Teaching DSM-III to clinicians. Some problems of the DSM-III system reducing reliability, using the diagnosis and classification of depressive disorders as an example.

PubMed

Malt, U F

1986-01-01

Experiences from teaching DSM-III to more than three hundred Norwegian psychiatrists and clinical psychologists suggest that reliable DSM-III diagnoses can be achieved within a few hours training with reference to the decision trees and the diagnostic criteria only. The diagnoses provided are more reliable than the corresponding ICD diagnoses which the participants were more familiar with. The three main sources of reduced reliability of the DSM-III diagnoses are related to: poor knowledge of the criteria which often is connected with failure of obtaining diagnostic key information during the clinical interview; unfamiliar concepts and vague or ambiguous criteria. The two first issues are related to the quality of the teaching of DSM-III. The third source of reduced reliability reflects unsolved validity issues. By using the classification of five affective case stories as examples, these sources of diagnostic pitfalls, reducing reliability and ways to overcome these problems when teaching the DSM-III system, are discussed. It is concluded that the DSM-III system of classification is easy to teach and that the system is superior to other classification systems available from a reliability point of view. The current version of the DSM-III system, however, partly owes a high degree of reliability to broad and heterogeneous diagnostic categories like the concept major depression, which may have questionable validity. Thus, the future revisions of the DSM-III system should, above all, address the issue of validity.

DSM Generation from ALSO/PRISM Images Using SAT-PP

NASA Astrophysics Data System (ADS)

Wolff, Kirsten; Gruen, Armin

2008-11-01

One of the most important products of ALOS/PRISM image data are accurate DSMs. To exploit the full potential of the full resolution of PRISM for DSM generation, a highly developed image matcher is needed. As a member of the validation and calibration team for PRISM we published earlier results of DSM generation using PRISM image triplets in combination with our software package SAT-PP. The overall accuracy across all object and image features for all tests lies between 1-5 pixels in matching, depending primarily on surface roughness, vegetation, image texture and image quality. Here we will discuss some new results. We focus on four different topics: the use of two different evaluation methods, the difference between a 5m and a 10m GSD for the final PRISM DSM, the influence of the level of initial information and the comparison of the quality of different combinations of the three different views forward, nadir and backward. All tests have been conducted with our testfield Bern/Thun, Switzerland.

Concordance between gambling disorder diagnoses in the DSM-IV and DSM-5; Results from the National Epidemiological Survey of Alcohol and Related Disorders

PubMed Central

Petry, Nancy M.; Blanco, Carlos; Jin, Chelsea; Grant, Bridget F.

2015-01-01

The fifth edition of the Diagnostic and Statistic Manual for Mental Disorders (DSM-5) eliminates the committing illegal acts criterion and reduces the threshold for a diagnosis of gambling disorder to four of nine criteria. This study compared the DSM-5 “4 of 9” classification system to the “5 of 10” DSM-IV system, as well as other permutations (i.e., just lowing the threshold to four criteria or just eliminating the illegal acts criterion) in 43,093 respondents to the National Epidemiological Survey of Alcohol and Related Conditions. Subgroups were analyzed to ascertain if changes will impact differentially diagnoses based on gender, age or race/ethnicity. In the full sample and each subpopulation, prevalence rates were higher when the DSM-5 classification system was employed relative to the DSM-IV system, but the hit rate between the two systems ranged from 99.80% to 99.96%. Across all gender, age and racial/ethnic subgroups, specificity was greater than 99% when the DSM-5 system was employed relative to the DSM-IV system, and sensitivity was 100%. Results from this study suggest that eliminating the illegal acts criterion has little impact on diagnosis of gambling disorder, but lowering the threshold for diagnosis does increase the base rate in the general population and each subgroup, even though overall rates remain low and sensitivity and specificity are high. PMID:24588275

An appraisal of the DSM-III system.

PubMed

Adamson, J

1989-05-01

DSM-III is a major document in the history of psychiatry. The DSM-III system is here seen as an instrument that promotes the scientific development of psychiatry and the clarity of communication among psychiatrists. However a major theme of this review is that reliability does not ensure validity. While making this point it is recognized that the major defects in the DSM-III system result from scientific inadequacies inherent in present day psychiatry. This review also may be taken as an amplification of the statement in DSM-III-R that it is not a textbook. In particular the data required to arrive at diagnoses in the DSM-III system do not provide sufficient information to arrive at a comprehensive biopsychosocial case formulation, a shortcoming that has relevance for teaching and clinical practice.

Comparison of Uas-Based Photogrammetry Software for 3d Point Cloud Generation: a Survey Over a Historical Site

NASA Astrophysics Data System (ADS)

Alidoost, F.; Arefi, H.

2017-11-01

Nowadays, Unmanned Aerial System (UAS)-based photogrammetry offers an affordable, fast and effective approach to real-time acquisition of high resolution geospatial information and automatic 3D modelling of objects for numerous applications such as topography mapping, 3D city modelling, orthophoto generation, and cultural heritages preservation. In this paper, the capability of four different state-of-the-art software packages as 3DSurvey, Agisoft Photoscan, Pix4Dmapper Pro and SURE is examined to generate high density point cloud as well as a Digital Surface Model (DSM) over a historical site. The main steps of this study are including: image acquisition, point cloud generation, and accuracy assessment. The overlapping images are first captured using a quadcopter and next are processed by different software to generate point clouds and DSMs. In order to evaluate the accuracy and quality of point clouds and DSMs, both visual and geometric assessments are carry out and the comparison results are reported.

Implications of DSM-5 for the diagnosis of pediatric eating disorders.

PubMed

Limburg, Karina; Shu, Chloe Y; Watson, Hunna J; Hoiles, Kimberley J; Egan, Sarah J

2018-05-01

The aim of the study was to compare the DSM-IV, DSM-5, and ICD-10 eating disorders (ED) nomenclatures to assess their value in the classification of pediatric eating disorders. We investigated the prevalence of the disorders in accordance with each system's diagnostic criteria, diagnostic concordance between the systems, and interrater reliability. Participants were 1062 children and adolescents assessed at intake to a specialist Eating Disorders Program (91.6% female, mean age 14.5 years, SD = 1.75). Measures were collected from routine intake assessments. DSM-5 categorization led to a lower prevalence of unspecified EDs when compared with DSM-IV. There was almost complete overlap for specified EDs. Kappa values indicated almost excellent agreement between the two coders on all three diagnostic systems, although there was higher interrater reliability for DSM-5 and ICD-10 when compared with DSM-IV. DSM-5 nomenclature is useful in classifying eating disorders in pediatric clinical samples. © 2018 Wiley Periodicals, Inc.

Delirium diagnosis defined by cluster analysis of symptoms versus diagnosis by DSM and ICD criteria: diagnostic accuracy study.

PubMed

Sepulveda, Esteban; Franco, José G; Trzepacz, Paula T; Gaviria, Ana M; Meagher, David J; Palma, José; Viñuelas, Eva; Grau, Imma; Vilella, Elisabet; de Pablo, Joan

2016-05-26

Information on validity and reliability of delirium criteria is necessary for clinicians, researchers, and further developments of DSM or ICD. We compare four DSM and ICD delirium diagnostic criteria versions, which were developed by consensus of experts, with a phenomenology-based natural diagnosis delineated using cluster analysis of delirium features in a sample with a high prevalence of dementia. We also measured inter-rater reliability of each system when applied by two evaluators from distinct disciplines. Cross-sectional analysis of 200 consecutive patients admitted to a skilled nursing facility, independently assessed within 24-48 h after admission with the Delirium Rating Scale-Revised-98 (DRS-R98) and for DSM-III-R, DSM-IV, DSM-5, and ICD-10 criteria for delirium. Cluster analysis (CA) delineated natural delirium and nondelirium reference groups using DRS-R98 items and then diagnostic systems' performance were evaluated against the CA-defined groups using logistic regression and crosstabs for discriminant analysis (sensitivity, specificity, percentage of subjects correctly classified by each diagnostic system and their individual criteria, and performance for each system when excluding each individual criterion are reported). Kappa Index (K) was used to report inter-rater reliability for delirium diagnostic systems and their individual criteria. 117 (58.5 %) patients had preexisting dementia according to the Informant Questionnaire on Cognitive Decline in the Elderly. CA delineated 49 delirium subjects and 151 nondelirium. Against these CA groups, delirium diagnosis accuracy was highest using DSM-III-R (87.5 %) followed closely by DSM-IV (86.0 %), ICD-10 (85.5 %) and DSM-5 (84.5 %). ICD-10 had the highest specificity (96.0 %) but lowest sensitivity (53.1 %). DSM-III-R had the best sensitivity (81.6 %) and the best sensitivity-specificity balance. DSM-5 had the highest inter-rater reliability (K =0.73) while DSM-III-R criteria were the least reliable. Using our CA-defined, phenomenologically-based delirium designations as the reference standard, we found performance discordance among four diagnostic systems when tested in subjects where comorbid dementia was prevalent. The most complex diagnostic systems have higher accuracy and the newer DSM-5 have higher reliability. Our novel phenomenological approach to designing a delirium reference standard may be preferred to guide revisions of diagnostic systems in the future.

Cognitive and Adaptive Skills in Toddlers Who Meet Criteria for Autism in DSM-IV but Not DSM-5

ERIC Educational Resources Information Center

Jashar, Dasal Tenzin; Brennan, Laura A.; Barton, Marianne L.; Fein, Deborah

2016-01-01

The current study compared adaptive and cognitive skills, and autism severity of toddlers with an autism spectrum disorder (ASD) diagnosis under DSM-IV but not DSM-5 criteria (DSM-IV only group) to those who met autism criteria under both diagnostic systems (DSM-5 group) and to those without ASD (non-ASD group). The toddlers in the DSM-IV only…

sA Comparison of DSM-IV-TR and DSM-5 Diagnostic Classifications in the Clinical Diagnosis of Autistic Spectrum Disorder

ERIC Educational Resources Information Center

Yaylaci, Ferhat; Miral, Suha

2017-01-01

Aim of this study was to compare children diagnosed with Pervasive Developmental Disorder (PDD) according to DSM-IV-TR and DSM-5 diagnostic systems. One hundred fifty children aged between 3 and 15 years diagnosed with PDD by DSM-IV-TR were included. PDD symptoms were reviewed through psychiatric assessment based on DSM-IV-TR and DSM-5 criteria.…

Observing Crop-Height Dynamics Using a UAV

NASA Astrophysics Data System (ADS)

Ziliani, M. G.; Parkes, S. D.; McCabe, M.

2017-12-01

Retrieval of vegetation height during a growing season is a key indicator for monitoring crop status, offering insight to the forecast yield relative to previous planting cycles. Improvement in Unmanned Aerial Vehicle (UAV) technologies, supported by advances in computer vision and photogrammetry software, has enabled retrieval of crop heights with much higher spatial resolution and coverage. These methodologies retrieve a Digital Surface Map (DSM), which combine terrain and crop elements to obtain a Crop Surface Map (CSM). Here we describe an automated method for deriving high resolution CSMs from a DSM, using RGB imagery from a UAV platform. Importantly, the approach does not require the need for a digital terrain map (DTM). The method involves distinguishing between vegetation and bare-ground cover pixels, using vegetation index maps from the RGB orthomosaic derived from the same flight as the DSM. We show that the absolute crop height can be extracted to within several centimeters, exploiting the data captured from a single UAV flight. In addition, the method is applied across five surveys during a maize growing cycle and compared against a terrain map constructed from a baseline UAV survey undertaken prior to crop growth. Results show that the approach is able to reproduce the observed spatial variability of the crop height within the maize field throughout the duration of the growing season. This is particularly valuable since it may be employed to detect intra-field problems (i.e. fertilizer variability, inefficiency in the irrigation system, salinity etc.) at different stages of the season, from which remedial action can be initiated to mitigate against yield loss. The method also demonstrates that UAV imagery combined with commercial photogrammetry software can determine a CSM from a single flight without the requirement of a prior DTM. This, together with the dynamic crop height estimation, provide useful information with which to inform precision agricultural management at the local scale.

Assessment of Semi-Structured Clinical Interview for Mobile Phone Addiction Disorder.

PubMed

Alavi, Seyyed Salman; Mohammadi, Mohammad Reza; Jannatifard, Fereshteh; Mohammadi Kalhori, Soroush; Sepahbodi, Ghazal; BabaReisi, Mohammad; Sajedi, Sahar; Farshchi, Mojtaba; KhodaKarami, Rasul; Hatami Kasvaee, Vahid

2016-04-01

The Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR) classified mobile phone addiction disorder under "impulse control disorder not elsewhere classified". This study surveyed the diagnostic criteria of DSM-IV-TR for the diagnosis of mobile phone addiction in correspondence with Iranian society and culture. Two hundred fifty students of Tehran universities were entered into this descriptive-analytical and cross-sectional study. Quota sampling method was used. At first, semi- structured clinical interview (based on DSM-IV-TR) was performed for all the cases, and another specialist reevaluated the interviews. Data were analyzed using content validity, inter-scorer reliability (Kappa coefficient) and test-retest via SPSS18 software. The content validity of the semi- structured clinical interview matched the DSM-IV-TR criteria for behavioral addiction. Moreover, their content was appropriate, and two items, including "SMS pathological use" and "High monthly cost of using the mobile phone" were added to promote its validity. Internal reliability (Kappa) and test-retest reliability were 0.55 and r = 0.4 (p<0. 01) respectively. The results of this study revealed that semi- structured diagnostic criteria of DSM-IV-TR are valid and reliable for diagnosing mobile phone addiction, and this instrument is an effective tool to diagnose this disorder.

Convergent, discriminant, and criterion validity of DSM-5 traits.

PubMed

Yalch, Matthew M; Hopwood, Christopher J

2016-10-01

Section III of the Diagnostic and Statistical Manual of Mental Disorders (5th edi.; DSM-5; American Psychiatric Association, 2013) contains a system for diagnosing personality disorder based in part on assessing 25 maladaptive traits. Initial research suggests that this aspect of the system improves the validity and clinical utility of the Section II Model. The Computer Adaptive Test of Personality Disorder (CAT-PD; Simms et al., 2011) contains many similar traits as the DSM-5, as well as several additional traits seemingly not covered in the DSM-5. In this study we evaluate the convergent and discriminant validity between the DSM-5 traits, as assessed by the Personality Inventory for DSM-5 (PID-5; Krueger et al., 2012), and CAT-PD in an undergraduate sample, and test whether traits included in the CAT-PD but not the DSM-5 provide incremental validity in association with clinically relevant criterion variables. Results supported the convergent and discriminant validity of the PID-5 and CAT-PD scales in their assessment of 23 out of 25 DSM-5 traits. DSM-5 traits were consistently associated with 11 criterion variables, despite our having intentionally selected clinically relevant criterion constructs not directly assessed by DSM-5 traits. However, the additional CAT-PD traits provided incremental information above and beyond the DSM-5 traits for all criterion variables examined. These findings support the validity of pathological trait models in general and the DSM-5 and CAT-PD models in particular, while also suggesting that the CAT-PD may include additional traits for consideration in future iterations of the DSM-5 system. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

Five years of experience with the DSM-III system in clinical work and research: some concluding remarks.

PubMed

Malt, U

1986-01-01

The reliability of the DSM-III is superior to other classification systems available in psychiatry. However, reliability depends on proper knowledge of the system. Some pitfalls reducing reliability of axis 1 diagnosis which commonly are overlooked are discussed. Secondly, some problems of validity of axis 1 and 2 are considered. This is done by discussing the differential diagnosis of organic mental disorders and other psychiatric disorders with concomittant physical dysfunction, and the diagnoses of post-traumatic stress disorders and adjustment disorders among others. The emphasis on health care seeking behaviour as a diagnostic criteria in the DSM-III system, may cause a social, racial and sexual bias in DSM-III diagnoses. The present discussion of the DSM-III system from a clinical point of view indicates the need for validation studies based on clinical experience with the DSM-III. These studies should include more out-patients and patients with psychopathology who do not seek psychiatric treatment. Such studies must also apply alternative diagnostic standards like the ICD-9 and not only rely on structured psychiatric interviews constructed for DSM-III diagnoses. The discussion of axis 4 points to the problem of wanting to combine reliable rating with clinically meaningful information. It is concluded that the most important issue to be settled regarding axis 4 in the future revisions is the aim of including this axis. The discussion of axis 5 concludes that axis 5 is biased toward poor functioning and thus may be less usefull when applied on patients seen outside hospitals. Despite these problems of the DSM-III, our experiences indicate that the use of the DSM-III is fruitful both for the patient, the clinician and the researcher. Thus, the cost of time and effort needed to learn to use the DSM-III properly are small compared to the benefits achieved by using the system.

The relationship between five-factor model and diagnostic and statistical manual of mental disorder-fifth edition personality traits on patients with antisocial personality disorder.

PubMed

Amini, Mahdi; Pourshahbaz, Abbas; Mohammadkhani, Parvaneh; Ardakani, Mohammad-Reza Khodaie; Lotfi, Mozhgan; Ramezani, Mohammad Arash

2015-05-01

Despite the fact that new criteria of antisocial personality disorder (ASPD) in diagnostic and statistical manual of mental disorders-fifth edition (DSM-5) were resulted from five-factor model (FFM), there is a small amount of studies that investigate the relations between proposed personality traits and FFM. Also, cross-cultural study in this field continuously would be needed. The aim of the present study was to evaluate the relation between the FFM and DSM-5 ASPD pathological traits. This study was a cross-sectional study design. The participants consisted of 122 individuals with ASPD that selected from prisoners (73.0%), outpatients (18.0%), and inpatients (9.0%). They were recruited from Tehran Prisoners, and Clinical Psychology and Psychiatry Clinics of Razi and Taleghani Hospitals, Tehran, Iran, since 2013-2014. The Sample was selected based on judgmental sampling. The structured clinical interview for DSM-IV axis II disorders-Personality Questionnaire, NEO-Personality Inventory-Revised, and DSM-5 personality trait rating form were used to diagnosis and assessment of personality disorder. Pearson correlation has been used for data analysis. All statistical analyses were performed using the SPSS 16 software. The results indicate that neuroticism (N) has positive significant relationship with hostility (r = 0.33, P < 0.01), manipulativeness (r = 0.25, P < 0.01), deceitfulness (r =.23, P < 0.01), impulsivity (r = 0.20, P < 0.05), and negative relation with risk taking (r = -0.23, P < 0.01). Also, there was significant relationship between extraversion (E) with manipulativeness (r = 0.28, P < 0.01) and deceitfulness (r = 0.32, P < 0.01). Agreeableness and conscientiousness have negative significant relation with DSM-5 traits. In addition, results showed that there is positive significant relationship between FFM and DSM-5 personality traits with DSM-fourth edition-text revision (DSM-IV-TR) ASPD symptoms (P < 0.01). Except manipulativeness, deceitfulness, and callousness, there is positively significant relationship between DSM-5 ASPD traits and DSM-IV-TR ASPD symptoms. The present study helps to understand the adequacy of dimensional approach to evaluation of ASPD pathology, specifically on Iranian sample.

A comparison of delirium diagnosis in elderly medical inpatients using the CAM, DRS-R98, DSM-IV and DSM-5 criteria.

PubMed

Adamis, Dimitrios; Rooney, Siobhan; Meagher, David; Mulligan, Owen; McCarthy, Geraldine

2015-06-01

The recently published DSM-5 criteria for delirium may lead to different case identification and rates of delirium than previous classifications. The aims of this study are to determine how the new DSM-5 criteria compare with DSM-IV in identification of delirium in elderly medical inpatients and to investigate the agreement between different methods, using CAM, DRS-R98, DSM-IV, and DSM-5 criteria. Prospective, observational study of elderly patients aged 70+ admitted under the acute medical teams in a regional general hospital. Each participant was assessed within 3 days of admission using the DSM-5, and DSM-IV criteria plus the DRS-R98, and CAM scales. We assessed 200 patients [mean age 81.1±6.5; 50% female; pre-existing cognitive impairment in 63%]. The prevalence rates of delirium for each diagnostic method were: 13.0% (n = 26) for DSM-5; 19.5% (n = 39) for DSM-IV; 13.5% (n = 27) for DRS-R98 and 17.0%, (n = 34) for CAM. Using tetrachoric correlation coefficients the agreement between DSM-5 and DSM-IV was statistically significant (ρtetr = 0.64, SE = 0.1, p < 0.0001). Similar significant agreement was found between the four methods. DSM-IV is the most inclusive diagnostic method for delirium, while DSM-5 is the most restrictive. In addition, these classification systems identify different cases of delirium. This could have clinical, financial, and research implications. However, both classification systems have significant agreement in the identification of the same concept (delirium). Clarity of diagnosis is required for classification but also further research considering the relevance in predicting outcomes can allow for more detailed evaluation of the DSM-5 criteria.

A Comparison of DSM-IV-TR and DSM-5 Diagnostic Classifications in the Clinical Diagnosis of Autistic Spectrum Disorder.

PubMed

Yaylaci, Ferhat; Miral, Suha

2017-01-01

Aim of this study was to compare children diagnosed with Pervasive Developmental Disorder (PDD) according to DSM-IV-TR and DSM-5 diagnostic systems. One hundred fifty children aged between 3 and 15 years diagnosed with PDD by DSM-IV-TR were included. PDD symptoms were reviewed through psychiatric assessment based on DSM-IV-TR and DSM-5 criteria. Clinical severity was determined using Childhood Autism Rating Scale (CARS) and Autism Behavior Checklist (ABC). A statistically significant decrease (19.3 %) was detected in the diagnostic ratio with DSM-5. Age and symptom severity differed significantly between those who were and were not diagnosed with PDD using DSM-5. B4 criteria in DSM-5 was most common criterion. Results indicate that individuals diagnosed with PDD by DSM-IV-TR criteria may not be diagnosed using DSM-5 criteria.

Optimizing interplanetary trajectories with deep space maneuvers. M.S. Thesis

NASA Technical Reports Server (NTRS)

Navagh, John

1993-01-01

Analysis of interplanetary trajectories is a crucial area for both manned and unmanned missions of the Space Exploration Initiative. A deep space maneuver (DSM) can improve a trajectory in much the same way as a planetary swingby. However, instead of using a gravitational field to alter the trajectory, the on-board propulsion system of the spacecraft is used when the vehicle is not near a planet. The purpose is to develop an algorithm to determine where and when to use deep space maneuvers to reduce the cost of a trajectory. The approach taken to solve this problem uses primer vector theory in combination with a non-linear optimizing program to minimize Delta(V). A set of necessary conditions on the primer vector is shown to indicate whether a deep space maneuver will be beneficial. Deep space maneuvers are applied to a round trip mission to Mars to determine their effect on the launch opportunities. Other studies which were performed include cycler trajectories and Mars mission abort scenarios. It was found that the software developed was able to locate quickly DSM's which lower the total Delta(V) on these trajectories.

Optimizing interplanetary trajectories with deep space maneuvers

NASA Astrophysics Data System (ADS)

Navagh, John

1993-09-01

Analysis of interplanetary trajectories is a crucial area for both manned and unmanned missions of the Space Exploration Initiative. A deep space maneuver (DSM) can improve a trajectory in much the same way as a planetary swingby. However, instead of using a gravitational field to alter the trajectory, the on-board propulsion system of the spacecraft is used when the vehicle is not near a planet. The purpose is to develop an algorithm to determine where and when to use deep space maneuvers to reduce the cost of a trajectory. The approach taken to solve this problem uses primer vector theory in combination with a non-linear optimizing program to minimize Delta(V). A set of necessary conditions on the primer vector is shown to indicate whether a deep space maneuver will be beneficial. Deep space maneuvers are applied to a round trip mission to Mars to determine their effect on the launch opportunities. Other studies which were performed include cycler trajectories and Mars mission abort scenarios. It was found that the software developed was able to locate quickly DSM's which lower the total Delta(V) on these trajectories.

DSM-IV, DSM-5, and ICD-11: Identifying children with posttraumatic stress disorder after disasters.

PubMed

Danzi, BreAnne A; La Greca, Annette M

2016-12-01

Different criteria for diagnosing posttraumatic stress disorder (PTSD) have been recommended by the 5th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) and the proposed 11th edition of the International Classification of Diseases (ICD-11). Although children are vulnerable to PTSD following disasters, little is known about whether these revised criteria are appropriate for preadolescents, as diagnostic revisions have been based primarily on adult research. This study investigated rates of PTSD using DSM-IV, DSM-5, and ICD-11 diagnostic criteria, and their associations with symptom severity, impairment, and PTSD risk factors. Children (7-11 years) exposed to Hurricanes Ike (n = 327) or Charley (n = 383) completed measures 8-9 months postdisaster. Using diagnostic algorithms for DSM-IV, DSM-5, and ICD-11, rates of 'probable' PTSD were calculated. Across samples, rates of PTSD were similar. However, there was low agreement across the diagnostic systems, with about a third overlap in identified cases. Children identified only by ICD-11 had higher 'core' symptom severity but lower impairment than children identified only by DSM-IV or DSM-5. ICD-11 was associated with more established risk factors for PTSD than was DSM-5. Findings revealed differences in PTSD diagnosis across major diagnostic systems for preadolescent children, with no clear advantage to any one system. Further research on developmentally sensitive PTSD criteria for preadolescent children is needed. © 2016 Association for Child and Adolescent Mental Health.

A low power biomedical signal processor ASIC based on hardware software codesign.

PubMed

Nie, Z D; Wang, L; Chen, W G; Zhang, T; Zhang, Y T

2009-01-01

A low power biomedical digital signal processor ASIC based on hardware and software codesign methodology was presented in this paper. The codesign methodology was used to achieve higher system performance and design flexibility. The hardware implementation included a low power 32bit RISC CPU ARM7TDMI, a low power AHB-compatible bus, and a scalable digital co-processor that was optimized for low power Fast Fourier Transform (FFT) calculations. The co-processor could be scaled for 8-point, 16-point and 32-point FFTs, taking approximate 50, 100 and 150 clock circles, respectively. The complete design was intensively simulated using ARM DSM model and was emulated by ARM Versatile platform, before conducted to silicon. The multi-million-gate ASIC was fabricated using SMIC 0.18 microm mixed-signal CMOS 1P6M technology. The die area measures 5,000 microm x 2,350 microm. The power consumption was approximately 3.6 mW at 1.8 V power supply and 1 MHz clock rate. The power consumption for FFT calculations was less than 1.5 % comparing with the conventional embedded software-based solution.

Accuracy Assessment of Coastal Topography Derived from Uav Images

NASA Astrophysics Data System (ADS)

Long, N.; Millescamps, B.; Pouget, F.; Dumon, A.; Lachaussée, N.; Bertin, X.

2016-06-01

To monitor coastal environments, Unmanned Aerial Vehicle (UAV) is a low-cost and easy to use solution to enable data acquisition with high temporal frequency and spatial resolution. Compared to Light Detection And Ranging (LiDAR) or Terrestrial Laser Scanning (TLS), this solution produces Digital Surface Model (DSM) with a similar accuracy. To evaluate the DSM accuracy on a coastal environment, a campaign was carried out with a flying wing (eBee) combined with a digital camera. Using the Photoscan software and the photogrammetry process (Structure From Motion algorithm), a DSM and an orthomosaic were produced. Compared to GNSS surveys, the DSM accuracy is estimated. Two parameters are tested: the influence of the methodology (number and distribution of Ground Control Points, GCPs) and the influence of spatial image resolution (4.6 cm vs 2 cm). The results show that this solution is able to reproduce the topography of a coastal area with a high vertical accuracy (< 10 cm). The georeferencing of the DSM require a homogeneous distribution and a large number of GCPs. The accuracy is correlated with the number of GCPs (use 19 GCPs instead of 10 allows to reduce the difference of 4 cm); the required accuracy should be dependant of the research problematic. Last, in this particular environment, the presence of very small water surfaces on the sand bank does not allow to improve the accuracy when the spatial resolution of images is decreased.

First Prismatic Building Model Reconstruction from Tomosar Point Clouds

NASA Astrophysics Data System (ADS)

Sun, Y.; Shahzad, M.; Zhu, X.

2016-06-01

This paper demonstrates for the first time the potential of explicitly modelling the individual roof surfaces to reconstruct 3-D prismatic building models using spaceborne tomographic synthetic aperture radar (TomoSAR) point clouds. The proposed approach is modular and works as follows: it first extracts the buildings via DSM generation and cutting-off the ground terrain. The DSM is smoothed using BM3D denoising method proposed in (Dabov et al., 2007) and a gradient map of the smoothed DSM is generated based on height jumps. Watershed segmentation is then adopted to oversegment the DSM into different regions. Subsequently, height and polygon complexity constrained merging is employed to refine (i.e., to reduce) the retrieved number of roof segments. Coarse outline of each roof segment is then reconstructed and later refined using quadtree based regularization plus zig-zag line simplification scheme. Finally, height is associated to each refined roof segment to obtain the 3-D prismatic model of the building. The proposed approach is illustrated and validated over a large building (convention center) in the city of Las Vegas using TomoSAR point clouds generated from a stack of 25 images using Tomo-GENESIS software developed at DLR.

Distributed Space Mission Design for Earth Observation Using Model-Based Performance Evaluation

NASA Technical Reports Server (NTRS)

Nag, Sreeja; LeMoigne-Stewart, Jacqueline; Cervantes, Ben; DeWeck, Oliver

2015-01-01

Distributed Space Missions (DSMs) are gaining momentum in their application to earth observation missions owing to their unique ability to increase observation sampling in multiple dimensions. DSM design is a complex problem with many design variables, multiple objectives determining performance and cost and emergent, often unexpected, behaviors. There are very few open-access tools available to explore the tradespace of variables, minimize cost and maximize performance for pre-defined science goals, and therefore select the most optimal design. This paper presents a software tool that can multiple DSM architectures based on pre-defined design variable ranges and size those architectures in terms of predefined science and cost metrics. The tool will help a user select Pareto optimal DSM designs based on design of experiments techniques. The tool will be applied to some earth observation examples to demonstrate its applicability in making some key decisions between different performance metrics and cost metrics early in the design lifecycle.

Airborne laser scanning for forest health status assessment and radiative transfer modelling

NASA Astrophysics Data System (ADS)

Novotny, Jan; Zemek, Frantisek; Pikl, Miroslav; Janoutova, Ruzena

2013-04-01

Structural parameters of forest stands/ecosystems are an important complementary source of information to spectral signatures obtained from airborne imaging spectroscopy when quantitative assessment of forest stands are in the focus, such as estimation of forest biomass, biochemical properties (e.g. chlorophyll /water content), etc. The parameterization of radiative transfer (RT) models used in latter case requires three-dimensional spatial distribution of green foliage and woody biomass. Airborne LiDAR data acquired over forest sites bears these kinds of 3D information. The main objective of the study was to compare the results from several approaches to interpolation of digital elevation model (DEM) and digital surface model (DSM). We worked with airborne LiDAR data with different density (TopEye Mk II 1,064nm instrument, 1-5 points/m2) acquired over the Norway spruce forests situated in the Beskydy Mountains, the Czech Republic. Three different interpolation algorithms with increasing complexity were tested: i/Nearest neighbour approach implemented in the BCAL software package (Idaho Univ.); ii/Averaging and linear interpolation techniques used in the OPALS software (Vienna Univ. of Technology); iii/Active contour technique implemented in the TreeVis software (Univ. of Freiburg). We defined two spatial resolutions for the resulting coupled raster DEMs and DSMs outputs: 0.4 m and 1 m, calculated by each algorithm. The grids correspond to the same spatial resolutions of hyperspectral imagery data for which the DEMs were used in a/geometrical correction and b/building a complex tree models for radiative transfer modelling. We applied two types of analyses when comparing between results from the different interpolations/raster resolution: 1/calculated DEM or DSM between themselves; 2/comparison with field data: DEM with measurements from referential GPS, DSM - field tree alometric measurements, where tree height was calculated as DSM-DEM. The results of the analyses show that: 1/averaging techniques tend to underestimate the tree height and the generated surface does not follow the first LiDAR echoes both for 1 m and 0.4 m pixel size; 2/we did not find any significant difference between tree heights calculated by nearest neighbour algorithm and the active contour technique for 1 m pixel output but the difference increased with finer resolution (0.4 m); 3/the accuracy of the DEMs calculated by tested algorithms is similar.

Cognitive and Adaptive Skills in Toddlers Who Meet Criteria for Autism in DSM-IV but not DSM-5

PubMed Central

Brennan, Laura A.; Barton, Marianne L.; Fein, Deborah

2017-01-01

The current study compared adaptive and cognitive skills, and autism severity of toddlers with an autism spectrum disorder (ASD) diagnosis under DSM-IV but not DSM-5 criteria (DSM-IV only group) to those who met autism criteria under both diagnostic systems (DSM-5 group) and to those without ASD (non-ASD group). The toddlers in the DSM-IV only group were less delayed on various domains of adaptive (Communication, Socialization) and cognitive (Expressive and Receptive language, Fine Motor, Visual Reception) skills, and had less severe symptoms of ASD than the DSM-5 group. Thus, they might have the best potential for successful intervention. The DSM-IV only group did not differ from the non-ASD group in any adaptive or cognitive skills except for socialization skills, the hallmark of ASD. PMID:27628939

Cognitive and Adaptive Skills in Toddlers Who Meet Criteria for Autism in DSM-IV but not DSM-5.

PubMed

Jashar, Dasal Tenzin; Brennan, Laura A; Barton, Marianne L; Fein, Deborah

2016-12-01

The current study compared adaptive and cognitive skills, and autism severity of toddlers with an autism spectrum disorder (ASD) diagnosis under DSM-IV but not DSM-5 criteria (DSM-IV only group) to those who met autism criteria under both diagnostic systems (DSM-5 group) and to those without ASD (non-ASD group). The toddlers in the DSM-IV only group were less delayed on various domains of adaptive (Communication, Socialization) and cognitive (Expressive and Receptive language, Fine Motor, Visual Reception) skills, and had less severe symptoms of ASD than the DSM-5 group. Thus, they might have the best potential for successful intervention. The DSM-IV only group did not differ from the non-ASD group in any adaptive or cognitive skills except for socialization skills, the hallmark of ASD.

"DSM IV," "DSM-5," and the Five-Factor Model: the Diagnosis of Personality Disorder with Intellectual and Developmental Disabilities

ERIC Educational Resources Information Center

Lindsay, William R.; Steptoe, Lesley; McVicker, Ronnie; Haut, Fabian; Robertson, Colette

2018-01-01

In "DSM-5" there has been a move to dimensional personality disorder (PD) diagnosis, incorporating personality theory in the form of the five-factor model (FFM). It proposes an alternative assessment system based on diagnostic indicators and the FFM, while retaining "DSM-IV" categorical criteria. Four individuals with…

Panic Disorder and Agoraphobia: Considerations for DSM-V

ERIC Educational Resources Information Center

Schmidt, Norman B.; Norr, Aaron M.; Korte, Kristina J.

2014-01-01

With the upcoming release of the fifth edition of the "Diagnostic and Statistical Manual of Mental Disorders" (DSM-V) there has been a necessary critique of the DSM-IV including questions regarding how to best improve the next iteration of the DSM classification system. The aim of this article is to provide commentary on the probable…

The relationship between five-factor model and diagnostic and statistical manual of mental disorder-fifth edition personality traits on patients with antisocial personality disorder

PubMed Central

Amini, Mahdi; Pourshahbaz, Abbas; Mohammadkhani, Parvaneh; Ardakani, Mohammad-Reza Khodaie; Lotfi, Mozhgan; Ramezani, Mohammad Arash

2015-01-01

Background: Despite the fact that new criteria of antisocial personality disorder (ASPD) in diagnostic and statistical manual of mental disorders-fifth edition (DSM-5) were resulted from five-factor model (FFM), there is a small amount of studies that investigate the relations between proposed personality traits and FFM. Also, cross-cultural study in this field continuously would be needed. The aim of the present study was to evaluate the relation between the FFM and DSM-5 ASPD pathological traits. Materials and Methods: This study was a cross-sectional study design. The participants consisted of 122 individuals with ASPD that selected from prisoners (73.0%), outpatients (18.0%), and inpatients (9.0%). They were recruited from Tehran Prisoners, and Clinical Psychology and Psychiatry Clinics of Razi and Taleghani Hospitals, Tehran, Iran, since 2013-2014. The Sample was selected based on judgmental sampling. The structured clinical interview for DSM-IV axis II disorders-Personality Questionnaire, NEO-Personality Inventory-Revised, and DSM-5 personality trait rating form were used to diagnosis and assessment of personality disorder. Pearson correlation has been used for data analysis. All statistical analyses were performed using the SPSS 16 software. Results: The results indicate that neuroticism (N) has positive significant relationship with hostility (r = 0.33, P < 0.01), manipulativeness (r = 0.25, P < 0.01), deceitfulness (r =.23, P < 0.01), impulsivity (r = 0.20, P < 0.05), and negative relation with risk taking (r = −0.23, P < 0.01). Also, there was significant relationship between extraversion (E) with manipulativeness (r = 0.28, P < 0.01) and deceitfulness (r = 0.32, P < 0.01). Agreeableness and conscientiousness have negative significant relation with DSM-5 traits. In addition, results showed that there is positive significant relationship between FFM and DSM-5 personality traits with DSM-fourth edition-text revision (DSM-IV-TR) ASPD symptoms (P < 0.01). Conclusion: Except manipulativeness, deceitfulness, and callousness, there is positively significant relationship between DSM-5 ASPD traits and DSM-IV-TR ASPD symptoms. The present study helps to understand the adequacy of dimensional approach to evaluation of ASPD pathology, specifically on Iranian sample. PMID:26487876

Diagnostic Concordance between DSM-5 and ICD-10 Cannabis Use Disorders.

PubMed

Proctor, Steven L; Williams, Daniel C; Kopak, Albert M; Voluse, Andrew C; Connolly, Kevin M; Hoffmann, Norman G

2016-07-01

With the recent federal mandate that all U.S. health care settings transition to ICD-10 billing codes, empirical evidence is necessary to determine if the DSM-5 designations map to their respective ICD-10 diagnostic categories/billing codes. The present study examined the concordance between DSM-5 and ICD-10 cannabis use disorder diagnoses. Data were derived from routine clinical assessments of 6871 male and 801 female inmates recently admitted to a state prison system from 2000 to 2003. DSM-5 and ICD-10 diagnostic determinations were made from algorithms corresponding to the respective diagnostic formulations. Past 12-month prevalence rates of cannabis use disorders were comparable across classification systems. The vast majority of inmates with no DSM-5 diagnosis continued to have no diagnosis per the ICD-10, and a similar proportion with a DSM-5 severe diagnosis received an ICD-10 dependence diagnosis. Most of the variation in diagnostic classifications was accounted for by those with a DSM-5 moderate diagnosis in that approximately half of these cases received an ICD-10 dependence diagnosis while the remaining cases received a harmful use diagnosis. Although there appears to be a generally high level of agreement between diagnostic classification systems for those with no diagnosis or those evincing symptoms of a more severe condition, concordance between DSM-5 moderate and ICD-10 dependence diagnoses was poor. Additional research is warranted to determine the appropriateness and implications of the current DSM-5 coding guidelines regarding the assignment of an ICD-10 dependence code for those with a DSM-5 moderate diagnosis. Copyright © 2016 Elsevier Ltd. All rights reserved.

Transforming Healthcare Delivery: Integrating Dynamic Simulation Modelling and Big Data in Health Economics and Outcomes Research.

PubMed

Marshall, Deborah A; Burgos-Liz, Lina; Pasupathy, Kalyan S; Padula, William V; IJzerman, Maarten J; Wong, Peter K; Higashi, Mitchell K; Engbers, Jordan; Wiebe, Samuel; Crown, William; Osgood, Nathaniel D

2016-02-01

In the era of the Information Age and personalized medicine, healthcare delivery systems need to be efficient and patient-centred. The health system must be responsive to individual patient choices and preferences about their care, while considering the system consequences. While dynamic simulation modelling (DSM) and big data share characteristics, they present distinct and complementary value in healthcare. Big data and DSM are synergistic-big data offer support to enhance the application of dynamic models, but DSM also can greatly enhance the value conferred by big data. Big data can inform patient-centred care with its high velocity, volume, and variety (the three Vs) over traditional data analytics; however, big data are not sufficient to extract meaningful insights to inform approaches to improve healthcare delivery. DSM can serve as a natural bridge between the wealth of evidence offered by big data and informed decision making as a means of faster, deeper, more consistent learning from that evidence. We discuss the synergies between big data and DSM, practical considerations and challenges, and how integrating big data and DSM can be useful to decision makers to address complex, systemic health economics and outcomes questions and to transform healthcare delivery.

Relating DSM-5 section II and section III personality disorder diagnostic classification systems to treatment planning.

PubMed

Morey, Leslie C; Benson, Kathryn T

2016-07-01

Beginning with DSM-III, the inclusion of a "personality" axis was designed to encourage awareness of personality disorders and the treatment-related implications of individual differences, but since that time there is little accumulated evidence that the personality disorder categories provide substantial treatment-related guidance. The DSM-5 Personality and Personality Disorders Work Group sought to develop an Alternative Model for personality disorder, and this study examined whether this model is more closely related to clinicians' decision-making processes than the traditional categorical personality disorder diagnoses. A national sample of 337 clinicians provided complete personality disorder diagnostic information and several treatment-related clinical judgments about one of their patients. The dimensional concepts of the DSM-5 Alternative Model for personality disorders demonstrated stronger relationships than categorical DSM-IV/DSM-5 Section II diagnoses to 10 of 11 clinical judgments regarding differential treatment planning, optimal treatment intensity, and long-term prognosis. The constructs of the DSM-5 Alternative Model for personality disorders may provide more clinically useful information for treatment planning than the official categorical personality disorder diagnostic system retained in DSM-5 Section II. Copyright © 2016 Elsevier Inc. All rights reserved.

DSM-5 pathological personality traits and the personality assessment inventory.

PubMed

Hopwood, Christopher J; Wright, Aidan G C; Krueger, Robert F; Schade, Nick; Markon, Kristian E; Morey, Leslie C

2013-06-01

Section 3 of the DSM-5 will include a pathological personality trait system rooted in the quantitative epistemology of personality and clinical psychology. This system has the potential to enhance the clinical utility of the diagnostic nosology by providing a means for the dimensional assessment of individuals with psychopathology. However, there is limited research on the associations of DSM-5 traits with common mental disorders and related clinical phenomena as measured by currently popular assessment instruments. The purpose of this article was to evaluate the convergence of the DSM-5 trait system with a well-validated broadband clinical instrument, the Personality Assessment Inventory (PAI). Bivariate correlations were examined and factor analytic methods were used to examine the degree to which the DSM-5 traits and PAI capture common variance in personality and mental health. In a student sample (N = 1,001), we found broad convergence between the DSM-5 traits and PAI, which could be organized effectively using five factors. The implications of these findings for using traits to address issues related to diagnostic co-occurrence and heterogeneity in routine clinical assessment are discussed.

Comparison of diagnostic classification systems for delirium with new research criteria that incorporate the three core domains.

PubMed

Trzepacz, Paula T; Meagher, David J; Franco, José G

2016-05-01

Diagnostic classification systems do not incorporate phenomenological research findings about the three core symptom domains of delirium (Attentional/Cognitive, Circadian, Higher Level Thinking). We evaluated classification performances of novel Trzepacz, Meagher, and Franco research diagnostic criteria (TMF) that incorporate those domains and ICD-10, DSM-III-R, DSM-IV, and DSM-5. Primary data analysis of 641 patients with mixed neuropsychiatric profiles. Delirium (n=429) and nondelirium (n=212) reference standard groups were identified using cluster analysis of symptoms assessed using the Delirium Rating Scale-Revised-98. Accuracy, sensitivity, specificity, positive and negative predictive values (PPV, NPV), and likelihood ratios (LR+, LR-) are reported. TMF criteria had high sensitivity and specificity (87.4% and 89.2%), more balanced than DSM-III-R (100% and 31.6%), DSM-IV (97.7% and 74.1%), DSM-5 (97.7% and 72.6%), and ICD-10 (66.2% and 100%). PPV of DSM-III-R, DSM-IV, and DSM-5 were <90.0%, while PPV for ICD-10 and TMF were >90%. ICD-10 had the lowest NPV (59.4%). TMF had the highest LR+ (8.06) and DSM-III-R the lowest LR- (0.0). Overall, values for DSM-IV and DSM-5 were similar, whereas for ICD-10 and DSM-III-R were inverse of each other. In the pre-existing cognitive impairment/dementia subsample (n=128), TMF retained its highest LR+ though specificity (58.3%) became less well balanced with sensitivity (87.9%), which still exceeded that of DSM. TMF research diagnostic criteria performed well, with more balanced sensitivity and specificity and the highest likelihood ratio for delirium identification. Reflecting the three core domains of delirium, TMF criteria may have advantages in biological research where delineation of this syndrome is important. Copyright © 2016. Published by Elsevier Inc.

Finite Element Simulations of Kaikoura, NZ Earthquake using DInSAR and High-Resolution DSMs

NASA Astrophysics Data System (ADS)

Barba, M.; Willis, M. J.; Tiampo, K. F.; Glasscoe, M. T.; Clark, M. K.; Zekkos, D.; Stahl, T. A.; Massey, C. I.

2017-12-01

Three-dimensional displacements from the Kaikoura, NZ, earthquake in November 2016 are imaged here using Differential Interferometric Synthetic Aperture Radar (DInSAR) and high-resolution Digital Surface Model (DSM) differencing and optical pixel tracking. Full-resolution co- and post-seismic interferograms of Sentinel-1A/B images are constructed using the JPL ISCE software. The OSU SETSM software is used to produce repeat 0.5 m posting DSMs from commercial satellite imagery, which are supplemented with UAV derived DSMs over the Kaikoura fault rupture on the eastern South Island, NZ. DInSAR provides long-wavelength motions while DSM differencing and optical pixel tracking provides both horizontal and vertical near fault motions, improving the modeling of shallow rupture dynamics. JPL GeoFEST software is used to perform finite element modeling of the fault segments and slip distributions and, in turn, the associated asperity distribution. The asperity profile is then used to simulate event rupture, the spatial distribution of stress drop, and the associated stress changes. Finite element modeling of slope stability is accomplished using the ultra high-resolution UAV derived DSMs to examine the evolution of post-earthquake topography, landslide dynamics and volumes. Results include new insights into shallow dynamics of fault slip and partitioning, estimates of stress change, and improved understanding of its relationship with the associated seismicity, deformation, and triggered cascading hazards.

