria has been revisited and revised to align with GLAAD guidelines for language use.

·       The box Understanding Changes in DSM-5 and DSM-5-TR: Sexual and Gender-Related Experiences has been updated in relation to new culturally sensitive language use in DSM-5-TR.

Chapter 12:

Please check all that apply

?Major Changes      ?Minor Changes      ?Changed Tables/Figures             

?Changes Data &Statistics    ?Changed References/Citation

 

Summary of Changes:

    

·       Data on drug use and substance use disorder prevalence have been thoroughly updated throughout this chapter based on the most recent available data from the Substance Abuse and Mental Health Services Administration and the United Nations.

·       The section Disorderered Substance Use, Dependence, and Addition has been retitled.

·       New study citations have been added on the risk of brain changes in adolescents associated with drug use and on the epigenetic factors involved in the association between teenage alcohol consumption and later-life alcohol use disorder and anxiety.

·       New study citations have been added on what GWAS approaches reveal about the heritability of addiction.

·       New study citations have been added on the neural networks involved in the reward experiences of taking drugs.

·       The section Alcohol has been reorganized to discuss culturally accepted uses before clinically disordered uses.

·       New study citations have been added on how alcohol influences the brain through changes in gene expression and epigenetic processes.

·       Table 12.3 has been updated with the DSM-5-TR criteria for Alcohol Use Disorder.

·       Table 12.4 has been updated with the DSM-5-TR criteria for Alcohol Intoxication.

·       Table 12.5 has been updated with the DSM-5-TR criteria for Alcohol Withdrawal.

·       The section Cannabis, Hallucinogens, and Opioids has been retitled.

·       Table 12.6 has been updated through 2022 with developments related to the legalization of cannabis in the United States.

·       A new study citation has been added on the effects of cannabis on the developing brain.

·       A new figure and study citation has been added on changes in the brain related to cannabis use disorder.

·       The box Lens: The Legalization of Cannabis has been updated to reflect the legal status of cannabis use by states.

·       A new study citation has been added on psilocybin as a potential treatment for major depressive disorder.

Chapter 13:

Please check all that apply

?Major Changes      ?Minor Changes      ?Changed Tables/Figures             

?Changes Data &Statistics    ?Changed References/Citation

 

Summary of Changes:

·       A new study citation has been added on a narrative study that examined the nature of the delusions experienced by people with schizophrenia.

·       Table 13.2 has been updated with the DSM-5-TR diagnostic criteria for Schizophrenia.

·       The chapter now discusses the AMP-SCZ initiative.

·       New study citations have been added on the relationship between the gut microbiome and schizophrenia.

·       New study citations have been added on GWAS research related to schizophrenia.

·       A new study citation has been added on the genetics of schizophrenia.

·       A new study citation has been added on work by the ENIGMA Working Group that used data from over 3000 individuals to compare the brain structure of individuals at high risk for developing psychosis and a control group.

·       A new study citation has been added on network models of schizophrenia.

New study citations have been added on the neurotransmitters involved in schizophrenia

    

Chapter 14:

Please check all that apply

?Major Changes      ?Minor Changes      ?Changed Tables/Figures             

?Changes Data &Statistics    ?Changed References/Citation

 

Summary of Changes:  .

·       Table 14.1 has been updated with the DSM-5-TR diagnostic criteria for General Personality Disorder.

·       New study citations have been added on comorbidities among personality disorders as seen in both clinic-based studies and large-scale studies of the general population.

·       New study citations have been added on the neurobiological processes that underlie borderline personality disorder.

·       New prevalence data has been added for obsessive-compulsive personality disorder.

Chapter 15:

Please check all that apply

?Major Changes      ?Minor Changes      ?Changed Tables/Figures             

?Changes Data &Statistics    ?Changed References/Citation

 

Summary of Changes:

    

·       The heading structure and learning objectives in this chapter have been streamlined and realigned to facilitate easier reading.

·       Data on aging populations worldwide have been updated based on the most recent available data from the U.S. Census Bureau.

·       A new study citation has been added on genes that can change during aging and how these relate to neurocognitive disorders.

·       Table 15.1 has been updated with the DSM-5-TR criteria for Mild Neurocognitive Disorder.

·       Table 15.2 has been updated with the DSM-5-TR criteria for Major Neurocognitive Disorder.

·       New study citations have been added on neurocognitive disorder due to Alzheimer’s disease.

·       Prevalence data for Alzheimer’s disease has been updated.

·       Table 15.2 has been updated with the DSM-5-TR criteria for Neurocognitive Disorder due to Alzheimer’s disease.

·       Coverage of recent research related to microglia has been added, noting the importance of microglia in the development of Alzheimer’s disease.

·       New study citations have been added on Alzheimer’s’ association with the APOE gene and the TREM2 gene as well as GWAS approaches that are searching for risk locations of additional genes.

 

Chapter 16:

Please check all that apply

?Major Changes      ?Minor Changes      ?Changed Tables/Figures             

?Changes Data &Statistics    ?Changed References/Citation

 

Summary of Changes:

·       Discussions of mass shootings in the United States have been updated to account for recent events.

·       The section Competency to Stand Trial has been reframed with new subheadings added to facilitate easier reading.