A cross-national examination of differences in classification of lifetime alcohol use disorder between DSM-IV and DSM-5: Findings from the World Mental Health Survey

PubMed Central

Slade, Tim; Chiu, Wai-Tat; Glantz, Meyer; Kessler, Ronald C.; Lago, Luise; Sampson, Nancy; Al-Hamzawi, Ali; Florescu, Silvia; Moskalewicz, Jacek; Murphy, Sam; Navarro-Mateu, Fernando; de Galvis, Yolanda Torres; Viana, Maria Carmen; Xavier, Miguel; Degenhardt, Louisa

2016-01-01

Aims To examine the diagnostic overlap in DSM-IV and DSM-5 alcohol use disorder (AUD) and determine the clinical correlates of changing diagnostic status across the two classification systems. Design DSM-IV and DSM-5 definitions of AUD were compared using cross-national community survey data. Setting Nine low-, middle- and high-income countries. Participants/Cases 31,367 respondents to surveys in the World Health Organization World Mental Health Survey Initiative. Measures Composite International Diagnostic Interview, version 3.0 was used to derive DSM-IV and DSM-5 lifetime diagnoses of AUD. Clinical characteristics, also assessed in the surveys, included lifetime DSM-IV anxiety, mood and drug use disorders, lifetime suicidal ideation, plan and attempt, general functional impairment and psychological distress. Findings Compared to DSM-IV AUD (12.3%, SE=0.3%), the DSM-5 definition yielded slightly lower prevalence estimates (10.8%, SE=0.2%). Almost one third (n=802) of all DSM-IV Abuse cases switched to sub-threshold according to DSM-5 and one quarter (n=467) of all DSM-IV diagnostic orphans switched to mild AUD according to DSM-5. New cases of DSM-5 AUD were largely similar to those who maintained their AUD across both classifications. Similarly, new DSM-5 non-cases were similar to those who were sub-threshold across both classifications. The exception to this was with regards to the prevalence of any lifetime drug use disorder. Conclusions In this large cross-national community sample, the prevalence of DSM-5 lifetime AUD was only slightly lower than the prevalence of DSM-IV lifetime AUD. Nonetheless there was considerable diagnostic switching, with a large number of people inconsistently identified across the two DSM classifications. PMID:27426631

The multiaxial system of DSM-III: where did it come from and where should it go? II. Empirical studies, innovations, and recommendations.

PubMed

Williams, J B

1985-02-01

In a companion report, the development of the DSM-III multiaxial system was described, as well as critiques that have been made of each of its five axes. In this report, empirical studies that provide information about the reliability and validity of the system are reviewed. In addition, suggestions that have been made for changes in the system are critically examined. Finally, this material is synthesized into specific proposals for improvements in the multiaxial system that will be considered by the recently constituted Work Group to Revise DSM-III.

Neurodevelopmental Disorders (ASD and ADHD): DSM-5, ICD-10, and ICD-11.

PubMed

Doernberg, Ellen; Hollander, Eric

2016-08-01

Neurodevelopmental disorders, specifically autism spectrum disorder (ASD) and attention-deficit/hyperactivity disorder (ADHD) have undergone considerable diagnostic evolution in the past decade. In the United States, the current system in place is the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), whereas worldwide, the International Statistical Classification of Diseases and Related Health Problems, Tenth Revision (ICD-10) serves as a general medical system. This review will examine the differences in neurodevelopmental disorders between these two systems. First, we will review the important revisions made from the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR) to the DSM-5, with respect to ASD and ADHD. Next, we will cover the similarities and differences between ASD and ADHD classification in the DSM-5 and the ICD-10, and how these differences may have an effect on neurodevelopmental disorder diagnostics and classification. By examining the changes made for the DSM-5 in 2013, and critiquing the current ICD-10 system, we can help to anticipate and advise on the upcoming ICD-11, due to come online in 2017. Overall, this review serves to highlight the importance of progress towards complementary diagnostic classification systems, keeping in mind the difference in tradition and purpose of the DSM and the ICD, and that these systems are dynamic and changing as more is learned about neurodevelopmental disorders and their underlying etiology. Finally this review will discuss alternative diagnostic approaches, such as the Research Domain Criteria (RDoC) initiative, which links symptom domains to underlying biological and neurological mechanisms. The incorporation of new diagnostic directions could have a great effect on treatment development and insurance coverage for neurodevelopmental disorders worldwide.

Examination of the Section III DSM-5 diagnostic system for personality disorders in an outpatient clinical sample

PubMed Central

Few, Lauren R.; Miller, Joshua D.; Rothbaum, Alex; Meller, Suzanne; Maples, Jessica; Terry, Douglas P.; Collins, Brittany; MacKillop, James

2014-01-01

The DSM-5 includes a novel approach to the diagnosis of personality disorders (PDs) in Section III, in order to stimulate further research with the possibility that this proposal will be included more formally in future DSM iterations. The current study provides the first test of this proposal in a clinical sample by simultaneously examining its two primary components: a system for rating personality impairment and a newly developed dimensional model of pathological personality traits. Participants were community adults currently receiving outpatient mental health treatment who completed a semi-structured interview for DSM-IV PDs and were then rated in terms of personality impairment and pathological traits. Data on the pathological traits were also collected via self-reports using the Personality Inventory for DSM-5 (PID-5). Both sets of trait scores were compared to self-report measures of general personality traits, internalizing symptoms, and externalizing behaviors. Inter-rater reliabilities for the clinicians’ ratings of impairment and the pathological traits were fair. The impairment ratings manifested substantial correlations with symptoms of depression and anxiety, DSM-5 PDs, and DSM-5 pathological traits. The clinician and self-reported personality trait scores demonstrated good convergence with one another, both accounted for substantial variance in DSM-IV PD constructs, and both manifested expected relations with the external criteria. The traits but not the impairment ratings demonstrated incremental validity in the prediction of the DSM-IV PDs. Overall, the current results support the general validity of several of the components of this new PD diagnostic system and point to areas that may require further modification. PMID:24364607

A comparison of DSM-III-R and ICD-10 personality disorder criteria in an out-patient population.

PubMed

Sara, G; Raven, P; Mann, A

1996-01-01

This study reports the results of a comparison of DSM-III-R and ICD-10 personality disorder criteria by application of both sets of criteria to the same group of patients. Despite the clinical relevance of these disorders and the need for reliable diagnostic criteria, such a comparison has not previously been reported. DSM-III-R and ICD-10 have converged in their classification of personality disorders, but some important differences between the two systems remain. Personality disorder diagnoses from both systems were obtained in 52 out-patients, using the Standardized Assessment of Personality (SAP), a brief, informant-based interview which yields diagnoses in both DSM-III-R and ICD-10. For individual personality disorder diagnoses, agreement between systems was limited. Thirty-four subjects received a personality disorder diagnosis that had an equivalent form in both systems, but only 10 subjects (29%) received the same primary diagnosis in each system. There was a difference in rate of diagnosis, with ICD-10 making significantly more personality disorder diagnoses. The lower diagnostic threshold of the ICD-10 contributed most of this effect. Further modifications in ICD-10 Diagnostic Criteria for Research (DCR) and DSM-IV to the personality disorder category have been considered. The omission in DSM-IV of three categories unique to that system and the raising of the threshold in ICD-10 DCR, do seem to have been helpful in promoting convergence.

Tourette's: syndrome, disorder or spectrum? Classificatory challenges and an appraisal of the DSM criteria.

PubMed

Robertson, Mary May; Eapen, Valsamma

2014-10-01

The fifth version of the Diagnostic and statistical manual of mental disorders (DSM-5) was released in May 2013 after 14 years of development and almost two decades after the last edition DSM-IV was published in 1994. We review the DSM journey with regards to Tourette Syndrome from the original publication of DSM 1 in 1952 till date. In terms of changes in DSM 5, the major shift has come in the placement of Tourette Syndrome under the 'Neurodevelopmental Disorders' alongside other disorders with a developmental origin. This review provides an overview of the changes in DSM-5 highlighting key points for clinical practice and research along with a snap shot of the current use of DSM as a classificatory system in different parts of the world and suggestions for improving the subtyping and the diagnostic confidence. Copyright © 2014 Elsevier B.V. All rights reserved.

DSM-III: the major achievements and an overview.

PubMed

Spitzer, R L; Williams, J B; Skodol, A E

1980-02-01

DSM-III will be published early this year. In the first part of this article the authors describe some of the major achievements of DSM-III: the process of its development, reaching consensus on many controversial diagnostic categories and a definition of mental disorder, the provision of diagnostic criteria and a multiaxial evaluation system, and the demonstration of improved diagnostic reliability. In the second part of the article the authors present an overview of DSM-III in which they describe its departures from DSM-II and the reasons for these changes. They conclude that in the next few years there should be systematic study of DSM-III in use, so that information about its strengths and limitations can be made available to those responsible for developing DSM-IV.

[Generalized anxiety disorder, now and the future: a perspective to the DSM-5].

PubMed

Otsubo, Tempei

2012-01-01

Generalized, persistent, and free-floating anxiety was first described by Freud in 1894. The diagnostic term generalized anxiety disorder (GAD) was not in classification systems until the publication of the diagnostic and statistical manual for mental disorders, third edition (DSM-III) in 1980. Initially considered as a residual category to be used when no other diagnosis could be made, it is not accepted that GAD represents a distinct diagnostic category yet. Since 1980, revisions to the diagnostic criteria for GAD in the DSM-III-R, DSM-IV and DSM-5 classifications have slightly redefined this disorder. The classification is fluid. The duration criterion has increased to 6 months in DSM-IV, but decreased to 3 months in DSM-5. This article reviews the development of diagnostic criteria for defining GAD from Freud to DSM-5 and compares the DSM-5 criterion with DSM-IV and the tenth revision of the International Classification of Disease. The impact of the changes in diagnostic criteria on research into GAD, and on diagnosis, differential diagnosis, will be discussed.

Alcohol Use Disorders in Argentinian Girls and Women 12 Months Before Delivery: Comparison of DSM-IV, DSM-5, and ICD-10 Diagnostic Criteria.

PubMed

López, Mariana B; Conde, Karina; Cremonte, Mariana

The evidence of important problems related to prenatal alcohol exposure has faced researchers with the problem of understanding and screening alcohol use in this population. Although any alcohol use should be considered risky during pregnancy, identifying alcohol-drinking problems (ADPs) could be especially important because women with ADPs could not benefit from a simple advice of abstinence and because their offsprings are subjected to a higher risk of problems related with prenatal alcohol exposure. In this context, we aim to study the prevalence and characteristics of ADPs in pregnant women, evaluating the performance of different diagnostic systems in this population. The aims of the study were to describe the prevalence of ADPs obtained with the criteria of the Diagnostic and Statistical Manual of Mental Disorders in its fourth (DSM-IV) and fifth edition (DSM-5), and the International Classification of Diseases (ICD)-10, in Argentinean females aged 13 to 44 years, 12 months before delivery; to evaluate the level of agreement between these classification systems; and to analyze the performance of each diagnosis criterion in this population. Data were collected through personal interviews of a probability sample of puerperal women (N = 641) in the city of Santa Fe (Argentina), between October 2010 and February 2011. Diagnoses compatible with DSM-IV, DSM-5, and ICD-10 were obtained through the Composite International Diagnostic Interview. Agreement among diagnostic systems was measured through Cohen kappa. Diagnosis criteria performance were analyzed considering their prevalence and discriminating ability (D value). Total ADP prevalence was 6.4% for DSM-IV (4.2% abuse and 2.2% dependence), 8.1% for DSM-5 (6.4% mild, 0.8% moderate, and 0.9% severe alcohol use disorder), and 14.1% for the ICD-10 (11.9% harmful use and 2.2% dependence). DSM-5 modifications improved agreement between DSM and ICD. The least prevalent and worst discriminating ability diagnostic criterion was "legal problems." The most prevalent and 1 of the best discriminating ability diagnostic criterion was '"health issues." DSM-IV and ICD-10 dependence prevalence was similar to that of previous studies in pregnant women, whereas abuse prevalence was surprisingly higher. Our results indicate a better performance of the DSM-5 alcohol use disorder category relative to the DSM-IV dual categorization. Nevertheless, the poor diagnostic performance of some DSM-5 criteria in this population could evidence their intercultural variability.

A Cross-National Examination of Differences in Classification of Lifetime Alcohol Use Disorder Between DSM-IV and DSM-5: Findings from the World Mental Health Survey.

PubMed

Slade, Tim; Chiu, Wai-Tat; Glantz, Meyer; Kessler, Ronald C; Lago, Luise; Sampson, Nancy; Al-Hamzawi, Ali; Florescu, Silvia; Moskalewicz, Jacek; Murphy, Sam; Navarro-Mateu, Fernando; Torres de Galvis, Yolanda; Viana, Maria Carmen; Xavier, Miguel; Degenhardt, Louisa

2016-08-01

The current study sought to examine the diagnostic overlap in DSM-IV and DSM-5 alcohol use disorder (AUD) and determine the clinical correlates of changing diagnostic status across the 2 classification systems. DSM-IV and DSM-5 definitions of AUD were compared using cross-national community survey data in 9 low-, middle-, and high-income countries. Participants were 31,367 respondents to surveys in the World Health Organization's World Mental Health Survey Initiative. The Composite International Diagnostic Interview, version 3.0, was used to derive DSM-IV and DSM-5 lifetime diagnoses of AUD. Clinical characteristics, also assessed in the surveys, included lifetime DSM-IV anxiety; mood and drug use disorders; lifetime suicidal ideation, plan, and attempt; general functional impairment; and psychological distress. Compared with DSM-IV AUD (12.3%, SE = 0.3%), the DSM-5 definition yielded slightly lower prevalence estimates (10.8%, SE = 0.2%). Almost one-third (n = 802) of all DSM-IV abuse cases switched to subthreshold according to DSM-5 and one-quarter (n = 467) of all DSM-IV diagnostic orphans switched to mild AUD according to DSM-5. New cases of DSM-5 AUD were largely similar to those who maintained their AUD across both classifications. Similarly, new DSM-5 noncases were similar to those who were subthreshold across both classifications. The exception to this was with regard to the prevalence of any lifetime drug use disorder. In this large cross-national community sample, the prevalence of DSM-5 lifetime AUD was only slightly lower than the prevalence of DSM-IV lifetime AUD. Nonetheless, there was considerable diagnostic switching, with a large number of people inconsistently identified across the 2 DSM classifications. Copyright © 2016 by the Research Society on Alcoholism.

An Introduction to the New DSM-III.

ERIC Educational Resources Information Center

Seligman, Linda

1983-01-01

Discusses and clarifies the diagnostic system of the Diagnostic and Statistical Manual of Mental Disorders (DSM-II). The DSM-II seeks to provide a detailed description of all categories of mental illness according to five diagnostic axes. Diagnoses are divided into 17 broad categories, each subdivided into specific diagnoses. (JAC)

Beyond the DSM-IV: Assumptions, Alternatives, and Alterations

ERIC Educational Resources Information Center

Lopez, Shane J.; Edwards, Lisa M.; Pedrotti, Jennifer Teramoto; Prosser, Ellie C.; LaRue, Stephanie; Spalitto, Susan Vehige; Ulven, Jon C.

2006-01-01

Current diagnostic processes reflect the limitations and utility of the framework of the "Diagnostic and Statistical Manual of Mental Disorders" (4th ed.; DSM-IV; American Psychiatric Association, 1994). Clinical information in the DSM-IV's 5-axis system almost exclusively focuses on weaknesses and pathology and is summarized in a flawed…

Neopositivism and the DSM psychiatric classification. An epistemological history. Part 1: Theoretical comparison.

PubMed

Aragona, Massimiliano

2013-06-01

Recent research suggests that the DSM psychiatric classification is in a paradigmatic crisis and that the DSM-5 will be unable to overcome it. One possible reason is that the DSM is based on a neopositivist epistemology which is inadequate for the present-day needs of psychopathology. However, in which sense is the DSM a neopositivist system? This paper will explore the theoretical similarities between the DSM structure and the neopositivist basic assumptions. It is shown that the DSM has the following neopositivist features: (a) a sharp distinction between scientific and non-scientific diagnoses; (b) the exclusion of the latter as nonsensical; (c) the faith on the existence of a purely observable basis (the description of reliable symptoms); (d) the introduction of the operative diagnostic criteria as rules of correspondence linking the observational level to the diagnostic concept.

Concordances and discrepancies between ICD-10 and DSM-IV criteria for anxiety disorders in childhood and adolescence

PubMed Central

2012-01-01

Background Mental disorders are classified by two major nosological systems, the ICD-10 and the DSM-IV-TR, consisting of different diagnostic criteria. The present study investigated the diagnostic concordance between the two systems for anxiety disorders in childhood and adolescence, in particular for separation anxiety disorder (SAD), specific phobia, social phobia, and generalized anxiety disorder (GAD). Methods A structured clinical interview, the Kinder-DIPS, was administered to 210 children and 258 parents. The percentage of agreement, kappa, and Yule’s Y coefficients were calculated for all diagnoses. Specific criteria causing discrepancies between the two classification systems were identified. Results DSM-IV-TR consistently classified more children than ICD-10 with an anxiety disorder, with a higher concordance between DSM-IV-TR and the ICD-10 child section (F9) than with the adult section (F4) of the ICD-10. This result was found for all four investigated anxiety disorders. The results revealed low to high levels of concordance and poor to good agreement between the classification systems, depending on the anxiety disorder. Conclusions The two classification systems identify different children with an anxiety disorder. However, it remains an open question, whether the research results can be generalized to clinical practice since DSM-IV-TR is mainly used in research while ICD-10 is widely established in clinical practice in Europe. Therefore, the population investigated by the DSM (research population) is not identical with the population examined using the ICD (clinical population). PMID:23267678

Disorders Related to Use of Psychoactive Substances in DSM-5: Changes and Challenges.

PubMed

Bhad, Roshan; Lal, Rakesh; Balhara, Yatan Pal Singh

2015-01-01

In the most recent edition of Diagnostic and Statistical Manual (DSM) that is DSM-5 many modifications have been made in substance use disorder section. These include changes in terminology; sections and categories; diagnostic criteria; threshold for diagnosis; severity; and specifier. Additionally, there have been certain additions and omissions from the earlier version. Critical evaluation of the changes made to the section on disorders related to use of psychoactive substances in India context has not been published so far. The current paper presents a critique of the changes made to the substance use disorder section in DSM-5. The rationale for these changes put forth by DSM-5 work group on substance related disorders have been discussed. Additionally, attempt has been made to highlight the possible future challenges consequent to the current nosological revision for substance use disorder category. Overall DSM-5 seems to be promising in fulfilling its goal of DSM-ICD harmonisation and movement towards an internationally compatible and practical diagnostic system for mental health disorders. It has increased the scope of addiction by inclusion of behavioural addiction. It has also tried to balance the categorical and dimensional approach to diagnosis. However, the real test of this newer edition of one of the most commonly used nosological systems will be during clinical care and research. This will help address the debatable issues regarding the changes that DSM-5 brings with it.

Assessment of Semi-Structured Clinical Interview for Mobile Phone Addiction Disorder

PubMed Central

Alavi, Seyyed Salman; Jannatifard, Fereshteh; Mohammadi Kalhori, Soroush; Sepahbodi, Ghazal; BabaReisi, Mohammad; Sajedi, Sahar; Farshchi, Mojtaba; KhodaKarami, Rasul; Hatami Kasvaee, Vahid

2016-01-01

Objective: The Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR) classified mobile phone addiction disorder under “impulse control disorder not elsewhere classified”. This study surveyed the diagnostic criteria of DSM-IV-TR for the diagnosis of mobile phone addiction in correspondence with Iranian society and culture. Method: Two hundred fifty students of Tehran universities were entered into this descriptive-analytical and cross-sectional study. Quota sampling method was used. At first, semi- structured clinical interview (based on DSM-IV-TR) was performed for all the cases, and another specialist reevaluated the interviews. Data were analyzed using content validity, inter-scorer reliability (Kappa coefficient) and test-retest via SPSS18 software. Results: The content validity of the semi- structured clinical interview matched the DSM–IV-TR criteria for behavioral addiction. Moreover, their content was appropriate, and two items, including “SMS pathological use” and “High monthly cost of using the mobile phone” were added to promote its validity. Internal reliability (Kappa) and test–retest reliability were 0.55 and r = 0.4 (p<0. 01) respectively. Conclusion: The results of this study revealed that semi- structured diagnostic criteria of DSM-IV-TR are valid and reliable for diagnosing mobile phone addiction, and this instrument is an effective tool to diagnose this disorder. PMID:27437008

The MMPI-2 Restructured Form Personality Psychopathology Five Scales: bridging DSM-5 Section 2 personality disorders and DSM-5 Section 3 personality trait dimensions.

PubMed

Finn, Jacob A; Arbisi, Paul A; Erbes, Christopher R; Polusny, Melissa A; Thuras, Paul

2014-01-01

This study examined in a college sample and a sample of non-treatment-seeking, trauma-exposed veterans the association between the MMPI-2 Restructured Form (MMPI-2-RF) Personality Psychopathology Five (PSY-5) Scales and DSM-5 Section 2 personality disorder (PD) criteria, the same system used in DSM-IV-TR, and the proposed broad personality trait dimensions contained in Section 3 of DSM-5. DSM-5 Section 2 PD symptoms were assessed using the SCID-II-PQ, and applying a replicated rational selection procedure to the SCID-II-PQ item pool, proxies for the DSM-5 Section 3 dimensions and select facets were constructed. The MMPI-2-RF PSY-5 scales demonstrated appropriate convergent and discriminant associations with both Section 2 PDs and Section 3 dimensions in both samples. These findings suggest the MMPI-2-RF PSY-5 scales can serve both conceptually and practically as a bridge between the DSM-5 Section 2 PD criteria and the DSM-5 Section 3 personality features.

Substance dependence and non-dependence in the Diagnostic and Statistical Manual of Mental Disorders (DSM) and the International Classification of Diseases (ICD): can an identical conceptualization be achieved?

PubMed

Saunders, John B

2006-09-01

This review summarizes the history of the development of diagnostic constructs that apply to repetitive substance use, and compares and contrasts the nature, psychometric performance and utility of the major diagnoses in the Diagnostic and Statistical Manual of Mental Disorders (DSM) and International Classification of Diseases (ICD) diagnostic systems. The available literature was reviewed with a particular focus on diagnostic concepts that are relevant for clinical and epidemiological practice, and so that research questions could be generated that might inform the development of the next generation of DSM and ICD diagnoses. The substance dependence syndrome is a psychometrically robust and clinically useful construct, which applies to a range of psychoactive substances. The differences between the DSM fourth edition (DSM-IV) and the ICD tenth edition (ICD-10) versions are minimal and could be resolved. DSM-IV substance abuse performs moderately well but, being defined essentially by social criteria, may be culture-dependent. ICD-10 harmful substance use performs poorly as a diagnostic entity. There are good prospects for resolving many of the differences between the DSM and ICD systems. A new non-dependence diagnosis is required. There would also be advantages in a subthreshold diagnosis of hazardous or risky substance use being incorporated into the two systems. Biomedical research can be drawn upon to define a psychophysiological 'driving force' which could underpin a broad spectrum of substance use disorders.

DSM-5 AND ICD-11 DEFINITIONS OF POSTTRAUMATIC STRESS DISORDER: INVESTIGATING “NARROW” AND “BROAD” APPROACHES

PubMed Central

Stein, Dan J.; McLaughlin, Katie A.; Koenen, Karestan C.; Atwoli, Lukoye; Friedman, Matthew J.; Hill, Eric D.; Maercker, Andreas; Petukhova, Maria; Shahly, Victoria; van Ommeren, Mark; Alonso, Jordi; Borges, Guilherme; de Girolamo, Giovanni; de Jonge, Peter; Demyttenaere, Koen; Florescu, Silvia; Karam, Elie G.; Kawakami, Norito; Matschinger, Herbert; Okoliyski, Michail; Posada-Villa, Jose; Scott, Kate M.; Viana, Maria Carmen; Kessler, Ronald C.

2014-01-01

Background The development of the Diagnostic and Statistical Manual of Mental Disorders 5th edition (DSM-5) and ICD-11 has led to reconsideration of diagnostic criteria for posttraumatic stress disorder (PTSD). The World Mental Health (WMH) Surveys allow investigation of the implications of the changing criteria compared to DSM-IV and ICD-10. Methods WMH Surveys in 13 countries asked respondents to enumerate all their lifetime traumatic events (TEs) and randomly selected one TE per respondent for PTSD assessment. DSMIV and ICD-10 PTSD were assessed for the 23,936 respondents who reported lifetime TEs in these surveys with the fully structured Composite International Diagnostic Interview (CIDI). DSM-5 and proposed ICD-11 criteria were approximated. Associations of the different criteria sets with indicators of clinical severity (distress-impairment, suicidality, comorbid fear-distress disorders, PTSD symptom duration) were examined to investigate the implications of using the different systems. Results A total of 5.6% of respondents met criteria for “broadly defined” PTSD (i.e., full criteria in at least one diagnostic system), with prevalence ranging from 3.0% with DSM-5 to 4.4% with ICD-10. Only one-third of broadly defined cases met criteria in all four systems and another one third in only one system (narrowly defined cases). Between-system differences in indicators of clinical severity suggest that ICD-10 criteria are least strict and DSM-IV criteria most strict. The more striking result, though, is that significantly elevated indicators of clinical significance were found even for narrowly defined cases for each of the four diagnostic systems. Conclusions These results argue for a broad definition of PTSD defined by any one of the different systems to capture all clinically significant cases of PTSD in future studies. PMID:24894802

Harmonisation of ICD-11 and DSM-V: opportunities and challenges.

PubMed

First, Michael B

2009-11-01

Differences in the ICD-10 and DSM-IV definitions for the same disorder impede international communication and research efforts. The forthcoming parallel development of DSM-V and ICD-11 offers an opportunity to harmonise the two classifications. This paper aims to facilitate the harmonisation process by identifying diagnostic differences between the two systems. DSM-IV-TR criteria sets and the ICD-10 Diagnostic Criteria for Research were compared and categorised into those with identical definitions, those with conceptually based differences and those in which differences are not conceptually based and appear to be unintentional. Of the 176 criteria sets in both systems, only one, transient tic disorder, is identical. Twenty-one per cent had conceptually based differences and 78% had non-conceptually based differences. Harmonisation of criteria sets, especially those with non-conceptually based differences, should be prioritised in the DSM-V and ICD-11 development process. Prior experience with the DSM-IV and ICD-10 harmonisation effort suggests that for the process to be successful steps should be taken as early as possible.

Development of the IMB Model and an Evidence-Based Diabetes Self-management Mobile Application.

PubMed

Jeon, Eunjoo; Park, Hyeoun-Ae

2018-04-01

This study developed a diabetes self-management mobile application based on the information-motivation-behavioral skills (IMB) model, evidence extracted from clinical practice guidelines, and requirements identified through focus group interviews (FGIs) with diabetes patients. We developed a diabetes self-management (DSM) app in accordance with the following four stages of the system development life cycle. The functional and knowledge requirements of the users were extracted through FGIs with 19 diabetes patients. A system diagram, data models, a database, an algorithm, screens, and menus were designed. An Android app and server with an SSL protocol were developed. The DSM app algorithm and heuristics, as well as the usability of the DSM app were evaluated, and then the DSM app was modified based on heuristics and usability evaluation. A total of 11 requirement themes were identified through the FGIs. Sixteen functions and 49 knowledge rules were extracted. The system diagram consisted of a client part and server part, 78 data models, a database with 10 tables, an algorithm, and a menu structure with 6 main menus, and 40 user screens were developed. The DSM app was Android version 4.4 or higher for Bluetooth connectivity. The proficiency and efficiency scores of the algorithm were 90.96% and 92.39%, respectively. Fifteen issues were revealed through the heuristic evaluation, and the app was modified to address three of these issues. It was also modified to address five comments received by the researchers through the usability evaluation. The DSM app was developed based on behavioral change theory through IMB models. It was designed to be evidence-based, user-centered, and effective. It remains necessary to fully evaluate the effect of the DSM app on the DSM behavior changes of diabetes patients.

Development of the IMB Model and an Evidence-Based Diabetes Self-management Mobile Application

PubMed Central

Jeon, Eunjoo

2018-01-01

Objectives This study developed a diabetes self-management mobile application based on the information-motivation-behavioral skills (IMB) model, evidence extracted from clinical practice guidelines, and requirements identified through focus group interviews (FGIs) with diabetes patients. Methods We developed a diabetes self-management (DSM) app in accordance with the following four stages of the system development life cycle. The functional and knowledge requirements of the users were extracted through FGIs with 19 diabetes patients. A system diagram, data models, a database, an algorithm, screens, and menus were designed. An Android app and server with an SSL protocol were developed. The DSM app algorithm and heuristics, as well as the usability of the DSM app were evaluated, and then the DSM app was modified based on heuristics and usability evaluation. Results A total of 11 requirement themes were identified through the FGIs. Sixteen functions and 49 knowledge rules were extracted. The system diagram consisted of a client part and server part, 78 data models, a database with 10 tables, an algorithm, and a menu structure with 6 main menus, and 40 user screens were developed. The DSM app was Android version 4.4 or higher for Bluetooth connectivity. The proficiency and efficiency scores of the algorithm were 90.96% and 92.39%, respectively. Fifteen issues were revealed through the heuristic evaluation, and the app was modified to address three of these issues. It was also modified to address five comments received by the researchers through the usability evaluation. Conclusions The DSM app was developed based on behavioral change theory through IMB models. It was designed to be evidence-based, user-centered, and effective. It remains necessary to fully evaluate the effect of the DSM app on the DSM behavior changes of diabetes patients. PMID:29770246

Performance of the Delirium Rating Scale-Revised-98 Against Different Delirium Diagnostic Criteria in a Population With a High Prevalence of Dementia.

PubMed

Sepulveda, Esteban; Franco, José G; Trzepacz, Paula T; Gaviria, Ana M; Viñuelas, Eva; Palma, José; Ferré, Gisela; Grau, Imma; Vilella, Elisabet

2015-01-01

Delirium diagnosis in elderly is often complicated by underlying dementia. We evaluated performance of the Delirium Rating Scale-Revised-98 (DRS-R98) in patients with high dementia prevalence and also assessed concordance among past and current diagnostic criteria for delirium. Cross-sectional analysis of newly admitted patients to a skilled nursing facility over 6 months, who were rated within 24-48 hours after admission. Interview for Diagnostic and Statistical Manual of Mental Disorders, 3rd edition-R (DSM)-III-R, DSM-IV, DSM-5, and International Classification of Diseases 10th edition delirium ratings, administration of the DRS-R98, and assessment of dementia using the Informant Questionnaire on Cognitive Decline in the Elderly were independently performed by 3 researchers. Discriminant analyses (receiver operating characteristics curves) were used to study DRS-R98 accuracy against different diagnostic criteria. Hanley and McNeil test compared the area under the curve for DRS-R98's discriminant performance for all diagnostic criteria. Dementia was present in 85/125 (68.0%) subjects, and 36/125 (28.8%) met criteria for delirium by at least 1 classification system, whereas only 19/36 (52.8%) did by all. DSM-III-R diagnosed the most as delirious (27.2%), followed by DSM-5 (24.8%), DSM-IV-TR (22.4%), and International Classification of Diseases 10th edition (16%). DRS-R98 had the highest AUC when discriminating DSM-III-R delirium (92.9%), followed by DSM-IV (92.4%), DSM-5 (91%), and International Classification of Diseases 10th edition (90.5%), without statistical differences among them. The best DRS-R98 cutoff score was ≥14.5 for all diagnostic systems except International Classification of Diseases 10th edition (≥15.5). There is a low concordance across diagnostic systems for identification of delirium. The DRS-R98 performs well despite differences across classification systems perhaps because it broadly assesses phenomenology, even in this population with a high prevalence of dementia. Copyright © 2015 The Academy of Psychosomatic Medicine. Published by Elsevier Inc. All rights reserved.

Inter-Observer Reliability of DSM-5 Substance Use Disorders*

PubMed Central

Denis, Cécile M.; Gelernter, Joel; Hart, Amy B.; Kranzler, Henry R.

2015-01-01

Aims Although studies have examined the impact of changes made in DSM-5 on the estimated prevalence of substance use disorder (SUD) diagnoses, there is limited evidence of the reliability of DSM-5 SUDs. We evaluated the inter-observer reliability of four DSM-5 SUDs in a sample in which we had previously evaluated the reliability of DSM-IV diagnoses, allowing us to compare the two systems. Methods Two different interviewers each assessed 173 subjects over a 2-week period using the Semi-Structured Assessment for Drug Dependence and Alcoholism (SSADDA). Using the percent agreement and kappa (κ) coefficient, we examined the reliability of DSM-5 lifetime alcohol, opioid, cocaine, and cannabis use disorders, which we compared to that of SSADDA-derived DSM-IV SUD diagnoses. We also assessed the effect of additional lifetime SUD and lifetime mood or anxiety disorder diagnoses on the reliability of the DSM-5 SUD diagnoses. Results Reliability was good to excellent for the four disorders, with κ values ranging from 0.65 to 0.94. Agreement was consistently lower for SUDs of mild severity than for moderate or severe disorders. DSM-5 SUD diagnoses showed greater reliability than DSM-IV diagnoses of abuse or dependence or dependence only. Co-occurring SUD and lifetime mood or anxiety disorders exerted a modest effect on the reliability of the DSM-5 SUD diagnoses. Conclusions For alcohol, opioid, cocaine and cannabis use disorders, DSM-5 criteria and diagnoses are at least as reliable as those of DSM-IV. PMID:26048641

Comparison of DSM-IV-TR and DSM-5 Criteria in Diagnosing Autism Spectrum Disorders in Singapore.

PubMed

Sung, Min; Goh, Tze Jui; Tan, Bei Lin Joelene; Chan, Jialei Stephanie; Liew, Hwee Sen Alvin

2018-04-28

Our study examines the Diagnostic and Statistical Manual-Fifth Edition (DSM-5) and Diagnostic and Statistical Manual-Fourth Edition, Text Revision (DSM-IV-TR) when applied concurrently against the best estimate clinical diagnoses for 110 children (5.1-19.6 years old) referred for diagnostic assessments of Autism Spectrum Disorder (ASD) in a Singaporean outpatient speciality clinic. DSM-IV-TR performed slightly better, yielding sensitivity of 0.946 and specificity of 0.889, compared to DSM-5 (sensitivity = 0.837; specificity = 0.833). When considering the ASD sub-categories, sensitivity ranged from 0.667 to 0.933, and specificity ranged from 0.900 to 0.975. More participants with a PDD-NOS best estimate clinical diagnosis (40%) were misclassified on DSM-5. Merits and weaknesses to both classification systems, and implications for access to services and policy changes are discussed.

Systems Operation Studies for Automated Guideway Transit Systems : Detailed Station Model Functional Specifications

DOT National Transportation Integrated Search

1981-07-01

The Detailed Station Model (DSM) is a discrete event model representing the interrelated queueing processes associated with vehicle and passenger activities in an AGT station. The DSM will provide operational and performance measures of alternative s...

System Operations Studies for Automated Guideway Transit Systems : Detailed Station Model User's Manual

DOT National Transportation Integrated Search

1981-07-01

The Detailed Station Model (DSM) is a discrete event model representing the interrelated queueing processes associated with vehicle and passenger activities in an AGT station. The DSM will provide operational and performance measures of alternative s...

Dsm Based Orientation of Large Stereo Satellite Image Blocks

NASA Astrophysics Data System (ADS)

d'Angelo, P.; Reinartz, P.

2012-07-01

High resolution stereo satellite imagery is well suited for the creation of digital surface models (DSM). A system for highly automated and operational DSM and orthoimage generation based on CARTOSAT-1 imagery is presented, with emphasis on fully automated georeferencing. The proposed system processes level-1 stereo scenes using the rational polynomial coefficients (RPC) universal sensor model. The RPC are derived from orbit and attitude information and have a much lower accuracy than the ground resolution of approximately 2.5 m. In order to use the images for orthorectification or DSM generation, an affine RPC correction is required. In this paper, GCP are automatically derived from lower resolution reference datasets (Landsat ETM+ Geocover and SRTM DSM). The traditional method of collecting the lateral position from a reference image and interpolating the corresponding height from the DEM ignores the higher lateral accuracy of the SRTM dataset. Our method avoids this drawback by using a RPC correction based on DSM alignment, resulting in improved geolocation of both DSM and ortho images. Scene based method and a bundle block adjustment based correction are developed and evaluated for a test site covering the nothern part of Italy, for which 405 Cartosat-1 Stereopairs are available. Both methods are tested against independent ground truth. Checks against this ground truth indicate a lateral error of 10 meters.

Estimating snow depth in real time using unmanned aerial vehicles

NASA Astrophysics Data System (ADS)

Niedzielski, Tomasz; Mizinski, Bartlomiej; Witek, Matylda; Spallek, Waldemar; Szymanowski, Mariusz

2016-04-01

In frame of the project no. LIDER/012/223/L-5/13/NCBR/2014, financed by the National Centre for Research and Development of Poland, we elaborated a fully automated approach for estimating snow depth in real time in the field. The procedure uses oblique aerial photographs taken by the unmanned aerial vehicle (UAV). The geotagged images of snow-covered terrain are processed by the Structure-from-Motion (SfM) method which is used to produce a non-georeferenced dense point cloud. The workflow includes the enhanced RunSFM procedure (keypoint detection using the scale-invariant feature transform known as SIFT, image matching, bundling using the Bundler, executing the multi-view stereo PMVS and CMVS2 software) which is preceded by multicore image resizing. The dense point cloud is subsequently automatically georeferenced using the GRASS software, and the ground control points are borrowed from positions of image centres acquired from the UAV-mounted GPS receiver. Finally, the digital surface model (DSM) is produced which - to improve the accuracy of georeferencing - is shifted using a vector obtained through precise geodetic GPS observation of a single ground control point (GCP) placed on the Laboratory for Unmanned Observations of Earth (mobile lab established at the University of Wroclaw, Poland). The DSM includes snow cover and its difference with the corresponding snow-free DSM or digital terrain model (DTM), following the concept of the digital elevation model of differences (DOD), produces a map of snow depth. Since the final result depends on the snow-free model, two experiments are carried out. Firstly, we show the performance of the entire procedure when the snow-free model reveals a very high resolution (3 cm/px) and is produced using the UAV-taken photographs and the precise GCPs measured by the geodetic GPS receiver. Secondly, we perform a similar exercise but the 1-metre resolution light detection and ranging (LIDAR) DSM or DTM serves as the snow-free model. Thus, the main objective of the paper is to present the performance of the new procedure for estimating snow depth and to compare the two experiments.

Inter-observer reliability of DSM-5 substance use disorders.

PubMed

Denis, Cécile M; Gelernter, Joel; Hart, Amy B; Kranzler, Henry R

2015-08-01

Although studies have examined the impact of changes made in DSM-5 on the estimated prevalence of substance use disorder (SUD) diagnoses, there is limited evidence concerning the reliability of DSM-5 SUDs. We evaluated the inter-observer reliability of four DSM-5 SUDs in a sample in which we had previously evaluated the reliability of DSM-IV diagnoses, allowing us to compare the two systems. Two different interviewers each assessed 173 subjects over a 2-week period using the Semi-Structured Assessment for Drug Dependence and Alcoholism (SSADDA). Using the percent agreement and kappa (κ) coefficient, we examined the reliability of DSM-5 lifetime alcohol, opioid, cocaine, and cannabis use disorders, which we compared to that of SSADDA-derived DSM-IV SUD diagnoses. We also assessed the effect of additional lifetime SUD and lifetime mood or anxiety disorder diagnoses on the reliability of the DSM-5 SUD diagnoses. Reliability was good to excellent for the four disorders, with κ values ranging from 0.65 to 0.94. Agreement was consistently lower for SUDs of mild severity than for moderate or severe disorders. DSM-5 SUD diagnoses showed greater reliability than DSM-IV diagnoses of abuse or dependence or dependence only. Co-occurring SUD and lifetime mood or anxiety disorders exerted a modest effect on the reliability of the DSM-5 SUD diagnoses. For alcohol, opioid, cocaine and cannabis use disorders, DSM-5 criteria and diagnoses are at least as reliable as those of DSM-IV. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Maximizing Energy Savings Reliability in BC Hydro Industrial Demand-side Management Programs: An Assessment of Performance Incentive Models

NASA Astrophysics Data System (ADS)

Gosman, Nathaniel

For energy utilities faced with expanded jurisdictional energy efficiency requirements and pursuing demand-side management (DSM) incentive programs in the large industrial sector, performance incentive programs can be an effective means to maximize the reliability of planned energy savings. Performance incentive programs balance the objectives of high participation rates with persistent energy savings by: (1) providing financial incentives and resources to minimize constraints to investment in energy efficiency, and (2) requiring that incentive payments be dependent on measured energy savings over time. As BC Hydro increases its DSM initiatives to meet the Clean Energy Act objective to reduce at least 66 per cent of new electricity demand with DSM by 2020, the utility is faced with a higher level of DSM risk, or uncertainties that impact the costeffective acquisition of planned energy savings. For industrial DSM incentive programs, DSM risk can be broken down into project development and project performance risks. Development risk represents the project ramp-up phase and is the risk that planned energy savings do not materialize due to low customer response to program incentives. Performance risk represents the operational phase and is the risk that planned energy savings do not persist over the effective measure life. DSM project development and performance risks are, in turn, a result of industrial economic, technological and organizational conditions, or DSM risk factors. In the BC large industrial sector, and characteristic of large industrial sectors in general, these DSM risk factors include: (1) capital constraints to investment in energy efficiency, (2) commodity price volatility, (3) limited internal staffing resources to deploy towards energy efficiency, (4) variable load, process-based energy saving potential, and (5) a lack of organizational awareness of an operation's energy efficiency over time (energy performance). This research assessed the capacity of alternative performance incentive program models to manage DSM risk in BC. Three performance incentive program models were assessed and compared to BC Hydro's current large industrial DSM incentive program, Power Smart Partners -- Transmission Project Incentives, itself a performance incentive-based program. Together, the selected program models represent a continuum of program design and implementation in terms of the schedule and level of incentives provided, the duration and rigour of measurement and verification (M&V), energy efficiency measures targeted and involvement of the private sector. A multi criteria assessment framework was developed to rank the capacity of each program model to manage BC large industrial DSM risk factors. DSM risk management rankings were then compared to program costeffectiveness, targeted energy savings potential in BC and survey results from BC industrial firms on the program models. The findings indicate that the reliability of DSM energy savings in the BC large industrial sector can be maximized through performance incentive program models that: (1) offer incentives jointly for capital and low-cost operations and maintenance (O&M) measures, (2) allow flexible lead times for project development, (3) utilize rigorous M&V methods capable of measuring variable load, process-based energy savings, (4) use moderate contract lengths that align with effective measure life, and (5) integrate energy management software tools capable of providing energy performance feedback to customers to maximize the persistence of energy savings. While this study focuses exclusively on the BC large industrial sector, the findings of this research have applicability to all energy utilities serving large, energy intensive industrial sectors.

Personality disorders are the vanguard of the post-DSM-5.0 era.

PubMed

Krueger, Robert F

2013-10-01

The process of constructing the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5; American Psychiatric Association, 2013) has concluded, with the manual published in May 2013. In this article, I review the evolution of personality disorders (PDs) in DSM-5 from my perspective as a participating workgroup member, and as an observer of the DSM-5 construction process. I emphasize well-documented shortcomings of the fourth edition of the DSM (DSM-IV; American Psychiatric Association, 1994), the diversity of potential changes to PD conceptualization and diagnosis that were proposed during the construction of DSM-5, and the final outcome, which consists of reproducing DSM-IV PD criteria in Section II of DSM-5 (diagnostic criteria and codes), while also printing a complete parallel PD system in Section III (emerging measures and models), with the idea of moving elements of the Section III material to Section II as DSM evolves (e.g., in DSM-5.1). Perhaps the PD field is too fractious to arrive at a consensus approach at this juncture, but, in addition, the current situation shows how the PD field is arguably the most forward-thinking area in contemporary psychopathology. This is because many PD scholars do not accept the inadequate polythetic-categorical approach to psychopathology classification of DSM-IV (which, owing to conservative political forces, also frames Section II of DSM-5). PD research is therefore at the vanguard in conceptualizing, studying, and treating psychopathology because it is not slavishly tethered to the DSM, and its approach to defining mental disorder through political processes. PsycINFO Database Record (c) 2013 APA, all rights reserved.

The DSM-5: Classification and criteria changes.

PubMed

Regier, Darrel A; Kuhl, Emily A; Kupfer, David J

2013-06-01

The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) marks the first significant revision of the publication since the DSM-IV in 1994. Changes to the DSM were largely informed by advancements in neuroscience, clinical and public health need, and identified problems with the classification system and criteria put forth in the DSM-IV. Much of the decision-making was also driven by a desire to ensure better alignment with the International Classification of Diseases and its upcoming 11th edition (ICD-11). In this paper, we describe select revisions in the DSM-5, with an emphasis on changes projected to have the greatest clinical impact and those that demonstrate efforts to enhance international compatibility, including integration of cultural context with diagnostic criteria and changes that facilitate DSM-ICD harmonization. It is anticipated that this collaborative spirit between the American Psychiatric Association (APA) and the World Health Organization (WHO) will continue as the DSM-5 is updated further, bringing the field of psychiatry even closer to a singular, cohesive nosology. Copyright © 2013 World Psychiatric Association.

PTSD or not PTSD? Comparing the proposed ICD-11 and the DSM-5 PTSD criteria among young survivors of the 2011 Norway attacks and their parents.

PubMed

Hafstad, G S; Thoresen, S; Wentzel-Larsen, T; Maercker, A; Dyb, G

2017-05-01

The conceptualization of post-traumatic stress disorder (PTSD) in the upcoming International Classification of Diseases (ICD)-11 differs in many respects from the diagnostic criteria in the Diagnostic and Statistical Manual for Mental Disorders, fifth edition (DSM-5). The consequences of these differences for individuals and for estimation of prevalence rates are largely unknown. This study investigated the concordance of the two diagnostic systems in two separate samples at two separate waves. Young survivors of the 2011 Norway attacks (n = 325) and their parents (n = 451) were interviewed at 4-6 months (wave 1) and 15-18 months (wave 2) after the shooting. PTSD was assessed with the UCLA PTSD Reaction Index for DSM-IV adapted for DSM-5, and a subset was used as diagnostic criteria for ICD-11. In survivors, PTSD prevalence did not differ significantly at any time point, but in parents, the DSM-5 algorithm produced significantly higher prevalence rates than the ICD-11 criteria. The overlap was fair for survivors, but amongst parents a large proportion of individuals met the criteria for only one of the diagnostic systems. No systematic differences were found between ICD-11 and DSM-5 in predictive validity. The proposed ICD-11 criteria and the DSM-5 criteria performed equally well when identifying individuals in distress. Nevertheless, the overlap between those meeting the PTSD diagnosis for both ICD-11 and DSM-5 was disturbingly low, with the ICD-11 criteria identifying fewer people than the DSM-5. This represents a major challenge in identifying individuals suffering from PTSD worldwide, possibly resulting in overtreatment or unmet needs for trauma-specific treatment, depending on the area of the world in which patients are being diagnosed.

Comparing the dimensional structure and diagnostic algorithms between DSM-5 and ICD-11 PTSD in children and adolescents.

PubMed

Sachser, Cedric; Berliner, Lucy; Holt, Tonje; Jensen, Tine; Jungbluth, Nathaniel; Risch, Elizabeth; Rosner, Rita; Goldbeck, Lutz

2018-02-01

In contrast to the DSM-5, which expanded the posttraumatic stress disorder (PTSD) symptom profile to 20 symptoms, a workgroup of the upcoming ICD-11 suggested a reduced symptom profile with six symptoms for PTSD. Therefore, the objective of the study was to investigate the dimensional structure of DSM-5 and ICD-11 PTSD in a clinical sample of trauma-exposed children and adolescents and to compare the diagnostic rates of PTSD between diagnostic systems. The study sample consisted of 475 self-reports and 424 caregiver-reports on the child and adolescent trauma screen (CATS), which were collected at pediatric mental health clinics in the US, Norway and Germany. The factor structure of the PTSD construct as defined in the DSM-5 and in alternative models of both DSM-5 and ICD-11 was investigated using confirmatory factor analyses (CFA). To evaluate differences in PTSD prevalence, McNemar's tests for correlated proportions were used. CFA results demonstrated excellent model fit for the proposed ICD-11 model of PTSD. For the DSM-5 models we found the best fit for the hybrid model. Diagnostic rates were significantly lower according to ICD-11 (self-report: 23.4%; caregiver-report: 16.5%) compared with the DSM-5 (self-report: 37.8%; caregiver-report: 31.8%). Agreement was low between diagnostic systems. Study findings provide support for an alternative latent dimensionality of DSM-5 PTSD in children and adolescents. The conceptualization of ICD-11 PTSD shows an excellent fit. Inconsistent PTSD constructs and significantly diverging diagnostic rates between DSM-5 and the ICD-11 will result in major challenges for researchers and clinicians in the field of psychotraumatology.

Automatic Generation of High Quality DSM Based on IRS-P5 Cartosat-1 Stereo Data

NASA Astrophysics Data System (ADS)

d'Angelo, Pablo; Uttenthaler, Andreas; Carl, Sebastian; Barner, Frithjof; Reinartz, Peter

2010-12-01

IRS-P5 Cartosat-1 high resolution stereo satellite imagery is well suited for the creation of digital surface models (DSM). A system for highly automated and operational DSM and orthoimage generation based on IRS-P5 Cartosat-1 imagery is presented, with an emphasis on automated processing and product quality. The proposed system processes IRS-P5 level-1 stereo scenes using the rational polynomial coefficients (RPC) universal sensor model. The described method uses an RPC correction based on DSM alignment instead of using reference images with a lower lateral accuracy, this results in improved geolocation of the DSMs and orthoimages. Following RPC correction, highly detailed DSMs with 5 m grid spacing are derived using Semiglobal Matching. The proposed method is part of an operational Cartosat-1 processor for the generation of a high resolution DSM. Evaluation of 18 scenes against independent ground truth measurements indicates a mean lateral error (CE90) of 6.7 meters and a mean vertical accuracy (LE90) of 5.1 meters.

Ensuring correct rollback recovery in distributed shared memory systems

NASA Technical Reports Server (NTRS)

Janssens, Bob; Fuchs, W. Kent

1995-01-01

Distributed shared memory (DSM) implemented on a cluster of workstations is an increasingly attractive platform for executing parallel scientific applications. Checkpointing and rollback techniques can be used in such a system to allow the computation to progress in spite of the temporary failure of one or more processing nodes. This paper presents the design of an independent checkpointing method for DSM that takes advantage of DSM's specific properties to reduce error-free and rollback overhead. The scheme reduces the dependencies that need to be considered for correct rollback to those resulting from transfers of pages. Furthermore, in-transit messages can be recovered without the use of logging. We extend the scheme to a DSM implementation using lazy release consistency, where the frequency of dependencies is further reduced.

It is time to bring borderline intellectual functioning back into the main fold of classification systems

PubMed Central

Wieland, Jannelien; Zitman, Frans G.

2016-01-01

Borderline intellectual functioning is an important and frequently unrecognised comorbid condition relevant to the diagnosis and treatment of any and all psychiatric disorders. In the DSM-IV-TR, it is defined by IQ in the 71–84 range. In DSM-5, IQ boundaries are no longer part of the classification, leaving the concept without a clear definition. This modification is one of the least highlighted changes in DSM-5. In this article we describe the history of the classification of borderline intellectual functioning. We provide information about it and on the importance of placing it in the right context and in the right place in future DSM editions and other classification systems such as the International Classification of Diseases. PMID:27512590

The use of the long modular diagnostics shield module to mitigate shutdown dose rates in the ITER diagnostics equatorial ports

NASA Astrophysics Data System (ADS)

Juárez, R.; Guirao, J.; Kolsek, A.; Lopez, A.; Pedroche, G.; Bertalot, L.; Udintsev, V. S.; Walsh, M. J.; Sauvan, P.; Sanz, J.

2018-05-01

The ITER equatorial port plugs are submitted to a drained weight limit of 45 T. This limitation can conflict with their radiation shielding demands, although some weight margin is being discussed. The port interspaces are subject to a shutdown dose rate limit of 100 µSv h‑1 after 106 s of cooling time. To meet it, the port plugs must show a neutron flux attenuation comparable to their neighborhood, despite considering penetrations to host systems. Most of this task relies on the drawer shield module (DSM). In this work, two DSM concepts are analyzed with this perspective: the box-based DSM and the modular DSM. Regardless the penetrations, the box-based DSM leads to unsatisfactory port plugs to meet both weight and SDDR requirements. On the contrary, the modular DSM shows a performance which allows for the adoption of such DSM concept, or equivalent, a port may comply with both requirements at the same time, provided the penetrations are well designed.

Behavior genetics of personality disorders: informing classification and conceptualization in DSM-5.

PubMed

South, Susan C; DeYoung, Nathaniel J

2013-07-01

Personality pathology is currently captured in the Diagnostic and Statistical Manual through 10 categorical personality disorder (PD) diagnoses grouped into three descriptive clusters. This classification system has been criticized by many for using discrete categories and arbitrary thresholds when making clinical decisions. To address these critiques, the DSM-5 Personality and Personality Disorders Work Group has put forth a proposal that significantly alters the structure and content of the DSM-IV PD section. If this DSM-5 Work Group has conducted its own systematic review of the empirical literature, this review has not been released or made widely available. As such, it is up to the psychology community at large to determine how well the suggested changes align with findings from extant PD research. The current article joins this effort by addressing the contribution of behavior genetic findings to the revision process for classification of PDs in DSM-5. First, we provide a brief review of the history of PD classification in the DSM. Next, we present an overview and rationale for each of the five major suggested changes to PD diagnoses. For each suggested change, we outline the available evidence from behavior genetics and interpretations of these findings. Finally, we offer a summary of considerations for PD classification as the DSM-5 moves forward. Review of the behavior genetics literature suggests that several features of the DSM-5 proposal, including the elimination of 4 PDs, merging clinical disorders and PDs on a single axis, and the implementation of a trait rating system, require significantly greater explication before a product is finalized.

Of mice and men, nature and nurture, and a few red herrings.

PubMed

Hauser, Marc D

2017-01-01

Burkart et al.'s proposal is based on three false premises: (1) theories of the mind are either domain-specific/modular (DSM) or domain-general (DG); (2) DSM systems are considered inflexible, built by nature; and (3) animal minds are deemed as purely DSM. Clearing up these conceptual confusions is a necessary first step in understanding how general intelligence evolved.

Demand-side management glossary

DOE Office of Scientific and Technical Information (OSTI.GOV)

Isaksen, L.; Ignelzi, P.C.

1992-10-01

Demand-side management (DSM) plays an increasingly important role in helping utilities meet capacity needs while addressing important customer service issues. In implementing utility-specific programs, however, DSM professionals have created an entire vocabulary of words and phrases that are often used and interpreted in very different ways by people with similar utility planning backgrounds. Such inconsistent terminology can hamper the very communication DSM seeks to support. Thus, this report-the first of its kind-presents a glossary of DSM terms, grouped under five major categories: (1) utility systems, (2) programs and techniques, (3) costs, revenues, and rates, (4) modeling and analysis, and (5)more » marketing. An index facilitates the rapid search for key words. This glossary together with a complimentary report entitled, Electric Utility DSM Programs: Terminology and Reporting Formats attempts to define some of the most common terms used in DSM today.« less

Demand-side management glossary. Final report

DOE Office of Scientific and Technical Information (OSTI.GOV)

Isaksen, L.; Ignelzi, P.C.

1992-10-01

Demand-side management (DSM) plays an increasingly important role in helping utilities meet capacity needs while addressing important customer service issues. In implementing utility-specific programs, however, DSM professionals have created an entire vocabulary of words and phrases that are often used and interpreted in very different ways by people with similar utility planning backgrounds. Such inconsistent terminology can hamper the very communication DSM seeks to support. Thus, this report-the first of its kind-presents a glossary of DSM terms, grouped under five major categories: (1) utility systems, (2) programs and techniques, (3) costs, revenues, and rates, (4) modeling and analysis, and (5)more » marketing. An index facilitates the rapid search for key words. This glossary together with a complimentary report entitled, Electric Utility DSM Programs: Terminology and Reporting Formats attempts to define some of the most common terms used in DSM today.« less

76 FR 42577 - Magnuson-Stevens Act Provisions; Fisheries of the Northeastern United States; Northeast...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-07-19

... comply with trip limits. However, the current system does not accurately account for the fish landed for... confirm the receipt of the TSH report via a back-up system specified by the DSM service provider. The... via a back-up system, after a time determined by the DSM provider, to confirm the receipt of the TSH...

Traffic & rural intersection monitoring with a solar-based infrared wireless system : phase 2 final report, long term effect and justification for further analysis, May 2008 [summary].

DOT National Transportation Integrated Search

2008-05-01

This study concerns the development and evaluation of a dynamic speed monitoring (DSM) system for use at rural intersections. The purpose of the DSM system is to give traffic speed feedback to drivers via an advisory sign, with the goals of improving...

Microgravity Isolation Control System Design Via High-Order Sliding Mode Control

NASA Technical Reports Server (NTRS)

Shkolnikov, Ilya; Shtessel, Yuri; Whorton, Mark S.; Jackson, Mark

2000-01-01

Vibration isolation control system design for a microgravity experiment mount is considered. The controller design based on dynamic sliding manifold (DSM) technique is proposed to attenuate the accelerations transmitted to an isolated experiment mount either from a vibrating base or directly generated by the experiment, as well as to stabilize the internal dynamics of this nonminimum phase plant. An auxiliary DSM is employed to maintain the high-order sliding mode on the primary sliding manifold in the presence of uncertain actuator dynamics of second order. The primary DSM is designed for the closed-loop system in sliding mode to be a filter with given characteristics with respect to the input external disturbances.

Does size really matter? A multisite study assessing the latent structure of the proposed ICD-11 and DSM-5 diagnostic criteria for PTSD

PubMed Central

Hansen, Maj; Hyland, Philip; Karstoft, Karen-Inge; Vaegter, Henrik B.; Bramsen, Rikke H.; Nielsen, Anni B. S.; Armour, Cherie; Andersen, Søren B.; Høybye, Mette Terp; Larsen, Simone Kongshøj; Andersen, Tonny E.

2017-01-01

ABSTRACT Background: Researchers and clinicians within the field of trauma have to choose between different diagnostic descriptions of posttraumatic stress disorder (PTSD) in the DSM-5 and the proposed ICD-11. Several studies support different competing models of the PTSD structure according to both diagnostic systems; however, findings show that the choice of diagnostic systems can affect the estimated prevalence rates. Objectives: The present study aimed to investigate the potential impact of using a large (i.e. the DSM-5) compared to a small (i.e. the ICD-11) diagnostic description of PTSD. In other words, does the size of PTSD really matter? Methods: The aim was investigated by examining differences in diagnostic rates between the two diagnostic systems and independently examining the model fit of the competing DSM-5 and ICD-11 models of PTSD across three trauma samples: university students (N = 4213), chronic pain patients (N = 573), and military personnel (N = 118). Results: Diagnostic rates of PTSD were significantly lower according to the proposed ICD-11 criteria in the university sample, but no significant differences were found for chronic pain patients and military personnel. The proposed ICD-11 three-factor model provided the best fit of the tested ICD-11 models across all samples, whereas the DSM-5 seven-factor Hybrid model provided the best fit in the university and pain samples, and the DSM-5 six-factor Anhedonia model provided the best fit in the military sample of the tested DSM-5 models. Conclusions: The advantages and disadvantages of using a broad or narrow set of symptoms for PTSD can be debated, however, this study demonstrated that choice of diagnostic system may influence the estimated PTSD rates both qualitatively and quantitatively. In the current described diagnostic criteria only the ICD-11 model can reflect the configuration of symptoms satisfactorily. Thus, size does matter when assessing PTSD. PMID:29201287

Does size really matter? A multisite study assessing the latent structure of the proposed ICD-11 and DSM-5 diagnostic criteria for PTSD.

PubMed

Hansen, Maj; Hyland, Philip; Karstoft, Karen-Inge; Vaegter, Henrik B; Bramsen, Rikke H; Nielsen, Anni B S; Armour, Cherie; Andersen, Søren B; Høybye, Mette Terp; Larsen, Simone Kongshøj; Andersen, Tonny E

2017-01-01

Background : Researchers and clinicians within the field of trauma have to choose between different diagnostic descriptions of posttraumatic stress disorder (PTSD) in the DSM-5 and the proposed ICD-11. Several studies support different competing models of the PTSD structure according to both diagnostic systems; however, findings show that the choice of diagnostic systems can affect the estimated prevalence rates. Objectives : The present study aimed to investigate the potential impact of using a large (i.e. the DSM-5) compared to a small (i.e. the ICD-11) diagnostic description of PTSD. In other words, does the size of PTSD really matter? Methods: The aim was investigated by examining differences in diagnostic rates between the two diagnostic systems and independently examining the model fit of the competing DSM-5 and ICD-11 models of PTSD across three trauma samples: university students ( N  = 4213), chronic pain patients ( N  = 573), and military personnel ( N  = 118). Results : Diagnostic rates of PTSD were significantly lower according to the proposed ICD-11 criteria in the university sample, but no significant differences were found for chronic pain patients and military personnel. The proposed ICD-11 three-factor model provided the best fit of the tested ICD-11 models across all samples, whereas the DSM-5 seven-factor Hybrid model provided the best fit in the university and pain samples, and the DSM-5 six-factor Anhedonia model provided the best fit in the military sample of the tested DSM-5 models. Conclusions : The advantages and disadvantages of using a broad or narrow set of symptoms for PTSD can be debated, however, this study demonstrated that choice of diagnostic system may influence the estimated PTSD rates both qualitatively and quantitatively. In the current described diagnostic criteria only the ICD-11 model can reflect the configuration of symptoms satisfactorily. Thus, size does matter when assessing PTSD.

The DSM-III personality disorders section: a commentary.

PubMed

Frances, A

1980-09-01

The author reviews the DSM-III section on personality disorders, discusses several of its more controversial diagnoses, and suggests some possible alternatives. He attributes the continued low reliability of personality diagnoses, compared with the other major sections of DSM-III, to two inherent obstacles: the lack of clear boundaries demarcating the personality disorders from normality and from one another, and the confounding influence of state and role factors. Nonetheless, the DSM-III multiaxial system highlights the importance of personality diagnosis and, together with the provision of clearly specified diagnostic criteria, achieves a considerably improved reliability compared with previous nomenclatures.

DSM-III as a research tool.

PubMed

Treece, C

1982-05-01

The author describes the use of the DSM-III's diagnostic criteria and classification system as a research instrument and discusses some of the advantages and drawbacks of DMS-III for a specific type of study. A rearrangement of the hierarchical order of the DSM-III diagnostic classes is suggested. This rearrangement provides for levels of certainty in analyzing interrater reliability and offers a simplified framework for summarizing group data. When this approach is combined with a structured interview and response format, it provides a flexible way of managing a large classification system for a smaller study without sacrificing standardization.

Gender and cultural issues in psychiatric nosological classification systems.

PubMed

van de Water, Tanya; Suliman, Sharain; Seedat, Soraya

2016-08-01

Much has changed since the two dominant mental health nosological systems, the International Classification of Diseases (ICD) and the Diagnostic and Statistical Manual of Mental Disorders (DSM), were first published in 1900 and 1952, respectively. Despite numerous modifications to stay up to date with scientific and cultural changes (eg, exclusion of homosexuality as a disorder) and to improve the cultural sensitivity of psychiatric diagnoses, the ICD and DSM have only recently renewed attempts at harmonization. Previous nosological iterations demonstrate the oscillation in the importance placed on the biological focus, highlighting the tension between a gender- and culture-free nosology (solely biological) and a contextually relevant understanding of mental illness. In light of the release of the DSM 5, future nosological systems, such as the ICD 11, scheduled for release in 2017, and the Research Development Criteria (RDoC), can learn from history and apply critiques. This article aims to critically consider gender and culture in previous editions of the ICD and DSM to inform forthcoming classifications.

Diagnosis of schizophrenia: a critical review of current diagnostic systems.

PubMed

Fenton, W S; Mosher, L R; Matthews, S M

1981-01-01

The data relevant to the evaluation of six systems for diagnosing schizophrenia are reviewed. They are summarized in terms of the reliability, predictive validity, specificity, and comprehensiveness of each system. Unfortunately, none, of these systems (Schneider's First-rank Symptoms, New Haven Schizophrenia Index, Flexible System, Feighner Criteria, Research Diagnostic Criteria, and DSM-III) have established construct validity. It is noted therefore that they are all, in a sense, arbitrary. Choosing one over another cannot be data-based. Because the elevation of any one diagnostic system to an official status is thought to be premature, clinicians and researchers alike are advised to exercise caution and openmindedness in their use of DSM-III. There is as yet no evidence that its criteria for schizophrenia are either less arbitrary or better (in identifying a group of "true" schizophrenics) than those of other systems or DSM-II.

Greater Prevalence of Proposed ICD-11 Alcohol and Cannabis Dependence Compared to ICD-10, DSM-IV, and DSM-5 in Treated Adolescents.

PubMed

Chung, Tammy; Cornelius, Jack; Clark, Duncan; Martin, Christopher

2017-09-01

Proposed International Classification of Diseases, 11th edition (ICD-11), criteria for substance use disorder (SUD) radically simplify the algorithm used to diagnose substance dependence. Major differences in case identification across DSM and ICD impact determinations of treatment need and conceptualizations of substance dependence. This study compared the draft algorithm for ICD-11 SUD against DSM-IV, DSM-5, and ICD-10, for alcohol and cannabis. Adolescents (n = 339, ages 14 to 18) admitted to intensive outpatient addictions treatment completed, as part of a research study, a Structured Clinical Interview for DSM SUDs adapted for use with adolescents and which has been used to assess DSM and ICD SUD diagnoses. Analyses examined prevalence across classification systems, diagnostic concordance, and sources of diagnostic disagreement. Prevalence of any past-year proposed ICD-11 alcohol or cannabis use disorder was significantly lower compared to DSM-IV and DSM-5 (ps < 0.01). However, prevalence of proposed ICD-11 alcohol and cannabis dependence diagnoses was significantly higher compared to DSM-IV, DSM-5, and ICD-10 (ps < 0.01). ICD-11 and DSM-5 SUD diagnoses showed only moderate concordance. For both alcohol and cannabis, youth typically met criteria for an ICD-11 dependence diagnosis by reporting tolerance and much time spent using or recovering from the substance, rather than symptoms indicating impaired control over use. The proposed ICD-11 dependence algorithm appears to "overdiagnose" dependence on alcohol and cannabis relative to DSM-IV and ICD-10 dependence, and DSM-5 moderate/severe use disorder, generating potential "false-positive" cases of dependence. Among youth who met criteria for proposed ICD-11 dependence, few reported impaired control over substance use, highlighting ongoing issues in the conceptualization and diagnosis of SUD. Copyright © 2017 by the Research Society on Alcoholism.

The 1-month prevalence of generalized anxiety disorder according to DSM-IV, DSM-V, and ICD-10 among nondemented 75-year-olds in Gothenburg, Sweden.

PubMed

Nilsson, Johan; Östling, Svante; Waern, Margda; Karlsson, Björn; Sigström, Robert; Guo, Xinxin; Skoog, Ingmar

2012-11-01

To examine the 1-month prevalence of generalized anxiety disorder (GAD) according to Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV), Diagnostic and Statistical Manual of Mental, Fifth Edition (DSM-V), and International Classification of Diseases, Tenth Revision (ICD-10), and the overlap between these criteria, in a population sample of 75-year-olds. We also aimed to examine comorbidity between GAD and other psychiatric diagnoses, such as depression. During 2005-2006, a comprehensive semistructured psychiatric interview was conducted by trained nurses in a representative population sample of 75-year-olds without dementia in Gothenburg, Sweden (N = 777; 299 men and 478 women). All psychiatric diagnoses were made according to DSM-IV. GAD was also diagnosed according to ICD-10 and DSM-V. The 1-month prevalence of GAD was 4.1% (N = 32) according to DSM-IV, 4.5% (N = 35) according to DSM-V, and 3.7% (N = 29) according to ICD-10. Only 46.9% of those with DSM-IV GAD fulfilled ICD-10 criteria, and only 51.7% and 44.8% of those with ICD-10 GAD fulfilled DSM-IV/V criteria. Instead, 84.4% and 74.3% of those with DSM-IV/V GAD and 89.7% of those with ICD-10 GAD had depression. Also other psychiatric diagnoses were common in those with ICD-10 and DSM-IV GAD. Only a small minority with GAD, irrespective of criteria, had no other comorbid psychiatric disorder. ICD-10 GAD was related to an increased mortality rate. While GAD was common in 75-year-olds, DSM-IV/V and ICD-10 captured different individuals. Current definitions of GAD may comprise two different expressions of the disease. There was greater congruence between GAD in either classification system and depression than between DSM-IV/V GAD and ICD-10 GAD, emphasizing the close link between these entities. 2012 American Association for Geriatric Psychiatry

Comparison of DSM-5 and proposed ICD-11 criteria for PTSD with DSM-IV and ICD-10: changes in PTSD prevalence in military personnel.

PubMed

Kuester, Annika; Köhler, Kai; Ehring, Thomas; Knaevelsrud, Christine; Kober, Louisa; Krüger-Gottschalk, Antje; Schäfer, Ingo; Schellong, Julia; Wesemann, Ulrich; Rau, Heinrich

2017-01-01

Background: Recently, changes have been introduced to the diagnostic criteria for posttraumatic stress disorder (PTSD) according to the Diagnostic and Statistical Manual of Mental Disorders (DSM) and the International Classification of Diseases (ICD). Objectives: This study investigated the effect of the diagnostic changes made from DSM-IV to DSM-5 and from ICD-10 to the proposed ICD-11. The concordance of provisional PTSD prevalence between the diagnostic criteria was examined in a convenience sample of 100 members of the German Armed Forces. Method: Based on questionnaire measurements, provisional PTSD prevalence was assessed according to DSM-IV, DSM-5, ICD-10, and proposed ICD-11 criteria. Consistency of the diagnostic status across the diagnostic systems was statistically evaluated. Results: Provisional PTSD prevalence was the same for DSM-IV and DSM-5 (both 56%) and comparable under DSM-5 versus ICD-11 proposal (48%). Agreement between DSM-IV and DSM-5, and between DSM-5 and the proposed ICD-11, was high (both p  < .001). Provisional PTSD prevalence was significantly increased under ICD-11 proposal compared to ICD-10 (30%) which was mainly due to the deletion of the time criterion. Agreement between ICD-10 and the proposed ICD-11 was low ( p  = .014). Conclusion: This study provides preliminary evidence for a satisfactory concordance between provisional PTSD prevalence based on the diagnostic criteria for PTSD that are defined using DSM-IV, DSM-5, and proposed ICD-11. This supports the assumption of a set of PTSD core symptoms as suggested in the ICD-11 proposal, when at the same time a satisfactory concordance between ICD-11 proposal and DSM was given. The finding of increased provisional PTSD prevalence under ICD-11 proposal in contrast to ICD-10 can be of guidance for future epidemiological research on PTSD prevalence, especially concerning further investigations on the impact, appropriateness, and usefulness of the time criterion included in ICD-10 versus the consequences of its deletion as proposed for ICD-11.

Comparison of DSM-5 and proposed ICD-11 criteria for PTSD with DSM-IV and ICD-10: changes in PTSD prevalence in military personnel

PubMed Central

Kuester, Annika; Köhler, Kai; Ehring, Thomas; Knaevelsrud, Christine; Kober, Louisa; Krüger-Gottschalk, Antje; Schäfer, Ingo; Schellong, Julia; Wesemann, Ulrich; Rau, Heinrich

2017-01-01

ABSTRACT Background: Recently, changes have been introduced to the diagnostic criteria for posttraumatic stress disorder (PTSD) according to the Diagnostic and Statistical Manual of Mental Disorders (DSM) and the International Classification of Diseases (ICD). Objectives:This study investigated the effect of the diagnostic changes made from DSM-IV to DSM-5 and from ICD-10 to the proposed ICD-11. The concordance of provisional PTSD prevalence between the diagnostic criteria was examined in a convenience sample of 100 members of the German Armed Forces. Method: Based on questionnaire measurements, provisional PTSD prevalence was assessed according to DSM-IV, DSM-5, ICD-10, and proposed ICD-11 criteria. Consistency of the diagnostic status across the diagnostic systems was statistically evaluated. Results: Provisional PTSD prevalence was the same for DSM-IV and DSM-5 (both 56%) and comparable under DSM-5 versus ICD-11 proposal (48%). Agreement between DSM-IV and DSM-5, and between DSM-5 and the proposed ICD-11, was high (both p < .001). Provisional PTSD prevalence was significantly increased under ICD-11 proposal compared to ICD-10 (30%) which was mainly due to the deletion of the time criterion. Agreement between ICD-10 and the proposed ICD-11 was low (p = .014). Conclusion: This study provides preliminary evidence for a satisfactory concordance between provisional PTSD prevalence based on the diagnostic criteria for PTSD that are defined using DSM-IV, DSM-5, and proposed ICD-11. This supports the assumption of a set of PTSD core symptoms as suggested in the ICD-11 proposal, when at the same time a satisfactory concordance between ICD-11 proposal and DSM was given. The finding of increased provisional PTSD prevalence under ICD-11 proposal in contrast to ICD-10 can be of guidance for future epidemiological research on PTSD prevalence, especially concerning further investigations on the impact, appropriateness, and usefulness of the time criterion included in ICD-10 versus the consequences of its deletion as proposed for ICD-11. PMID:29163862

Second International Workshop on Software Engineering and Code Design in Parallel Meteorological and Oceanographic Applications

NASA Technical Reports Server (NTRS)

OKeefe, Matthew (Editor); Kerr, Christopher L. (Editor)

1998-01-01

This report contains the abstracts and technical papers from the Second International Workshop on Software Engineering and Code Design in Parallel Meteorological and Oceanographic Applications, held June 15-18, 1998, in Scottsdale, Arizona. The purpose of the workshop is to bring together software developers in meteorology and oceanography to discuss software engineering and code design issues for parallel architectures, including Massively Parallel Processors (MPP's), Parallel Vector Processors (PVP's), Symmetric Multi-Processors (SMP's), Distributed Shared Memory (DSM) multi-processors, and clusters. Issues to be discussed include: (1) code architectures for current parallel models, including basic data structures, storage allocation, variable naming conventions, coding rules and styles, i/o and pre/post-processing of data; (2) designing modular code; (3) load balancing and domain decomposition; (4) techniques that exploit parallelism efficiently yet hide the machine-related details from the programmer; (5) tools for making the programmer more productive; and (6) the proliferation of programming models (F--, OpenMP, MPI, and HPF).

Posttraumatic stress disorder according to DSM-5 and DSM-IV diagnostic criteria: a comparison in a sample of Congolese ex-combatants

PubMed Central

Schaal, Susanne; Koebach, Anke; Hinkel, Harald; Elbert, Thomas

2015-01-01

Background Compared to DSM-IV, the criteria for diagnosing posttraumatic stress disorder (PTSD) have been modified in DSM-5. Objective The first aim of this study was to examine how these modifications impact rates of PTSD in a sample of Congolese ex-combatants. The second goal of this study was to investigate whether PTSD symptoms were associated with perpetrator-related acts or victim-related traumatic events. Method Ninety-five male ex-combatants in the eastern Democratic Republic of Congo were interviewed. Both the DSM-IV and the DSM-5 PTSD symptom criteria were assessed. Results The DSM-5 symptom criteria yielded a PTSD rate of 50% (n=47), whereas the DSM-IV symptom criteria were met by 44% (n=42). If the DSM-5 would be set as the current “gold standard,” then DSM-IV would have produced more false negatives (8%) than false positives (3%). A minority of participants (19%, n=18) indicated an event during which they were involved as a perpetrator as their most stressful event. Results of a regression analysis (R 2=0.40) showed that, after accounting for the number of types of traumatic events, perpetrated violent acts were not associated with the symptom severity of PTSD. Conclusions The findings demonstrate that more diagnostic cases were produced with the DSM-5 diagnostic rules than were dropped resulting in an increase in PTSD rates compared to the DSM-IV system. The missing association between PTSD symptoms and perpetrated violent acts might be explained by a potential fascinating and excited perception of these acts. PMID:25720994

A Proposal for a Dimensional Classification System Based on the Shared Features of the "DSM-IV" Anxiety and Mood Disorders: Implications for Assessment and Treatment

ERIC Educational Resources Information Center

Brown, Timothy A.; Barlow, David H.

2009-01-01

A wealth of evidence attests to the extensive current and lifetime diagnostic comorbidity of the "Diagnostic and Statistical Manual of Mental Disorders" (4th ed., "DSM-IV") anxiety and mood disorders. Research has shown that the considerable cross-sectional covariation of "DSM-IV" emotional disorders is accounted for by common higher order…

The Normalized-Rate Iterative Algorithm: A Practical Dynamic Spectrum Management Method for DSL

NASA Astrophysics Data System (ADS)

Statovci, Driton; Nordström, Tomas; Nilsson, Rickard

2006-12-01

We present a practical solution for dynamic spectrum management (DSM) in digital subscriber line systems: the normalized-rate iterative algorithm (NRIA). Supported by a novel optimization problem formulation, the NRIA is the only DSM algorithm that jointly addresses spectrum balancing for frequency division duplexing systems and power allocation for the users sharing a common cable bundle. With a focus on being implementable rather than obtaining the highest possible theoretical performance, the NRIA is designed to efficiently solve the DSM optimization problem with the operators' business models in mind. This is achieved with the help of two types of parameters: the desired network asymmetry and the desired user priorities. The NRIA is a centralized DSM algorithm based on the iterative water-filling algorithm (IWFA) for finding efficient power allocations, but extends the IWFA by finding the achievable bitrates and by optimizing the bandplan. It is compared with three other DSM proposals: the IWFA, the optimal spectrum balancing algorithm (OSBA), and the bidirectional IWFA (bi-IWFA). We show that the NRIA achieves better bitrate performance than the IWFA and the bi-IWFA. It can even achieve performance almost as good as the OSBA, but with dramatically lower requirements on complexity. Additionally, the NRIA can achieve bitrate combinations that cannot be supported by any other DSM algorithm.

Relating DSM-5 section III personality traits to section II personality disorder diagnoses.

PubMed

Morey, L C; Benson, K T; Skodol, A E

2016-02-01

The DSM-5 Personality and Personality Disorders Work Group formulated a hybrid dimensional/categorical model that represented personality disorders as combinations of core impairments in personality functioning with specific configurations of problematic personality traits. Specific clusters of traits were selected to serve as indicators for six DSM categorical diagnoses to be retained in this system - antisocial, avoidant, borderline, narcissistic, obsessive-compulsive and schizotypal personality disorders. The goal of the current study was to describe the empirical relationships between the DSM-5 section III pathological traits and DSM-IV/DSM-5 section II personality disorder diagnoses. Data were obtained from a sample of 337 clinicians, each of whom rated one of his or her patients on all aspects of the DSM-IV and DSM-5 proposed alternative model. Regression models were constructed to examine trait-disorder relationships, and the incremental validity of core personality dysfunctions (i.e. criterion A features for each disorder) was examined in combination with the specified trait clusters. Findings suggested that the trait assignments specified by the Work Group tended to be substantially associated with corresponding DSM-IV concepts, and the criterion A features provided additional diagnostic information in all but one instance. Although the DSM-5 section III alternative model provided a substantially different taxonomic structure for personality disorders, the associations between this new approach and the traditional personality disorder concepts in DSM-5 section II make it possible to render traditional personality disorder concepts using alternative model traits in combination with core impairments in personality functioning.

Clashing Diagnostic Approaches: DSM-ICD versus RDoC

PubMed Central

Lilienfeld, Scott O.; Treadway, Michael T.

2016-01-01

Since at least the middle of the past century, one overarching model of psychiatric classification, namely, that of the Diagnostic and Statistical Manual of Mental Disorders and International Classification of Diseases (DSM-ICD), has reigned supreme. This DSM-ICD approach embraces an Aristotelian view of mental disorders as largely discrete entities that are characterized by distinctive signs, symptoms, and natural histories. Over the past several years, however, a competing vision, namely, the Research Domain Criteria (RDoC) initiative launched by the National Institute of Mental Health, has emerged in response to accumulating anomalies within the DSM-ICD system. In contrast to DSM-ICD, RDoC embraces a Galilean view of psychopathology as the product of dysfunctions in neural circuitry. RDoC appears to be a valuable endeavor that holds out the long-term promise of an alternative system of mental illness classification. We delineate three sets of pressing challenges – conceptual, methodological, and logistical/pragmatic – that must be addressed for RDoC to realize its scientific potential, and conclude with a call for further research, including investigation of a rapprochement between Aristotelian and Galilean approaches to psychiatric classification. PMID:26845519

Gender differences in diagnosing antisocial personality disorder in methadone patients.

PubMed

Rutherford, M J; Alterman, A I; Cacciola, J S; Snider, E C

1995-09-01

The goal of this study was to evaluate gender differences in the prevalence rates, short-term reliability, and internal consistency of the diagnosis of antisocial personality disorder for DSM-III-R, DSM-III, and Research Diagnostic Criteria (RDC). A total of 37 men and 57 women methadone patients were diagnosed according to DSM-III-R, DSM-III, and RDC antisocial personality disorder criteria. The diagnostic rates, reliability, and internal consistency were lower for women than for men in all systems. DSM-III criteria resulted in the highest reliability for women, but for men, the DSM-III criteria were the least reliable. Examination of endorsement rates of individual antisocial personality disorder criteria revealed several significant gender differences on the majority of childhood criteria and on several adult criteria. Item-total correlations revealed that for women, the violent and aggressive childhood criteria in DSM-III-R that had not been included in DSM-III or RDC had a negative or no correlation to the assessment of antisocial personality disorder for women. The change in DSM-III-R from DSM-III childhood criteria appears to have resulted in a decrease in internal consistency and rates of antisocial personality disorder for women, but not for men. The results of this investigation indicate that the psychometric properties of the current antisocial personality disorder scales are weak for women, compared with men. To assess antisocial personality disorder in women it may be necessary to revise current, or develop new, diagnostic criteria.

A Survey of Terrain Modeling Technologies and Techniques

DTIC Science & Technology

2007-09-01

Washington , DC 20314-1000 ERDC/TEC TR-08-2 ii Abstract: Test planning, rehearsal, and distributed test events for Future Combat Systems (FCS) require...distance) for all five lines of control points. Blue circles are errors of DSM (original data), red squares are DTM (bare Earth, processed by Intermap...circles are DSM, red squares are DTM ........... 8 5 Distribution of errors for line No. 729. Blue circles are DSM, red squares are DTM

Antisocial personality disorder in DSM-5: missteps and missed opportunities.

PubMed

Lynam, Donald R; Vachon, David D

2012-10-01

This paper evaluates the proposal for antisocial personality disorder (ASPD) in the Diagnostic and Statistical Manual of Mental Disorders-fifth edition (DSM-5). Some aspects of the proposal are appealing: personality disorders will be assessed using trait criteria, and these criteria are similar to trait descriptions of DSM-IV ASPD. Other aspects of the proposal are less appealing. First, the DSM-5 will depend on a newly constructed personality trait system rather than relying on a well validated, widely studied one. Second, the trait profile of ASPD is incomplete; although this profile reflects the traits included in DSM-IV, it maps poorly onto the full personality profile of ASPD. Third, the DSM Workgroup missed an opportunity to finally unify ASPD and psychopathy; history and research suggest that these disorders have diverged mistakenly. Fourth, the newly proposed criteria of impairments in self- and interpersonal functioning are of questionable derivation and utility. (PsycINFO Database Record (c) 2012 APA, all rights reserved).

Synthesizing dimensional and categorical approaches to personality disorders: refining the research agenda for DSM-V Axis II.

PubMed

Krueger, Robert F; Skodol, Andrew E; Livesley, W John; Shrout, Patrick E; Huang, Yueqin

2007-01-01

Personality disorder researchers have long considered the utility of dimensional approaches to diagnosis, signaling the need to consider a dimensional approach for personality disorders in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-V). Nevertheless, a dimensional approach to personality disorders in DSM-V is more likely to succeed if it represents an orderly and logical progression from the categorical system in DSM-IV. With these considerations and opportunities in mind, the authors sought to delineate ways of synthesizing categorical and dimensional approaches to personality disorders that could inform the construction of DSM-V. This discussion resulted in (1) the idea of having a set of core descriptive elements of personality for DSM-V, (2) an approach to rating those elements for specific patients, (3) a way of combining those elements into personality disorder prototypes, and (4) a revised conception of personality disorder as a construct separate from personality traits. Copyright (c) 2007 John Wiley & Sons, Ltd.

The six most essential questions in psychiatric diagnosis: a pluralogue part 3: issues of utility and alternative approaches in psychiatric diagnosis

PubMed Central

2012-01-01

In face of the multiple controversies surrounding the DSM process in general and the development of DSM-5 in particular, we have organized a discussion around what we consider six essential questions in further work on the DSM. The six questions involve: 1) the nature of a mental disorder; 2) the definition of mental disorder; 3) the issue of whether, in the current state of psychiatric science, DSM-5 should assume a cautious, conservative posture or an assertive, transformative posture; 4) the role of pragmatic considerations in the construction of DSM-5; 5) the issue of utility of the DSM – whether DSM-III and IV have been designed more for clinicians or researchers, and how this conflict should be dealt with in the new manual; and 6) the possibility and advisability, given all the problems with DSM-III and IV, of designing a different diagnostic system. Part 1 of this article took up the first two questions. Part 2 took up the second two questions. Part 3 now deals with Questions 5 & 6. Question 5 confronts the issue of utility, whether the manual design of DSM-III and IV favors clinicians or researchers, and what that means for DSM-5. Our final question, Question 6, takes up a concluding issue, whether the acknowledged problems with the earlier DSMs warrants a significant overhaul of DSM-5 and future manuals. As in Parts 1 & 2 of this article, the general introduction, as well as the introductions and conclusions for the specific questions, are written by James Phillips, and the responses to commentaries are written by Allen Frances. PMID:22621419

Opioid-use disorder among patients on long-term opioid therapy: impact of final DSM-5 diagnostic criteria on prevalence and correlates.

PubMed

Boscarino, Joseph A; Hoffman, Stuart N; Han, John J

2015-01-01

Previously, we estimated the prevalence and risk factors for prescription opioid-use disorder among outpatients on opioid therapy using the Diagnostic and Statistical Manual of Mental Disorders (DSM)-5 and DSM-4 criteria. However, at the time, the DSM-5 criteria were not finalized. In the current study, we analyzed these data using the final DSM-5 criteria and compared these results. Using electronic records from a large US health care system, we identified outpatients receiving five or more prescription orders for opioid therapy in the past 12 months for noncancer pain (mean prescription orders =10.72; standard deviation =4.96). In 2008, we completed diagnostic interviews with 705 of these patients using the DSM-4 criteria. In the current study, we reassessed these results using the final DSM-5 criteria. The lifetime prevalence of DSM-5 opioid-use disorders using the final DSM-5 criteria was 58.7% for no or few symptoms (<2), 28.1% for mild symptoms (2-3), 9.7% for moderate symptoms (4-5), and 3.5% for severe symptoms (six or more). Thus, the lifetime prevalence of "any" prescription opioid-use disorder in this cohort was 41.3% (95% confidence interval [CI] =37.6-45.0). A comparison to the DSM-4 criteria indicated that the majority of patients with lifetime DSM-4 opioid dependence were now classified as having mild opioid-use disorder, based on the DSM-5 criteria (53.6%; 95% CI =44.1-62.8). In ordinal logistic regression predicting no/few, mild, moderate, and severe opioid-use disorder, the best predictors were age <65 years, current pain impairment, trouble sleeping, suicidal thoughts, anxiety disorders, illicit drug use, and history of substance abuse treatment. Given the final DSM-5 criteria, including the elimination of tolerance and withdrawal, inclusion of craving and abuse symptoms, and introduction of a new graded severity classification, the prevalence of opioid-use disorders has changed, while many of the DSM-4 risk factors for opioid dependence were similar. To our knowledge, this is one of the first studies to compare the final results for DSM-5 versus DSM-4 prescription opioid-use disorders among a high-risk patient population.

Opioid-use disorder among patients on long-term opioid therapy: impact of final DSM-5 diagnostic criteria on prevalence and correlates

PubMed Central

Boscarino, Joseph A; Hoffman, Stuart N; Han, John J

2015-01-01

Aims Previously, we estimated the prevalence and risk factors for prescription opioid-use disorder among outpatients on opioid therapy using the Diagnostic and Statistical Manual of Mental Disorders (DSM)-5 and DSM-4 criteria. However, at the time, the DSM-5 criteria were not finalized. In the current study, we analyzed these data using the final DSM-5 criteria and compared these results. Methods Using electronic records from a large US health care system, we identified outpatients receiving five or more prescription orders for opioid therapy in the past 12 months for noncancer pain (mean prescription orders =10.72; standard deviation =4.96). In 2008, we completed diagnostic interviews with 705 of these patients using the DSM-4 criteria. In the current study, we reassessed these results using the final DSM-5 criteria. Results The lifetime prevalence of DSM-5 opioid-use disorders using the final DSM-5 criteria was 58.7% for no or few symptoms (<2), 28.1% for mild symptoms (2–3), 9.7% for moderate symptoms (4–5), and 3.5% for severe symptoms (six or more). Thus, the lifetime prevalence of “any” prescription opioid-use disorder in this cohort was 41.3% (95% confidence interval [CI] =37.6–45.0). A comparison to the DSM-4 criteria indicated that the majority of patients with lifetime DSM-4 opioid dependence were now classified as having mild opioid-use disorder, based on the DSM-5 criteria (53.6%; 95% CI =44.1–62.8). In ordinal logistic regression predicting no/few, mild, moderate, and severe opioid-use disorder, the best predictors were age <65 years, current pain impairment, trouble sleeping, suicidal thoughts, anxiety disorders, illicit drug use, and history of substance abuse treatment. Conclusion Given the final DSM-5 criteria, including the elimination of tolerance and withdrawal, inclusion of craving and abuse symptoms, and introduction of a new graded severity classification, the prevalence of opioid-use disorders has changed, while many of the DSM-4 risk factors for opioid dependence were similar. To our knowledge, this is one of the first studies to compare the final results for DSM-5 versus DSM-4 prescription opioid-use disorders among a high-risk patient population. PMID:26316838

A Survey of Inhalant Use Disorders among Delinquent Youth: Prevalence, Clinical Features, and Latent Structure of DSM-IV Diagnostic Criteria

PubMed Central

Howard, Matthew O; Perron, Brian E

2009-01-01

Background Inhalant use is among the most pernicious and poorly understood forms of adolescent substance use. Many youth in the juvenile justice system have used inhalants, but little is known about inhalant use disorders (IUDs) in antisocial youth populations. The purpose of this study was to examine the prevalence, clinical features, and latent structure of DSM-IV IUDs in a state population of antisocial youth. Methods Cross-sectional survey conducted in 2003. Of 740 youth residing in Missouri State Division of Youth Services' (MDYS) residential treatment facilities at the time the study was conducted, 723 (97.7%) completed interviews. Eighty-seven percent were male, with a mean age of 15.5 (SD = 1.2). Nearly 4 in 10 youth (38.5%; n = 279) reported lifetime inhalant use. Youth ranged from very mildly to severely antisocial. Results Of 279 inhalant users, 52 (18.6%) met DSM-IV inhalant abuse criteria and 79 (28.3%) met inhalant dependence criteria. Five of 10 IUD criteria were met by > 10% of the total sample. Latent class analyses demonstrated a substantial concordance between DSM-IV-defined IUDs and an empirically-derived classification based on responses to DSM-IV IUD diagnostic criteria. Conclusion IUDs and constituent criteria were prevalent among youth in the juvenile justice system. Two groups of problem inhalant users were identified, symptomatic users-DSM-IV inhalant abuse and highly symptomatic users-DSM-IV inhalant dependence, which differed primarily in severity of inhalant-related problems. Inhalant screening, prevention and treatment efforts in juvenile justice settings are rarely delivered, but critically needed. PMID:19267939

DSM-5 field trials in the United States and Canada, Part I: study design, sampling strategy, implementation, and analytic approaches.

PubMed

Clarke, Diana E; Narrow, William E; Regier, Darrel A; Kuramoto, S Janet; Kupfer, David J; Kuhl, Emily A; Greiner, Lisa; Kraemer, Helena C

2013-01-01

This article discusses the design,sampling strategy, implementation,and data analytic processes of the DSM-5 Field Trials. The DSM-5 Field Trials were conducted by using a test-retest reliability design with a stratified sampling approach across six adult and four pediatric sites in the United States and one adult site in Canada. A stratified random sampling approach was used to enhance precision in the estimation of the reliability coefficients. A web-based research electronic data capture system was used for simultaneous data collection from patients and clinicians across sites and for centralized data management.Weighted descriptive analyses, intraclass kappa and intraclass correlation coefficients for stratified samples, and receiver operating curves were computed. The DSM-5 Field Trials capitalized on advances since DSM-III and DSM-IV in statistical measures of reliability (i.e., intraclass kappa for stratified samples) and other recently developed measures to determine confidence intervals around kappa estimates. Diagnostic interviews using DSM-5 criteria were conducted by 279 clinicians of varied disciplines who received training comparable to what would be available to any clinician after publication of DSM-5.Overall, 2,246 patients with various diagnoses and levels of comorbidity were enrolled,of which over 86% were seen for two diagnostic interviews. A range of reliability coefficients were observed for the categorical diagnoses and dimensional measures. Multisite field trials and training comparable to what would be available to any clinician after publication of DSM-5 provided “real-world” testing of DSM-5 proposed diagnoses.

Specific phobia: a review of DSM-IV specific phobia and preliminary recommendations for DSM-V.

PubMed

LeBeau, Richard T; Glenn, Daniel; Liao, Betty; Wittchen, Hans-Ulrich; Beesdo-Baum, Katja; Ollendick, Thomas; Craske, Michelle G

2010-02-01

The present review was conducted in order to evaluate the current diagnostic criteria for specific phobia (SP) in light of the empirical evidence gathered since DSM-IV and to propose changes to DSM-V where change is clearly and reliably indicated by the evidence. In response to questions put forth by the DSM-V Anxiety, OC Spectrum, Posttraumatic, and Dissociative Disorder Work Group, four primary areas were determined for this review: the accuracy and utility of the current SP type classification system, the validity of test anxiety as a type of SP, the boundary between agoraphobia and SP, and the reliability and utility of the diagnostic criteria for SP. Developmental issues are addressed within each area. Literature reviews examining academic findings published between 1994 and 2009 were carried out and the results are included herein. The review presents a number of options and preliminary recommendations to be considered for DSM-V. All of these recommendations should be considered tentative as they await the field trials and expert consensus necessary prior to their inclusion in the DSM-V. The present review also reveals a great need for future research in the area of SP and directions for such research is provided.

[An approach to DSM-5: a breakthrough in psychiatry?].

PubMed

Heerlein, Andrés L

2014-01-01

One of the main problems of current psychiatry is that its diagnostic classification systems are not precise and reliable, they do not help to identify with certainty a specific type of mental disorder and they frequently overlap two or more diagnoses. This may conduce to over diagnosis and overtreatment, which is the main criticism of the DSM system. The American Psychiatric Association (APA) launched recently the DSM-5, the fifth edition of its diagnostic manual, which provides diagnostic criteria for thousands of psychiatrist, psychologist and researchers and who will be using it in the next coming years. DSM-5, like the preceding editions, placed disorders in discrete categories such as bipolar disorder or schizophrenia. The problem is that scientists have been unable to find yet a genetic or neurobiological evidence to support the theory of mental disorders as separate categories. Several authors wanted the latest DSM to move away from the category model towards a new "dimensional approach", where disorders can be measured and mental illnesses overlapping can be reduced. Recent findings supports this new dimensional strategy, suggesting that the disorders are a product of shared risk factors that lead to abnormalities in specific drives, which can be measured and used to place persons on one of several spectra. In some parts the DSM-5 entered changes aiming to achieve a greater objectivity. The door for new changes in each category, dimension or criteria has been opened, favoring an evidence-based development of the future versions. DSM-5 is presented as a "living document" that can be updated easily. However, the category model still remains for many disorders. The future research in psychiatric diagnostic systems requires more genetic-molecular and neurophysiological evidence and more objective multinational field trials, in order to confirm the existence of the new diagnostic entities, spectrums or dimensions. This approach may provide us reliable information about the pathogenesis, psychopathology, adequate taxonomy and treatment of mental disorders.

Identification and Application of Plasmids Suitable for Transfer of Foreign DNA to Members of the Genus Gordonia

PubMed Central

Arenskötter, Matthias; Baumeister, Dirk; Kalscheuer, Rainer; Steinbüchel, Alexander

2003-01-01

Gene transfer systems for Gordonia polyisoprenivorans strains VH2 and Y2K based on electroporation and conjugation, respectively, were established. Several parameters were optimized, resulting in transformation efficiencies of >4 × 105 CFU/μg of plasmid DNA. In contrast to most previously described electroporation protocols, the highest efficiencies were obtained by applying a heat shock after the intrinsic electroporation. Under these conditions, transfer and autonomous replication of plasmid pNC9503 was also demonstrated to proceed in G. alkanivorans DSM44187, G. nitida DSM44499T, G. rubropertincta DSM43197T, G. rubropertincta DSM46038, and G. terrae DSM43249T. Conjugational plasmid DNA transfer to G. polyisoprenivorans resulted in transfer frequencies of up to 5 × 10−6 of the recipient cells. Recombinant strains capable of polyhydroxyalkanoate synthesis from alkanes were constructed. PMID:12902293

The hierarchical structure of DSM-5 pathological personality traits.

PubMed

Wright, Aidan G C; Thomas, Katherine M; Hopwood, Christopher J; Markon, Kristian E; Pincus, Aaron L; Krueger, Robert F

2012-11-01

A multidimensional trait system has been proposed for representing personality disorder (PD) features in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) to address problematic classification issues such as comorbidity. In this model, which may also assist in providing scaffolding for the underlying structure of major forms of psychopathology more generally, 25 primary traits are organized by 5 higher order dimensions: Negative Affect, Detachment, Antagonism, Disinhibition, and Psychoticism. We examined (a) the generalizability of the structure proposed for DSM-5 PD traits, and (b) the potential for an integrative hierarchy based upon DSM-5 PD traits to represent the dimensions scaffolding psychopathology more generally. A large sample of student participants (N = 2,461) completed the Personality Inventory for DSM-5, which operationalizes the DSM-5 traits. Exploratory factor analysis replicated the initially reported 5-factor structure, as indicated by high factor congruencies. The 2-, 3-, and 4-factor solutions estimated in the hierarchy of the DSM-5 traits bear close resemblance to existing models of common mental disorders, temperament, and personality pathology. Thus, beyond the description of individual differences in personality disorder, the trait dimensions might provide a framework for the metastructure of psychopathology in the DSM-5 and the integration of a number of ostensibly competing models of personality trait covariation. (PsycINFO Database Record (c) 2012 APA, all rights reserved).

Current viewpoints on DSM-5 in Japan.

PubMed

Kuroki, Toshihide; Ishitobi, Makoto; Kamio, Yoko; Sugihara, Genichi; Murai, Toshiya; Motomura, Keisuke; Ogasawara, Kazuyoshi; Kimura, Hiroyuki; Aleksic, Branko; Ozaki, Norio; Nakao, Tomohiro; Yamada, Kazuo; Yoshiuchi, Kazuhiro; Kiriike, Nobuo; Ishikawa, Toshio; Kubo, Chiharu; Matsunaga, Chiaki; Miyata, Hisatsugu; Asada, Takashi; Kanba, Shigenobu

2016-09-01

The fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) was published in 2013, and its official Japanese version was published in 2014. The Japanese Government uses classifications from the 10th revision of the I nternational C lassification of D iseases (ICD-10) to categorize disorders and determine treatment fees. However, since the publication of the DSM-III, the use of the DSM system has become prevalent in research and educational settings in Japan. In addition to traditional psychiatry, both the ICD and the DSM are taught by many Japanese medical schools, and virtually all clinical research and trials refer to the DSM to define targeted disorders. Amid the current backdrop in which the reputation of the DSM-5 is being established, the editorial board of P sychiatry and C linical N eurosciences has asked Japanese experts across 12 specialties to examine the structure of the DSM-5, including the following categories: Neurodevelopmental Disorders, Schizophrenia Spectrum Disorders, Major Depression, Bipolar Disorders, Obsessive-Compulsive Disorders, Somatic Symptom Disorder, Eating Disorders, Substance-Related and Addictive Disorders, Gender Dysphoria, and Neurocognitive Disorders. Although opinions were only obtained from these selected experts, we believe that we have succeeded, to a certain extent, in presenting views that are representative of each specialty. © 2016 The Authors. Psychiatry and Clinical Neurosciences © 2016 Japanese Society of Psychiatry and Neurology.

The six most essential questions in psychiatric diagnosis: A pluralogue part 2: Issues of conservatism and pragmatism in psychiatric diagnosis

PubMed Central

2012-01-01

In face of the multiple controversies surrounding the DSM process in general and the development of DSM-5 in particular, we have organized a discussion around what we consider six essential questions in further work on the DSM. The six questions involve: 1) the nature of a mental disorder; 2) the definition of mental disorder; 3) the issue of whether, in the current state of psychiatric science, DSM-5 should assume a cautious, conservative posture or an assertive, transformative posture; 4) the role of pragmatic considerations in the construction of DSM-5; 5) the issue of utility of the DSM – whether DSM-III and IV have been designed more for clinicians or researchers, and how this conflict should be dealt with in the new manual; and 6) the possibility and advisability, given all the problems with DSM-III and IV, of designing a different diagnostic system. Part I of this article took up the first two questions. Part II will take up the second two questions. Question 3 deals with the question as to whether DSM-V should assume a conservative or assertive posture in making changes from DSM-IV. That question in turn breaks down into discussion of diagnoses that depend on, and aim toward, empirical, scientific validation, and diagnoses that are more value-laden and less amenable to scientific validation. Question 4 takes up the role of pragmatic consideration in a psychiatric nosology, whether the purely empirical considerations need to be tempered by considerations of practical consequence. As in Part 1 of this article, the general introduction, as well as the introductions and conclusions for the specific questions, are written by James Phillips, and the responses to commentaries are written by Allen Frances. PMID:22512887

Impact of the diagnostic changes to post-traumatic stress disorder for DSM-5 and the proposed changes to ICD-11.

PubMed

O'Donnell, Meaghan L; Alkemade, Nathan; Nickerson, Angela; Creamer, Mark; McFarlane, Alexander C; Silove, Derrick; Bryant, Richard A; Forbes, David

2014-09-01

There have been changes to the criteria for diagnosing post-traumatic stress disorder (PTSD) in DSM-5 and changes are proposed for ICD-11. To investigate the impact of the changes to diagnostic criteria for PTSD in DSM-5 and the proposed changes in ICD-11 using a large multisite trauma-exposed sample and structured clinical interviews. Randomly selected injury patients admitted to four hospitals were assessed 72 months post trauma (n = 510). Structured clinical interviews for PTSD and major depressive episode, as well as self-report measures of disability and quality of life were administered. Current prevalence of PTSD under DSM-5 scoring was not significantly different from DSM-IV (6.7% v. 5.9%, z = 0.53, P = 0.59). However, the ICD-11 prevalence was significantly lower than ICD-10 (3.3% v. 9.0%, z = -3.8, P<0.001). The PTSD current prevalence was significantly higher for DSM-5 than ICD-11 (6.7% v. 3.3%, z = 2.5, P = 0.01). Using ICD-11 tended to show lower rates of comorbidity with depression and a slightly lower association with disability. The diagnostic systems performed in different ways in terms of current prevalence rates and levels of comorbidity with depression, but on other broad key indicators they were relatively similar. There was overlap between those with PTSD diagnosed by ICD-11 and DSM-5 but a substantial portion met one but not the other set of criteria. This represents a challenge for research because the phenotype that is studied may be markedly different according to the diagnostic system used. Royal College of Psychiatrists.

The DSM-5: Hyperbole, Hope or Hypothesis?

PubMed

Berk, Michael

2013-05-14

The furore preceding the release of the new edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) is in contrast to the incremental changes to several diagnostic categories, which are derived from new research since its predecessor's birth in 1990. While many of these changes are indeed controversial, they do reflect the intrinsic ambiguity of the extant literature. Additionally, this may be a mirror of the frustration of the field's limited progress, especially given the false hopes at the dawn of the "decade of the brain". In the absence of a coherent pathophysiology, the DSM remains no more than a set of consensus based operationalized adjectives, albeit with some degree of reliability. It does not cleave nature at its joints, nor does it aim to, but neither does alternate systems. The largest problem with the DSM system is how it's used; sometimes too loosely by clinicians, and too rigidly by regulators, insurers, lawyers and at times researchers, who afford it reference and deference disproportionate to its overt acknowledged limitations.

Women-specific mental disorders in DSM-V: are we failing again?

PubMed

Wittchen, Hans-Ulrich

2010-02-01

Despite a wealth of studies on differences regarding the biobehavioral and social-psychological bases of mental disorders in men and women and repeated calls for increased attention, women-specific issues have so far not been comprehensively addressed in past diagnostic classification systems of mental disorders. There is also increasing evidence that this situation will not change significantly in the upcoming revisions of ICD-11 and DSM-V. This paper explores reasons for this continued failure, highlighting three major barriers: the fragmentation of the field of women's mental health research, lack of emphasis on diagnostic classificatory issues beyond a few selected clinical conditions, and finally, the "current rules of game" used by the current DSM-V Task Forces in the revision process of DSM-V. The paper calls for concerted efforts of researchers, clinicians, and other stakeholders within a more coherent and comprehensive framework aiming at broader coverage of women-specific diagnostic classificatory issues in future diagnostic systems.

A Framework for Orbital Performance Evaluation in Distributed Space Missions for Earth Observation

NASA Technical Reports Server (NTRS)

Nag, Sreeja; LeMoigne-Stewart, Jacqueline; Miller, David W.; de Weck, Olivier

2015-01-01

Distributed Space Missions (DSMs) are gaining momentum in their application to earth science missions owing to their unique ability to increase observation sampling in spatial, spectral and temporal dimensions simultaneously. DSM architectures have a large number of design variables and since they are expected to increase mission flexibility, scalability, evolvability and robustness, their design is a complex problem with many variables and objectives affecting performance. There are very few open-access tools available to explore the tradespace of variables which allow performance assessment and are easy to plug into science goals, and therefore select the most optimal design. This paper presents a software tool developed on the MATLAB engine interfacing with STK, for DSM orbit design and selection. It is capable of generating thousands of homogeneous constellation or formation flight architectures based on pre-defined design variable ranges and sizing those architectures in terms of predefined performance metrics. The metrics can be input into observing system simulation experiments, as available from the science teams, allowing dynamic coupling of science and engineering designs. Design variables include but are not restricted to constellation type, formation flight type, FOV of instrument, altitude and inclination of chief orbits, differential orbital elements, leader satellites, latitudes or regions of interest, planes and satellite numbers. Intermediate performance metrics include angular coverage, number of accesses, revisit coverage, access deterioration over time at every point of the Earth's grid. The orbit design process can be streamlined and variables more bounded along the way, owing to the availability of low fidelity and low complexity models such as corrected HCW equations up to high precision STK models with J2 and drag. The tool can thus help any scientist or program manager select pre-Phase A, Pareto optimal DSM designs for a variety of science goals without having to delve into the details of the engineering design process.

Recurrent Holocene movement on the Susitna Glacier Thrust Fault: The structure that initiated the Mw 7.9 Denali Fault earthquake, central Alaska

USGS Publications Warehouse

Personius, Stephen; Crone, Anthony J.; Burns, Patricia A.; Reitman, Nadine G.

2017-01-01

We conducted a trench investigation and analyzed pre‐ and postearthquake topography to determine the timing and size of prehistoric surface ruptures on the Susitna Glacier fault (SGF), the thrust fault that initiated the 2002 Mw 7.9 Denali fault earthquake sequence in central Alaska. In two of our three hand‐excavated trenches, we found clear evidence for a single pre‐2002 earthquake (penultimate earthquake [PE]) and determined an age of 2210±420  cal. B.P. (2σ) for this event. We used structure‐from‐motion software to create a pre‐2002‐earthquake digital surface model (DSM) from 1:62,800‐scale aerial photography taken in 1980 and compared this DSM with postearthquake 5‐m/pixel Interferometric Synthetic Aperature Radar topography taken in 2010. Topographic profiles measured from the pre‐earthquake DSM show features that we interpret as fault and fold scarps. These landforms were about the same size as those formed in 2002, so we infer that the PE was similar in size to the initial (Mw 7.2) subevent of the 2002 sequence. A recurrence interval of 2270 yrs and dip slip of ∼4.8  m yield a single‐interval slip rate of ∼1.8  mm/yr. The lack of evidence for pre‐PE deformation indicates probable episodic (clustering) behavior on the SGF that may be related to strain migration among other similarly oriented thrust faults that together accommodate shortening south of the Denali fault. We suspect that slip‐partitioned thrust‐triggered earthquakes may be a common occurrence on the Denali fault system, but documenting the frequency of such events will be very difficult, given the lack of long‐term paleoseismic records, the number of potential thrust‐earthquake sources, and the pervasive glacial erosion in the region.

DSM-III field trials: II. Initial experience with the multiaxial system.

PubMed

Spitzer, R L; Forman, J B

1979-06-01

The multiaxial system of DSM-III includes nondiagnostic data that are valuable in understanding possible etiological factors and in treatment planning and prognosis. The authors describe the reliability of axis IV--severity of psychosocial stressors--and axis V--highest level of adaptive functioning in the past year--for 281 adult patients interviewed in phase one of the DSM-III field trials. The kappa coefficient of agreement for axis IV was .62 for joint interviews and .58 for separate interviews, which the authors consider at least fair. Reliability for axis V was quite good, .80 for joint interviews and .69 for separate interviews. Eighty-one percent of the participating clinicians judged the multiaxial system to be a useful addition to traditional diagnostic evaluation, although many indicated that they had difficulty quantifying severity of psychosocial stressors.

Do mental health professionals use diagnostic classifications the way we think they do? A global survey.

PubMed

First, Michael B; Rebello, Tahilia J; Keeley, Jared W; Bhargava, Rachna; Dai, Yunfei; Kulygina, Maya; Matsumoto, Chihiro; Robles, Rebeca; Stona, Anne-Claire; Reed, Geoffrey M

2018-06-01

We report on a global survey of diagnosing mental health professionals, primarily psychiatrists, conducted as a part of the development of the ICD-11 mental and behavioural disorders classification. The survey assessed these professionals' use of various components of the ICD-10 and the DSM, their attitudes concerning the utility of these systems, and usage of "residual" (i.e., "other" or "unspecified") categories. In previous surveys, most mental health professionals reported they often use a formal classification system in everyday clinical work, but very little is known about precisely how they are using those systems. For example, it has been suggested that most clinicians employ only the diagnostic labels or codes from the ICD-10 in order to meet administrative requirements. The present survey was conducted with clinicians who were members of the Global Clinical Practice Network (GCPN), established by the World Health Organization as a tool for global participation in ICD-11 field studies. A total of 1,764 GCPN members from 92 countries completed the survey, with 1,335 answering the questions with reference to the ICD-10 and 429 to the DSM (DSM-IV, DSM-IV-TR or DSM-5). The most frequent reported use of the classification systems was for administrative or billing purposes, with 68.1% reporting often or routinely using them for that purpose. A bit more than half (57.4%) of respondents reported often or routinely going through diagnostic guidelines or criteria systematically to determine whether they apply to individual patients. Although ICD-10 users were more likely than DSM-5 users to utilize the classification for administrative purposes, other differences were either slight or not significant. Both classifications were rated to be most useful for assigning a diagnosis, communicating with other health care professionals and teaching, and least useful for treatment selection and determining prognosis. ICD-10 was rated more useful than DSM-5 for administrative purposes. A majority of clinicians reported using "residual" categories at least sometimes, with around 12% of ICD-10 users and 19% of DSM users employing them often or routinely, most commonly for clinical presentations that do not conform to a specific diagnostic category or when there is insufficient information to make a more specific diagnosis. These results provide the most comprehensive available information about the use of diagnostic classifications of mental disorders in ordinary clinical practice. © 2018 World Psychiatric Association.

Experiences with the DSM-III in a psychiatric consultation/liaison service.

PubMed

Larsen, F

1986-01-01

375 patients referred to consultation/liaison service at a general hospital from the neurological and internal medical department were diagnosed according to the DSM-III criteria for axis I and II. The sample represents all the patients referred from the two departments in a two year period. The phenomenological approach of the DSM-III and its reliability, is an advantage over older classification systems in the psychiatric consultation/liaison work. The system was easily applicable in this setting, leaving only 4 percent with "Diagnoses deferred" on both axes. From the consultation/liaison psychiatrist's point of view, special problems seemed to exist concerning the categories "Somatoform disorders" and "Psychological factors affecting physical condition", and the concepts of the axis II.

Effective Cross Section of Cold Formed Steel Column Under Axial Compression

NASA Astrophysics Data System (ADS)

Manikandan, P.; Pradeep, T.

2018-06-01

The compressive resistance of cold-formed steel (CFS) section may be governed by local, distortional or overall buckling and any apparent interaction between these modes. A new inventive stiffened CFS section is elected in this study, selected cross sections geometries and lengths are chosen such that all the types of buckling modes are met with. Buckling plot is plotted using linear elastic buckling analysis software (CUFSM). Using the test results obtained in the literature, the developed finite element model is calibrated and furthers a total of 126 parametric study is conducted such as a consequence of dimensions and the length of the cross section, thickness and yield stress. The FEA included relevant material and geometric imperfections. All the columns are analyzed under pin end conditions with axial compression. The analysis results demonstrate that the DSM equations generally assess the strength of stiffened section conservatively. Modifications to the DSM equations are recommended to evaluate the strength of stiffened section more precisely.

Comorbidity in "DSM" Childhood Mental Disorders: A Functional Perspective

ERIC Educational Resources Information Center

Cipani, Ennio

2014-01-01

In this article, I address the issue of comorbidity and its prevalence in the prior "Diagnostic and Statistical Manual of Mental Disorders" ("DSM") classification systems. The focus on the topography or form of presenting problems as the venue for determining mental disorders is scrutinized as the possible cause. Addressing the…

Counsellors Respond to the DSM-IV-TR

ERIC Educational Resources Information Center

Strong, Tom; Gaete, Joaquin; Sametband, Ines N.; French, Jared; Eeson, Jen

2012-01-01

The Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR) is an administrative fact for many counsellors. This psychiatric approach to formulating client concerns runs counter to those used by counsellors of many approaches (e.g., systemic, feminist). Using an online survey of counsellors (N = 116), invited contributions to a website…

Prediction-based manufacturing center self-adaptive demand side energy optimization in cyber physical systems

NASA Astrophysics Data System (ADS)

Sun, Xinyao; Wang, Xue; Wu, Jiangwei; Liu, Youda

2014-05-01

Cyber physical systems(CPS) recently emerge as a new technology which can provide promising approaches to demand side management(DSM), an important capability in industrial power systems. Meanwhile, the manufacturing center is a typical industrial power subsystem with dozens of high energy consumption devices which have complex physical dynamics. DSM, integrated with CPS, is an effective methodology for solving energy optimization problems in manufacturing center. This paper presents a prediction-based manufacturing center self-adaptive energy optimization method for demand side management in cyber physical systems. To gain prior knowledge of DSM operating results, a sparse Bayesian learning based componential forecasting method is introduced to predict 24-hour electric load levels for specific industrial areas in China. From this data, a pricing strategy is designed based on short-term load forecasting results. To minimize total energy costs while guaranteeing manufacturing center service quality, an adaptive demand side energy optimization algorithm is presented. The proposed scheme is tested in a machining center energy optimization experiment. An AMI sensing system is then used to measure the demand side energy consumption of the manufacturing center. Based on the data collected from the sensing system, the load prediction-based energy optimization scheme is implemented. By employing both the PSO and the CPSO method, the problem of DSM in the manufacturing center is solved. The results of the experiment show the self-adaptive CPSO energy optimization method enhances optimization by 5% compared with the traditional PSO optimization method.

A dual system model of preferences under risk.

PubMed

Mukherjee, Kanchan

2010-01-01

This article presents a dual system model (DSM) of decision making under risk and uncertainty according to which the value of a gamble is a combination of the values assigned to it independently by the affective and deliberative systems. On the basis of research on dual process theories and empirical research in Hsee and Rottenstreich (2004) and Rottenstreich and Hsee (2001) among others, the DSM incorporates (a) individual differences in disposition to rational versus emotional decision making, (b) the affective nature of outcomes, and (c) different task construals within its framework. The model has good descriptive validity and accounts for (a) violation of nontransparent stochastic dominance, (b) fourfold pattern of risk attitudes, (c) ambiguity aversion, (d) common consequence effect, (e) common ratio effect, (f) isolation effect, and (g) coalescing and event-splitting effects. The DSM is also used to make several novel predictions of conditions under which specific behavior patterns may or may not occur.

[Substance-related and addictive disorders in the DSM-5].

PubMed

Thomasius, Rainer; Sack, Peter-Michael; Strittmatter, Esther; Kaess, Michael

2014-03-01

This paper concerns the revised classification of Substance-Related and Addictive Disorders in the fifth edition of the American Psychiatric Association's (APA) Diagnostic and Statistical Manual of Mental Disorders (DSM-5). In DSM-5, substance use disorders are diagnosed on a continuum of severity specified by explicit operationalized diagnostic criteria. "Gambling disorder" is the only behavioral addiction added to the DSM. Furthermore, preliminary criteria for "Caffeine Use Disorder" and "Internet Gaming Disorder" have now been defined in the manual. Adopting the DSM-5 criteria catalogue within the German treatment system for children and adolescents with substance use disorders or at risk for developing substance use disorders would be of great significance. Since the diagnostic threshold is lower, more patients would be eligible for treatment. Thus, early intervention in the area of substance use disorders should be strengthened, a development that appears to be highly desirable from the perspective of child and adolescent psychiatry. The current Section III diagnoses, with their now comprehensive diagnostic criteria, facilitate more internationally compatible research.

What is generalized anxiety disorder?

PubMed

Rickels, K; Rynn, M A

2001-01-01

Generalized, persistent, and free-floating anxiety was first described by Freud in 1894, although the diagnostic term generalized anxiety disorder (GAD) was not included in classification systems until 1980 (Diagnostic and Statistical Manual for Mental Disorders, Third Edition [DSM-III]). Initially considered a residual category to be used when no other diagnosis could be made, it is now widely accepted that GAD represents a distinct diagnostic category. Since 1980, revisions to the diagnostic criteria for GAD in the DSM-III-R and DSM-IV classifications have markedly redefined this disorder, increasing the duration criterion to 6 months and increasing the emphasis on worry and psychic symptoms. This article reviews the development of the diagnostic criteria for defining GAD from Freud to DSM-IV and compares the DSM-IV criteria with the criteria set forth in the tenth revision of the International Classification of Diseases. The impact of the changes in diagnostic criteria on research into GAD, and on diagnosis, differential diagnosis, and treatment of GAD, will be discussed.

A retrospective study of the impact of DSM-5 on the diagnosis of eating disorders in Victoria, Australia.

PubMed

Caudle, Henry; Pang, Christine; Mancuso, Sam; Castle, David; Newton, Richard

2015-01-01

This study compares the DSM-IV and DSM-5 diagnostic criteria for eating disorders. DSM-IV resulted in a large number of patients being diagnosed with Eating Disorder Not Otherwise Specified (EDNOS). In DSM-5 the residual category is renamed Other Specified Feeding and Eating Disorders (OSFED) and Unspecified Eating Disorders (UFED) however the diagnostic criteria for the residual category in each of the diagnostic systems remains the same. This study aims to evaluate the changes in percentages of patients in a residual DSM-IV category compared to a residual DSM-5 category by retrospectively applying DSM-5 criteria to the clinical records of a patient population in a clinical setting. It also aims to compare the psychopathology between the EDNOS and OSFED/UFED groups. 285 participants were recruited from a specialised eating disorder clinic in Australia over a 5-year period from 2009 until 2014. The clinical records of patients with diagnoses of anorexia nervosa (AN), bulimia nervosa (BN) and EDNOS were retrospectively assessed using the DSM-5 criteria. All patients who had attended the clinic and received an eating disorder diagnosis during this period were included in the study. No patients were diagnosed with binge eating disorder during the study period. This is surprising given the prevalence of binge eating disorder in the community. It is possible that individuals with binge eating disorder were not referred to the clinic following the initial referral and assessment due to the lack of binge eating specific interventions available. The referral process may also have been skewed towards AN, BN and EDNOS due to a perception by referring parties that binge eating disorder was a 'milder' condition that did not require specialist intervention. Information in the clinical records included structured clinical interviews, and self-rating scales of eating disorder and other psychiatric symptoms and a longitudinal narrative of patient performance and attitude during observed meals. We observed a 23.5% reduction in the diagnosis of OSFED/UFED with the implementation of DSM-5 compared to EDNOS with DSM-IV. The removal of Criterion D, amenorrhoea, was the leading cause for transition from EDNOS to AN. DSM-5 has reduced the reliance on EDNOS. However this study was unable to examine the reliability of the new diagnostic criteria or the impact of DSM-5 on binge eating disorder.

Contributions from personality- and psychodynamically oriented assessment to the development of the DSM-5 personality disorders.

PubMed

Huprich, Steven K

2011-07-01

Advances in personality assessment over the past 20 years have notably influenced the proposed assessment and classification of personality disorders in the Diagnostic and Statistical Manual of Mental Disorders (5th ed. [DSM-5]). However, a considerable body of personality assessment and psychodynamically oriented assessment research has significant relevance to the way in which personality disorders are evaluated that appears to have gone unrecognized in the current proposals for DSM-5. In this article, I discuss the ways in which some of these 2 bodies of literature can and should inform the DSM-5 so that the diagnostic nomenclature can be more scientifically and comprehensively informed and consequently improve the clinical utility of a diagnostic system in need of considerable revision.

Diagnostic ambivalence: psychiatric workarounds and the Diagnostic and Statistical Manual of Mental Disorders.

PubMed

Whooley, Owen

2010-03-01

In 1980 the American Psychiatric Association (APA), faced with increased professional competition, revised the Diagnostic and Statistical Manual of Mental Disorders (DSM). Psychiatric expertise was redefined along a biomedical model via a standardised nosology. While they were an integral part of capturing professional authority, the revisions demystified psychiatric expertise, leaving psychiatrists vulnerable to infringements upon their autonomy by institutions adopting the DSM literally. This research explores the tensions surrounding standardisation in psychiatry. Drawing on in-depth interviews with psychiatrists, I explore the 'sociological ambivalence' psychiatrists feel towards the DSM, which arises from the tension between the desire for autonomy in practice and the professional goal of legitimacy within the system of mental health professions. To carve a space for autonomy for their practice, psychiatrists develop 'workarounds' that undermine the DSM in practice. These workarounds include employing alternative diagnostic typologies, fudging the numbers (or codes) on official paperwork and negotiating diagnoses with patients. In creating opportunities for patient input and resistance to fixed diagnoses, the varied use of the DSM raises fundamental questions for psychiatrists about the role of the biomedical model of mental illness, especially its particular manifestation in the DSM.

Substance use and addictive disorders in DSM-5 and ICD 10 and the draft ICD 11.

PubMed

Saunders, John B

2017-07-01

The present review compares and contrasts the diagnostic entities and taxonomy of substance use and addictive disorders in the beta draft of the Eleventh Revision of the International Classification of Diseases (ICD 11), which was released in November 2016, and the Fifth Edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), which was published in mid-2013. Recently published papers relevant to these two classification systems are examined. New initiatives in diagnosis and assessment including the addictions neuroclinical assessment are noted. The draft ICD 11 retains substance dependence as the 'master diagnosis' in contrast to the broader and heterogeneous concept of substance use disorder in DSM-5 and there is empirical support for the coherence of substance dependence for alcohol, cannabis, and prescribed opioids. Both systems now include gambling disorder in the addictive disorders section, with it being transferred from the impulse control disorders section. The new diagnosis of Internet gaming disorder is included in DSM-5 as a condition for further study, and gaming disorder is grouped with the substance and gambling disorders in the draft ICD 11. Initiatives from the U.S. National Institutes of Health (NIH) are highlighting the importance of capturing the neurobiological phases of the addictive cycle in clinical diagnosis and assessment. Although most of the changes in the draft ICD 11 and DSM-5 are incremental, the contrast between DSM-5 substance use disorder and substance dependence in the draft ICD 11, and the inclusion of gambling disorder and gaming disorder will generate much discussion and research.

How well do the DSM-5 alcohol use disorder designations map to the ICD-10 disorders?

PubMed

Hoffmann, Norman G; Kopak, Albert M

2015-04-01

The Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5), and the International Statistical Classification of Diseases and Related Health Problems, 10th edition (ICD-10), both establish diagnostic criteria for alcohol use disorders. The dimensional severity perspective provided by the DSM-5 may overlap in important ways but also may diverge from the categorical harmful use versus dependence designations presented by the ICD-10. It is especially important to consider the convergence of these 2 diagnostic approaches as the DSM is widely used by clinicians, but the U.S. Centers for Medicare and Medicaid Services has recently required that providers bill for services using the ICD-10 designations. Data from 6,871 male and 801 female admissions to a state prison system were used to compare the DSM-5 severity index for alcohol use disorder to the ICD-10 clinical and research formulations for harmful use and dependence. The DSM-5 and the ICD-10 were highly convergent for the most severe alcohol use disorders and also for those who did not receive a diagnosis. Most DSM-5 moderate alcohol use disorder cases were classified as dependence cases under both the clinical and research ICD criteria. In contrast, there was much more variation in the DSM mild cases. These were divided into categories of harmful use or misuse, depending on whether the clinical or research ICD criteria were applied. Results were similar among male and female inmates. The DSM-5 and ICD-10 exhibit a high level of agreement for cases that would not receive a diagnosis as well as the most severe cases. However, there are important distinctions to be made between the 2 approaches for mild and moderate DSM disorders in addition to harmful use/misuse cases in the ICD. The cases influenced by these discrepancies are most likely to be affected by recently implemented service provider billing practices. Copyright © 2015 by the Research Society on Alcoholism.

The Structure of Psychopathology in a Community Sample of Preschoolers

ERIC Educational Resources Information Center

Strickland, Jennifer; Keller, Jennifer; Lavigne, John V.; Gouze, Karen; Hopkins, Joyce; LeBailly, Susan

2011-01-01

Despite growing interest in the development of alternative diagnostic classification systems for psychopathology in young children, little is known about the adequacy of the DSM symptom structure for describing psychopathology in this population. This paper examines the fit of the DSM-IV emotional (ED) and disruptive behavior disorder (DD) symptom…

The DSM-5: Hyperbole, Hope or Hypothesis?

PubMed Central

2013-01-01

The furore preceding the release of the new edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) is in contrast to the incremental changes to several diagnostic categories, which are derived from new research since its predecessor’s birth in 1990. While many of these changes are indeed controversial, they do reflect the intrinsic ambiguity of the extant literature. Additionally, this may be a mirror of the frustration of the field’s limited progress, especially given the false hopes at the dawn of the “decade of the brain”. In the absence of a coherent pathophysiology, the DSM remains no more than a set of consensus based operationalized adjectives, albeit with some degree of reliability. It does not cleave nature at its joints, nor does it aim to, but neither does alternate systems. The largest problem with the DSM system is how it’s used; sometimes too loosely by clinicians, and too rigidly by regulators, insurers, lawyers and at times researchers, who afford it reference and deference disproportionate to its overt acknowledged limitations. PMID:23672603

Dimensional approaches to psychiatric classification: refining the research agenda for DSM-V: an introduction.

PubMed

Regier, Darrel A

2007-01-01

The American Psychiatric Association (APA) will publish the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-V), in 2012. This paper reviews the extended, multi-faceted research planning preparations that APA has undertaken, several in collaboration with the World Health Organization and the U.S. National Institutes of Health, to assess the current state of diagnosis-relevant research and to generate short- and long-term recommendations for research needed to enrich DSM-V and future psychiatric classifications. This research review and planning process has underscored widespread interest among nosologists in the US and globally regarding the potential benefits for research and clinical practice of incorporating a dimensional component into the existing categorical, or binary, classification system in the DSM. Toward this end, the APA and its partners convened an international conference in July 2006 to critically appraise the use of dimensional constructs in psychiatric diagnostic systems. Resultant papers appear in this issue of International Journal of Methods in Psychiatric Research and in a forthcoming monograph to be published by APA. Copyright (c) 2007 John Wiley & Sons, Ltd.

An evaluation of ICD-11 posttraumatic stress disorder criteria in two samples of adolescents and young adults exposed to mass shootings: factor analysis and comparisons to ICD-10 and DSM-IV.

PubMed

Haravuori, Henna; Kiviruusu, Olli; Suomalainen, Laura; Marttunen, Mauri

2016-05-12

The proposed posttraumatic stress disorder (PTSD) criteria for the International Classification of Diseases (ICD) 11th revision are simpler than the criteria in ICD-10, DSM-IV or DSM-5. The aim of this study was to evaluate the ICD-11 PTSD factor structure in samples of young people, and to compare PTSD prevalence rates and diagnostic agreement between the different diagnostic systems. Possible differences in clinical characteristics of the PTSD cases identified by ICD-11, ICD-10 and DSM-IV are explored. Two samples of adolescents and young adults were followed after exposure to similar mass shooting incidents in their schools. Semi-structured diagnostic interviews were performed to assess psychiatric diagnoses and PTSD symptom scores (N = 228, mean age 17.6 years). PTSD symptom item scores were used to compose diagnoses according to the different classification systems. Confirmatory factor analyses indicated that the proposed ICD-11 PTSD symptoms represented two rather than three factors; re-experiencing and avoidance symptoms comprised one factor and hyperarousal symptoms the other factor. In the studied samples, the three-factor ICD-11 criteria identified 51 (22.4%) PTSD cases, the two-factor ICD-11 identified 56 (24.6%) cases and the DSM-IV identified 43 (18.9%) cases, while the number of cases identified by ICD-10 was larger, being 85 (37.3%) cases. Diagnostic agreement of the ICD-11 PTSD criteria with ICD-10 and DSM-IV was moderate, yet the diagnostic agreement turned to be good when an impairment criterion was imposed on ICD-10. Compared to ICD-11, ICD-10 identified cases with less severe trauma exposure and posttraumatic symptoms and DSM-IV identified cases with less severe trauma exposure. The findings suggest that the two-factor model of ICD-11 PTSD is preferable to the three-factor model. The proposed ICD-11 criteria are more restrictive compared to the ICD-10 criteria. There were some differences in the clinical characteristics of the PTSD cases identified by ICD-11, when compared to ICD-10 and DSM-IV.

On the convergence between PSY-5 domains and PID-5 domains and facets: implications for assessment of DSM-5 personality traits.

PubMed

Anderson, Jaime L; Sellbom, Martin; Bagby, R Michael; Quilty, Lena C; Veltri, Carlo O C; Markon, Kristian E; Krueger, Robert F

2013-06-01

The DSM-5 Personality and Personality Disorders workgroup and their consultants have developed the 220-item, self-report Personality Inventory for the DSM-5 (PID-5) for direct assessment of the proposed personality trait system for DSM-5; however, most practicing clinical psychologists will likely continue to rely on separate omnibus measures to index symptoms and traits associated with psychopathology. The Minnesota Multiphasic Personality Inventory-2 Restructured Form (MMPI-2-RF) is one such measure and assesses the Personality Psychopathology Five (PSY-5) domains, which are conceptual cognates of the DSM-5 trait domains. The current study examined the associations between the MMPI-2-RF PSY-5 scales and the DSM-5 trait domains and facets indexed by the PID-5. A clear pattern of convergence was found indicating that each of the PSY-5 scales was most highly correlated with its conceptually expected PID-5 counterpart (rs = .44-.67; Mdn r = .53) and facet correlations generally showed the same pattern. Similarly, when each of the PSY-5 scales was regressed onto the PID-5 domains, the conceptually expected pattern of associations emerged even more clearly. Finally, a joint exploratory factor analysis with the PSY-5 and PID-5 trait facet scales indicated a five-factor solution that clearly resembled both of the PSY-5/DSM-5 trait domains. These results show clear evidence that the MMPI-2-RF has utility in the assessment of dimensional personality traits proposed for the upcoming DSM-5.

Low altitude aerial photogrammetry application to braided river systems. Example of the Buech River, Alps, France.

NASA Astrophysics Data System (ADS)

Jules Fleury, Thomas; Pothin, Virginie; Vella, Claude; Dussouillez, Philippe; Izem, Abdelkoddouss

2015-04-01

Low-altitude aerial photogrammetry offers new opportunities for geomorphology and other fields requiring very high-resolution topographic data. It combines the advantages of the reproducibility of GPS topographic surveys with the high accuracy of LIDAR, but at relatively low-cost, easy-to-deploy and with the synaptic advantage of remote sensing. In order to evaluate the potential of photogrammetry on river systems and to assess river-bed changes and erosion-accretion processes, we conducted several surveys over the period of one year on the Buech river, a gravel-bed braided river located in the French Southern Alps. The study area is located directly upstream of a gravel pit and there is an interest in evaluating its effects on the riverbed. Our field protocol was comprised of vertical aerial photographs taken from a microlight aircraft flying approximately 300 ft above the ground. The equipment used was a full-frame DSLR with a wide angle lense, synchronised with a DGPS onboard. Fourty 40cm wide targets were placed on the ground and georeferenced by RTK DGPS with an accuracy of 2cm. In addition, close to one thousand Ground Control Points (GCPs) were measured within the different types of ground surfaces (vegetated, water, gravels) in order to assess the Digital Terrain Model (DTM) accuracy. We operated the production of the 3D model and its derived products: Digital Surface Model (DSM) and orthophotography, with user-friendly Agisoft (c) Photoscan Professional software. The processing of several hundred pictures with 2.5 cm ground resolution resulted in a DSM with a resolution of 10 cm and a vertical accuracy within 5 cm. As is expected, accuracy was best on bare bars and decreased with increasing vegetation density. To complement the DSM in the wetted channels, we used the orthophotos to establish a relationship between water color and flow depth using statistical multivariate regressions. Merging the bathymetric model and the DSM produced a DTM with a vertical accuracy within 10cm. Subtle riverbed micro-morphologies (cm to m) not visible using classical techniques could be mapped : individual gravels, scour and deposition around woody debris, intra-bar channels, vertical bar faces etc. Multiple acquisitions combined have permit quantification of volumes eroded or accumulated during an hydrological event. The exceptional quality of the results obtained using this technique, both quantitative and qualitative, offers exciting new prospects for fluvial geomorphic studies. The limitations surrounding this technique include : the large volume of data produced, processing time, the large number of GCPs required to constraint the model and the lack of a NIR channel for image classification.

Development of a GIFTS (Graphics-Oriented Interactive Finite-Element Time-Sharing System) Plotting Package Compatible with Either PLOT10 or IBM/DSM Graphics.

DTIC Science & Technology

1983-06-01

1D-A132 95 DEVELOPMENT OF A GIFTS (GRAPHICS ORIENTED INTERACTIVE i/i FINITE-ELEMENT TIME..(U) NAVAL POSTGRADUATE SCHOOL I MONTEREY CA T R PICKLES JUN...183 THESIS " DEVELOPMENT OF A GIFTS PLOTTING PACKAGE COMPATIBLE WITH EITHER PLOT10 OR IBM/DSM GRAPHICS by Thomas R. Pickles June 1983 Thesis Advisor: G...TYPEAFtWEPORT & PERIOD COVERED Development of GIFTS Plotting Package Bi ’s Thesis; Compatible with either PLOTl0 or June 1983 IBM/DSM Graphics 6. PERFORMING ORO

Deriving ICD-11 personality disorder domains from dsm-5 traits: initial attempt to harmonize two diagnostic systems.

PubMed

Bach, B; Sellbom, M; Kongerslev, M; Simonsen, E; Krueger, R F; Mulder, R

2017-07-01

The personality disorder domains proposed for the ICD-11 comprise Negative Affectivity, Detachment, Dissociality, Disinhibition, and Anankastia, which are reasonably concordant with the higher-order trait domains in the Alternative DSM-5 Model for Personality Disorders. We examined (i) whether designated DSM-5 trait facets can be used to describe the proposed ICD-11 trait domains, and (ii) how these ICD-11 trait features are hierarchically organized. A mixed Danish derivation sample (N = 1541) of 615 psychiatric out-patients and 925 community participants along with a US replication sample (N = 637) completed the Personality Inventory for DSM-5 (PID-5). Sixteen PID-5 traits were designated to cover features of the ICD-11 trait domains. Exploratory structural equation modeling (ESEM) analyzes showed that the designated traits were meaningfully organized in the proposed ICD-11 five-domain structure as well as other recognizable higher-order models of personality and psychopathology. Model fits revealed that the five proposed ICD-11 personality disorder domains were satisfactorily resembled, and replicated in the independent US sample. The proposed ICD-11 personality disorder domains can be accurately described using designated traits from the DSM-5 personality trait system. A scoring algorithm for the ICD-11 personality disorder domains is provided in appendix. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

DSM and the Death of Phenomenology in America: An Example of Unintended Consequences

PubMed Central

Andreasen, Nancy C.

2007-01-01

During the 19th century and early 20th century, American psychiatry shared many intellectual traditions and values with Great Britain and Europe. These include principles derived from the Enlightenment concerning the dignity of the individual and the value of careful observation. During the 20th century, however, American psychiatry began to diverge, initially due to a much stronger emphasis on psychoanalytic principles, particularly in comparison with Great Britain. By the 1960s and 1970s, studies such as the US-UK study and the International Pilot Study of Schizophrenia demonstrated that the psychodynamic emphasis had gone too far, leading to diagnostic imprecision and inadequate evaluation of traditional evaluations of signs and symptoms of psychopathology. Diagnostic and Statistical Manual of Mental Disorders, Third Edition (DSM-III) was developed in this context, under the leadership of representatives from institutions that had retained the more traditional British-European approaches (eg, Washington University, Iowa). The goal of DSM-III was to create a comprehensive system for diagnosing and evaluating psychiatric patients that would be more reliable, more valid, and more consistent with international approaches. This goal was realized in many respects, but unfortunately it also had many unintended consequences. Although the original creators realized that DSM represented a “best effort” rather than a definitive “ground truth,” DSM began to be given total authority in training programs and health care delivery systems. Since the publication of DSM-III in 1980, there has been a steady decline in the teaching of careful clinical evaluation that is targeted to the individual person's problems and social context and that is enriched by a good general knowledge of psychopathology. Students are taught to memorize DSM rather than to learn complexities from the great psychopathologists of the past. By 2005, the decline has become so severe that it could be referred to as “the death of phenomenology in the United States.” PMID:17158191

The TRPV1 channel in rodents is a major target for antinociceptive effect of the probiotic Lactobacillus reuteri DSM 17938

PubMed Central

Perez-Burgos, Azucena; Wang, Lu; McVey Neufeld, Karen-Anne; Mao, Yu-Kang; Ahmadzai, Mustafa; Janssen, Luke J; Stanisz, Andrew M; Bienenstock, John; Kunze, Wolfgang A

2015-01-01

Abstract Certain bacteria exert visceral antinociceptive activity, but the mechanisms involved are not determined. Lactobacillus reuteri DSM 17938 was examined since it may be antinociceptive in children. Since transient receptor potential vanilloid 1 (TRPV1) channel activity may mediate nociceptive signals, we hypothesized that TRPV1 current is inhibited by DSM. We tested this by examining the effect of DSM on the firing frequency of spinal nerve fibres in murine jejunal mesenteric nerve bundles following serosal application of capsaicin. We also measured the effects of DSM on capsaicin-evoked increase in intracellular Ca2+ or ionic current in dorsal root ganglion (DRG) neurons. Furthermore, we tested the in vivo antinociceptive effects of oral DSM on gastric distension in rats. Live DSM reduced the response of capsaicin- and distension-evoked firing of spinal nerve action potentials (238 ± 27.5% vs. 129 ± 17%). DSM also reduced the capsaicin-evoked TRPV1 ionic current in DRG neuronal primary culture from 83 ± 11% to 41 ± 8% of the initial response to capsaicin only. Another lactobacillus (Lactobacillus rhamnosus JB-1) with known visceral anti-nociceptive activity did not have these effects. DSM also inhibited capsaicin-evoked Ca2+ increase in DRG neurons; an increase in Ca2+ fluorescence intensity ratio of 2.36 ± 0.31 evoked by capsaicin was reduced to 1.25 ± 0.04. DSM releasable products (conditioned medium) mimicked DSM inhibition of capsaicin-evoked excitability. The TRPV1 antagonist 6-iodonordihydrocapsaicin or the use of TRPV1 knock-out mice revealed that TRPV1 channels mediate about 80% of the inhibitory effect of DSM on mesenteric nerve response to high intensity gut distension. Finally, feeding with DSM inhibited perception in rats of painful gastric distension. Our results identify a specific target channel for a probiotic with potential therapeutic properties. Key points Certain probiotic bacteria have been shown to reduce distension-dependent gut pain, but the mechanisms involved remain obscure. Live luminal Lactobacillus reuteri (DSM 17938) and its conditioned medium dose dependently reduced jejunal spinal nerve firing evoked by distension or capsaicin, and 80% of this response was blocked by a specific TRPV1 channel antagonist or in TRPV1 knockout mice. The specificity of DSM action on TRPV1 was further confirmed by its inhibition of capsaicin-induced intracellular calcium increases in dorsal root ganglion neurons. Another lactobacillus with ability to reduce gut pain did not modify this response. Prior feeding of rats with DSM inhibited the bradycardia induced by painful gastric distension. These results offer a system for the screening of new and improved candidate bacteria that may be useful as novel therapeutic adjuncts in gut pain. PMID:26084409

Overview and Analysis of the Behaviourist Criticism of the "Diagnostic and Statistical Manual of Mental Disorders (DSM)"

ERIC Educational Resources Information Center

Andersson, Gerhard; Ghaderi, Ata

2006-01-01

While a majority of cognitive behavioural researchers and clinicians adhere to the classification system provided in the "Diagnostic and Statistical Manual of Mental Disorders (DSM-IV)," strong objections have been voiced among behaviourists who find the dichotomous allocation of patients into psychiatric diagnoses incompatible with the philosophy…

Comparison of DSM-IV and DSM-5 criteria for alcohol use disorders in VA primary care patients with frequent heavy drinking enrolled in a trial.

PubMed

Takahashi, Traci; Lapham, Gwen; Chavez, Laura J; Lee, Amy K; Williams, Emily C; Richards, Julie E; Greenberg, Diane; Rubinsky, Anna; Berger, Douglas; Hawkins, Eric J; Merrill, Joseph O; Bradley, Katharine A

2017-07-18

Criteria for alcohol use disorders (AUD) in the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) were intended to result in a similar prevalence of AUD as DSM-IV. We evaluated the prevalence of AUD using DSM-5 and DSM-IV criteria, and compared characteristics of patients who met criteria for: neither DSM-5 nor DSM-IV AUD, DSM-5 alone, DSM-IV alone, or both, among Veterans Administration (VA) outpatients in the Considering Healthier drinking Options In primary CarE (CHOICE) trial. VA primary care patients who reported frequent heavy drinking and enrolled in the CHOICE trial were interviewed at baseline using the DSM-IV Mini International Neuropsychiatric Interview for AUD, as well as questions about socio-demographics, mental health, alcohol craving, and substance use. We compared characteristics across 4 mutually exclusive groups based on DSM-5 and DSM-IV criteria. Of 304 participants, 13.8% met criteria for neither DSM-5 nor DSM-IV AUD; 12.8% met criteria for DSM-5 alone, and 73.0% met criteria for both DSM-IV and DSM-5. Only 1 patient (0.3%) met criteria for DSM-IV AUD alone. Patients meeting both DSM-5 and DSM-IV criteria had more negative drinking consequences, mental health symptoms and self-reported readiness to change compared with those meeting DSM-5 criteria alone or neither DSM-5 nor DSM-IV criteria. In this sample of primary care patients with frequent heavy drinking, DSM-5 identified 13% more patients with AUD than DSM-IV. This group had a lower mental health symptom burden and less self-reported readiness to change compared to those meeting criteria for both DSM-IV and DSM-5 AUD. Trial Registration ClinicalTrials.gov NCT01400581. 2011 February 17.

The psychometric properties of the personality inventory for DSM-5 in an APA DSM-5 field trial sample.

PubMed

Quilty, Lena C; Ayearst, Lindsay; Chmielewski, Michael; Pollock, Bruce G; Bagby, R Michael

2013-06-01

Section 3 of the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) includes a hybrid model of personality pathology, in which dimensional personality traits are used to derive one of seven categorical personality disorder diagnoses. The Personality Inventory for DSM-5 (PID-5) was developed by the DSM-5 Personality and Personality Disorders workgroup and their consultants to produce a freely available instrument to assess the personality traits within this new system. To date, the psychometric properties of the PID-5 have been evaluated primarily in undergraduate student and community adult samples. In the current investigation, we extend this line of research to a psychiatric patient sample who participated in the APA DSM-5 Field Trial (Centre for Addiction and Mental Health site). A total of 201 psychiatric patients (102 men, 99 women) completed the PID-5 and the Revised NEO Personality Inventory (NEO PI-R). The internal consistencies of the PID-5 domain and facet trait scales were acceptable. Results supported the unidimensional structure of all trait scales but one, and the convergence between the PID-5 and analogous NEO PI-R scales. Evidence for discriminant validity was mixed. Overall, the current investigation provides support for the psychometric properties of this diagnostic instrument in psychiatric samples.

An extremely thermophilic anaerobic bacterium Caldicellulosiruptor sp. F32 exhibits distinctive properties in growth and xylanases during xylan hydrolysis.

PubMed

Ying, Yu; Meng, Dongdong; Chen, Xiaohua; Li, Fuli

2013-08-15

An anaerobic, extremely thermophilic, and cellulose- and xylan-degrading bacterium F32 was isolated from biocompost. Sequence analysis of the 16S rRNA gene of this strain showed that it was closely related to Caldicellulosiruptor saccharolyticus DSM 8903 (99.0% identity). Physiological and biochemical data also supported that identification of strain F32 as a Caldicellulosiruptor species. The proteins secreted by Caldicellulosiruptor sp. F32 grown on xylan showed a xylanase activity of 7.74U/mg, which was 2.5 times higher than that of C. saccharolyticus DSM 8903. Based on the genomic sequencing data, 2 xylanase genes, JX030400 and JX030401, were identified in Caldicellulosiruptor sp. F32. The xylanase encoded by JX030401 shared 97% identity with Csac_0696 of C. saccharolyticus DSM 8903, while that encoded by JX030400 shared 94% identity with Athe_0089 of C. bescii DSM 6725, which was not found in the genome of strain DSM 8903. Xylanse encoded by JX030400 had 9-fold higher specific activity than JX030401. Our results indicated that although the 2 strains shared high identity, the xylanase system in Caldicellulosiruptor sp. F32 was more efficient than that in C. saccharolyticus DSM 8903. Copyright © 2013 Elsevier Inc. All rights reserved.

The craving withdrawal model for alcoholism: towards the DSM-V. Improving the discriminant validity of alcohol use disorder diagnosis.

PubMed

de Bruijn, Carla; van den Brink, Wim; de Graaf, Ron; Vollebergh, Wilma A M

2005-01-01

To compare the discriminant validity of the DSM-IV and the ICD-10 classification of alcohol use disorders (AUD) with an alternative classification, the craving withdrawal model (CWM). CWM requires craving and withdrawal for the diagnosis of alcohol dependence and raises the alcohol abuse threshold to two DSM-IV AUD criteria. Data were derived from The Netherlands Mental Health Survey and Incidence Study, a large representative sample of the general Dutch population. In the present study, only non-abstinent subjects were included (n=6041). Three diagnostic systems (DSM-IV, ICD-10, and CWM) were compared using the following discriminant variables: alcohol intake, psychiatric comorbidity, functional status, familial alcohol problems, and treatment sought. The year prevalence of CWM alcohol dependence was lower than the prevalence of ICD-10 and DSM-IV dependence (0.3% vs 1.4% and 1.4%). The year prevalence of abuse was similar for CWM and DSM-IV (4.7 and 4.9%), but lower for ICD-10 harmful use (1.7%). DSM-IV resulted in a poor distinction between normality and abuse and ICD-10 resulted in a poor distinction between harmful use and dependence. In contrast, the CWM distinctions between normality and abuse, and between abuse, and dependence were significant for most of the discriminant variables. This study indicates that CWM improves the discriminant validity of AUD diagnoses. The predictive validity of the CWM for alcohol and other substance use disorders remain to be studied.

Field trial of a diagnostic axis for defense mechanisms for DSM-IV.

PubMed

Perry, J C; Hoglend, P; Shear, K; Vaillant, G E; Horowitz, M; Kardos, M E; Bille, H; Kagan, D

1998-01-01

Following critiques that the DSM multiaxial system lacks psychodynamic information useful for treatment, an axis for defense mechanisms was developed for DSM-IV, including up to 7 individual defenses from a glossary of 27, and 3 predominant defense levels from a list of 7. We tested the feasibility, reliability, and discriminability of the proposed axis. Clinician and psychiatric resident volunteers were trained at two U.S. and one Norwegian sites. After conducting initial interviews on 107 patients, they rated the DSM-III-R and defense axes, as did a second blind rater. Median kappa reliabilities were .42 (individual defenses), and .47 (defense levels). A summary measure, Overall Defensive Functioning (ODF), had similar reliability to current GAF (IR .68 vs. .62), similar 1-month stability (.75 vs. .78), but greater 6-month stability (.51 vs. .17). Independent of Axis III, ODF had small to moderate associations with other Axes and symptoms. Our findings indicate that the defense axis is a feasible, acceptably reliable, and nonredundant addition to DSM-IV, which may prove useful for planning and conducting treatment.

[THE PSYCHIATRIC DIAGNOSIS GUIDE - DSM-5 - INNOVATIONS AND CRITICISM].

PubMed

Hess, Shmuel; Zemishlany, Zvi

2015-05-01

The Diagnostic and Statistical Manual of Mental Disorders (DSM) is published by the American Psychiatric Association (APA) as a guide for diagnosing psychiatric diseases and enables the alignment of psychiatric diagnoses with those of the psychologists, the social workers, the nursing staff and other mental health professionals. In addition, it helps bring cohesion to research, public health policy, education, the field of insurance and compensation and the legal system. After 14 years of hard work, the updated version of the DSM, the DSM-5, was published on May 2013. The current review aims to update the readers on the essence of the DSM and the methods of psychiatric diagnosing and to present the main changes in the field, as expressed in the 5th edition of the guide. In addition to details of those changes we included discussions of the criticisms brought against them. We hope that the review will contribute to broadening the readers' knowledge, broaden exposure and familiarity with the psychiatric lingo and to strengthening the professional ties between psychiatrists and professionals in other, tangential, medical fields.

Screening for PTSD among detained adolescents: Implications of the changes in the DSM-5.

PubMed

Modrowski, Crosby A; Bennett, Diana C; Chaplo, Shannon D; Kerig, Patricia K

2017-01-01

Screening for posttraumatic stress disorder (PTSD) is highly relevant for youth involved in the juvenile justice system given their high rates of trauma exposure and posttraumatic stress symptoms. However, to date, no studies have investigated the implications of the recent revisions to the Diagnostic and Statistical Manual for Mental Disorders (5th ed., DSM-5; American Psychiatric Association [APA], 2013) diagnostic criteria for PTSD for screening in this population. To this end, the present study compared PTSD screening rates using the Diagnostic and Statistical Manual of Mental Disorders (4th ed., text rev., DSM-IV-TR; APA, 2013) versus DSM-5 criteria in a group of detained adolescents. Participants included 209 youth (60 girls) aged 13-19 (M = 15.97, SD = 1.24). Youth completed measures of lifetime trauma exposure and past-month posttraumatic stress symptoms. Over 95% of youth in the sample reported exposure to at least 1 type of traumatic event. Approximately 19.60% of the sample screened positive for PTSD according to the DSM-5 compared to 17.70% according to the DSM-IV-TR. Girls were more likely than boys to screen positive for PTSD according to the DSM-IV-TR compared to the DSM-5. The main factors accounting for the differences in screening rates across the versions of PTSD criteria involved the removal of Criterion A2 from the DSM-5, the separation of avoidance symptoms (Criterion C) into their own cluster, the addition of a cluster involving negative alterations in cognitions and mood (Criterion D), and revisions to the cluster of arousal symptoms (Criterion E). Future research should continue to investigate gender differences in PTSD symptoms in youth and consider the implications of these diagnostic changes for the accurate diagnosis and referral to treatment of adolescents who demonstrate posttraumatic stress reactions. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

[Influence of a low-calorie diet with inclusion of probiotic product containing bacterias Lactobacillus plantarum Tensia DSM 21380 on clinical and metabolic characteristics in patients with obesity and arterial hypertension].

PubMed

Sharafetdinov, Kh Kh; Plotnikova, O A; Alekseeva, R I; Sentsova, T B; Kaganov, B S

2012-01-01

In a number of studies it is shown that regular use of the probiotic products containing Lactobacillus plantarum Tensia DSM 21380 in complex dietary treatment, not only modulates intestinal microflora, but also has a positive influence on a functional condition of cardiovascular system including levelels of systolic and diastolic blood pressure. The aim of this research was to study the influence of dietotherapy with inclusion of the probiotic product containing Lactobacillus plantarum Tensia DSM 21380, on clinical and metabolic characteristics in patients with obesity and accompanying arterial hypertension (AH).

Toward the Reliable Diagnosis of DSM-5 Premenstrual Dysphoric Disorder: The Carolina Premenstrual Assessment Scoring System (C-PASS)

PubMed Central

Eisenlohr-Moul, Tory A.; Girdler, Susan S.; Schmalenberger, Katja M.; Dawson, Danyelle N.; Surana, Pallavi; Johnson, Jacqueline L.; Rubinow, David R.

2016-01-01

Objective Despite evidence for the validity of premenstrual dysphoric disorder (PMDD) and its recent inclusion in DSM-5, variable diagnostic practices compromise the construct validity of the diagnosis and threaten the clarity of efforts to understand and treat its underlying pathophysiology. In an effort to hasten and streamline the translation of the new DSM-5 criteria for PMDD into terms compatible with existing research practices, we present the development and initial validation of the Carolina Premenstrual Assessment Scoring System (C-PASS). The C-PASS is a standardized scoring system for making DSM-5 PMDD diagnoses using 2 or more menstrual cycles of daily symptom ratings using the Daily Record of Severity of Problems (DRSP). Method Two hundred women recruited for retrospectively-reported premenstrual emotional symptoms provided 2–4 menstrual cycles of daily symptom ratings on the DRSP. Diagnoses were made by expert clinician and the C-PASS. Results Agreement of C-PASS diagnosis with expert clinical diagnosis was excellent; overall correct classification by the C-PASS was estimated at 98%. Consistent with previous evidence, retrospective reports of premenstrual symptom increases were a poor predictor of prospective C-PASS diagnosis. Conclusions The C-PASS (available as a worksheet, Excel macro, and SAS macro) is a reliable and valid companion protocol to the DRSP that standardizes and streamlines the complex, multilevel diagnosis of DSM-5 PMDD. Consistent use of this robust diagnostic method would result in more clearly-defined, homogeneous samples of women with PMDD, thereby improving the clarity of studies seeking to characterize or treat the underlying pathophysiology of the disorder. PMID:27523500

The use of LiDAR-derived high-resolution DSM and intensity data to support modelling of urban flooding

NASA Astrophysics Data System (ADS)

Aktaruzzaman, Md.; Schmitt, Theo G.

2011-11-01

This paper addresses the issue of a detailed representation of an urban catchment in terms of hydraulic and hydrologic attributes. Modelling of urban flooding requires a detailed knowledge of urban surface characteristics. The advancement in spatial data acquisition technology such as airborne LiDAR (Light Detection and Ranging) has greatly facilitated the collection of high-resolution topographic information. While the use of the LiDAR-derived Digital Surface Model (DSM) has gained popularity over the last few years as input data for a flood simulation model, the use of LiDAR intensity data has remained largely unexplored in this regard. LiDAR intensity data are acquired along with elevation data during the data collection mission by an aircraft. The practice of using of just aerial images with RGB (Red, Green and Blue) wavebands is often incapable of identifying types of surface under the shadow. On the other hand, LiDAR intensity data can provide surface information independent of sunlight conditions. The focus of this study is the use of intensity data in combination with aerial images to accurately map pervious and impervious urban areas. This study presents an Object-Based Image Analysis (OBIA) framework for detecting urban land cover types, mainly pervious and impervious surfaces in order to improve the rainfall-runoff modelling. Finally, this study shows the application of highresolution DSM and land cover maps to flood simulation software in order to visualize the depth and extent of urban flooding phenomena.

Model building techniques for analysis.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Walther, Howard P.; McDaniel, Karen Lynn; Keener, Donald

2009-09-01

The practice of mechanical engineering for product development has evolved into a complex activity that requires a team of specialists for success. Sandia National Laboratories (SNL) has product engineers, mechanical designers, design engineers, manufacturing engineers, mechanical analysts and experimentalists, qualification engineers, and others that contribute through product realization teams to develop new mechanical hardware. The goal of SNL's Design Group is to change product development by enabling design teams to collaborate within a virtual model-based environment whereby analysis is used to guide design decisions. Computer-aided design (CAD) models using PTC's Pro/ENGINEER software tools are heavily relied upon in the productmore » definition stage of parts and assemblies at SNL. The three-dimensional CAD solid model acts as the design solid model that is filled with all of the detailed design definition needed to manufacture the parts. Analysis is an important part of the product development process. The CAD design solid model (DSM) is the foundation for the creation of the analysis solid model (ASM). Creating an ASM from the DSM currently is a time-consuming effort; the turnaround time for results of a design needs to be decreased to have an impact on the overall product development. This effort can be decreased immensely through simple Pro/ENGINEER modeling techniques that summarize to the method features are created in a part model. This document contains recommended modeling techniques that increase the efficiency of the creation of the ASM from the DSM.« less

Revising the personality disorder diagnostic criteria for the Diagnostic and Statistical Manual of Mental Disorders-Fifth Edition (DSM-V): consider the later life context.

PubMed

Balsis, Steve; Segal, Daniel L; Donahue, Cailin

2009-10-01

The categorical measurement approach implemented by the Diagnostic and Statistical Manual of Mental Disorders-Fourth Edition (DSM-IV) personality disorder (PD) diagnostic system is theoretically and pragmatically limited. As a result, many prominent psychologists now advocate for a shift away from this approach in favor of more conceptually sound dimensional measurement. This shift is expected to improve the psychometric properties of the personality disorder (PD) diagnostic system and make it more useful for clinicians and researchers. The current article suggests that despite the probable benefits of such a change, several limitations will remain if the new diagnostic system does not closely consider the context of later life. A failure to address the unique challenges associated with the assessment of personality in older adults likely will result in the continued limited validity, reliability, and utility of the Diagnostic and Statistical Manual of Mental Disorders (DSM) system for this growing population. This article discusses these limitations and their possible implications. (c) 2009 APA, all rights reserved.

Integration of Heterogenous Digital Surface Models

NASA Astrophysics Data System (ADS)

Boesch, R.; Ginzler, C.

2011-08-01

The application of extended digital surface models often reveals, that despite an acceptable global accuracy for a given dataset, the local accuracy of the model can vary in a wide range. For high resolution applications which cover the spatial extent of a whole country, this can be a major drawback. Within the Swiss National Forest Inventory (NFI), two digital surface models are available, one derived from LiDAR point data and the other from aerial images. Automatic photogrammetric image matching with ADS80 aerial infrared images with 25cm and 50cm resolution is used to generate a surface model (ADS-DSM) with 1m resolution covering whole switzerland (approx. 41000 km2). The spatially corresponding LiDAR dataset has a global point density of 0.5 points per m2 and is mainly used in applications as interpolated grid with 2m resolution (LiDAR-DSM). Although both surface models seem to offer a comparable accuracy from a global view, local analysis shows significant differences. Both datasets have been acquired over several years. Concerning LiDAR-DSM, different flight patterns and inconsistent quality control result in a significantly varying point density. The image acquisition of the ADS-DSM is also stretched over several years and the model generation is hampered by clouds, varying illumination and shadow effects. Nevertheless many classification and feature extraction applications requiring high resolution data depend on the local accuracy of the used surface model, therefore precise knowledge of the local data quality is essential. The commercial photogrammetric software NGATE (part of SOCET SET) generates the image based surface model (ADS-DSM) and delivers also a map with figures of merit (FOM) of the matching process for each calculated height pixel. The FOM-map contains matching codes like high slope, excessive shift or low correlation. For the generation of the LiDAR-DSM only first- and last-pulse data was available. Therefore only the point distribution can be used to derive a local accuracy measure. For the calculation of a robust point distribution measure, a constrained triangulation of local points (within an area of 100m2) has been implemented using the Open Source project CGAL. The area of each triangle is a measure for the spatial distribution of raw points in this local area. Combining the FOM-map with the local evaluation of LiDAR points allows an appropriate local accuracy evaluation of both surface models. The currently implemented strategy ("partial replacement") uses the hypothesis, that the ADS-DSM is superior due to its better global accuracy of 1m. If the local analysis of the FOM-map within the 100m2 area shows significant matching errors, the corresponding area of the triangulated LiDAR points is analyzed. If the point density and distribution is sufficient, the LiDAR-DSM will be used in favor of the ADS-DSM at this location. If the local triangulation reflects low point density or the variance of triangle areas exceeds a threshold, the investigated location will be marked as NODATA area. In a future implementation ("anisotropic fusion") an anisotropic inverse distance weighting (IDW) will be used, which merges both surface models in the point data space by using FOM-map and local triangulation to derive a quality weight for each of the interpolation points. The "partial replacement" implementation and the "fusion" prototype for the anisotropic IDW make use of the Open Source projects CGAL (Computational Geometry Algorithms Library), GDAL (Geospatial Data Abstraction Library) and OpenCV (Open Source Computer Vision).

Integration of aerial remote sensing imaging data in a 3D-GIS environment

NASA Astrophysics Data System (ADS)

Moeller, Matthias S.

2003-03-01

For some years sensor systems have been available providing digital images of a new quality. Especially aerial stereo scanners acquire digital multispectral images with an extremely high ground resolution of about 0.10 - 0.15m and provide in addition a Digital Surface Models (DSM). These imaging products both can be used for a detailed monitoring at scales up to 1:500. The processed georeferenced multispectral orthoimages can be readily integrated into GIS making them useful for a number of applications. The DSM, derived from forward and backward facing sensors of an aerial imaging system provides a ground resolution of 0.5 m and can be used for 3D visualization purposes. In some cases it is essential, to store the ground elevation as a Digital Terrain Model (DTM) and also the height of 3-dimensional objects in a separated database. Existing automated algorithms do not work precise for the extraction of DTM from aerial scanner DSM. This paper presents a new approach which combines the visible image data and the DSM data for the generation of DTM with a reliable geometric accuracy. Already existing cadastral data can be used as a knowledge base for the extraction of building heights in cities. These elevation data is the essential source for a GIS based urban information system with a 3D visualization component.

Obsessive compulsive and related disorders: comparing DSM-5 and ICD-11.

PubMed

Marras, Anna; Fineberg, Naomi; Pallanti, Stefano

2016-08-01

Obsessive-compulsive disorder (OCD) has been recognized as mainly characterized by compulsivity rather than anxiety and, therefore, was removed from the anxiety disorders chapter and given its own in both the American Psychiatric Association (APA) Diagnostic and Statistical Manual of Mental Disorders (DSM-5) and the Beta Draft Version of the 11th revision of the World Health Organization (WHO) International Classification of Diseases (ICD-11). This revised clustering is based on increasing evidence of common affected neurocircuits between disorders, differently from previous classification systems based on interrater agreement. In this article, we focus on the classification of obsessive-compulsive and related disorders (OCRDs), examining the differences in approach adopted by these 2 nosological systems, with particular attention to the proposed changes in the forthcoming ICD-11. At this stage, notable differences in the ICD classification are emerging from the previous revision, apparently converging toward a reformulation of OCRDs that is closer to the DSM-5.

Geometric processing workflow for vertical and oblique hyperspectral frame images collected using UAV

NASA Astrophysics Data System (ADS)

Markelin, L.; Honkavaara, E.; Näsi, R.; Nurminen, K.; Hakala, T.

2014-08-01

Remote sensing based on unmanned airborne vehicles (UAVs) is a rapidly developing field of technology. UAVs enable accurate, flexible, low-cost and multiangular measurements of 3D geometric, radiometric, and temporal properties of land and vegetation using various sensors. In this paper we present a geometric processing chain for multiangular measurement system that is designed for measuring object directional reflectance characteristics in a wavelength range of 400-900 nm. The technique is based on a novel, lightweight spectral camera designed for UAV use. The multiangular measurement is conducted by collecting vertical and oblique area-format spectral images. End products of the geometric processing are image exterior orientations, 3D point clouds and digital surface models (DSM). This data is needed for the radiometric processing chain that produces reflectance image mosaics and multiangular bidirectional reflectance factor (BRF) observations. The geometric processing workflow consists of the following three steps: (1) determining approximate image orientations using Visual Structure from Motion (VisualSFM) software, (2) calculating improved orientations and sensor calibration using a method based on self-calibrating bundle block adjustment (standard photogrammetric software) (this step is optional), and finally (3) creating dense 3D point clouds and DSMs using Photogrammetric Surface Reconstruction from Imagery (SURE) software that is based on semi-global-matching algorithm and it is capable of providing a point density corresponding to the pixel size of the image. We have tested the geometric processing workflow over various targets, including test fields, agricultural fields, lakes and complex 3D structures like forests.

Do DSM-5 Eating Disorder Criteria Overpathologize Normative Eating Patterns among Individuals with Obesity?

PubMed Central

Eddy, Kamryn T.; Murray, Helen B.; Gorman, Mark J.

2014-01-01

Background. DSM-5 revisions have been criticized in the popular press for overpathologizing normative eating patterns—particularly among individuals with obesity. To evaluate the evidence for this and other DSM-5 critiques, we compared the point prevalence and interrater reliability of DSM-IV versus DSM-5 eating disorders (EDs) among adults seeking weight-loss treatment. Method. Clinicians (n = 2) assigned DSM-IV and DSM-5 ED diagnoses to 100 participants via routine clinical interview. Research assessors (n = 3) independently conferred ED diagnoses via Structured Clinical Interview for DSM-IV and a DSM-5 checklist. Results. Research assessors diagnosed a similar proportion of participants with EDs under DSM-IV (29%) versus DSM-5 (32%). DSM-5 research diagnoses included binge eating disorder (9%), bulimia nervosa (2%), subthreshold binge eating disorder (5%), subthreshold bulimia nervosa (2%), purging disorder (1%), night eating syndrome (6%), and other (7%). Interrater reliability between clinicians and research assessors was “substantial” for both DSM-IV (κ = 0.64, 84% agreement) and DSM-5 (κ = 0.63, 83% agreement). Conclusion. DSM-5 ED criteria can be reliably applied in an obesity treatment setting and appear to yield an overall ED point prevalence comparable to DSM-IV. PMID:25057413

[Addictive behaviours from DSM-IV to DSM-5].

PubMed

van den Brink, W

2014-01-01

The 5th edition of the DSM was published in May, 2013. The new edition incorporates important changes in the classification of addiction. To compare the classification of addictive behaviours presented in DSM-IV with the classification presented in DSM-5 and to comment on the changes introduced into the new version. First of all, the historical developments of the concept of addiction and the classification of addictive behaviours up to DSM-IV are summarised. Then the changes that have been incorporated into DSM-5 are described. The main changes are: (1) DSM-IV substance related disorders and DSM-IV pathological gambling have been combined into one new DSM-5 category, namely 'Substance Related and Addictive Disorders'; (2) DSM-IV abuse and dependence have been combined into one new DSM-5 diagnosis, namely 'Substance Use Disorder'; (2a) the DSM-IV abuse criterion 'recurrent substance-related legal problems' and the DSM-5 criterion 'craving' has been introduced; and (2b) the criteria for (partial) remission have been sharpened. DSM-5 is an improvement on DSM-IV, but for the diagnosis of a psychiatric disorder and the treatment of a psychiatric patient, classification needs to be complemented with staging and profiling.

Insights into the degradation capacities of Amycolatopsis tucumanensis DSM 45259 guided by microarray data.

PubMed

Bourguignon, Natalia; Bargiela, Rafael; Rojo, David; Chernikova, Tatyana N; de Rodas, Sara A López; García-Cantalejo, Jesús; Näther, Daniela J; Golyshin, Peter N; Barbas, Coral; Ferrero, Marcela; Ferrer, Manuel

2016-12-01

The analysis of catabolic capacities of microorganisms is currently often achieved by cultivation approaches and by the analysis of genomic or metagenomic datasets. Recently, a microarray system designed from curated key aromatic catabolic gene families and key alkane degradation genes was designed. The collection of genes in the microarray can be exploited to indicate whether a given microbe or microbial community is likely to be functionally connected with certain degradative phenotypes, without previous knowledge of genome data. Herein, this microarray was applied to capture new insights into the catabolic capacities of copper-resistant actinomycete Amycolatopsis tucumanensis DSM 45259. The array data support the presumptive ability of the DSM 45259 strain to utilize single alkanes (n-decane and n-tetradecane) and aromatics such as benzoate, phthalate and phenol as sole carbon sources, which was experimentally validated by cultivation and mass spectrometry. Interestingly, while in strain DSM 45259 alkB gene encoding an alkane hydroxylase is most likely highly similar to that found in other actinomycetes, the genes encoding benzoate 1,2-dioxygenase, phthalate 4,5-dioxygenase and phenol hydroxylase were homologous to proteobacterial genes. This suggests that strain DSM 45259 contains catabolic genes distantly related to those found in other actinomycetes. Together, this study not only provided new insight into the catabolic abilities of strain DSM 45259, but also suggests that this strain contains genes uncommon within actinomycetes.

[Schizophrenia and other psychotic disorders in DSM-5: summary of the changes compared to DSM-IV].

PubMed

Paulzen, M; Schneider, F

2014-05-01

With the introduction of the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) numerous changes in the area of the schizophrenia spectrum and psychotic disorders have been implemented. Establishing a metastructure based on the characteristics of the spectrum of psychopathological disturbances should improve clarity. The classical subtypes of schizophrenia were eliminated and specific psychopathological dimensions for the assessment of disease severity were added. The special role of Schneiderian first rank symptoms was abandoned and a higher delineation towards schizoaffective disorders is made. The nosological status of catatonia is clarified and occurs together with a consistent use of catatonic disturbances over all chapters. The attenuated psychosis syndrome is added as a new condition for further study. The shared psychotic disorder in the sense of a folie à deux is no longer maintained. However, the initial goal to integrate more disorder-specific etiopathogenetic information into the reconceptualization could not be achieved. Contemporaneously to the development process of DSM-5 the National Institute of Mental Health (NIMH) carried out the research domain criteria project (RDoC) attempting to incorporate the current growth in knowledge of genetics, neurocognitive and cognitive sciences in future diagnostic systems. This article gives an overview of the changes that have been made within the revision process from DSM-IV to DSM-5.

Approximating a DSM-5 Diagnosis of PTSD Using DSM-IV Criteria

PubMed Central

Rosellini, Anthony J.; Stein, Murray B.; Colpe, Lisa J.; Heeringa, Steven G.; Petukhova, Maria V.; Sampson, Nancy A.; Schoenbaum, Michael; Ursano, Robert J.; Kessler, Ronald C.

2015-01-01

Background Diagnostic criteria for DSM-5 posttraumatic stress disorder (PTSD) are in many ways similar to DSM-IV criteria, raising the possibility that it might be possible to closely approximate DSM-5 diagnoses using DSM-IV symptoms. If so, the resulting transformation rules could be used to pool research data based on the two criteria sets. Methods The Pre-Post Deployment Study (PPDS) of the Army Study to Assess Risk and Resilience in Servicemembers (Army STARRS) administered a blended 30-day DSM-IV and DSM-5 PTSD symptom assessment based on the civilian PTSD Checklist for DSM-IV (PCL-C) and the PTSD Checklist for DSM-5 (PCL-5). This assessment was completed by 9,193 soldiers from three US Army Brigade Combat Teams approximately three months after returning from Afghanistan. PCL-C items were used to operationalize conservative and broad approximations of DSM-5 PTSD diagnoses. The operating characteristics of these approximations were examined compared to diagnoses based on actual DSM-5 criteria. Results The estimated 30-day prevalence of DSM-5 PTSD based on conservative (4.3%) and broad (4.7%) approximations of DSM-5 criteria using DSM-IV symptom assessments were similar to estimates based on actual DSM-5 criteria (4.6%). Both approximations had excellent sensitivity (92.6-95.5%), specificity (99.6-99.9%), total classification accuracy (99.4-99.6%), and area under the receiver operating characteristic curve (0.96-0.98). Conclusions DSM-IV symptoms can be used to approximate DSM-5 diagnoses of PTSD among recently-deployed soldiers, making it possible to recode symptom-level data from earlier DSM-IV studies to draw inferences about DSM-5 PTSD. However, replication is needed in broader trauma-exposed samples to evaluate the external validity of this finding. PMID:25845710

Reducing Interprocessor Dependence in Recoverable Distributed Shared Memory

NASA Technical Reports Server (NTRS)

Janssens, Bob; Fuchs, W. Kent

1994-01-01

Checkpointing techniques in parallel systems use dependency tracking and/or message logging to ensure that a system rolls back to a consistent state. Traditional dependency tracking in distributed shared memory (DSM) systems is expensive because of high communication frequency. In this paper we show that, if designed correctly, a DSM system only needs to consider dependencies due to the transfer of blocks of data, resulting in reduced dependency tracking overhead and reduced potential for rollback propagation. We develop an ownership timestamp scheme to tolerate the loss of block state information and develop a passive server model of execution where interactions between processors are considered atomic. With our scheme, dependencies are significantly reduced compared to the traditional message-passing model.

Background and rationale for the Society of Behavioral Medicine's position statement: expand United States health plan coverage for diabetes self-management education and support.

PubMed

Sharp, Lisa K; Fisher, Edwin B; Gerber, Ben S

2015-09-01

The Society of Behavioral Medicine (SBM) recognizes that diabetes self-management (DSM) education and support are fundamental to teaching people how to manage their diabetes and decrease disease-related complications. Implementation of the Patient Protection and Affordable Care Act provides an opportunity to expand DSM education and support to many people who are currently excluded from such services due to lack of insurance coverage, current policy barriers, or simple failure of healthcare systems to provide them. Extending the range and provision of such services could translate into reduced diabetic complications, a reduction in unnecessary healthcare utilization, and significant health-related cost savings on a national level. SBM recommends that public and private insurers be required to reimburse for 12 h of DSM education and support annually for anyone with diabetes. Further, SBM recognizes that a range of modes and providers of DSM education and support have been shown effective, and that patient preferences and resources may influence choice. To address this, SBM urges health organizations to increase and diversify approaches toward DSM education and support they offer.

[Critical evaluation of current diagnostic classification systems in psychiatry: the case of DSM-5].

PubMed

Luciano, Mario; Sampogna, Gaia; Del Vecchio, Valeria; De Rosa, Corrado; Albert, Umberto; Carrà, Giuseppe; Dell'Osso, Bernardo; Lorenzo, Giorgio Di; Ferrari, Silvia; Martinotti, Giovanni; Nanni, Maria Giulia; Pinna, Federica; Pompili, Maurizio; Volpe, Umberto; Catapano, Francesco; Fiorillo, Andrea

2016-01-01

Since its first edition, the Diagnostic and Statistical manual of Mental disorders (DSM) has had a great impact on the scientific community and the public opinion as well. In 2013, the American Psychiatric Association released the fifth edition of the manual and - as for the previous versions - several criticisms raised. In particular, the persistence of the categorical approach to mental disorders represents one of the main debated topics, as well as the introduction of new diagnostic syndromes, which are not based on an adequate evidences. Moreover, the threshold of diagnostic criteria for many mental disorders has been lowered, with the consequence that the boundaries between "normality" and "pathology" is not so clear. In this paper, we will: 1) report the historical development of the DSM from the publication of its first edition; 2) describe the main changes introduced in the DSM-5; 3) discuss critical elements in the DSM-5. The current debate regarding the validity of diagnostic manuals and its criteria is threatening the psychiatric discipline, but a possible solution should be represented by the integration of diagnostic criteria with the in-depth description of patient's psychopathological experiences.

Nosologic Comparisons of DSM-IV and DSM-5 Alcohol and Drug Use Disorders: Results From the National Epidemiologic Survey on Alcohol and Related Conditions–III

PubMed Central

Goldstein, Risë B.; Chou, S. Patricia; Smith, Sharon M.; Jung, Jeesun; Zhang, Haitao; Saha, Tulshi D.; Pickering, Roger P.; June Ruan, W.; Huang, Boji; Grant, Bridget F.

2015-01-01

Objective: The purpose of this study was to examine prevalences and concordances between Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV), and Fifth Edition (DSM-5) substance use disorders (SUDs) in a newly completed U.S. epidemiologic survey. Method: The National Epidemiologic Survey on Alcohol and Related Conditions–III surveyed 36,309 civilian, noninstitutionalized adults. SUDs were assessed using the Alcohol Use Disorder and Associated Disabilities Interview Schedule–5. Concordances between DSM-IV and DSM-5 disorders were assessed using kappa statistics. Results: Prevalences of past-year substance-specific DSM-5 disorders (2+ criteria) were modestly higher than those of DSM-IV dependence and abuse combined for alcohol, sedatives/tranquilizers, opioids, and heroin, but lower for cannabis, cocaine, and stimulants. Lifetime prevalences were lower under DSM-5. Prevalences were similar between moderate to severe (4+ criteria) DSM-5 disorders and dependence, whereas prevalences of DSM-5 disorders at 3+ criteria (DSM-5 [3+]) were higher, particularly for cannabis. Past-year concordances were excellent for DSM-IV dependence and abuse combined versus any DSM-5 and DSM-IV dependence versus DSM-5 moderate to severe disorders; lifetime concordances were fair to excellent. Past-year concordances between DSM-IV and DSM-5 (3+) were generally similar to or modestly higher than those with any DSM-5 disorder; lifetime concordances were mostly lower. Conclusions: Findings are consistent with those informing the development of DSM-5. Future research should examine differences in patterns between past-year and lifetime disorders, particularly for cannabis. Other questions warranting investigation include whether different combinations of the same numbers of criteria carry different clinical or nosologic implications, whether changes innosology yield changes in treatment demand, and whether changes in characteristics of individuals with DSM-5 SUDs dictate modifications to screening and intervention. PMID:25978823

Nosologic Comparisons of DSM-IV and DSM-5 Alcohol and Drug Use Disorders: Results From the National Epidemiologic Survey on Alcohol and Related Conditions-III.

PubMed

Goldstein, Risë B; Chou, S Patricia; Smith, Sharon M; Jung, Jeesun; Zhang, Haitao; Saha, Tulshi D; Pickering, Roger P; Ruan, W June; Huang, Boji; Grant, Bridget F

2015-05-01

The purpose of this study was to examine prevalences and concordances between Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV), and Fifth Edition (DSM-5) substance use disorders (SUDs) in a newly completed U.S. epidemiologic survey. The National Epidemiologic Survey on Alcohol and Related Conditions-III surveyed 36,309 civilian, noninstitutionalized adults. SUDs were assessed using the Alcohol Use Disorder and Associated Disabilities Interview Schedule-5. Concordances between DSM-IV and DSM-5 disorders were assessed using kappa statistics. Prevalences of past-year substance-specific DSM-5 disorders (2+ criteria) were modestly higher than those of DSM-IV dependence and abuse combined for alcohol, sedatives/tranquilizers, opioids, and heroin, but lower for cannabis, cocaine, and stimulants. Lifetime prevalences were lower under DSM-5. Prevalences were similar between moderate to severe (4+ criteria) DSM-5 disorders and dependence, whereas prevalences of DSM-5 disorders at 3+ criteria (DSM-5 [3+]) were higher, particularly for cannabis. Past-year concordances were excellent for DSM-IV dependence and abuse combined versus any DSM-5 and DSM-IV dependence versus DSM-5 moderate to severe disorders; lifetime concordances were fair to excellent. Past-year concordances between DSM-IV and DSM-5 (3+) were generally similar to or modestly higher than those with any DSM-5 disorder; lifetime concordances were mostly lower. Findings are consistent with those informing the development of DSM-5. Future research should examine differences in patterns between past-year and lifetime disorders, particularly for cannabis. Other questions warranting investigation include whether different combinations of the same numbers of criteria carry different clinical or nosologic implications, whether changes innosology yield changes in treatment demand, and whether changes in characteristics of individuals with DSM-5 SUDs dictate modifications to screening and intervention.

DSM-5 Personality Traits and DSM-IV Personality Disorders

PubMed Central

Hopwood, Christopher J.; Thomas, Katherine M.; Markon, Kristian E.; Wright, Aidan G.C.; Krueger, Robert F.

2014-01-01

Two issues pertinent to the DSM-5 proposal for personality pathology, the recovery of DSM-IV personality disorders (PDs) by proposed DSM-5 traits and the validity of the proposed DSM-5 hybrid model which incorporates both personality pathology symptoms and maladaptive traits, were evaluated in a large undergraduate sample (N = 808). Proposed DSM-5 traits as assessed with the Personality Inventory for DSM-5 explained a substantial proportion of variance in DSM-IV PDs as assessed with the Personality Diagnostic Questionnaire-4+, and trait indicators of the six proposed DSM-5 PDs were mostly specific to those disorders with some exceptions. Regression analyses support the DSM-5 hybrid model in that pathological traits and an indicator of general personality pathology severity provided incremental information about PDs. Findings are discussed in the context of broader issues around the proposed DSM-5 model of personality disorders. PMID:22250660

Crosswalk between DSM-IV Dependence and DSM-5 Substance Use Disorders for Opioids, Cannabis, Cocaine and Alcohol

PubMed Central

Compton, Wilson M.; Dawson, Deborah A.; Goldstein, Risë B.; Grant, Bridget F.

2013-01-01

Background Ascertaining agreement between DSM-IV and DSM-5 is important to determine the applicability of treatments for DSM-IV conditions to persons diagnosed according to the proposed DSM-5. Methods Data from a nationally representative sample of US adults were used to compare concordance of past-year DSM-IV Opioid, Cannabis, Cocaine and Alcohol Dependence with past-year DSM-5 disorders at thresholds of 3+, 4+ 5+ and 6+ positive DSM-5 criteria among past-year users of opioids (n=264), cannabis (n=1,622), cocaine (n=271) and alcohol (n=23,013). Substance-specific 2×2 tables yielded overall concordance (kappa), sensitivity, specificity, positive predictive values (PPV) and negative predictive values (NPV). Results For DSM-IV Alcohol, Cocaine and Opioid Dependence, optimal concordance occurred when 4+ DSM-5 criteria were endorsed, corresponding to the threshold for moderate DSM-5 Alcohol, Cocaine and Opioid Use Disorders. Maximal concordance of DSM-IV Cannabis Dependence and DSM-5 Cannabis Use Disorder occurred when 6+ criteria were endorsed, corresponding to the threshold for severe DSM-5 Cannabis Use Disorder. At these optimal thresholds, sensitivity, specificity, PPV and NPV generally exceeded 85% (>75% for cannabis). Conclusions Overall, excellent correspondence of DSM-IV Dependence with DSM-5 Substance Use Disorders was documented in this general population sample of alcohol, cannabis, cocaine and opioid users. Applicability of treatments tested for DSM-IV Dependence is supported by these results for those with a DSM-5 Alcohol, Cocaine or Opioid Use Disorder of at least moderate severity or Severe Cannabis Use Disorder. Further research is needed to provide evidence for applicability of treatments for persons with milder substance use disorders. PMID:23642316

Digital soil mapping in assessment of land suitability for organic farming

NASA Astrophysics Data System (ADS)

Ghambashidze, Giorgi; Kentchiashvili, Naira; Tarkhnishvili, Maia; Jolokhava, Tamar; Meskhi, Tea

2017-04-01

Digital soil mapping (DSM) is a fast-developing sub discipline of soil science which gets more importance along with increased availability of spatial data. DSM is based on three main components: the input in the form of field and laboratory observational methods, the process used in terms of spatial and non-spatial soil inference systems, and the output in the form of spatial soil information systems, which includes outputs in the form of rasters of prediction along with the uncertainty of prediction. Georgia is one of the countries who are under the way of spatial data infrastructure development, which includes soil related spatial data also. Therefore, it is important to demonstrate the capacity of DSM technics for planning and decision making process, in which assessment of land suitability is a major interest for those willing to grow agricultural crops. In that term land suitability assessment for establishing organic farms is in high demand as market for organically produced commodities is still increasing. It is the first attempt in Georgia to use DSM to predict areas with potential for organic farming development. Current approach is based on risk assessment of soil pollution with toxic elements (As, Hg, Pb, Cd, Cr) and prediction of bio-availability of those elements to plants on example of the region of Western Georgia, where detailed soil survey was conducted and spatial database of soil was created. The results of the study show the advantages of DSM at early stage assessment and depending on availability and quality of the input data, it can achieve acceptable accuracy.

Automation of image data processing. (Polish Title: Automatyzacja proces u przetwarzania danych obrazowych)

NASA Astrophysics Data System (ADS)

Preuss, R.

2014-12-01

This article discusses the current capabilities of automate processing of the image data on the example of using PhotoScan software by Agisoft. At present, image data obtained by various registration systems (metric and non - metric cameras) placed on airplanes, satellites, or more often on UAVs is used to create photogrammetric products. Multiple registrations of object or land area (large groups of photos are captured) are usually performed in order to eliminate obscured area as well as to raise the final accuracy of the photogrammetric product. Because of such a situation t he geometry of the resulting image blocks is far from the typical configuration of images. For fast images georeferencing automatic image matching algorithms are currently applied. They can create a model of a block in the local coordinate system or using initial exterior orientation and measured control points can provide image georeference in an external reference frame. In the case of non - metric image application, it is also possible to carry out self - calibration process at this stage. Image matching algorithm is also used in generation of dense point clouds reconstructing spatial shape of the object (area). In subsequent processing steps it is possible to obtain typical photogrammetric products such as orthomosaic, DSM or DTM and a photorealistic solid model of an object . All aforementioned processing steps are implemented in a single program in contrary to standard commercial software dividing all steps into dedicated modules. Image processing leading to final geo referenced products can be fully automated including sequential implementation of the processing steps at predetermined control parameters. The paper presents the practical results of the application fully automatic generation of othomosaic for both images obtained by a metric Vexell camera and a block of images acquired by a non - metric UAV system

Exploring optimum cut-off scores to screen for probable posttraumatic stress disorder within a sample of UK treatment-seeking veterans

PubMed Central

Murphy, Dominic; Ross, Jana; Ashwick, Rachel; Armour, Cherie; Busuttil, Walter

2017-01-01

ABSTRACT Background: Previous research exploring the psychometric properties of the scores of measures of posttraumatic stress disorder (PTSD) suggests there is variation in their functioning depending on the target population. To date, there has been little study of these properties within UK veteran populations. Objective: This study aimed to determine optimally efficient cut-off values for the Impact of Event Scale-Revised (IES-R) and the PTSD Checklist for DSM-5 (PCL-5) that can be used to assess for differential diagnosis of presumptive PTSD. Methods: Data from a sample of 242 UK veterans assessed for mental health difficulties were analysed. The criterion-related validity of the PCL-5 and IES-R were evaluated against the Clinician-Administered PTSD Scale for DSM-5 (CAPS-5). Kappa statistics were used to assess the level of agreement between the DSM-IV and DSM-5 classification systems. Results: The optimal cut-off scores observed within this sample were 34 or above on the PCL-5 and 46 or above on the IES-R. The PCL-5 cut-off is similar to the previously reported values, but the IES-R cut-off identified in this study is higher than has previously been recommended. Overall, a moderate level of agreement was found between participants screened positive using the DSM-IV and DSM-5 classification systems of PTSD. Conclusions: Our findings suggest that the PCL-5 and IES-R can be used as brief measures within veteran populations presenting at secondary care to assess for PTSD. The use of a higher cut-off for the IES-R may be helpful for differentiating between veterans who present with PTSD and those who may have some sy`mptoms of PTSD but are sub-threshold for meeting a diagnosis. Further, the use of more accurate optimal cut-offs may aid clinicians to better monitor changes in PTSD symptoms during and after treatment. PMID:29435200

Exploring optimum cut-off scores to screen for probable posttraumatic stress disorder within a sample of UK treatment-seeking veterans.

PubMed

Murphy, Dominic; Ross, Jana; Ashwick, Rachel; Armour, Cherie; Busuttil, Walter

2017-01-01

Background : Previous research exploring the psychometric properties of the scores of measures of posttraumatic stress disorder (PTSD) suggests there is variation in their functioning depending on the target population. To date, there has been little study of these properties within UK veteran populations. Objective : This study aimed to determine optimally efficient cut-off values for the Impact of Event Scale-Revised (IES-R) and the PTSD Checklist for DSM-5 (PCL-5) that can be used to assess for differential diagnosis of presumptive PTSD. Methods : Data from a sample of 242 UK veterans assessed for mental health difficulties were analysed. The criterion-related validity of the PCL-5 and IES-R were evaluated against the Clinician-Administered PTSD Scale for DSM-5 (CAPS-5). Kappa statistics were used to assess the level of agreement between the DSM-IV and DSM-5 classification systems. Results : The optimal cut-off scores observed within this sample were 34 or above on the PCL-5 and 46 or above on the IES-R. The PCL-5 cut-off is similar to the previously reported values, but the IES-R cut-off identified in this study is higher than has previously been recommended. Overall, a moderate level of agreement was found between participants screened positive using the DSM-IV and DSM-5 classification systems of PTSD. Conclusions : Our findings suggest that the PCL-5 and IES-R can be used as brief measures within veteran populations presenting at secondary care to assess for PTSD. The use of a higher cut-off for the IES-R may be helpful for differentiating between veterans who present with PTSD and those who may have some sy`mptoms of PTSD but are sub-threshold for meeting a diagnosis. Further, the use of more accurate optimal cut-offs may aid clinicians to better monitor changes in PTSD symptoms during and after treatment.

Forest inventory with LiDAR and stereo DSM on Washington department of natural resources lands

Treesearch

Jacob L. Strunk; Peter J. Gould

2015-01-01

DNR’s forest inventory group has completed its first version of a new remote-sensing based forest inventory system covering 1.4 million acres of DNR forest lands. We use a combination of field plots, lidar, NAIP, and a NAIP-derived canopy surface DSM. Given that height drives many key inventory variables (e.g. height, volume, biomass, carbon), remote-sensing derived...

DSM and electric utility competitiveness: An Illinois perspective

DOE Office of Scientific and Technical Information (OSTI.GOV)

Jackson, P.W.

1994-12-31

A predominant theme in the current electric utility industry literature is that competitive forces have emerged and may become more prominent. The wholesale bulk power market is alreadly competitive, as non-utility energy service providers already have had a significant impact on that market; this trend was accelerated by the Energy Policy Act of 1992. Although competition at the retail level is much less pervasive, electric utility customers increasingly have greater choice in selecting energy services. These choices may include, depending on the customer, the ability to self-generate, switch fuels, move to a new location, or rely more heavily on demand-sidemore » management as a means of controlling electric energy use. This paper explores the subject of how demand-side management (DSM) programs, which are often developed by a utility to satisfy resource requirements as a part of its least-cost planning process, can affect the utility`s ability to compete in the energy services marketplace. In this context, the term `DSM` is used in this paper to refer to those demand-side services and programs which provide resources to the utility`s system. Depending on one`s perspective, DSM programs (so defined) can be viewed either as an enhancement to the competitive position of a utility by enabling it to provide its customers with a broader menu of energy services, simultaneously satisfying the objectives of the utility as well as those of the customers, or as a detractor to a utility`s ability to compete. In the latter case, the concern is with respect to the potential for adverse rate impacts on customers who are not participants in DSM programs. The paper consists of an identification of the pros and cons of DSM as a competitive strategy, the tradeoff which can occur between the cost impacts and rate impacts of DSM, and an examination of alternative strategies for maximizing the utilization of DSM both as a resource and as a competitive strategy.« less

The six most essential questions in psychiatric diagnosis: a pluralogue part 1: conceptual and definitional issues in psychiatric diagnosis

PubMed Central

2012-01-01

In face of the multiple controversies surrounding the DSM process in general and the development of DSM-5 in particular, we have organized a discussion around what we consider six essential questions in further work on the DSM. The six questions involve: 1) the nature of a mental disorder; 2) the definition of mental disorder; 3) the issue of whether, in the current state of psychiatric science, DSM-5 should assume a cautious, conservative posture or an assertive, transformative posture; 4) the role of pragmatic considerations in the construction of DSM-5; 5) the issue of utility of the DSM - whether DSM-III and IV have been designed more for clinicians or researchers, and how this conflict should be dealt with in the new manual; and 6) the possibility and advisability, given all the problems with DSM-III and IV, of designing a different diagnostic system. Part I of this article will take up the first two questions. With the first question, invited commentators express a range of opinion regarding the nature of psychiatric disorders, loosely divided into a realist position that the diagnostic categories represent real diseases that we can accurately name and know with our perceptual abilities, a middle, nominalist position that psychiatric disorders do exist in the real world but that our diagnostic categories are constructs that may or may not accurately represent the disorders out there, and finally a purely constructivist position that the diagnostic categories are simply constructs with no evidence of psychiatric disorders in the real world. The second question again offers a range of opinion as to how we should define a mental or psychiatric disorder, including the possibility that we should not try to formulate a definition. The general introduction, as well as the introductions and conclusions for the specific questions, are written by James Phillips, and the responses to commentaries are written by Allen Frances. PMID:22243994

In through the out door: a commentary on "personality disorders are the vanguard of the post-DSM-5.0 era".

PubMed

Pincus, Aaron L

2013-10-01

Comments on an article by Krueger (see record 2013-45025-008). Pincus thanks Krueger for sharing his candid, highly informative views on the process and outcome of the DSM-5 (American Psychiatric Association; APA, 2013) Personality Disorder (PD) Work Group. As an "outsider," Pincus identifies with Krueger's descriptions of the scholarly anxiety evoked by following the unfolding process via the dsm5 .org Web site. In the end, however, Pincus thinks Section III is the right place for the proposal. He feels that its developmental process was more ambitious, but also more circuitous, than other revision efforts. Despite the APA's rejection of the proposal for Section II, Pincus agrees with Krueger's vision that continued research on viable aspects of the system represents an important next step in the post-DSM-5.0 era, and the system's inclusion in Section III should provide additional impetus for new research that advances the science of personality pathology. Thus, Pincus takes the optimistic view that innovation in conceptualizing and diagnosing PD has actually made it in through the out door. He notes that how things progress from here is hard to predict. PsycINFO Database Record (c) 2013 APA, all rights reserved.

Diagnostic Changes to DSM-5: The Potential Impact on Juvenile Justice.

PubMed

Haney-Caron, Emily; Brogan, Leah; NeMoyer, Amanda; Kelley, Sharon; Heilbrun, Kirk

2016-12-01

Legal decision-makers have discretion at every stage of processing in the juvenile justice system, and individual youth characteristics (e.g., a particular psychiatric diagnosis) influence how a youth progresses through the system. As a result, changes in diagnostic criteria in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) may affect the rates of diagnoses among justice-involved youths and subsequently influence youths' experiences within the justice system. In this article, we identify the diagnoses most likely to exert such influences and review the prevalence of diagnosis and psychiatric disorder symptomatology in justice-involved youths. We highlight the DSM-5 changes in diagnostic criteria for internalizing and externalizing disorders that commonly occur among justice-involved youths and the potential impact of these changes on the rates of diagnoses within this population. Finally, we address the limitations of using psychiatric diagnoses in juvenile justice decision making, including the potential for biasing legal decision-makers and the importance of considering context as part of diagnosis. © 2016 American Academy of Psychiatry and the Law.

Performance Modeling and Measurement of Parallelized Code for Distributed Shared Memory Multiprocessors

NASA Technical Reports Server (NTRS)

Waheed, Abdul; Yan, Jerry

1998-01-01

This paper presents a model to evaluate the performance and overhead of parallelizing sequential code using compiler directives for multiprocessing on distributed shared memory (DSM) systems. With increasing popularity of shared address space architectures, it is essential to understand their performance impact on programs that benefit from shared memory multiprocessing. We present a simple model to characterize the performance of programs that are parallelized using compiler directives for shared memory multiprocessing. We parallelized the sequential implementation of NAS benchmarks using native Fortran77 compiler directives for an Origin2000, which is a DSM system based on a cache-coherent Non Uniform Memory Access (ccNUMA) architecture. We report measurement based performance of these parallelized benchmarks from four perspectives: efficacy of parallelization process; scalability; parallelization overhead; and comparison with hand-parallelized and -optimized version of the same benchmarks. Our results indicate that sequential programs can conveniently be parallelized for DSM systems using compiler directives but realizing performance gains as predicted by the performance model depends primarily on minimizing architecture-specific data locality overhead.

Posttraumatic Stress Disorder and Complex Posttraumatic Stress Disorder in DSM-5 and ICD-11: Clinical and Behavioral Correlates.

PubMed

Hyland, Philip; Shevlin, Mark; Fyvie, Claire; Karatzias, Thanos

2018-04-01

The American Psychiatric Association and the World Health Organization provide distinct trauma-based diagnoses in the fifth edition of the Diagnostic and Statistical Manual (DSM-5), and the forthcoming 11th version of the International Classification of Diseases (ICD-11), respectively. The DSM-5 conceptualizes posttraumatic stress disorder (PTSD) as a single, broad diagnosis, whereas the ICD-11 proposes two "sibling" disorders: PTSD and complex PTSD (CPTSD). The objectives of the current study were to: (a) compare prevalence rates of PTSD/CPTSD based on each diagnostic system; (b) identify clinical and behavioral variables that distinguish ICD-11 CPTSD and PTSD diagnoses; and (c) examine the diagnostic associations for ICD-11 CPTSD and DSM-5 PTSD. Participants in a predominately female clinical sample (N = 106) completed self-report scales to measure ICD-11 PTSD and CPTSD, DSM-5 PTSD, and depression, anxiety, borderline personality disorder, dissociation, destructive behaviors, and suicidal ideation and self-harm. Significantly more people were diagnosed with PTSD according to the DSM-5 criteria (90.4%) compared to those diagnosed with PTSD and CPTSD according to the ICD-11 guidelines (79.8%). An ICD-11 CPTSD diagnosis was distinguished from an ICD-11 PTSD diagnosis by higher levels of dissociation (d = 1.01), depression (d = 0.63), and borderline personality disorder (d = 0.55). Diagnostic associations with depression, anxiety, and suicidal ideation and self-harm were higher for ICD-11 CPTSD compared to DSM-5 PTSD (by 10.7%, 4.0%, and 7.0%, respectively). These results have implications for differential diagnosis and for the development of targeted treatments for CPTSD. Copyright © 2018 International Society for Traumatic Stress Studies.

Substance use disorders: Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV) and International Classification of Diseases, tenth edition (ICD-10).

PubMed

Hasin, Deborah; Hatzenbuehler, Mark L; Keyes, Katherine; Ogburn, Elizabeth

2006-09-01

Two major nomenclatures, Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV) and International Classification of Diseases, tenth edition (ICD-10), currently define substance use disorders for broad audiences of users with different training, experience and interests. A comparison of these definitions and their implications for DSM-V and ICD-11 has not been available. The background for the dependence concept and abuse, harmful use, withdrawal, substance-induced disorders and remission and other substance-related conditions is reviewed. Reliability evidence is presented, as is validity evidence from approaches including psychometric, genetic and animal studies. The relevance of the DSM-IV and ICD-10 compared to alternative systems (e.g. the Addiction Severity Index) is considered. Reliability and psychometric validity evidence for substance dependence is consistently strong, but more mixed for abuse and harmful use. Findings on the genetics of alcohol disorders support the validity of the dependence concept, while animal studies underscore the centrality of continued use despite negative consequences to the concept of dependence. While few studies on substance-induced disorders have been conducted, those published show good reliability and validity when elements of DSM-IV and ICD-10 are combined. Dependence in DSM-V and ICD-11 should be retained, standardizing both criteria sets and adding a severity measure. The consequences of heavy use should be measured independently of dependence; add cannabis withdrawal if further research supports existing evidence; conduct further studies of the substance-induced psychiatric categories; standardize their criteria across DSM-V and ICD-11; develop a theoretical basis for better remission criteria; consider changing substance 'abuse' to substance 'dysfunction disorder'; and conduct clinician education on the value of the diagnostic criteria.

Validity of DSM-IV attention–deficit/hyperactivity disorder symptom dimensions and subtypes

PubMed Central

Willcutt, Erik G.; Nigg, Joel T.; Pennington, Bruce F.; Solanto, Mary V.; Rohde, Luis A.; Tannock, Rosemary; Loo, Sandra K.; Carlson, Caryn L.; McBurnett, Keith; Lahey, Benjamin B.

2013-01-01

DSM-IV criteria for ADHD specify two dimensions of inattention and hyperactivity-impulsivity symptoms that are used to define three nominal subtypes: predominantly hyperactive-impulsive type (ADHD-H), predominantly inattentive type (ADHD-I), and combined type (ADHD-C). To aid decision-making for DSM-5 and other future diagnostic systems, a comprehensive literature review and meta-analysis of 546 studies was completed to evaluate the validity of the DSM-IV model of ADHD. Results indicated that DSM-IV criteria identify individuals with significant and persistent impairment in social, academic, occupational, and adaptive functioning when intelligence, demographic factors, and concurrent psychopathology are controlled. Available data overwhelmingly support the concurrent, predictive, and discriminant validity of the distinction between inattention and hyperactivity-impulsivity symptoms, and indicate that nearly all differences among the nominal subtypes are consistent with the relative levels of inattention and hyperactivity-impulsivity symptoms that define the subtypes. In contrast, the validity of the DSM-IV subtype model is compromised by weak evidence for the validity of ADHD-H after first grade, minimal support for the distinction between ADHD-I and ADHD-C in studies of etiological influences, academic and cognitive functioning, and treatment response, and the marked longitudinal instability of all three subtypes. Overall, it is concluded that the DSM-IV ADHD subtypes provide a convenient clinical shorthand to describe the functional and behavioral correlates of current levels of inattention and hyperactivity-impulsivity symptoms, but do not identify discrete subgroups with sufficient long-term stability to justify the classification of distinct forms of the disorder. Empirical support is stronger for an alternative model that would replace the subtypes with dimensional modifiers that reflect the number of inattention and hyperactivity-impulsivity symptoms at the time of assessment. PMID:22612200

[Attention deficit hyperactivity disorder in adults. Benchmarking diagnosis using the Wender-Reimherr adult rating scale].

PubMed

Rösler, M; Retz, W; Retz-Junginger, P; Stieglitz, R D; Kessler, H; Reimherr, F; Wender, P H

2008-03-01

We report on a study comparing different systems for the diagnosis of attention deficit hyperactivity disorder (ADHD) in adulthood. Recruited for evaluation were 168 patients referred to our ADHD outpatient unit. We used the Diagnostic and Statistical Manual of Mental Disorders 4th edn. (DSM-IV), International Classification of Diseases 10th edn. (ICD-10), and Utah criteria for diagnostic assessment and the Wender Utah rating scale, ADHD Self Report (ADHD-SR), and Wender Reimherr Adult Attention Deficit Disorder Rating Scale as psychopathological assessment tools. We present basic psychometric data of the Wender-Reimherr Interview (WRI). Internal consistency was determined as 0.82 (alpha). The inter-rater reliability was 1.0 (kappa coefficient) regarding ADHD diagnoses, and the ICC was 0.98 referring to the WRI total scores. The convergent validity with the ADHD-SR was 0.65 (Spearman coefficient). In 126 of 168 patients an ADHD diagnosis was made according to at least one of the three systems. The DSM-IV diagnostic set led to 119 ADHD diagnoses. As compared with the two other systems, this is about the minimum level for an ADHD diagnosis. All of the 87 ADHD diagnoses according to ICD-10 were covered by DSM-IV. The ICD-10 had no independent psychopathological items and therefore offered no additional points for the diagnostic procedure than the DSM-IV. The situation regarding Utah criteria is different. These criteria contain seven psychopathological domains: inattention, hyperactivity, disorganisation, impulsivity, affective lability, overreactivity, and hot temper. They can be assessed by use of the WRI. Ninety-three of 168 patients were diagnosed as having ADHD according to the Utah concept, which is much lower than with the DSM-IV. The particular definition of the disorder by the Utah criteria resulted in seven patients having only a Utah diagnosis but no DSM-IV diagnosis. Thus we are in a position to say that the Utah criteria have a relatively high level for making an ADHD diagnosis but in certain cases move beyond the DSM-IV. Of the patients 56% had ADHD diagnoses according to all three classification instruments. Examining the factor structure of the ADHD psychopathology represented by seven WRI and three ADHD-SR subscales, we found a two-factor solution explaining for 63% of the variance. Factor 1 was designated by impulsivity, affective lability, hyperactivity, and hot temper; factor 2 consisted of inattention, disorganisation, and overreactivity.

Did the DSM-5 Improve the Traumatic Stressor Criterion?: Association of DSM-IV and DSM-5 Criterion A with Posttraumatic Stress Disorder Symptoms.

PubMed

Larsen, Sadie E; Berenbaum, Howard

2017-01-01

A recent meta-analysis found that DSM-III- and DSM-IV-defined traumas were associated with only slightly higher posttraumatic stress disorder (PTSD) symptoms than nontraumatic stressors. The current study is the first to examine whether DSM-5-defined traumas were associated with higher levels of PTSD than DSM-IV-defined traumas. Further, we examined theoretically relevant event characteristics to determine whether characteristics other than those outlined in the DSM could predict PTSD symptoms. One hundred six women who had experienced a trauma or significant stressor completed questionnaires assessing PTSD, depression, impairment, and event characteristics. Events were rated for whether they qualified as DSM-IV and DSM-5 trauma. There were no significant differences between DSM-IV-defined traumas and stressors. For DSM-5, effect sizes were slightly larger but still nonsignificant (except for significantly higher hyperarousal following traumas vs. stressors). Self-reported fear for one's life significantly predicted PTSD symptoms. Our results indicate that the current DSM-5 definition of trauma, although a slight improvement from DSM-IV, is not highly predictive of who develops PTSD symptoms. Our study also indicates the importance of individual perception of life threat in the prediction of PTSD. © 2017 S. Karger AG, Basel.

A perspective on the current issues in the DSM-5 classification of personality disorders.

PubMed

Guelfi, Julien D

2013-06-01

David Kupfer chaired the DSM-5 Task Force, and Andrew Skodol the working group, on personality disorders. Various initial propositions were posted on the Internet in 2010 for comment and discussion: new general definition, new criteria, new diagnostic procedures, reduction in the number of categories, and dimensional representation. Following numerous criticisms, the Task Force's final decisions were made public on December 1, 2012. Personality disorders now figure alongside other mental disorders, because of the deletion of Axis II. The methodology concerning personality traits is in a third section to promote new studies. The new proposed hybrid system has not, to date, proven better than the categories of the DSM-IV. These various decisions are commented upon.

The Puzzling Unidimensionality of DSM-5 Substance Use Disorder Diagnoses

PubMed Central

MacCoun, Robert J.

2013-01-01

There is a perennial expert debate about the criteria to be included or excluded for the DSM diagnoses of substance use dependence. Yet analysts routinely report evidence for the unidimensionality of the resulting checklist. If in fact the checklist is unidimensional, the experts are wrong that the criteria are distinct, so either the experts are mistaken or the reported unidimensionality is spurious. I argue for the latter position, and suggest that the traditional reflexive measurement model is inappropriate for the DSM; a formative measurement model would be a more accurate characterization of the institutional process by which the checklist is created, and a network or causal model would be a more appropriate foundation for a scientifically grounded diagnostic system. PMID:24324446

A perspective on the current issues in the DSM-5 classification of personality disorders

PubMed Central

Guelfi, Julien D.

2013-01-01

David Kupfer chaired the DSM-5 Task Force, and Andrew Skodol the working group, on personality disorders. Various initial propositions were posted on the Internet in 2010 for comment and discussion: new general definition, new criteria, new diagnostic procedures, reduction in the number of categories, and dimensional representation. Following numerous criticisms, the Task Force's final decisions were made public on December 1, 2012. Personality disorders now figure alongside other mental disorders, because of the deletion of Axis II. The methodology concerning personality traits is in a third section to promote new studies. The new proposed hybrid system has not, to date, proven better than the categories of the DSM-IV. These various decisions are commented upon. PMID:24174887

Paradigm shifts and the development of the diagnostic and statistical manual of mental disorders: past experiences and future aspirations.

PubMed

First, Michael B

2010-11-01

Work is currently under way on the Diagnostic and Statistical Manual of Mental Disorders (DSM), Fifth Edition, due to be published by the American Psychiatric Association in 2013. Dissatisfaction with the current categorical descriptive approach has led to aspirations for a paradigm shift for DSM-5. A historical review of past revisions of the DSM was performed. Efforts undertaken before the start of the DSM-5 development process to conduct a state-of-the science review and set a research agenda were examined to determine if results supported a paradigm shift for DSM-5. Proposals to supplement DSM-5 categorical diagnosis with dimensional assessments are reviewed and critiqued. DSM revisions have alternated between paradigm shifts (the first edition of the DSM in 1952 and DSM-III in 1980) and incremental improvements (DSM-II in 1968, DSM-III-R in 1987, and DSM-IV in 1994). The results of the review of the DSM-5 research planning initiatives suggest that despite the scientific advances that have occurred since the descriptive approach was first introduced in 1980, the field lacks a sufficiently deep understanding of mental disorders to justify abandoning the descriptive approach in favour of a more etiologically based alternative. Proposals to add severity and cross-cutting dimensions throughout DSM-5 are neither paradigm shifting, given that simpler versions of such dimensions are already a component of DSM-IV, nor likely to be used by busy clinicians without evidence that they improve clinical outcomes. Despite initial aspirations that DSM would undergo a paradigm shift with this revision, DSM-5 will continue to adopt a descriptive categorical approach, albeit with a greatly expanded dimensional component.

Concordance between DSM-5 and DSM-IV nicotine, alcohol, and cannabis use disorder diagnoses among pediatric patients.

PubMed

Kelly, Sharon M; Gryczynski, Jan; Mitchell, Shannon Gwin; Kirk, Arethusa; O'Grady, Kevin E; Schwartz, Robert P

2014-07-01

The recently published Diagnostic and Statistical Manual of Mental Disorders-5 (DSM-5) includes several major revisions to substance use diagnoses. Studies have evaluated the impact of these changes among adult samples but research with adolescent samples is lacking. 525 adolescents (93% African American) awaiting primary care appointments in Baltimore, Maryland were recruited for a study evaluating a substance use screening instrument. Participants were assessed for DSM-5 nicotine, alcohol, and cannabis use disorder, DSM-IV alcohol and cannabis abuse, and DSM-IV dependence for all three substances during the past year using the modified Composite International Diagnostic Interview-2, Substance Abuse Module. Contingency tables examining DSM-5 vs. DSM-IV joint frequency distributions were examined for each substance. Diagnoses were more prevalent using DSM-5 criteria compared with DSM-IV for nicotine (4.0% vs. 2.7%), alcohol (4.6% vs. 3.8%), and cannabis (10.7% vs. 8.2%). Cohen's κ, Somers' d, and Cramer's V ranged from 0.70 to 0.99 for all three substances. Of the adolescents categorized as "diagnostic orphans" under DSM-IV, 7/16 (43.8%), 9/29 (31.0%), and 13/36 (36.1%) met criteria for DSM-5 disorder for nicotine, alcohol, and cannabis, respectively. Additionally, 5/17 (29.4%) and 1/21 (4.8%) adolescents who met criteria for DSM-IV abuse did not meet criteria for a DSM-5 diagnosis for alcohol and cannabis, respectively. Categorizing adolescents using DSM-5 criteria may result in diagnostic net widening-particularly for cannabis use disorders-by capturing adolescents who were considered diagnostic orphans using DSM-IV criteria. Future research examining the validity of DSM-5 substance use disorders with larger and more diverse adolescent samples is needed. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Concordance between DSM-5 and DSM-IV nicotine, alcohol, and cannabis use disorder diagnoses among pediatric patients

PubMed Central

Kelly, Sharon M.; Gryczynski, Jan; Mitchell, Shannon Gwin; Kirk, Arethusa; O’Grady, Kevin E.; Schwartz, Robert P.

2014-01-01

Background The recently published Diagnostic and Statistical Manual of Mental Disorders-5 (DSM-5) includes several major revisions to substance use diagnoses. Studies have evaluated the impact of these changes among adult samples but research with adolescent samples is lacking. Methods 525 adolescents (93% African American) awaiting primary care appointments in Baltimore, Maryland were recruited for a study evaluating a substance use screening instrument. Participants were assessed for DSM-5 nicotine, alcohol, and cannabis use disorder, DSM-IV alcohol and cannabis abuse, and DSM-IV dependence for all three substances during the past year using the modified Composite International Diagnostic Interview-2, Substance Abuse Module. Contingency tables examining DSM-5 vs. DSM-IV joint frequency distributions were examined for each substance. Results Diagnoses were more prevalent using DSM-5 criteria compared with DSM-IV for nicotine (4.0% vs. 2.7%), alcohol (4.6% vs. 3.8%), and cannabis (10.7% vs. 8.2%). Cohen's κ, Somers' d, and Cramer's V ranged from 0.70-0.99 for all three substances. Of the adolescents categorized as “diagnostic orphans” under DSM-IV, 7/16 (43.8%), 9/29 (31.0%), and 13/36 (36.1%) met criteria for DSM-5 disorder for nicotine, alcohol, and cannabis, respectively. Additionally, 5/17 (29.4%) and 1/21 (4.8%) adolescents who met criteria for DSM-IV abuse did not meet criteria for a DSM-5 diagnosis for alcohol and cannabis, respectively. Conclusions Categorizing adolescents using DSM-5 criteria may result in diagnostic net widening-particularly for cannabis use disorders-by capturing adolescents who were considered diagnostic orphans using DSM-IV criteria. Future research examining the validity of DSM-5 substance use disorders with larger and more diverse adolescent samples is needed. PMID:24793367

The Effect of Draft DSM-5 Criteria on Posttraumatic Stress Disorder Prevalence

PubMed Central

Calhoun, Patrick S.; Hertzberg, Jeffrey S.; Kirby, Angela C.; Dennis, Michelle F.; Hair, Lauren P.; Dedert, Eric A.; Beckham, Jean C.

2012-01-01

Background This study was designed to examine the concordance of proposed DSM-5 posttraumatic stress disorder (PTSD) criteria with DSM-IV classification rules and examine the impact of the proposed DSM-5 PTSD criteria on prevalence. Method The sample (N=185) included participants who were recruited for studies focused on trauma and health conducted at an academic medical center and VA medical center in the southeastern United States. The prevalence and concordance between DSM-IV and the proposed DSM-5 classifications were calculated based on results from structured clinical interviews. Prevalence rates and diagnostic efficiency indices including sensitivity, specificity, area under the curve (AUC), and Kappa were calculated for each of the possible ways to define DSM-5 PTSD. Results Ninety-five percent of the sample reported an event that met both DSM-IV PTSD Criterion A1 and A2, but only 89% reported a trauma that met Criterion A on DSM-5. Results examining concordance between DSM-IV and DSM-5 algorithms indicated that several of the algorithms had AUCs above .90. The requirement of two symptoms from both Clusters D and E provided strong concordance to DSM-IV (AUC = .93; Kappa = .86) and a greater balance between sensitivity and specificity than requiring three symptoms in both Clusters D and E. Conclusions Despite several significant changes to the diagnostic criteria for PTSD for DSM-5, several possible classification rules provided good concordance with DSM-IV. The magnitude of the impact of DSM-5 decision rules on prevalence will be largely affected by the DSM-IV PTSD base rate in the population of interest. PMID:23109002

The role of identity in the DSM-5 classification of personality disorders

PubMed Central

2013-01-01

In the revised Diagnostic and Statistical Manual DSM-5 the definition of personality disorder diagnoses has not been changed from that in the DSM-IV-TR. However, an alternative model for diagnosing personality disorders where the construct “identity” has been integrated as a central diagnostic criterion for personality disorders has been placed in section III of the manual. The alternative model’s hybrid nature leads to the simultaneous use of diagnoses and the newly developed “Level of Personality Functioning-Scale” (a dimensional tool to define the severity of the disorder). Pathological personality traits are assessed in five broad domains which are divided into 25 trait facets. With this dimensional approach, the new classification system gives, both clinicians and researchers, the opportunity to describe the patient in much more detail than previously possible. The relevance of identity problems in assessing and understanding personality pathology is illustrated using the new classification system applied in two case examples of adolescents with a severe personality disorder. PMID:23902698

The role of identity in the DSM-5 classification of personality disorders.

PubMed

Schmeck, Klaus; Schlüter-Müller, Susanne; Foelsch, Pamela A; Doering, Stephan

2013-07-31

In the revised Diagnostic and Statistical Manual DSM-5 the definition of personality disorder diagnoses has not been changed from that in the DSM-IV-TR. However, an alternative model for diagnosing personality disorders where the construct "identity" has been integrated as a central diagnostic criterion for personality disorders has been placed in section III of the manual. The alternative model's hybrid nature leads to the simultaneous use of diagnoses and the newly developed "Level of Personality Functioning-Scale" (a dimensional tool to define the severity of the disorder). Pathological personality traits are assessed in five broad domains which are divided into 25 trait facets. With this dimensional approach, the new classification system gives, both clinicians and researchers, the opportunity to describe the patient in much more detail than previously possible. The relevance of identity problems in assessing and understanding personality pathology is illustrated using the new classification system applied in two case examples of adolescents with a severe personality disorder.

How Voting and Consensus Created the Diagnostic and Statistical Manual of Mental Disorders (DSM-III).

PubMed

Davies, James

2017-04-01

This paper examines how Task Force votes were central to the development of Diagnostic and Statistical Manual of Mental Disorders (DSM-III and DSM-III-R). Data were obtained through a literature review, investigation of DSM archival material housed at the American Psychiatric Association (APA), and interviews with key Task Force members of DSM-III and DSM-III-R. Such data indicate that Task Force votes played a central role in the making of DSM-III, from establishing diagnostic criteria and diagnostic definitions to settling questions about the inclusion or removal of diagnostic categories. The paper concludes that while the APA represented DSM-III, and the return to descriptive psychiatry it inaugurated, as a triumph of empirically based decision-making, the evidence presented here fails to support that view. Since the DSM is a cumulative project, and as DSM-III lives on through subsequent editions, this paper calls for a more socio-historically informed understanding of DSM's construction to be deployed in how the DSM is taught and implemented in training and clinical settings.

Autism Spectrum Disorders According to "DSM-IV-TR" and Comparison with "DSM-5" Draft Criteria: An Epidemiological Study

ERIC Educational Resources Information Center

Mattila, Marja-Leena; Kielinen, Marko; Linna, Sirkka-Liisa; Jussila, Katja; Ebeling, Hanna; Bloigu, Risto; Joseph, Robert M.; Moilanen, Irma

2011-01-01

Objective: The latest definitions of autism spectrum disorders (ASDs) were specified in "DSM-IV-TR" in 2000. "DSM-5" criteria are planned for 2013. Here, we estimated the prevalence of ASDs and autism according to "DSM-IV-TR," clarified confusion concerning diagnostic criteria, and evaluated "DSM-5" draft…

Bone density, body composition, and psychopathology of anorexia nervosa spectrum disorders in DSM-IV vs DSM-5

PubMed Central

Schorr, Melanie; Thomas, Jennifer J.; Eddy, Kamryn T.; Dichtel, Laura E.; Lawson, Elizabeth A.; Meenaghan, Erinne; Paskal, Margaret Lederfine; Fazeli, Pouneh K.; Faje, Alexander T.; Misra, Madhusmita; Klibanski, Anne; Miller, Karen K.

2016-01-01

Objective DSM-5 revised diagnostic criteria for anorexia nervosa (AN) by eliminating the amenorrhea requirement, liberalizing weight and psychological criteria, and adding the formal diagnosis of “atypical AN” for individuals with AN psychological symptoms without low weight. We sought to determine whether bone density (BMD) is impaired in women diagnosed with AN using the new, more liberal DSM-5 criteria. Method Cross-sectional study of 168 women, 18–45y: 1) AN by DSM-IV (DSM-IV)(n=37), 2) AN by DSM-5 but not DSM-IV criteria (DSM-5)(n=33), 3) atypical AN (ATYPICAL)(n=77), 4) healthy comparison group (HC)(n=21). Measurements included dual energy x-ray absorptiometry, Eating Disorder Examination-Questionnaire, Eating Disorder Inventory-2, Hamilton Depression and Anxiety Rating Scales. Results BMD Z-score <−1.0 was present in 78% of DSM-IV, 82% of DSM-5, and 69% of ATYPICAL. Mean Z-scores were comparably low in DSM-IV and DSM-5, intermediate in ATYPICAL, and highest in HC. Lack of prior low weight or amenorrhea was, but history of overweight/obesity was not, protective against bone loss. Mean lean mass and percent fat mass were significantly lower in all AN groups than HC. DSM-IV, DSM-5 and ATYPICAL had comparable psychopathology. Discussion Despite liberalizing diagnostic criteria, many women diagnosed with AN and atypical AN using DSM-5 criteria have low BMD. Presence or history of low weight and/or amenorrhea remain important indications for DXA. Loss of lean mass, in addition to fat mass, is present in all AN groups, and may contribute to low BMD. The deleterious effect of eating disorders on BMD extends beyond those with current low weight and amenorrhea. PMID:27527115

The effect of draft DSM-V criteria on posttraumatic stress disorder prevalence.

PubMed

Calhoun, Patrick S; Hertzberg, Jeffrey S; Kirby, Angela C; Dennis, Michelle F; Hair, Lauren P; Dedert, Eric A; Beckham, Jean C

2012-12-01

This study was designed to examine the concordance of proposed DSM-V posttraumatic stress disorder (PTSD) criteria with DSM-IV classification rules and examine the impact of the proposed DSM-V PTSD criteria on prevalence. The sample (N = 185) included participants who were recruited for studies focused on trauma and health conducted at an academic medical center and VA medical center in the southeastern United States. The prevalence and concordance between DSM-IV and the proposed DSM-V classifications were calculated based on results from structured clinical interviews. Prevalence rates and diagnostic efficiency indices including sensitivity, specificity, area under the curve (AUC), and Kappa were calculated for each of the possible ways to define DSM-V PTSD. Ninety-five percent of the sample reported an event that met both DSM-IV PTSD Criterion A1 and A2, but only 89% reported a trauma that met Criterion A on DSM-V. Results examining concordance between DSM-IV and DSM-V algorithms indicated that several of the algorithms had AUCs above 0.90. The requirement of two symptoms from both Clusters D and E provided strong concordance to DSM-IV (AUC = 0.93; Kappa = 0.86) and a greater balance between sensitivity and specificity than requiring three symptoms in both Clusters D and E. Despite several significant changes to the diagnostic criteria for PTSD for DSM-V, several possible classification rules provided good concordance with DSM-IV. The magnitude of the impact of DSM-V decision rules on prevalence will be largely affected by the DSM-IV PTSD base rate in the population of interest. © 2012 Wiley Periodicals, Inc.

DSM-IV: a nosology sold before its time?

PubMed

Zimmerman, M; Jampala, V C; Sierles, F S; Taylor, M A

1991-04-01

The purpose of this study was to determine whether American psychiatrists believe that DSM-IV is being published too soon after DSM-III-R. The authors conducted a mail survey of the attitudes of practicing psychiatrists (N = 454), residency program directors (N = 128), residents (N = 1,331), and researchers (N = 196) toward the scheduled publication of DSM-IV in the early 1990s. They found that the majority of all four groups believed that DSM-IV is being published prematurely. In contrast to respondents who believed that the timing of DSM-IV is appropriate, those who indicated that it is being published too soon had more recently completed their residency training and also believed that DSM-III-R was published prematurely. There was no association between the psychiatrists' responses and their theoretical orientation, Board certification status, ownership of the DSM manuals, the length of time they had used DSM-III, and the diagnostic manual (DSM-III or DSM-III-R) they were currently using. The belief that DSM-IV is being published too soon could contribute to underuse of DSM-IV by substantial numbers of psychiatrists. Thus, to foster compliance with it, APA must preserve in its efforts to demonstrate that the advantages of publishing it in 1993 outweigh the disadvantages of adopting yet another manual.

Schizoaffective disorder diagnosed according to different diagnostic criteria--systematic literature search and meta-analysis of key clinical characteristics and heterogeneity.

PubMed

Pagel, Tobias; Franklin, Jeremy; Baethge, Christopher

2014-03-01

Schizoaffective disorder is viewed as a heterogeneous diagnosis among psychotic illnesses. Different diagnostic systems differ in their definition with DSM (-IIIR, -IV, and -V) providing a narrower definition than RDC and ICD-10. It is unclear whether this difference is reflected in patient samples diagnosed according to different diagnostic systems. Exploratory study based on a systematic review of studies of schizoaffective disorder samples diagnosed by either RDC and ICD-10 (group of "broad criteria") or DSM-IIIR and -IV ("narrow criteria"); comparison (by Mann-Whitney-U-tests) of key characteristics, such as age, number of hospitalizations, or scores in psychometric tests, between more broadly and more narrowly defined schizoaffective disorder samples using standard deviations as a measurement of heterogeneity as well as weighted means and percentages. To reduce selection bias only studies including schizoaffective patient samples together with affective disorder and schizophrenia samples were selected. 55 studies were included, 14 employing RDC, 4 ICD-10, 20 DSM-IIIR, and 17 DSM-IV. Thirteen characteristics were compared: patients diagnosed according to broader criteria had fewer previous hospitalizations (2.2 vs. 5.4) and were both less often male (42 vs. 51%) and married (21 vs. 40%). Heterogeneity was similar in both groups but slightly higher in RDC and ICD-10 samples than in DSM-IIIR and -IV-samples: +4% regarding demographic and clinical course data and +13% regarding psychometric tests (pooled SD). Secular trends and different designs may have confounded the results and limit generalizability. Some comparisons were underpowered. Differences in diagnostic criteria are reflected in key characteristics of samples. The association of larger heterogeneity with wider diagnostic criteria supports employing standard deviations as a measurement of heterogeneity. Copyright © 2013 Elsevier B.V. All rights reserved.

Symmetrical treatment of "Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition", for major depressive disorders.

PubMed

Sawamura, Jitsuki; Morishita, Shigeru; Ishigooka, Jun

2016-01-01

We previously presented a group theoretical model that describes psychiatric patient states or clinical data in a graded vector-like format based on modulo groups. Meanwhile, the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5, the current version), is frequently used for diagnosis in daily psychiatric treatments and biological research. The diagnostic criteria of DSM-5 contain simple binominal items relating to the presence or absence of specific symptoms. In spite of its simple form, the practical structure of the DSM-5 system is not sufficiently systemized for data to be treated in a more rationally sophisticated way. To view the disease states in terms of symmetry in the manner of abstract algebra is considered important for the future systematization of clinical medicine. We provide a simple idea for the practical treatment of the psychiatric diagnosis/score of DSM-5 using depressive symptoms in line with our previously proposed method. An expression is given employing modulo-2 and -7 arithmetic (in particular, additive group theory) for Criterion A of a 'major depressive episode' that must be met for the diagnosis of 'major depressive disorder' in DSM-5. For this purpose, the novel concept of an imaginary value 0 that can be recognized as an explicit 0 or implicit 0 was introduced to compose the model. The zeros allow the incorporation or deletion of an item between any other symptoms if they are ordered appropriately. Optionally, a vector-like expression can be used to rate/select only specific items when modifying the criterion/scale. Simple examples are illustrated concretely. Further development of the proposed method for the criteria/scale of a disease is expected to raise the level of formalism of clinical medicine to that of other fields of natural science.

Cognitive impairment in schizophrenia and affective psychoses: implications for DSM-V criteria and beyond.

PubMed

Bora, Emre; Yücel, Murat; Pantelis, Christos

2010-01-01

It has recently been suggested that the diagnostic criteria of schizophrenia should include specific reference to cognitive impairments characterizing the disorder. Arguments in support of this assertion contend that such inclusion would not only serve to increase the awareness of cognitive deficits in affected patients, among both clinicians and researchers alike, but also increase the "point of rarity" between schizophrenia and mood disorders. The aim of the current article is to examine this latter assertion in light of the recent opinion piece provided by Keefe and Fenton (Keefe RSE, Fenton WS. How should DSM-V criteria for schizophrenia include cognitive impairment? Schizophr Bull. 2007;33:912-920). Through literature review, we explore the issue of whether cognitive deficits do in fact differentiate the major psychoses. The overall results of this inquiry suggest that inclusion of cognitive impairment criteria in Diagnostic and Statistical Manual of Mental Disorders (Fifth Edition) (DSM-V) would not provide a major advancement in discriminating schizophrenia from bipolar disorder and affective psychoses. Therefore, while cognitive impairment should be included in DSM-V, it should not dictate diagnostic specificity--at least not until more comprehensive evidence-based reviews of the current diagnostic system have been undertaken. Based on this evidence, we consider several alternatives for the DSM-V definition of cognitive impairment in schizophrenia, including (1) the inclusion of cognitive impairment as a specifier and (2) the definition of cognitive impairment as a dimension within a hybrid categorical-dimensional system. Given the state of current evidence, these possibilities appear to represent the most parsimonious approaches to the inclusion of cognitive deficits in the diagnostic criteria of schizophrenia and, potentially, of mood disorders.

From DSM-IV to DSM-5 alcohol use disorder: an overview of epidemiological data.

PubMed

Bartoli, Francesco; Carrà, Giuseppe; Crocamo, Cristina; Clerici, Massimo

2015-02-01

The fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) has made several changes to criteria for alcohol use disorder (AUD). The objective of this systematic review is to assess if new DSM-5 diagnostic criteria will increase the prevalence rates of AUD in clinical and non-clinical samples as compared with DSM-IV criteria. We searched PubMed, Scopus, and PsycINFO (via ProQuest) electronic databases, with no language restrictions. We included studies with data available on both DSM-IV (and DSM-IV-TR) and DSM-5 AUD in samples of adults, estimating from each study an expected increase in prevalence rates with relevant 95% confidence intervals (CIs). Twelve studies were included in this review. Seven studies showed an increase, two no substantial difference, and three a decrease in AUD prevalence according to DSM-5 diagnostic criteria, with differences in rates (95% CIs) varying between -12.4% (-27.4 to +5.6%) and +61.3% (+46.7 to +77.3%). Additional analyses provided confirmatory results. DSM-5 diagnostic criteria seem to inflate prevalence rates of AUD as compared with DSM-IV. The increasing likelihood of a DSM-5 AUD diagnosis may be explained by the amount of DSM-IV 'diagnostic orphans' which are more prevalent than DSM-IV single-criterion alcohol abuse individuals. Further research should be aimed to study if similar trends are detectable also for other substance use disorders that experienced similar changes in DSM-5 diagnostic criteria. Copyright © 2014 Elsevier Ltd. All rights reserved.

[Alcohol-related cognitive impairment and the DSM-5].

PubMed

Walvoort, S J W; Wester, A J; Doorakkers, M C; Kessels, R P C; Egger, J I M

2016-01-01

It is evident from the dsm-iv-tr that alcohol-related impairment is extremely difficult to classify accurately. As a result, cognitive deficits can easily be overlooked. The dsm-5, however, incorporates a new category, namely 'neurocognitive disorders', which may lead to significant improvements in clinical practice. To compare the classification of alcohol-related cognitive dysfunction in dsm-iv-tr and dsm-5 and to discuss the clinical relevance of the revised classification in the dsm-5. We compare the chapters of the dsm-iv-tr and the dsm-5 concerning alcohol-related cognitive impairment and describe the changes that have been made. The dsm-5 puts greater emphasis on alcohol-related neurocognitive impairment. Not only does dsm-5 distinguish between the degree of severity (major or minor neurocognitive disorder), it also distinguishes between the type of impairment (non-amnestic-type versus confabulating-amnestic type). It also makes a distinction between the durations of impairment (behavioural and/or persistent disorders). The dsm-5 gives a clearer description of alcohol-related neurocognitive dysfunction than does dsm-iv-tr and it stresses the essential role of neuropsychological assessment in the classification, diagnosis, and treatment of neurocognitive disorders.

DIFFERENCES IN THE PROFILES OF DSM-IV AND DSM-5 ALCOHOL USE DISORDERS: IMPLICATIONS FOR CLINICIANS

PubMed Central

Dawson, Deborah A.; Goldstein, Risë B.; Grant, Bridget F.

2013-01-01

Background Existing information on consequences of the DSM-5 revision for diagnosis of alcohol use disorders (AUD) has gaps, including missing information critical to understanding implications of the revision for clinical practice. Methods Data from Wave 2 of the National Epidemiologic Survey on Alcohol and Related Conditions were used to compare AUD severity, alcohol consumption and treatment, sociodemographic and health characteristics and psychiatric comorbidity among individuals with DSM-IV abuse versus DSM-5 moderate AUD and DSM-IV dependence versus DSM-5 severe AUD. For each pair of disorders, we additionally compared three mutually exclusive groups: individuals positive solely for the DSM-IV disorder, those positive solely for the DSM-5 disorder and those positive for both. Results Whereas 80.5% of individuals positive for DSM-IV dependence were positive for DSM-5 severe AUD, only 58.0% of those positive for abuse were positive for moderate AUD. The profiles of individuals with DSM-IV dependence and DSM-5 severe AUD were almost identical. The only significant (p<.005) difference, more AUD criteria among the former, reflected the higher criterion threshold (≥4 vs. ≥3) for severe AUD relative to dependence. In contrast, the profiles of individuals with DSM-5 moderate AUD and DSM-IV abuse differed substantially. The former endorsed more AUD criteria, had higher rates of physiological dependence, were less likely to be White and male, had lower incomes, were less likely to have private and more likely to have public health insurance, and had higher levels of comorbid anxiety disorders than the latter. Conclusions Similarities between the profiles of DSM-IV and DSM-5 AUD far outweigh differences; however, clinicians may face some changes with respect to appropriate screening and referral for cases at the milder end of the AUD severity spectrum, and the mechanisms through which these will be reimbursed may shift slightly from the private to public sector. PMID:22974144

Safety, tolerability, pharmacokinetics, and activity of the novel long-acting antimalarial DSM265: a two-part first-in-human phase 1a/1b randomised study.

PubMed

McCarthy, James S; Lotharius, Julie; Rückle, Thomas; Chalon, Stephan; Phillips, Margaret A; Elliott, Suzanne; Sekuloski, Silvana; Griffin, Paul; Ng, Caroline L; Fidock, David A; Marquart, Louise; Williams, Noelle S; Gobeau, Nathalie; Bebrevska, Lidiya; Rosario, Maria; Marsh, Kennan; Möhrle, Jörg J

2017-06-01

DSM265 is a novel antimalarial that inhibits plasmodial dihydroorotate dehydrogenase, an enzyme essential for pyrimidine biosynthesis. We investigated the safety, tolerability, and pharmacokinetics of DSM265, and tested its antimalarial activity. Healthy participants aged 18-55 years were enrolled in a two-part study: part 1, a single ascending dose (25-1200 mg), double-blind, randomised, placebo-controlled study, and part 2, an open-label, randomised, active-comparator controlled study, in which participants were inoculated with Plasmodium falciparum induced blood-stage malaria (IBSM) and treated with DSM265 (150 mg) or mefloquine (10 mg/kg). Primary endpoints were DSM265 safety, tolerability, and pharmacokinetics. Randomisation lists were created using a validated, automated system. Both parts were registered with the Australian New Zealand Clinical Trials Registry, number ACTRN12613000522718 (part 1) and number ACTRN12613000527763 (part 2). In part 1, 73 participants were enrolled between April 12, 2013, and July 14, 2015 (DSM265, n=55; placebo, n=18). In part 2, nine participants were enrolled between Sept 30 and Nov 25, 2013 (150 mg DSM265, n=7; 10 mg/kg mefloquine, n=2). In part 1, 117 adverse events were reported; no drug-related serious or severe events were reported. The most common drug-related adverse event was headache. The mean DSM265 peak plasma concentration (C max ) ranged between 1310 ng/mL and 34 800 ng/mL and was reached in a median time (t max ) between 1·5 h and 4 h, with a mean elimination half-life between 86 h and 118 h. In part 2, the log 10 parasite reduction ratio at 48 h in the DSM265 (150 mg) group was 1·55 (95% CI 1·42-1·67) and in the mefloquine (10 mg/kg) group was 2·34 (2·17-2·52), corresponding to a parasite clearance half-life of 9·4 h (8·7-10·2) and 6·2 h (5·7-6·7), respectively. The median minimum inhibitory concentration of DSM265 in blood was estimated as 1040 ng/mL (range 552-1500), resulting in a predicted single efficacious dose of 340 mg. Parasite clearance was significantly faster in participants who received mefloquine than in participants who received DSM265 (p<0·0001). The good safety profile, long elimination half-life, and antimalarial effect of DSM265 supports its development as a partner drug in a single-dose antimalarial combination treatment. Wellcome Trust, UK Department for International Development, Global Health Innovative Technology Fund, Bill & Melinda Gates Foundation. Copyright © 2017 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY license. Published by Elsevier Ltd.. All rights reserved.

A Prospective Study of the Concordance of DSM-IV and DSM-5 Diagnostic Criteria for Autism Spectrum Disorder

ERIC Educational Resources Information Center

Mazurek, Micah O.; Lu, Frances; Symecko, Heather; Butter, Eric; Bing, Nicole M.; Hundley, Rachel J.; Poulsen, Marie; Kanne, Stephen M.; Macklin, Eric A.; Handen, Benjamin L.

2017-01-01

The transition from DSM-IV to DSM-5 criteria for autism spectrum disorder (ASD) sparked considerable concern about the potential implications of these changes. This study was designed to address limitations of prior studies by prospectively examining the concordance of DSM-IV and final DSM-5 criteria on a consecutive sample of 439 children…

Caught in an unconscious split: commentary on "the ironic fate of the personality disorders in DSM-5".

PubMed

Silk, Kenneth R

2013-10-01

Silk comments that "The Ironic Fate of the Personality Disorders in DSM-5" (see record 2013-45025-004) is a clearly written, accurate account of events attendant to the development and eventual rejection by the American Psychiatric Association (APA) of the Personality and Personality Disorders Work Group's (PPDWG's) proposal for a substantially revised system for diagnosing personality disorders (PD) in the Diagnostic and Statistical Manual of Mental Disorders (5th ed.; DSM-5; American Psychiatric Association, 2013). Silk appreciates the authors' dispassionate account of what was a difficult and, at times, affect-laden process for not only those in the PPDWG but also other clinicians and researchers in the wider PD community. PsycINFO Database Record (c) 2013 APA, all rights reserved.

Complete genome sequence, lifestyle, and multi-drug resistance of the human pathogen Corynebacterium resistens DSM 45100 isolated from blood samples of a leukemia patient

PubMed Central

2012-01-01

Background Corynebacterium resistens was initially recovered from human infections and recognized as a new coryneform species that is highly resistant to antimicrobial agents. Bacteremia associated with this organism in immunocompromised patients was rapidly fatal as standard minocycline therapies failed. C. resistens DSM 45100 was isolated from a blood culture of samples taken from a patient with acute myelocytic leukemia. The complete genome sequence of C. resistens DSM 45100 was determined by pyrosequencing to identify genes contributing to multi-drug resistance, virulence, and the lipophilic lifestyle of this newly described human pathogen. Results The genome of C. resistens DSM 45100 consists of a circular chromosome of 2,601,311 bp in size and the 28,312-bp plasmid pJA144188. Metabolic analysis showed that the genome of C. resistens DSM 45100 lacks genes for typical sugar uptake systems, anaplerotic functions, and a fatty acid synthase, explaining the strict lipophilic lifestyle of this species. The genome encodes a broad spectrum of enzymes ensuring the availability of exogenous fatty acids for growth, including predicted virulence factors that probably contribute to fatty acid metabolism by damaging host tissue. C. resistens DSM 45100 is able to use external L-histidine as a combined carbon and nitrogen source, presumably as a result of adaptation to the hitherto unknown habitat on the human skin. Plasmid pJA144188 harbors several genes contributing to antibiotic resistance of C. resistens DSM 45100, including a tetracycline resistance region of the Tet W type known from Lactobacillus reuteri and Streptococcus suis. The tet(W) gene of pJA144188 was cloned in Corynebacterium glutamicum and was shown to confer high levels of resistance to tetracycline, doxycycline, and minocycline in vitro. Conclusions The detected gene repertoire of C. resistens DSM 45100 provides insights into the lipophilic lifestyle and virulence functions of this newly recognized pathogen. Plasmid pJA144188 revealed a modular architecture of gene regions that contribute to the multi-drug resistance of C. resistens DSM 45100. The tet(W) gene encoding a ribosomal protection protein is reported here for the first time in corynebacteria. Cloning of the tet(W) gene mediated resistance to second generation tetracyclines in C. glutamicum, indicating that it might be responsible for the failure of minocycline therapies in patients with C. resistens bacteremia. PMID:22524407

Performance of the RAPS4/RAPS4-QF for DSM-5 compared to DSM-IV alcohol use disorders in the general population: Data from the 2000-2010 National Alcohol Surveys.

PubMed

Cherpitel, Cheryl J; Ye, Yu

2015-06-01

A number of relatively short screening instruments have been developed for identifying alcohol use disorders (AUD), but performance has been evaluated against the standard Diagnostic and Statistical Manual of Mental and Behavior Disorders (DSM) criteria, and it is not known how screening instruments may perform based on the newly formulated DSM-5 criteria, which is a radical departure from previous versions of the DSM. Analyzed here is the performance of the RAPS4/RAPS4-QF against DSM-5 criteria for AUD compared to DSM-IV dependence and abuse criteria. Sensitivity and specificity are analyzed in a merged sample of 21,386 respondents from three National Alcohol Surveys of the U.S. general population (2000, 2005, 2010). Sensitivity of the RAPS4 was lower for DSM-5 AUD (62.5%) than for DSM-IV dependence (88%), while the RAPS4-QF was higher for DSM-5 AUD (90.3%) than for DSM-IV abuse (81.3%), or abuse/dependence (85.8%), while maintaining good specificity (84%). Sensitivity of the RAPS4-QF was higher for males (92%) compared to females (86.6%) and highest for whites (93.8%) followed by Hispanics (84.2%) and blacks (82.4%). Screening instruments may not perform similarly for DSM-5 as for DSM-IV AUD, and data here suggest the RAPS4-QF may be a good instrument choice for identifying those meeting criteria for DSM-5 AUD. These data also suggest the need for additional research and a similar evaluation of other commonly used screening instruments for DSM-5 AUD. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Validity of proposed DSM-5 diagnostic criteria for nicotine use disorder: results from 734 Israeli lifetime smokers

PubMed Central

Shmulewitz, D.; Wall, M.M.; Aharonovich, E.; Spivak, B.; Weizman, A.; Frisch, A.; Grant, B. F.; Hasin, D.

2013-01-01

Background The fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) proposes aligning nicotine use disorder (NUD) criteria with those for other substances, by including the current DSM fourth edition (DSM-IV) nicotine dependence (ND) criteria, three abuse criteria (neglect roles, hazardous use, interpersonal problems) and craving. Although NUD criteria indicate one latent trait, evidence is lacking on: (1) validity of each criterion; (2) validity of the criteria as a set; (3) comparative validity between DSM-5 NUD and DSM-IV ND criterion sets; and (4) NUD prevalence. Method Nicotine criteria (DSM-IV ND, abuse and craving) and external validators (e.g. smoking soon after awakening, number of cigarettes per day) were assessed with a structured interview in 734 lifetime smokers from an Israeli household sample. Regression analysis evaluated the association between validators and each criterion. Receiver operating characteristic analysis assessed the association of the validators with the DSM-5 NUD set (number of criteria endorsed) and tested whether DSM-5 or DSM-IV provided the most discriminating criterion set. Changes in prevalence were examined. Results Each DSM-5 NUD criterion was significantly associated with the validators, with strength of associations similar across the criteria. As a set, DSM-5 criteria were significantly associated with the validators, were significantly more discriminating than DSM-IV ND criteria, and led to increased prevalence of binary NUD (two or more criteria) over ND. Conclusions All findings address previous concerns about the DSM-IV nicotine diagnosis and its criteria and support the proposed changes for DSM-5 NUD, which should result in improved diagnosis of nicotine disorders. PMID:23312475

Reliability, Validity, and Classification Accuracy of the DSM-5 Diagnostic Criteria for Gambling Disorder and Comparison to DSM-IV.

PubMed

Stinchfield, Randy; McCready, John; Turner, Nigel E; Jimenez-Murcia, Susana; Petry, Nancy M; Grant, Jon; Welte, John; Chapman, Heather; Winters, Ken C

2016-09-01

The DSM-5 was published in 2013 and it included two substantive revisions for gambling disorder (GD). These changes are the reduction in the threshold from five to four criteria and elimination of the illegal activities criterion. The purpose of this study was to twofold. First, to assess the reliability, validity and classification accuracy of the DSM-5 diagnostic criteria for GD. Second, to compare the DSM-5-DSM-IV on reliability, validity, and classification accuracy, including an examination of the effect of the elimination of the illegal acts criterion on diagnostic accuracy. To compare DSM-5 and DSM-IV, eight datasets from three different countries (Canada, USA, and Spain; total N = 3247) were used. All datasets were based on similar research methods. Participants were recruited from outpatient gambling treatment services to represent the group with a GD and from the community to represent the group without a GD. All participants were administered a standardized measure of diagnostic criteria. The DSM-5 yielded satisfactory reliability, validity and classification accuracy. In comparing the DSM-5 to the DSM-IV, most comparisons of reliability, validity and classification accuracy showed more similarities than differences. There was evidence of modest improvements in classification accuracy for DSM-5 over DSM-IV, particularly in reduction of false negative errors. This reduction in false negative errors was largely a function of lowering the cut score from five to four and this revision is an improvement over DSM-IV. From a statistical standpoint, eliminating the illegal acts criterion did not make a significant impact on diagnostic accuracy. From a clinical standpoint, illegal acts can still be addressed in the context of the DSM-5 criterion of lying to others.

A novel approach for automatic snow depth estimation using UAV-taken images without ground control points

NASA Astrophysics Data System (ADS)

Mizinski, Bartlomiej; Niedzielski, Tomasz

2017-04-01

Recent developments in snow depth reconstruction based on remote sensing techniques include the use of photographs of snow-covered terrain taken by unmanned aerial vehicles (UAVs). There are several approaches that utilize visible-light photos (RGB) or near infrared images (NIR). The majority of the methods in question are based on reconstructing the digital surface model (DSM) of the snow-covered area with the use of the Structure-from-Motion (SfM) algorithm and the stereo-vision software. Having reconstructed the above-mentioned DSM it is straightforward to calculate the snow depth map which may be produced as a difference between the DSM of snow-covered terrain and the snow-free DSM, known as the reference surface. In order to use the aforementioned procedure, the high spatial accuracy of the two DSMs must be ensured. Traditionally, this is done using the ground control points (GCPs), either artificial or natural terrain features that are visible on aerial images, the coordinates of which are measured in the field using the Global Navigation Satellite System (GNSS) receiver by qualified personnel. The field measurements may be time-taking (GCPs must be well distributed in the study area, therefore the field experts should travel over long distances) and dangerous (the field experts may be exposed to avalanche risk or cold). Thus, there is a need to elaborate methods that enable the above-mentioned automatic snow depth map production without the use of GCPs. One of such attempts is shown in this paper which aims to present the novel method which is based on real-time processing of snow-covered and snow-free dense point clouds produced by SfM. The two stage georeferencing is proposed. The initial (low accuracy) one assigns true geographic, and subsequently projected, coordinates to the two dense point clouds, while the said initially-registered dense point clouds are matched using the iterative closest point (ICP) algorithm in the final (high accuracy) stage. The stable reference is offered by specially-selected trees which are located in the vicinity of the terrain of interest. The method has already been implemented and along with the presentation of its concept, a few case studies from the Izerskie Mountains (southwestern Poland) are discussed. Although the method reveals several constraints, it may serve the purpose of generating the snow depth maps with reasonable accuracy, in particular in the absence of GCPs. The snow depth estimation algorithm has been elaborated in frame of the research grant no. LIDER/012/223/L-5/13/NCBR/2014 financed by the National Centre for Research and Development of Poland.

Autism Spectrum Disorder in the DSM-5: Diagnostic Sensitivity and Specificity in Early Childhood.

PubMed

Christiansz, Jessica A; Gray, Kylie M; Taffe, John; Tonge, Bruce J

2016-06-01

Changes to the DSM-5 Autism Spectrum Disorder (ASD) criteria raised concerns among parents and practitioners that the criteria may exclude some children with Pervasive Developmental Disorder (PDD). Few studies have examined DSM-5 sensitivity and specificity in children less than 5 years of age. This study evaluated 185 children aged 20-55 months with DSM-IV PDD or developmental delay. Autism Diagnostic Interview-Revised (ADI-R) and Autism Diagnostic Observation Schedule (ADOS) data was assigned to DSM-5 subdomains. Children displaying the required symptomatology were classified with DSM-5 ASD. DSM-IV clinical diagnoses were compared to DSM-5 classifications. Using combined ADI-R/ADOS information, sensitivity was .84 and specificity was .54. Comorbid behaviour and emotional problems were significantly lower in children with PDD that did not meet DSM-5 criteria.

[Forensic assessment of DSM-5 posttraumatic stress disorder: a commentary on the transition from DSM-IV-TR (I)].

PubMed

Stevens, A; Fabra, M

2013-12-01

In May 2013 the American Psychiatric Association (APA) has released the latest and fifth edition of the diagnostic and statistical manual of mental disorders (DSM-5). Like its predecessor, the DSM-IV-TR, it will have considerable impact on the science of Psychiatry. The DSM-5 describes - actually available in English - the present medical knowledge about mental disorders. In the short run, German medical science and scientific medicolegal expertises will continue to rely on the German version of the DSM-IV-TR, however, they will be difficult to defend without bearing in mind the changes that DSM-5 brings about. This report discusses the transition from DSM-IV-TR to DSM-5 with regard to posttraumatic stress disorder (PTSD) and provides suggestions, how the criteria might be evaluated.

A Prospective Study of the Concordance of DSM-IV and DSM-5 Diagnostic Criteria for Autism Spectrum Disorder.

PubMed

Mazurek, Micah O; Lu, Frances; Symecko, Heather; Butter, Eric; Bing, Nicole M; Hundley, Rachel J; Poulsen, Marie; Kanne, Stephen M; Macklin, Eric A; Handen, Benjamin L

2017-09-01

The transition from DSM-IV to DSM-5 criteria for autism spectrum disorder (ASD) sparked considerable concern about the potential implications of these changes. This study was designed to address limitations of prior studies by prospectively examining the concordance of DSM-IV and final DSM-5 criteria on a consecutive sample of 439 children referred for autism diagnostic evaluations. Concordance and discordance were assessed using a consistent diagnostic battery. DSM-5 criteria demonstrated excellent overall specificity and good sensitivity relative to DSM-IV criteria. Sensitivity and specificity were strongest for children meeting DSM-IV criteria for autistic disorder, but poor for those meeting criteria for Asperger's disorder and pervasive developmental disorder. Higher IQ, older age, female sex, and less pronounced ASD symptoms were associated with greater discordance.

Large-conductance voltage- and Ca2+-activated K+ channel regulation by protein kinase C in guinea pig urinary bladder smooth muscle

PubMed Central

Hristov, Kiril L.; Smith, Amy C.; Parajuli, Shankar P.; Malysz, John

2013-01-01

Large-conductance voltage- and Ca2+-activated K+ (BK) channels are critical regulators of detrusor smooth muscle (DSM) excitability and contractility. PKC modulates the contraction of DSM and BK channel activity in non-DSM cells; however, the cellular mechanism regulating the PKC-BK channel interaction in DSM remains unknown. We provide a novel mechanistic insight into BK channel regulation by PKC in DSM. We used patch-clamp electrophysiology, live-cell Ca2+ imaging, and functional studies of DSM contractility to elucidate BK channel regulation by PKC at cellular and tissue levels. Voltage-clamp experiments showed that pharmacological activation of PKC with PMA inhibited the spontaneous transient BK currents in native freshly isolated guinea pig DSM cells. Current-clamp recordings revealed that PMA significantly depolarized DSM membrane potential and inhibited the spontaneous transient hyperpolarizations in DSM cells. The PMA inhibitory effects on DSM membrane potential were completely abolished by the selective BK channel inhibitor paxilline. Activation of PKC with PMA did not affect the amplitude of the voltage-step-induced whole cell steady-state BK current or the single BK channel open probability (recorded in cell-attached mode) upon inhibition of all major Ca2+ sources for BK channel activation with thapsigargin, ryanodine, and nifedipine. PKC activation with PMA elevated intracellular Ca2+ levels in DSM cells and increased spontaneous phasic and nerve-evoked contractions of DSM isolated strips. Our results support the concept that PKC activation leads to a reduction of BK channel activity in DSM via a Ca2+-dependent mechanism, thus increasing DSM contractility. PMID:24352333

Bone density, body composition, and psychopathology of anorexia nervosa spectrum disorders in DSM-IV vs DSM-5.

PubMed

Schorr, Melanie; Thomas, Jennifer J; Eddy, Kamryn T; Dichtel, Laura E; Lawson, Elizabeth A; Meenaghan, Erinne; Lederfine Paskal, Margaret; Fazeli, Pouneh K; Faje, Alexander T; Misra, Madhusmita; Klibanski, Anne; Miller, Karen K

2017-04-01

DSM-5 revised the diagnostic criteria for anorexia nervosa (AN) by eliminating the amenorrhea requirement, liberalizing weight and psychological criteria, and adding the formal diagnosis of "atypical AN" for individuals with AN psychological symptoms without low weight. We sought to determine whether bone density (BMD) is impaired in women diagnosed with AN using the new, more liberal, DSM-5 criteria. Cross-sectional study of 168 women, 18 - 45y: (1) AN by DSM-IV (DSM-IV AN) (n = 37), (2) AN by DSM-5 but not DSM-IV criteria (DSM-5 AN) (n = 33), (3) atypical AN (ATYPICAL AN) (n = 77), (4) healthy comparison group (HC) (n = 21). Measurements included dual energy X-ray absorptiometry, Eating Disorder Examination-Questionnaire, Eating Disorder Inventory-2, Hamilton Depression and Anxiety Rating Scales. BMD Z-score <-1.0 was present in 78% of DSM-IV, 82% of DSM-5, and 69% of ATYPICAL. Mean Z-scores were comparably low in DSM-IV and DSM-5, intermediate in ATYPICAL, and highest in HC. Lack of prior low weight or amenorrhea was, but history of overweight/obesity was not, protective against bone loss. Mean lean mass and percent fat mass were significantly lower in all AN groups than HC. DSM-IV, DSM-5, and ATYPICAL had comparable psychopathology. Despite liberalizing diagnostic criteria, many women diagnosed with AN and atypical AN using DSM-5 criteria have low BMD. Presence or history of low weight and/or amenorrhea remain important indications for DXA. Loss of lean mass, in addition to fat mass, is present in all AN groups, and may contribute to low BMD. The deleterious effect of eating disorders on BMD extends beyond those with current low weight and amenorrhea. © 2016 Wiley Periodicals, Inc.(Int J Eat Disord 2017; 50:343-351). © 2016 Wiley Periodicals, Inc.

DSM-V from the perspective of the DSM-IV experience.

PubMed

Walsh, B Timothy

2007-11-01

This article provides a brief overview of the development of the diagnostic criteria for eating disorders in DSM-IV. The process by which DSM-IV was developed is reviewed, including perspectives on what constitutes diagnostic validity and clinical utility, and their importance in assessing proposed changes in diagnostic criteria. The question of whether alterations in diagnostic criteria would clearly improve clinical utility was a major consideration in the DSM-IV process. Because of concerns that changes in diagnostic criteria would be disruptive and might entail loss of established knowledge, the DSM-IV Task Force assumed a generally conservative stance vis-à-vis change. The process of developing DSM-V is just beginning, and it is far from clear what alterations in diagnostic criteria for eating disorders will occur. However, the evolution of DSM-IV may provide a useful perspective on the development of DSM-V. (c) 2007 by Wiley Periodicals, Inc.

DSM-5 changes enhance parent identification of symptoms in adolescents with ADHD.

PubMed

Sibley, Margaret H; Kuriyan, Aparajita B

2016-08-30

This study evaluates the impact of the DSM-5 ADHD symptom wording changes on symptom endorsement among adolescents with ADHD. Parents of adolescents with systematically diagnosed DSM-IV-TR ADHD (N=78) completed counterbalanced DSM-IV-TR and DSM-5 ADHD symptom checklists in a single sitting. General linear models were conducted to evaluate whether the new DSM-5 symptom descriptors influenced the total number of ADHD symptoms and overall ADHD symptom severity endorsed by parents, how demographic factors were associated with noted changes in symptom endorsement when moving to the DSM-5, and which DSM ADHD items displayed notable changes in endorsement rates under the new wording. On average, parents identified 1.15 additional symptoms of ADHD in adolescents when moving from the DSM-IV-TR to the DSM-5. Increased symptom identification was not specific to age, sex, ethnicity, race, or socioeconomic status. Over half of the sample experienced increased symptom endorsement when changing texts (59.0%). Under the new DSM-5 wording, four symptoms had statistically significant endorsement increases (range: 11.2-16.7%): difficulty sustaining attention, easily distracted, difficulty organizing tasks and activities, and does not seem to listen. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Generalized worry disorder: a review of DSM-IV generalized anxiety disorder and options for DSM-V.

PubMed

Andrews, Gavin; Hobbs, Megan J; Borkovec, Thomas D; Beesdo, Katja; Craske, Michelle G; Heimberg, Richard G; Rapee, Ronald M; Ruscio, Ayelet Meron; Stanley, Melinda A

2010-02-01

Generalized anxiety disorder (GAD) has undergone a series of substantial classificatory changes since its first inclusion in DSM-III. The majority of these revisions have been in response to its poor inter-rater reliability and concerns that it may lack diagnostic validity. This article provides options for the revision of the DSM-IV GAD criteria for DSM-V. First, searches were conducted to identify the evidence that previous DSM Work Groups relied upon when revising the DSM-III-R GAD and the overanxious disorder classifications. Second, the literature pertaining to the DSM-IV criteria for GAD was examined. The review presents a number of options to be considered for DSM-V. One option is for GAD to be re-labeled in DSM-V as generalized worry disorder. This would reflect its hallmark feature. Proposed revisions would result in a disorder that is characterized by excessive anxiety and worry generalized to a number of events or activities for 3 months or more. Worry acts as a cognitive coping strategy that manifests in avoidant behaviors. The reliability and validity of the proposed changes could be investigated in DSM-V validity tests and field trials.

The impact of revised DSM-5 criteria on the relative distribution and inter-rater reliability of eating disorder diagnoses in a residential treatment setting.

PubMed

Thomas, Jennifer J; Eddy, Kamryn T; Murray, Helen B; Tromp, Marilou D P; Hartmann, Andrea S; Stone, Melissa T; Levendusky, Philip G; Becker, Anne E

2015-09-30

This study evaluated the relative distribution and inter-rater reliability of revised DSM-5 criteria for eating disorders in a residential treatment program. Consecutive adolescent and young adult females (N=150) admitted to a residential eating disorder treatment facility were assigned both DSM-IV and DSM-5 diagnoses by a clinician (n=14) via routine clinical interview and a research assessor (n=4) via structured interview. We compared the frequency of diagnostic assignments under each taxonomy and by type of assessor. We evaluated concordance between clinician and researcher assignment through inter-rater reliability kappa and percent agreement. Significantly fewer patients received either clinician or researcher diagnoses of a residual eating disorder under DSM-5 (clinician-12.0%; researcher-31.3%) versus DSM-IV (clinician-28.7%; researcher-59.3%), with the majority of reassigned DSM-IV residual cases reclassified as DSM-5 anorexia nervosa. Researcher and clinician diagnoses showed moderate inter-rater reliability under DSM-IV (κ=.48) and DSM-5 (κ=.57), though agreement for specific DSM-5 other specified feeding or eating disorder (OSFED) presentations was poor (κ=.05). DSM-5 revisions were associated with significantly less frequent residual eating disorder diagnoses, but not with reduced inter-rater reliability. Findings support specific dimensions of clinical utility for revised DSM-5 criteria for eating disorders. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Evaluation of a research diagnostic algorithm for DSM-5 neurocognitive disorders in a population-based cohort of older adults.

PubMed

Eramudugolla, Ranmalee; Mortby, Moyra E; Sachdev, Perminder; Meslin, Chantal; Kumar, Rajeev; Anstey, Kaarin J

2017-03-04

There is little information on the application and impact of revised criteria for diagnosing dementia and mild cognitive impairment (MCI), now termed major and mild neurocognitive disorders (NCDs) in the DSM-5. We evaluate a psychometric algorithm for diagnosing DSM-5 NCDs in a community-dwelling sample, and characterize the neuropsychological and functional profile of expert-diagnosed DSM-5 NCDs relative to DSM-IV dementia and International Working Group criteria for MCI. A population-based sample of 1644 adults aged 72-78 years was assessed. Algorithmic diagnostic criteria used detailed neuropsychological data, medical history, longitudinal cognitive performance, and informant interview. Those meeting all criteria for at least one diagnosis had data reviewed by a neurologist (expert diagnosis) who achieved consensus with a psychiatrist for complex cases. The algorithm accurately classified DSM-5 major NCD (area under the curve (AUC) = 0.95, 95% confidence interval (CI) 0.92-0.97), DSM-IV dementia (AUC = 0.91, 95% CI 0.85-0.97), DSM-5 mild NCD (AUC = 0.75, 95% CI 0.70-0.80), and MCI (AUC = 0.76, 95% CI 0.72-0.81) when compared to expert diagnosis. Expert diagnosis of dementia using DSM-5 criteria overlapped with 90% of DSM-IV dementia cases, but resulted in a 127% increase in diagnosis relative to DSM-IV. Additional cases had less severe memory, language impairment, and instrumental activities of daily living (IADL) impairments compared to cases meeting DSM-IV criteria for dementia. DSM-5 mild NCD overlapped with 83% of MCI cases and resulted in a 19% increase in diagnosis. These additional cases had a subtly different neurocognitive profile to MCI cases, including poorer social cognition. DSM-5 NCD criteria can be operationalized in a psychometric algorithm in a population setting. Expert diagnosis using DSM-5 NCD criteria captured most cases with DSM-IV dementia and MCI in our sample, but included many additional cases suggesting that DSM-5 criteria are broader in their categorization.

Validity of DSM-IV attention deficit/hyperactivity disorder symptom dimensions and subtypes.

PubMed

Willcutt, Erik G; Nigg, Joel T; Pennington, Bruce F; Solanto, Mary V; Rohde, Luis A; Tannock, Rosemary; Loo, Sandra K; Carlson, Caryn L; McBurnett, Keith; Lahey, Benjamin B

2012-11-01

Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (DSM-IV) criteria for attention deficit/hyperactivity disorder (ADHD) specify two dimensions of inattention and hyperactivity-impulsivity symptoms that are used to define three nominal subtypes: predominantly hyperactive-impulsive type (ADHD-H), predominantly inattentive type (ADHD-I), and combined type (ADHD-C). To aid decision making for DSM-5 and other future diagnostic systems, a comprehensive literature review and meta-analysis of 546 studies was completed to evaluate the validity of the DSM-IV model of ADHD. Results indicated that DSM-IV criteria identify individuals with significant and persistent impairment in social, academic, occupational, and adaptive functioning when intelligence, demographic factors, and concurrent psychopathology are controlled. Available data overwhelmingly support the concurrent, predictive, and discriminant validity of the distinction between inattention and hyperactivity-impulsivity symptoms, and indicate that nearly all differences among the nominal subtypes are consistent with the relative levels of inattention and hyperactivity-impulsivity symptoms that define the subtypes. In contrast, the DSM-IV subtype model is compromised by weak evidence for the validity of ADHD-H after first grade, minimal support for the distinction between ADHD-I and ADHD-C in studies of etiological influences, academic and cognitive functioning, and treatment response, and the marked longitudinal instability of all three subtypes. Overall, we conclude that the DSM-IV ADHD subtypes provide a convenient clinical shorthand to describe the functional and behavioral correlates of current levels of inattention and hyperactivity-impulsivity symptoms, but do not identify discrete subgroups with sufficient long-term stability to justify the classification of distinct forms of the disorder. Empirical support is stronger for an alternative model that would replace the subtypes with dimensional modifiers that reflect the number of inattention and hyperactivity-impulsivity symptoms at the time of assessment. (PsycINFO Database Record (c) 2012 APA, all rights reserved).

Ultramap: the all in One Photogrammetric Solution

NASA Astrophysics Data System (ADS)

Wiechert, A.; Gruber, M.; Karner, K.

2012-07-01

This paper describes in detail the dense matcher developed since years by Vexcel Imaging in Graz for Microsoft's Bing Maps project. This dense matcher was exclusively developed for and used by Microsoft for the production of the 3D city models of Virtual Earth. It will now be made available to the public with the UltraMap software release mid-2012. That represents a revolutionary step in digital photogrammetry. The dense matcher generates digital surface models (DSM) and digital terrain models (DTM) automatically out of a set of overlapping UltraCam images. The models have an outstanding point density of several hundred points per square meter and sub-pixel accuracy and are generated automatically. The dense matcher consists of two steps. The first step rectifies overlapping image areas to speed up the dense image matching process. This rectification step ensures a very efficient processing and detects occluded areas by applying a back-matching step. In this dense image matching process a cost function consisting of a matching score as well as a smoothness term is minimized. In the second step the resulting range image patches are fused into a DSM by optimizing a global cost function. The whole process is optimized for multi-core CPUs and optionally uses GPUs if available. UltraMap 3.0 features also an additional step which is presented in this paper, a complete automated true-ortho and ortho workflow. For this, the UltraCam images are combined with the DSM or DTM in an automated rectification step and that results in high quality true-ortho or ortho images as a result of a highly automated workflow. The paper presents the new workflow and first results.

DSM-5 and ICD-11 as competing models of PTSD in preadolescent children exposed to a natural disaster: assessing validity and co-occurring symptomatology

PubMed Central

La Greca, Annette M.; Danzi, BreAnne A.; Chan, Sherilynn F.

2017-01-01

ABSTRACT Background: Major revisions have been made to the DSM and ICD models of post-traumatic stress disorder (PTSD). However, it is not known whether these models fit children’s post-trauma responses, even though children are a vulnerable population following disasters. Objective: Using data from Hurricane Ike, we examined how well trauma-exposed children’s symptoms fit the DSM-IV, DSM-5 and ICD-11 models, and whether the models varied by gender. We also evaluated whether elevated symptoms of depression and anxiety characterized children meeting PTSD criteria based on DSM-5 and ICD-11. Method: Eight-months post-disaster, children (N = 327, 7–11 years) affected by Hurricane Ike completed measures of PTSD, anxiety and depression. Algorithms approximated a PTSD diagnosis based on DSM-5 and ICD-11 models. Results: Using confirmatory factor analysis, ICD-11 had the best-fitting model, followed by DSM-IV and DSM-5. The ICD-11 model also demonstrated strong measurement invariance across gender. Analyses revealed poor overlap between DSM-5 and ICD-11, although children meeting either set of criteria reported severe PTSD symptoms. Further, children who met PTSD criteria for DSM-5, but not for ICD-11, reported significantly higher levels of depression and general anxiety than children not meeting DSM-5 criteria. Conclusions: Findings support the parsimonious ICD-11 model of PTSD for trauma-exposed children, although adequate fit also was obtained for DSM-5. Use of only one model of PTSD, be it DSM-5 or ICD-11, will likely miss children with significant post-traumatic stress. DSM-5 may identify children with high levels of comorbid symptomatology, which may require additional clinical intervention. PMID:28451076

DSM-5 and ICD-11 as competing models of PTSD in preadolescent children exposed to a natural disaster: assessing validity and co-occurring symptomatology.

PubMed

La Greca, Annette M; Danzi, BreAnne A; Chan, Sherilynn F

2017-01-01

Background : Major revisions have been made to the DSM and ICD models of post-traumatic stress disorder (PTSD). However, it is not known whether these models fit children's post-trauma responses, even though children are a vulnerable population following disasters. Objective : Using data from Hurricane Ike, we examined how well trauma-exposed children's symptoms fit the DSM-IV, DSM-5 and ICD-11 models, and whether the models varied by gender. We also evaluated whether elevated symptoms of depression and anxiety characterized children meeting PTSD criteria based on DSM-5 and ICD-11. Method : Eight-months post-disaster, children ( N  = 327, 7-11 years) affected by Hurricane Ike completed measures of PTSD, anxiety and depression. Algorithms approximated a PTSD diagnosis based on DSM-5 and ICD-11 models. Results : Using confirmatory factor analysis, ICD-11 had the best-fitting model, followed by DSM-IV and DSM-5. The ICD-11 model also demonstrated strong measurement invariance across gender. Analyses revealed poor overlap between DSM-5 and ICD-11, although children meeting either set of criteria reported severe PTSD symptoms. Further, children who met PTSD criteria for DSM-5, but not for ICD-11, reported significantly higher levels of depression and general anxiety than children not meeting DSM-5 criteria. Conclusions : Findings support the parsimonious ICD-11 model of PTSD for trauma-exposed children, although adequate fit also was obtained for DSM-5. Use of only one model of PTSD, be it DSM-5 or ICD-11, will likely miss children with significant post-traumatic stress. DSM-5 may identify children with high levels of comorbid symptomatology, which may require additional clinical intervention.

Clinical value of DSM IV and DSM 5 criteria for diagnosing the most prevalent somatoform disorders in patients with medically unexplained physical symptoms (MUPS).

PubMed

van Dessel, Nikki Claassen-; van der Wouden, Johannes C; Dekker, Joost; van der Horst, Henriette E

2016-03-01

This study aimed (1) to describe frequencies of DSM IV somatisation disorder, undifferentiated somatoform disorder and pain disorder versus DSM 5 somatic symptom disorder (SSD) in a multi-setting population of patients with medically unexplained physical symptoms (MUPS), (2) to investigate differences in sociodemographic and (psycho)pathological characteristics between these diagnostic groups and (3) to explore the clinical relevance of the distinction between mild and moderate DSM 5 SSD. We used baseline data of a cohort of 325 MUPS patients. Measurements included questionnaires about symptom severity, physical functioning, anxiety, depression, health anxiety and illness perceptions. These questionnaires were used as proxy measures for operationalization of DSM IV and DSM 5 diagnostic criteria. 92.9% of participants fulfilled criteria of a DSM IV somatoform disorder, while 45.5% fulfilled criteria of DSM 5 SSD. Participants fulfilling criteria of DSM 5 SSD suffered from more severe symptoms than those only fulfilling criteria of a DSM IV somatoform disorder(mean PHQ-15 score of 13.98 (SD 5.17) versus 11.23 (SD 4.71), P-value<0.001). Furthermore their level of physical functioning was significantly lower. Compared to patients with mild SSD, patients with moderate SSD suffered from significantly lower physical functioning and higher levels of depression. Within a population of MUPS patients DSM 5 SSD criteria are more restrictive than DSM IV criteria for somatoform disorders. They are associated with higher symptom severity and lower physical functioning. However, further specification of the positive psychological criteria of DSM 5 SSD may improve utility in research and practice. Copyright © 2016 Elsevier Inc. All rights reserved.

Novel regulatory mechanism in human urinary bladder: central role of transient receptor potential melastatin 4 channels in detrusor smooth muscle function

PubMed Central

Hristov, Kiril L.; Smith, Amy C.; Parajuli, Shankar P.; Malysz, John; Rovner, Eric S.

2016-01-01

Transient receptor potential melastatin 4 (TRPM4) channels are Ca2+-activated nonselective cation channels that have been recently identified as regulators of detrusor smooth muscle (DSM) function in rodents. However, their expression and function in human DSM remain unexplored. We provide insights into the functional role of TRPM4 channels in human DSM under physiological conditions. We used a multidisciplinary experimental approach, including RT-PCR, Western blotting, immunohistochemistry and immunocytochemistry, patch-clamp electrophysiology, and functional studies of DSM contractility. DSM samples were obtained from patients without preoperative overactive bladder symptoms. RT-PCR detected mRNA transcripts for TRPM4 channels in human DSM whole tissue and freshly isolated single cells. Western blotting and immunohistochemistry with confocal microscopy revealed TRPM4 protein expression in human DSM. Immunocytochemistry further detected TRPM4 protein expression in DSM single cells. Patch-clamp experiments showed that 9-phenanthrol, a selective TRPM4 channel inhibitor, significantly decreased the transient inward cation currents and voltage step-induced whole cell currents in freshly isolated human DSM cells. In current-clamp mode, 9-phenanthrol hyperpolarized the human DSM cell membrane potential. Furthermore, 9-phenanthrol attenuated the spontaneous phasic, carbachol-induced and nerve-evoked contractions in human DSM isolated strips. Significant species-related differences in TRPM4 channel activity between human, rat, and guinea pig DSM were revealed, suggesting a more prominent physiological role for the TRPM4 channel in the regulation of DSM function in humans than in rodents. In conclusion, TRPM4 channels regulate human DSM excitability and contractility and are critical determinants of human urinary bladder function. Thus, TRPM4 channels could represent promising novel targets for the pharmacological or genetic control of overactive bladder. PMID:26791488

Comparison of ICD-10R, DSM-IV-TR and DSM-5 in an Adult Autism Spectrum Disorder Diagnostic Clinic

ERIC Educational Resources Information Center

Wilson, C. Ellie; Gillan, Nicola; Spain, Deborah; Robertson, Dene; Roberts, Gedeon; Murphy, Clodagh M.; Maltezos, Stefanos; Zinkstok, Janneke; Johnston, Katie; Dardani, Christina; Ohlsen, Chris; Deeley, P. Quinton; Craig, Michael; Mendez, Maria A.; Happé, Francesca; Murphy, Declan G. M.

2013-01-01

An Autism Spectrum Disorder (ASD) diagnosis is often used to access services. We investigated whether ASD diagnostic outcome varied when DSM-5 was used compared to ICD-10R and DSM-IV-TR in a clinical sample of 150 intellectually able adults. Of those diagnosed with an ASD using ICD-10R, 56% met DSM-5 ASD criteria. A further 19% met DSM-5 (draft)…

Agreement between Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, and the proposed DSM-V attention deficit hyperactivity disorder diagnostic criteria: an exploratory study.

PubMed

Ghanizadeh, Ahmad

2013-01-01

There is no empirical literature about the American Psychiatry Association proposed new diagnostic criteria for attention deficit hyperactivity disorder (ADHD). This study examined the agreement between ADHD diagnosis derived from Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV), and DSM-V diagnostic criteria. It also reports sensitivity, specificity, and agreement for ADHD diagnosis. A clinical sample of 246 children and adolescents were interviewed face to face using both ADHD diagnostic criteria for DSM-V and DSM-IV by interviewing clinician. Comorbid psychiatric disorders were screened using DSM-IV criteria. The rate of ADHD diagnosis using DSM-V was significantly higher than the rate detected by using DSM-IV diagnostic criteria. The sensitivity of DSM-V diagnostic criteria was 100%, while its specificity was 71.1%. The kappa agreement between DSM-IV and DSM-V was 0.75. In addition, positive predictive value was 85.1%. All the four newly added symptoms to ADHD diagnostic criteria are statistically more common in the children with ADHD than those in the comparison group. However, these symptoms are also very common in the children without ADHD. It is expected that the rate of ADHD would increase using the proposed ADHD DSM-V criteria. Moreover, the newly added symptoms have a low specificity for ADHD diagnosis. Copyright © 2013 Elsevier Inc. All rights reserved.

Forest STEM Volume Calculation Using Airborne LIDAR Data

NASA Astrophysics Data System (ADS)

Büyüksalih, I.; Bayburt, S.; Schardt, M.; Büyüksalih, G.

2017-05-01

Airborne LiDAR data have been collected for the city of Istanbul using Riegl laser scanner Q680i with 400 kHz and an average flight height of 600 m. The flight campaign was performed by a helicopter and covers an area of 5400 km2. According to a flight speed of 80 knot a point density of more than 16 points/m2 and a laser footprint size of 30 cm could be achieved. As a result of bundle adjustment, in total, approximately 17,000 LAS files with the file size of 500 m by 700 m have been generated for the whole city. The main object classes Ground, Building, Vegetation (medium, high) were derived from these LAS files using the macros in Terrasolid software. The forest area under investigation is located northwest of the city of Istanbul, main tree species occurring in the test site are pine (pinus pinaster), oak (quercus) and beech (fagus). In total, 120 LAS tiles covering the investigation area have been analysed using the software IMPACT of Joanneum Research Forschungsgesellschaft, Graz, Austria. First of all, the digital terrain model (DTM) and the digital surface models (DSM) were imported and converted into a raster file from the original laser point clouds with a spatial resolution of 50 cm. Then, a normalized digital surface model (nDSM) was derived as the difference between DSM and the DTM. Tree top detection was performed by multi - resolution filter operations and tree crowns were segmented by a region growing algorithms develop specifically for this purpose. Breast Height Diameter (BHD) was calculated on the base of tree height and crown areas derived from image segmentation applying allometric functions found in literature. The assessment of stem volume was then calculated as a function of tree height and BHD. A comparison of timber volume estimated from the LiDAR data and field plots measured by the Forest Department of Istanbul showed R2 of 0.46. The low correlation might arise either from the low quality of the field plots or from the inadequacy of the allometric functions used for BHD and stem volume modelling. Further investigations therefore will concentrate both on improving the quality of field measurements and the adoption of the allometric functions to the specific site condition of the forests under investigation. Finally stand boundaries of the forest area made available by the forest department of Istanbul were superimposed to the LiDAR data and the single tree measurements aggregated to the stand level. Aside from the LiDAR data, a Pleiades multispectral image characterized by four spectral bands (blue, green, red and near infrared) and a GSD of 2.8 m has been used for the classification of different tree species. For this purpose the near infrared band covering the spectral range of 0.75 μm to 0.90 μm has been utilized and the IMPACT software used.

A distinct language and a historic pendulum: the evolution of the Diagnostic and Statistical Manual of Mental Disorders.

PubMed

Sanders, James L

2011-12-01

Historically, the Diagnostic and Statistical Manual of Mental Disorders (DSM) has met an important need in defining a common language of psychiatric diagnosis in North America. Understanding the development of the DSM can help researchers and practitioners better understand this diagnostic language. The history of the DSM, from its precursors to recent proposed revisions for its fifth edition, is reviewed and compared while avoiding the presentist bias. The development of DSM resembles a historic pendulum, from DSM-I emphasizing psychodynamics and causality to DSM-III and DSM-IV emphasizing empiricism and logical positivism. The proposed changes in etiological- and dimensional-based classification for DSM-V represent a slight backswing toward the center. 2011 Elsevier Inc. All rights reserved.

Symptom severity scale of the DSM5 for schizophrenia, and other psychotic disorders: diagnostic validity and clinical feasibility.

PubMed

Ritsner, Michael S; Mar, Maria; Arbitman, Marina; Grinshpoon, Alexander

2013-06-30

Innovations in DSM5 include dimensional diagnosis of schizophrenia (SZ) and other psychotic (OP) disorders using the symptom severity scale (SS-DSM5). We evaluated the psychometric properties and diagnostic validity of the SS-DSM5 scale using a cross-sectional design and an unselected convenience unselected sample of 314 inpatients and outpatients with SZ/OP and mood disorders who received standard care in routine clinical practice. The SS-DSM5 scale, the Clinical Global Impression-Severity scale (CGI-S), the Positive and Negative Syndrome Scale (PANSS), and the Bech-Rafaelsen Mania Scale (BRMS) were administered. Factor structure, reliability, internal consistency, convergent and diagnostic ability of the DSM5-SS were evaluated. Factor analysis indicated two latent factors underlying the SS-DSM5 (Psychotic and Deficit sub-scales). Cronbach's alpha was >0.70. Convergent validity of the SS-DSM5 was highly significant. Patients with SZ/PO disorders were correctly diagnosed (77.9%) using the SS-DSM5 scale (72% using PANSS). The agreement of the diagnostic decisions between the SS-DSM5 and PANSS was substantial for SZ/PO disorders (Kappa=0.75). Classifying participants with SZ/PO versus mood disorders using SS-DSM5 provided a sensitivity of 95%, and specificity of 34%. Thus, this study suggests that the SS-DSM5 has acceptable psychometric properties and that its use in clinical practice and research is feasible in clinical settings. The dimensional option for the diagnosis of schizophrenia and related disorders using SS-DSM5 is discussed. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Diagnostic Distribution of eating disorders: Comparison between DSMIV- TR and DSM-5.

PubMed

Serrano-Troncoso, Eduardo; Cañas, Laura; Carbonell, Xavier; Carulla, Marta; Palma, Carolina; Matalí, Josep; Dolz, Montse

2017-01-01

The fifth edition of Diagnostic and Statistical Manual of Mental Disorders (DSM-5) includes a significant revision of Eating Disorders (ED). The objective of this study is to compare the distribution of diagnosis of ED in adolescents according to DSM-VI-TR and DSM-5 criteria. A second objective is to study the psychopathological differences between patients with ED (based on DSM-IV-TR) and those whose diagnosis changed by applying DSM-5 criteria. One hundred and one adolescents diagnosed with ED (mean: 14.68 years; SD: 1.46) were evaluated with clinical interviews and scales for eating psychopathology, perfectionism, anxiety, and depression. Applying the DSM-5 criteria led to a significant decrease in the diagnosed cases of Eating Disorders Not Otherwise Specified (EDNOS) (from 34.7% to 23.8%; p<0.001) and to a significant increase in those of anorexia nervosa (AN) (from 58.4% to 66.3%; p<0.001) and of bulimia nervosa (BN) (from 6.9% to 8.9%; p<0.001). No significant psychopathological differences were found between patients diagnosed with AN and BN based on DSM-IV-TR criteria and those newly diagnosed with AN and BN based on DSM-5 criteria. Using DSM-5 criteria for adolescents with ED leads to a significant decrease in the frequency of an EDNOS diagnosis. As similar psychopathological characteristics were observed between ED patients diagnosed based on DSM-IV-TR and those who were switched from EDNOS to AN or BN based on DSM-5, we conclude that the new criteria for ED in DSM-5 are valid for an adolescent population.

Increased Activity or Energy as a Primary Criterion for the Diagnosis of Bipolar Mania in DSM-5: Findings From the STEP-BD Study.

PubMed

Machado-Vieira, Rodrigo; Luckenbaugh, David A; Ballard, Elizabeth D; Henter, Ioline D; Tohen, Mauricio; Suppes, Trisha; Zarate, Carlos A

2017-01-01

DSM-5 describes "a distinct period of abnormally and persistently elevated, expansive, or irritable mood and abnormally and persistently increased activity or energy" as a primary criterion for mania. Thus, increased energy or activity is now considered a core symptom of manic and hypomanic episodes. Using data from the Systematic Treatment Enhancement Program for Bipolar Disorder study, the authors analyzed point prevalence data obtained at the initial visit to assess the diagnostic validity of this new DSM-5 criterion. The study hypothesis was that the DSM-5 criterion would alter the prevalence of mania and/or hypomania. The authors compared prevalence, clinical characteristics, validators, and outcome in patients meeting the DSM-5 criteria (i.e., DSM-IV criteria plus the DSM-5 criterion of increased activity or energy) and those who did not meet the new DSM-5 criterion (i.e., who only met DSM-IV criteria). All 4,360 participants met DSM-IV criteria for bipolar disorder, and 310 met DSM-IV criteria for a manic or hypomanic episode. When the new DSM-5 criterion of increased activity or energy was added as a coprimary symptom, the prevalence of mania and hypomania was reduced. Although minor differences were noted in clinical and concurrent validators, no changes were observed in longitudinal outcomes. The findings confirm that including increased activity or energy as part of DSM-5 criterion A decreases the prevalence of manic and hypomanic episodes but does not affect longitudinal clinical outcomes.

The use of old and recent DSM definitions of premature ejaculation in observational studies: a contribution to the present debate for a new classification of PE in the DSM-V.

PubMed

Waldinger, Marcel D; Schweitzer, Dave H

2008-05-01

The DSM-III definition of premature ejaculation (PE) contains the criterion "control" but not that of "ejaculation time." In contrast, the Diagnostic and Statistical Manual of Mental Disorders (4th edition, Text Revision) (DSM-IV-TR) contains the criterion "short ejaculation time," while it lacks "control." To review the adequacy and consequent use of all criteria of the DSM-IV-TR definition in previously published PE Internet surveys. Reviewing all published cohort studies on PE from 2004 to 2007. MEDLINE and EMBASE computer bibliographies were used. Definitions of DSM-III, DSM-IV-TR, and International Classification of Diseases. Five papers, of which three are original studies, reported inclusion of men with PE according to DSM-IV-TR definition but omitted to apply the required "short ejaculation time" criterion. These studies, which have defined PE according to subjective criteria such as control, actually referred to the DSM-III definition. Using DSM-III-like definitions in three different studies revealed a highly variable prevalence of PE (32.5%, 27.6%, and 13.0%). In contrast, based on studies using a 1-minute cutoff point, being the time that is required to call ejaculation time "short" or using the criterion "persistent occurrence," PE revealed to be far less prevalent (5-6%). Unacceptable discrepancies of PE definitions according to DSM-III (abandoned but still used) and DSM-IV-TR argue strongly in favor of a multidimensional new classification of PE for the DSM-V.

A Survey of Cost Estimating Methodologies for Distributed Spacecraft Missions

NASA Technical Reports Server (NTRS)

Foreman, Veronica; Le Moigne, Jacqueline; de Weck, Oliver

2016-01-01

Satellite constellations present unique capabilities and opportunities to Earth orbiting and near-Earth scientific and communications missions, but also present new challenges to cost estimators. An effective and adaptive cost model is essential to successful mission design and implementation, and as Distributed Spacecraft Missions (DSM) become more common, cost estimating tools must become more representative of these types of designs. Existing cost models often focus on a single spacecraft and require extensive design knowledge to produce high fidelity estimates. Previous research has examined the shortcomings of existing cost practices as they pertain to the early stages of mission formulation, for both individual satellites and small satellite constellations. Recommendations have been made for how to improve the cost models for individual satellites one-at-a-time, but much of the complexity in constellation and DSM cost modeling arises from constellation systems level considerations that have not yet been examined. This paper constitutes a survey of the current state-of-the-art in cost estimating techniques with recommendations for improvements to increase the fidelity of future constellation cost estimates. To enable our investigation, we have developed a cost estimating tool for constellation missions. The development of this tool has revealed three high-priority weaknesses within existing parametric cost estimating capabilities as they pertain to DSM architectures: design iteration, integration and test, and mission operations. Within this paper we offer illustrative examples of these discrepancies and make preliminary recommendations for addressing them. DSM and satellite constellation missions are shifting the paradigm of space-based remote sensing, showing promise in the realms of Earth science, planetary observation, and various heliophysical applications. To fully reap the benefits of DSM technology, accurate and relevant cost estimating capabilities must exist; this paper offers insights critical to the future development and implementation of DSM cost estimating tools.

A Survey of Cost Estimating Methodologies for Distributed Spacecraft Missions

NASA Technical Reports Server (NTRS)

Foreman, Veronica L.; Le Moigne, Jacqueline; de Weck, Oliver

2016-01-01

Satellite constellations present unique capabilities and opportunities to Earth orbiting and near-Earth scientific and communications missions, but also present new challenges to cost estimators. An effective and adaptive cost model is essential to successful mission design and implementation, and as Distributed Spacecraft Missions (DSM) become more common, cost estimating tools must become more representative of these types of designs. Existing cost models often focus on a single spacecraft and require extensive design knowledge to produce high fidelity estimates. Previous research has examined the limitations of existing cost practices as they pertain to the early stages of mission formulation, for both individual satellites and small satellite constellations. Recommendations have been made for how to improve the cost models for individual satellites one-at-a-time, but much of the complexity in constellation and DSM cost modeling arises from constellation systems level considerations that have not yet been examined. This paper constitutes a survey of the current state-of-theart in cost estimating techniques with recommendations for improvements to increase the fidelity of future constellation cost estimates. To enable our investigation, we have developed a cost estimating tool for constellation missions. The development of this tool has revealed three high-priority shortcomings within existing parametric cost estimating capabilities as they pertain to DSM architectures: design iteration, integration and test, and mission operations. Within this paper we offer illustrative examples of these discrepancies and make preliminary recommendations for addressing them. DSM and satellite constellation missions are shifting the paradigm of space-based remote sensing, showing promise in the realms of Earth science, planetary observation, and various heliophysical applications. To fully reap the benefits of DSM technology, accurate and relevant cost estimating capabilities must exist; this paper offers insights critical to the future development and implementation of DSM cost estimating tools.

A sustainable development of a city electrical grid via a non-contractual Demand-Side Management

NASA Astrophysics Data System (ADS)

Samoylenko, Vladislav O.; Pazderin, Andrew V.

2017-06-01

An increasing energy consumption of large cities as well as an extreme high density of city electrical loads leads to the necessity to search for an alternative approaches to city grid development. The ongoing implementation of the energy accounting tariffs with differentiated rates depending upon the market conditions and changing in a short-term perspective, provide the possibility to use it as a financial incentive base of a Demand-Side Management (DSM). Modern hi-technology energy metering and accounting systems with a large number of functions and consumer feedback are supposed to be the good means of DSM. Existing systems of Smart Metering (SM) billing usually provide general information about consumption curve, bills and compared data, but not the advanced statistics about the correspondence of financial and electric parameters. Also, consumer feedback is usually not fully used. So, the efforts to combine the market principle, Smart Metering and a consumer feedback for an active non-contractual load control are essential. The paper presents the rating-based multi-purpose system of mathematical statistics and algorithms of DSM efficiency estimation useful for both the consumers and the energy companies. The estimation is performed by SM Data processing systems. The system is aimed for load peak shaving and load curve smoothing. It is focused primarily on a retail market support. The system contributes to the energy efficiency and a distribution process improvement by the manual management or by the automated Smart Appliances interaction.

The Relationship Between the Childhood Autism Rating Scale: Second Edition and Clinical Diagnosis Utilizing the DSM-IV-TR and the DSM-5.

PubMed

Dawkins, Tamara; Meyer, Allison T; Van Bourgondien, Mary E

2016-10-01

The Childhood Autism Rating Scale, Second Edition (CARS2; 2010) includes two rating scales; the CARS2-Standard Version (CARS2-ST) and the newly developed CARS2-High Functioning Version (CARS2-HF). To assess the diagnostic agreement between the CARS2 and DSM-IV-TR versus DSM-5 criteria for Autism Spectrum Disorder (ASD), clinicians at community based centers of the University of North Carolina TEACCH Autism Program rated participants seen for a diagnostic evaluation on symptoms of autism using both the DSM-IV-TR and DSM-5 criteria and either the CARS2-HF or the CARS2-ST. Findings suggest that overall, the diagnostic agreement of the CARS2 remains high across DSM-IV and DSM-5 criteria for autism.

Changing paradigms from a historical DSM-III and DSM-IV view toward an evidence-based definition of premature ejaculation. Part I--validity of DSM-IV-TR.

PubMed

Waldinger, Marcel D; Schweitzer, Dave H

2006-07-01

In former days, information obtained from randomized well-controlled clinical trials and epidemiological studies on premature ejaculation (PE) was not available, thereby hampering the efforts of the consecutive DSM Work Groups on Sexual Disorders to formulate an evidence-based definition of PE. The current DSM-IV-TR definition of PE is still nonevidence based. In addition, the requirement that persistent self-perceived PE, distress, and interpersonal difficulties, in absence of a quantified ejaculation time, are necessary to establish the diagnosis remains disputable. To investigate the validity and reliability of DSM and ICD diagnosis of premature ejaculation. The historical development of DSM and ICD classification of mental disorders is critically reviewed, and two studies using the DSM-IV-TR definition of PE is critically reanalyzed. Reanalysis of two studies using the DSM-IV-TR definition of PE has shown that DSM-diagnosed PE can be accompanied by long intravaginal ejaculation latency time (IELT) values. The reanalysis revealed a low positive predictive value for the DSM-IV-TR definition when used as a diagnostic test. A similar situation pertains to the American Urological Association (AUA) definition of PE, which is practically a copy of the DSM-IV-TR definition. It should be emphasized that any evidence-based definition of PE needs objectively collected patient-reported outcome (PRO) data from epidemiological studies, as well as reproducible quantifications of the IELT.

TRPA1-dependent regulation of bladder detrusor smooth muscle contractility in normal and type I diabetic rats

PubMed Central

Philyppov, Igor B.; Paduraru, Oksana N.; Gulak, Kseniya L.; Skryma, Roman; Prevarskaya, Natalia; Shuba, Yaroslav M.

2016-01-01

TRPA1 is a Ca2+-permeable cation channel that is activated by painful low temperatures (˂17 °C), irritating chemicals, reactive metabolites and mediators of inflammation. In the bladder TRPA1 is predominantly expressed in sensory afferent nerve endings, where it mediates sensory transduction. The contractile effect of its activation on detrusor smooth muscle (DSM) is explained by the release from sensory afferents of inflammatory factors – tachykinins and prostaglandins, which cause smooth muscle cell contraction. Diabetes is a systemic disease, with common complications being diabetic cystopathies and urinary incontinence. However, data on how diabetes affects bladder contractility associated with TRPA1 activation are not available. In this study, by using a rat model with streptozotocin-induced type I diabetes, contractility measurements of DSM strips in response to TRPA1-activating and modulating pharmacological agents and assessment of TRPA1 mRNA expression in bladder-innervating dorsal root ganglia, we have shown that diabetes enhances the TRPA1-dependent mechanism involved in bladder DSM contractility. This is not due to changes in TRPA1 expression, but mainly due to the general inflammatory reaction caused by diabetes. The latter leads to an increase in cyclooxygenase-2-dependent prostaglandin synthesis through the mechanisms associated with substance P activity. This results in the enhanced functional coupling between the tachykinin and prostanoid systems, and the concomitant increase of their impact on DSM contractility in response to TRPA1 activation. PMID:26935999

TRPA1-dependent regulation of bladder detrusor smooth muscle contractility in normal and type I diabetic rats.

PubMed

Philyppov, Igor B; Paduraru, Oksana N; Gulak, Kseniya L; Skryma, Roman; Prevarskaya, Natalia; Shuba, Yaroslav M

2016-01-01

TRPA1 is a Ca(2+)-permeable cation channel that is activated by painful low temperatures (<17°C), irritating chemicals, reactive metabolites and mediators of inflammation. In the bladder TRPA1 is predominantly expressed in sensory afferent nerve endings, where it mediates sensory transduction. The contractile effect of its activation on detrusor smooth muscle (DSM) is explained by the release from sensory afferents of inflammatory factors - tachykinins and prostaglandins, which cause smooth muscle cell contraction. Diabetes is a systemic disease, with common complications being diabetic cystopathies and urinary incontinence. However, data on how diabetes affects bladder contractility associated with TRPA1 activation are not available. In this study, by using a rat model with streptozotocin-induced type I diabetes, contractility measurements of DSM strips in response to TRPA1-activating and modulating pharmacological agents and assessment of TRPA1 mRNA expression in bladder-innervating dorsal root ganglia, we have shown that diabetes enhances the TRPA1-dependent mechanism involved in bladder DSM contractility. This is not due to changes in TRPA1 expression, but mainly due to the general inflammatory reaction caused by diabetes. The latter leads to an increase in cyclooxygenase-2-dependent prostaglandin synthesis through the mechanisms associated with substance P activity. This results in the enhanced functional coupling between the tachykinin and prostanoid systems, and the concomitant increase of their impact on DSM contractility in response to TRPA1 activation.

[Conceptual foundation of the operational diagnostic approach in psychiatry].

PubMed

Jäger, M; Strauss, A; Frasch, K; Becker, T

2007-08-01

Based on the pioneering work of Emil Kraepelin, Karl Jaspers, Kurt Schneider and representatives of logical empiricism, the basic principles of the operational diagnostic approach in psychiatry are described. Operational diagnostic systems like ICD-10 and DSM-IV aimed at a standardisation of psychiatric language which can be accepted by different schools in psychiatry. However, ICD-10 and DSM-IV should not be misinterpreted as "nosology" because they do not reflect a specific model of psychiatric diseases. The advantages of operational diagnostic systems as instruments for communication in a clinical and scientific context are limited by the fact that they disregard the subjective psychopathology. This dimension, however, deserves attention in clinic and research.

DSM-5 under-Identifies PDDNOS: Diagnostic Agreement between the DSM-5, DSM-IV, and Checklist for Autism Spectrum Disorder

ERIC Educational Resources Information Center

Mayes, Susan Dickerson; Black, Amanda; Tierney, Cheryl D.

2013-01-01

Agreement between the DSM-5, DSM-IV, and Checklist for Autism Spectrum Disorder was assessed in 125 children with autism spectrum disorder (ASD), which included high and low functioning autism (HFA and LFA) and pervasive developmental disorder not otherwise specified (PDDNOS), and children with other clinical disorders (e.g., ADHD, mental…

Handbook of evaluation of utility DSM programs. [Demand-Side Management (DSM)

DOE Office of Scientific and Technical Information (OSTI.GOV)

Hirst, E.; Reed, J.; Bronfman, B.

Program evaluation has become a central issue in the world of utility integrated resource planning. The DSM programs that utilities were operating to meet federal requirements or to improve customer relations are now becoming big business. DSM is being considered an important resource in a utility's portfolio of options. In the last five years, the amount of money that utilities have invested in DSM has grown exponentially in most regulatory jurisdictions. Market analysts are now talking about DSM being a $30 billion industry by the end of the decade. If the large volume of DSM-program investments was not enough tomore » highlight the importance of evaluation, then the introduction of regulatory incentives has really focused the spotlight. This handbook was developed through a process that involved many of those people who represent the diverse constituencies of DSM-program evaluation. We have come to recognize the many technical disciplines that must be employed to evaluate DSM programs. An analysis might start out based on the principles of utility load research to find out what happened, but a combination of engineering and statistical methods must be used to triangulate'' an estimate of what would have happened without the program. The difference, of course, is that elusive but prized result of evaluation: what happened as the direct result of the DSM program. Technical performance of DSM measures is not the sole determinant of the answer, either. We also recognize the importance of such behavioral attributes of DSM as persistence and free ridership. Finally, DSM evaluation is meaningless without attention to planning an approach, communicating results to relevant decision-makers, and focusing as much on the process as the impacts of the program. These topics are all covered in this handbook.« less

The discriminative capacity of CBCL/1½-5-DSM5 scales to identify disruptive and internalizing disorders in preschool children.

PubMed

de la Osa, Nuria; Granero, Roser; Trepat, Esther; Domenech, Josep Maria; Ezpeleta, Lourdes

2016-01-01

This paper studies the discriminative capacity of CBCL/1½-5 (Manual for the ASEBA Preschool-Age Forms & Profiles, University of Vermont, Research Center for Children, Youth, & Families, Burlington, 2000) DSM5 scales attention deficit and hyperactivity disorder (ADHD), oppositional defiant disorder (ODD), anxiety and depressive problems for detecting the presence of DSM5 (DSM5 diagnostic and statistical manual of mental disorders, APA, Arlington, 2013) disorders, ADHD, ODD, Anxiety and Mood disorders, assessed through diagnostic interview, in children aged 3-5. Additionally, we compare the clinical utility of the CBCL/1½-5-DSM5 scales with respect to analogous CBCL/1½-5 syndrome scales. A large community sample of 616 preschool children was longitudinally assessed for the stated age group. Statistical analysis was based on ROC procedures and binary logistic regressions. ADHD and ODD CBCL/1½-5-DSM5 scales achieved good discriminative ability to identify ADHD and ODD interview's diagnoses, at any age. CBCL/1½-5-DSM5 Anxiety scale discriminative capacity was fair for unspecific anxiety disorders in all age groups. CBCL/1½-5-DSM5 depressive problems' scale showed the poorest discriminative capacity for mood disorders (including depressive episode with insufficient symptoms), oscillating into the poor-to-fair range. As a whole, DSM5-oriented scales generally did not provide evidence better for discriminative capacity than syndrome scales in identifying DSM5 diagnoses. CBCL/1½-5-DSM5 scales discriminate externalizing disorders better than internalizing disorders for ages 3-5. Scores on the ADHD and ODD CBCL/1½-5-DSM5 scales can be used to screen for DSM5 ADHD and ODD disorders in general populations of preschool children.

Are symptoms of spirit possessed patients covered by the DSM-IV or DSM-5 criteria for possession trance disorder? A mixed-method explorative study in Uganda.

PubMed

van Duijl, Marjolein; Kleijn, Wim; de Jong, Joop

2013-09-01

As in many cultures, spirit possession is a common idiom of distress in Uganda. The DSM-IV contains experimental research criteria for dissociative and possession trance disorder (DTD and PTD), which are under review for the DSM-5. In the current proposed categories of the DSM-5, PTD is subsumed under dissociative identity disorder (DID) and DTD under dissociative disorders not elsewhere classified. Evaluation of these criteria is currently urgently required. This study explores the match between local symptoms of spirit possession in Uganda and experimental research criteria for PTD in the DSM-IV and proposed criteria for DID in the DSM-5. A mixed-method approach was used combining qualitative and quantitative research methods. Local symptoms were explored of 119 spirit possessed patients, using illness narratives and a cultural dissociative symptoms' checklist. Possible meaningful clusters of symptoms were inventoried through multiple correspondence analysis. Finally, local symptoms were compared with experimental criteria for PTD in the DSM-IV and proposed criteria for DID in the DSM-5. Illness narratives revealed different phases of spirit possession, with passive-influence experiences preceding the actual possession states. Multiple correspondence analysis of symptoms revealed two dimensions: 'passive' and 'active' symptoms. Local symptoms, such as changes in consciousness, shaking movements, and talking in a voice attributed to spirits, match with DSM-IV-PTD and DSM-5-DID criteria. Passive-influence experiences, such as feeling influenced or held by powers from outside, strange dreams, and hearing voices, deserve to be more explicitly described in the proposed criteria for DID in the DSM-5. The suggested incorporation of PTD in DID in the DSM-5 and the envisioned separation of DTD and PTD in two distinctive categories have disputable aspects.

Identification of Two Glutathione-dependent 3,6-Dichlorogentisate Dehalogenases and Their Roles in the Catabolism of the Herbicide Dicamba in Rhizorhabdus dicambivorans Ndbn-20.

PubMed

Li, Na; Tong, Ren-Lei; Yao, Li; Chen, Qing; Yan, Xin; Ding, De-Rong; Qiu, Ji-Guo; He, Jian; Jiang, Jian-Dong

2018-06-22

The herbicide dicamba is initially demethylated to 3,6-dichlorosalicylate (3,6-DCSA) in Rhizorhabdus dicambivorans Ndbn-20 and is subsequently 5-hydroxylated to 3,6-dichlorogentisate (3,6-DCGA). In the present study, two glutathione-dependent 3,6-DCGA dehalogenases, DsmH1 and DsmH2, were identified in strain Ndbn-20. DsmH2 shared low identity (only 31%) with the tetrachlorohydroquinone (TCHQ) dehalogenase PcpC from Sphingobium chlorophenolicum ATCC 39723, while DsmH1 shared high identity (79%) with PcpC. In the phylogenetic tree of related glutathione S-transferases (GSTs), DsmH1 and DsmH2, together with PcpC and the 2,5-dichlorohydroquinone dehalogenase LinD, formed a separate clade. DsmH1 and DsmH2 were synthesized in Escherichia coli BL21 and purified as His-tagged enzymes. Both enzymes required glutathione (GSH) as a co-factor and could 6-dechlorinate 3,6-DCGA to 3-chlorogentisate in vitro DsmH2 had significantly higher catalytic efficiency toward 3,6-DCGA than DsmH1. Transcription and disruption analysis revealed that DsmH2 but not DsmH1 was responsible for the 6-dechlorination of 3,6-DCGA in strain Ndbn-20 in vivo Furthermore, we propose a novel 'eta' class of GSTs to accommodate the four bacterial dehalogenases PcpC, LinD, DsmH1, and DsmH2. IMPORTANCE Dicamba is an important herbicide, and its use and leakage into the environment have dramatically increased since the large-scale planting of genetically modified (GM) dicamba-resistant crops in 2015. However, the complete catabolic pathway of dicamba has remained unknown, which limits its ecotoxicological studies. Our previous study revealed that 3,6-DCGA was an intermediate of dicamba degradation in strain Ndbn-20. In this study, we identified two glutathione-dependent 3,6-DCGA dehalogenases, DsmH1 and DsmH2, and demonstrated that DsmH2 was physiologically responsible for the 6-dechlorination of 3,6-DCGA in strain Ndbn-20. GSTs play an important role in the detoxification and degradation of a variety of endogenous and exogenous toxic compounds. Based on their sequence identities, phylogenetic status and functions, the four bacterial GSH-dependent dehalogenases (PcpC, LinD, DsmH1, and DsmH2) were reclassified as a new 'eta' class of GSTs. This study helps us to elucidate the microbial catabolism of dicamba and enhances our understanding of the diversity and functions of GSTs. Copyright © 2018 American Society for Microbiology.

Dimensional structure of DSM-5 posttraumatic stress symptoms: support for a hybrid Anhedonia and Externalizing Behaviors model.

PubMed

Armour, Cherie; Tsai, Jack; Durham, Tory A; Charak, Ruby; Biehn, Tracey L; Elhai, Jon D; Pietrzak, Robert H

2015-02-01

Several revisions to the symptom clusters of posttraumatic stress disorder (PTSD) have been made in the 5th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). Central to the focus of this study was the revision of PTSD's tripartite structure in DSM-IV into four symptom clusters in DSM-5. Emerging confirmatory factor analytic (CFA) studies have suggested that DSM-5 PTSD symptoms may be best represented by one of two 6-factor models: (1) an Externalizing Behaviors model characterized by a factor which combines the irritability/anger and self-destructive/reckless behavior items; and (2) an Anhedonia model characterized by items of loss of interest, detachment, and restricted affect. The current study conducted CFAs of DSM-5 PTSD symptoms assessed using the PTSD Checklist for DSM-5 (PCL-5) in two independent and diverse trauma-exposed samples of a nationally representative sample of 1484 U.S. veterans and a sample of 497 Midwestern U.S. university undergraduate students. Relative fits of the DSM-5 model, the DSM-5 Dysphoria model, the DSM-5 Dysphoric Arousal model, the two 6-factor models, and a newly proposed 7-factor Hybrid model, which consolidates the two 6-factor models, were evaluated. Results revealed that, in both samples, both 6-factor models provided significantly better fit than the 4-factor DSM-5 model, the DSM-5 Dysphoria model and the DSM-5 Dysphoric Arousal model. Further, the 7-factor Hybrid model, which incorporates key features of both 6-factor models and is comprised of re-experiencing, avoidance, negative affect, anhedonia, externalizing behaviors, and anxious and dysphoric arousal symptom clusters, provided superior fit to the data in both samples. Results are discussed in light of theoretical and empirical support for the latent structure of DSM-5 PTSD symptoms. Copyright © 2014 Elsevier Ltd. All rights reserved.

Reliability and validity of the DSM-IV-TR and proposed DSM-5 criteria for pedophilia: Implications for the ICD-11 and the next DSM.

PubMed

Seto, Michael C; Fedoroff, J Paul; Bradford, John M; Knack, Natasha; Rodrigues, Nicole C; Curry, Susan; Booth, Brad; Gray, Jonathan; Cameron, Colin; Bourget, Dominique; Messina, Sarina; James, Elizabeth; Watson, Diane; Gulati, Sanjiv; Balmaceda, Rufino; Ahmed, Adekunle G

We tested the inter-rater reliability and criterion-related validity of the DSM-IV-TR pedophilia diagnosis and proposed DSM-5 pedohebephilia diagnosis in a sample of 79 men who had committed child pornography offenses, contact sexual offenses against children, or who were referred because of concerns about whether they had a sexual interest in children. Participants were evaluated by two independent psychiatrists with an interview and questionnaire regarding demographic characteristics, sexual history, and self-reported sexual interests; they also completed phallometric and visual reaction time testing. Kappa was .59 for ever meeting DSM-IV-TR criteria for pedophilia and .52 for ever meeting the proposed DSM-5 criteria for pedohebephilia. Ever meeting DSM-IV-TR diagnosis was significantly related to self-reported index of sexual interest in children (highest AUC=.81, 95% CI=.70-.91, p<.001) and to indices of sexual interest in children from phallometric testing (AUC=.70; 95% CI=.52-.89; p<.05) or a computerized assessment based on visual reaction time and self-report (AUC=.75; 95% CI=.62-.88; p<.005). Ever meeting the proposed DSM-5 "diagnosis" was similarly related to self-report (AUC=.84, 95% CI=.74-.94, p<.001) and to the two objective indices, with AUCs of .69 (95% CI=.53-.85; p<.05) and .77 (95% CI=.64-.89; p<.001), respectively. Because the pDSM-5 criteria did not produce significantly better reliability or validity results and users are more familiar with the current DSM-5 criteria, we believe these results suggest the revision of DSM-5 and development of ICD-11 could benefit from drawing on the current DSM-5 criteria, which are essentially the same as DSM-IV-TR except for a distinction between having a paraphilia (the interest) and a paraphilic disorder (the paraphilia plus clinically significant distress or impairment). Copyright © 2016. Published by Elsevier Ltd.

Autism spectrum disorders according to DSM-IV-TR and comparison with DSM-5 draft criteria: an epidemiological study.

PubMed

Mattila, Marja-Leena; Kielinen, Marko; Linna, Sirkka-Liisa; Jussila, Katja; Ebeling, Hanna; Bloigu, Risto; Joseph, Robert M; Moilanen, Irma

2011-06-01

The latest definitions of autism spectrum disorders (ASDs) were specified in DSM-IV-TR in 2000. DSM-5 criteria are planned for 2013. Here, we estimated the prevalence of ASDs and autism according to DSM-IV-TR, clarified confusion concerning diagnostic criteria, and evaluated DSM-5 draft criteria for ASD posted by the American Psychiatry Association (APA) in February 2010. This was an epidemiological study of 5,484 eight-year-old children in Finland, 4,422 (81%) of them rated via the Autism Spectrum Screening Questionnaire by parents and/or teachers, and 110 examined by using a structured interview, semi-structured observation, IQ measurement, school-day observation, and patient records. Diagnoses were assigned according to DSM-IV-TR criteria and DSM-5 draft criteria in children with a full-scale IQ (FSIQ) ≥50. Patient records were evaluated in children with an FSIQ <50 to discover diagnoses of ASDs. The prevalence of ASDs was 8.4 in 1,000 and that of autism 4.1 in 1,000 according to DSM-IV-TR. Of the subjects with ASDs and autism, 65% and 61% were high-functioning (FSIQ ≥70), respectively. The prevalence of pervasive developmental disorder not otherwise specified was not estimated because of inconsistency in DSM-IV-TR criteria. DSM-5 draft criteria were shown to be less sensitive in regard to identification of subjects with ASDs, particularly those with Asperger's syndrome and some high-functioning subjects with autism. DSM-IV-TR helps with the definition of ASDs only up to a point. We suggest modifications to five details of DSM-5 draft criteria posted by the APA in February 2010. Completing revision of DSM criteria for ASDs is a challenging task. Copyright © 2011 American Academy of Child and Adolescent Psychiatry. Published by Elsevier Inc. All rights reserved.

The stressor criterion for posttraumatic stress disorder: Does it matter?

PubMed Central

Roberts, Andrea L.; Dohrenwend, Bruce P.; Aiello, Allison; Wright, Rosalind J.; Maercker, Andreas; Galea, Sandro; Koenen, Karestan C.

2013-01-01

Objective The definition of the stressor criterion for posttraumatic stress disorder (“Criterion A1”) is hotly debated with major revisions being considered for DSM-V. We examine whether symptoms, course, and consequences of PTSD vary predictably with the type of stressful event that precipitates symptoms. Method We used data from the 2009 PTSD diagnostic subsample (N=3,013) of the Nurses Health Study II. We asked respondents about exposure to stressful events qualifying under 1) DSM-III, 2) DSM-IV, or 3) not qualifying under DSM Criterion A1. Respondents selected the event they considered worst and reported subsequent PTSD symptoms. Among participants who met all other DSM-IV PTSD criteria, we compared distress, symptom severity, duration, impairment, receipt of professional help, and nine physical, behavioral, and psychiatric sequelae (e.g. physical functioning, unemployment, depression) by precipitating event group. Various assessment tools were used to determine fulfillment of PTSD Criteria B through F and to assess these 14 outcomes. Results Participants with PTSD from DSM-III events reported on average 1 more symptom (DSM-III mean=11.8 symptoms, DSM-IV=10.7, non-DSM=10.9) and more often reported symptoms lasted one year or longer compared to participants with PTSD from other groups. However, sequelae of PTSD did not vary systematically with precipitating event type. Conclusions Results indicate the stressor criterion as defined by the DSM may not be informative in characterizing PTSD symptoms and sequelae. In the context of ongoing DSM-V revision, these results suggest that Criterion A1 could be expanded in DSM-V without much consequence for our understanding of PTSD phenomenology. Events not considered qualifying stressors under the DSM produced PTSD as consequential as PTSD following DSM-III events, suggesting PTSD may be an aberrantly severe but nonspecific stress response syndrome. PMID:22401487

Bereavement-related depression: Did the changes induced by DSM-V make a difference? Results from a large population-based survey of French residents.

PubMed

Clesse, Florence; Leray, Emmanuelle; Bodeau-Livinec, Florence; Husky, Mathilde; Kovess-Masfety, Viviane

2015-08-15

DSM-V has been criticized for excessively expanding criteria for bereavement-related depression. The aim of this study was to quantify a potential increase in depression prevalence due to changes in diagnostic criteria and to assess the severity, clinical profile and healthcare use of new cases. A cross-sectional telephone survey was performed in 2005-2006 in four French regions. Twelve-month prevalence of psychiatric disorders was measured by CIDI-SF. Bereavement was assessed in those who endorsed the gate question to the depression module. Persons with bereavement-related depression according to DSM-IV and DSM-V diagnosis criteria were compared. Of the 22,138 respondents, 692 were bereaved. The prevalence of depression among those bereaved was 49.9% (95% CI ¼=43.7−56.0) according to DSM-IV and 59.6% (53.1−66.1) according to DSM-V [corrected]. The overall prevalence of major depression increased from 8.6% (8.1–9.1) with DSM-IV to 8.8% (8.3−9.3) with DSM-V . Cases diagnosed using DSM-IV presented more symptoms than cases diagnosed using DSM-V but clinical features were similar except regarding criterion E׳s symptoms. Healthcare use was similar between the two groups regarding consultations and psychotropic drug prescription. Some DSM-IV and DSM-V criteria were difficult to operationalize in the survey. The observed difference in prevalence according to DSM-IV and DSM-V may be reduced when clinical judgment is taken into account. The overall prevalence of major depression is only marginally increased by the new criteria. However, diagnostic changes increase the prevalence by 10 points among those bereaved. Diagnostic changes do not appear to modify service use. Copyright © 2015 Elsevier B.V. All rights reserved.

National Estimates of Exposure to Traumatic Events and PTSD Prevalence Using DSM-IV and DSM-5 Criteria

PubMed Central

Kilpatrick, Dean G.; Resnick, Heidi S.; Milanak, Melissa E.; Miller, Mark W.; Keyes, Katherine M.; Friedman, Matthew J.

2014-01-01

Prevalence of posttraumatic stress disorder (PTSD) defined according to the American Psychiatric Association’s Diagnostic and Statistical Manual fifth edition (DSM-5; 2013) and fourth edition (DSM-IV; 1994) was compared in a national sample of U.S. adults (N = 2,953) recruited from an online panel. Exposure to traumatic events, PTSD symptoms, and functional impairment were assessed online using a highly structured, self-administered survey. Traumatic event exposure using DSM-5 criteria was high (89.7%), and exposure to multiple traumatic event types was the norm. PTSD caseness was determined using Same Event (i.e., all symptom criteria met to the same event type) and Composite Event (i.e., symptom criteria met to a combination of event types) definitions. Lifetime, past-12-month, and past 6-month PTSD prevalence using the Same Event definition for DSM-5 was 8.3%, 4.7%, and 3.8% respectively. All 6 DSM-5 prevalence estimates were slightly lower than their DSM-IV counterparts, although only 2 of these differences were statistically significant. DSM-5 PTSD prevalence was higher among women than among men, and prevalence increased with greater traumatic event exposure. Major reasons individuals met DSM-IV criteria, but not DSM-5 criteria were the exclusion of nonaccidental, nonviolent deaths from Criterion A, and the new requirement of at least 1 active avoidance symptom. PMID:24151000

A triazolopyrimidine-based dihydroorotate dehydrogenase inhibitor (DSM421) with improved drug-like properties for treatment and prevention of malaria

PubMed Central

Phillips, Margaret A.; White, Karen L.; Kokkonda, Sreekanth; Deng, Xiaoyi; White, John; Mazouni, Farah El; Marsh, Kennan; Tomchick, Diana R.; Manjalanagara, Krishne; Rudra, Kakali Rani; Wirjanata, Grennady; Noviyanti, Rintis; Price, Ric N; Marfurt, Jutta; Shackleford, David M.; Chiu, Francis C.K.; Campbell, Michael; Jimenez-Diaz, Maria Belen; Bazaga, Santiago Ferrer; Angulo-Barturen, Iñigo; Martinez, Maria Santos; Lafuente-Monasterio, Maria; Kaminsky, Werner; Silue, Kigbafori; Zeeman, Anne-Marie; Kocken, Clemens; Leroy, Didier; Blasco, Benjamin; Rossignol, Emilie; Rueckle, Thomas; Matthews, Dave; Burrows, Jeremy N.; Waterson, David; Palmer, Michael J.; Rathod, Pradipsinh K.; Charman, Susan A.

2016-01-01

The emergence of drug resistant malaria parasites continues to hamper efforts to control this lethal disease. Dihydroorotate dehydrogenase has recently been validated as a new target for the treatment of malaria and a selective inhibitor (DSM265) of the Plasmodium enzyme is currently in clinical development. With the goal of identifying a backup compound to DSM265, we explored replacement of the SF5-aniline moiety of DSM265 with a series of CF3-pyridinyls, while maintaining the core triazolopyrimidine scaffold. This effort led to the identification of DSM421, which has improved solubility, lower intrinsic clearance and increased plasma exposure after oral dosing compared to DSM265, while maintaining a long predicted human half-life. Its improved physical and chemical properties will allow it to be formulated more readily than DSM265. DSM421 showed excellent efficacy in the SCID mouse model of P. falciparum malaria that supports the prediction of a low human dose (<200 mg). Importantly DSM421 showed equal activity against both P. falciparum and P. vivax field isolates, while DSM265 was more active on P. falciparum. DSM421 has the potential to be developed as a single dose cure or once-weekly chemopreventative for both P. falciparum and P. vivax malaria leading to its advancement as a preclinical development candidate. PMID:27641613

Convergence between DSM-IV-TR and DSM-5 diagnostic models for personality disorder: evaluation of strategies for establishing diagnostic thresholds.

PubMed

Morey, Leslie C; Skodol, Andrew E

2013-05-01

The Personality and Personality Disorders Work Group for the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) recommended substantial revisions to the personality disorders (PDs) section of DSM-IV-TR, proposing a hybrid categorical-dimensional model that represented PDs as combinations of core personality dysfunctions and various configurations of maladaptive personality traits. Although the DSM-5 Task Force endorsed the proposal, the Board of Trustees of the American Psychiatric Association (APA) did not, placing the Work Group's model in DSM-5 Section III ("Emerging Measures and Models") with other concepts thought to be in need of additional research. This paper documents the impact of using this alternative model in a national sample of 337 patients as described by clinicians familiar with their cases. In particular, the analyses focus on alternative strategies considered by the Work Group for deriving decision rules, or diagnostic thresholds, with which to assign categorical diagnoses. Results demonstrate that diagnostic rules could be derived that yielded appreciable correspondence between DSM-IV-TR and proposed DSM-5 PD diagnoses-correspondence greater than that observed in the transition between DSM-III and DSM-III-R PDs. The approach also represents the most comprehensive attempt to date to provide conceptual and empirical justification for diagnostic thresholds utilized within the DSM PDs.

Diagnostic assignment of criteria: clinicians and DSM-IV.

PubMed

Linde, J A; Clark, L A

1998-01-01

The study examined clinician matching of diagnostic criteria to selected DSM-IV Axis I and II disorders. A national sample of clinical psychologists and psychiatrists assigned symptom criteria, presented in scrambled order by axis, to DSM-IV diagnoses with which they believed the criteria belonged, without using the DSM. On average, clinicians assigned 69% of Axis I criteria and 75% of Axis II criteria to the designated DSM-IV diagnosis. The Axis II data represent increased agreement over the 66% found for DSM-III-R. Reasons for the increase are discussed, focusing on modifications made in DSM-IV and increased familiarity with personality disorders. The significantly higher rate of agreement for Axis II over Axis I contrasts with typical reliability data which suggests that Axis I disorders are better defined. Specific points of disagreement between clinician criteria assignments and the DSM-IV are discussed.

Brief Report: Investigating the Implications of Applying the New DSM-5 Criteria for Diagnosing Autism Spectrum Disorder in a Preschool Population in Singapore.

PubMed

Wong, Chui Mae; Koh, Hwan Cui

2016-09-01

Diagnostic reports for 206 children who underwent an assessment for autism spectrum disorder (ASD) using the DSM-IV-TR criteria, were re-evaluated using the DSM-5 criteria. Mean age of the children at time of diagnosis was 3 years 10 months. Of the 202 children diagnosed with ASD on the DSM-IV-TR, 184 (91.1 %) also met the DSM-5 criteria for ASD. The overall concordance rate of ASD diagnosis on the DSM-IV-TR and DSM-5 was higher than that reported in other studies. Of the 18 children who did not meet DSM-5 criteria for ASD, 16 children met all social communication criteria but did not fulfil at least two restricted and repetitive behaviour (RRB) criteria. Six of those children had further RRBs emerging later on follow-up.

The DSM and Professional Practice: Research, Clinical, and Institutional Perspectives.

PubMed

Halpin, Michael

2016-06-01

How mental illnesses are defined has significant ramifications, given the substantial social and individual repercussions of these conditions. Using actor-network theory, I analyze how mental health professionals use the Diagnostic and Statistical Manual of Mental Disorders (DSM) in their work. Drawing on observations of a neuropsychological laboratory and interviews with 27 professionals (i.e., psychiatrists, psychologists), I investigate how the DSM is used in research, clinical, and institutional work. In research, the DSM influences study design and exclusion/inclusion criteria. In the clinic, the DSM influences how disorders are conceptualized and diagnosed. Institutionally, the DSM aligns the patient-professional encounter to insurance and pharmaceutical interests. I conclude that the DSM operates as multiple, context-specific taxonomies that pervasively influence professional practices, such that all possible actions must orient to DSM criteria, with professionals both a source and an object of institutionalized gaze. © American Sociological Association 2016.

A diagnostic and statistical manual of mental disorders history of premenstrual dysphoric disorder.

PubMed

Zachar, Peter; Kendler, Kenneth S

2014-04-01

The proposals to include a menstruation-related mood disorder in the Diagnostic and Statistical Manual of Mental Disorders, Revised Third Edition (DSM-III-R), and DSM-IV led to intense public and behind-the-scenes controversy. Although the controversies surrounding the DSM-5 revision were greater in number than the controversies of the earlier revisions, the DSM-5 proposal to include a menstruation-related mood disorder was not among them. Premenstrual dysphoric disorder was made an official disorder in the DSM-5 with no significant protest. To understand the factors that led to this change, we interviewed those psychiatrists and psychologists who were most involved in the DSM-IV revision. On the basis of these interviews, we offer a list of empirical and nonempirical considerations that led to the DSM-IV compromise and explore how key alterations in these considerations led to a different outcome for the DSM-5.

Comparing Diagnostic Outcomes of Autism Spectrum Disorder Using "DSM-IV-TR" and "DSM-5" Criteria

ERIC Educational Resources Information Center

Harstad, Elizabeth B.; Fogler, Jason; Sideridis, Georgios; Weas, Sarah; Mauras, Carrie; Barbaresi, William J.

2015-01-01

Controversy exists regarding the "DSM-5" criteria for ASD. This study tested the psychometric properties of the "DSM-5" model and determined how well it performed across different gender, IQ, and "DSM-IV-TR" sub-type, using clinically collected data on 227 subjects (median age = 3.95 years, majority had IQ > 70).…

Potential Impact of DSM-5 Criteria on Autism Spectrum Disorder Prevalence Estimates

PubMed Central

Maenner, Matthew J.; Rice, Catherine E.; Arneson, Carrie L.; Cunniff, Christopher; Schieve, Laura A.; Carpenter, Laura A.; Van Naarden Braun, Kim; Kirby, Russell S.; Bakian, Amanda V.; Durkin, Maureen S.

2014-01-01

IMPORTANCE The DSM-5 contains revised diagnostic criteria for autism spectrum disorder (ASD) from the DSM-IV-TR. Potential impacts of the new criteria on ASD prevalence are unclear. OBJECTIVE To assess potential effects of the DSM-5 ASD criteria on ASD prevalence estimation by retrospectively applying the new criteria to population-based surveillance data collected for previous ASD prevalence estimation. DESIGN, SETTING, AND PARTICIPANTS Cross-sectional, population-based ASD surveillance based on clinician review of coded behaviors documented in children’s medical and educational evaluations from 14 geographically defined areas in the United States participating in the Autism and Developmental Disabilities Monitoring (ADDM) Network in 2006 and 2008. This study included 8-year-old children living in ADDM Network study areas in 2006 or 2008, including 644 883 children under surveillance, of whom 6577 met surveillance ASD case status based on the DSM-IV-TR. MAIN OUTCOMES AND MEASURES Proportion of children meeting ADDM Network ASD criteria based on the DSM-IV-TR who also met DSM-5 criteria; overall prevalence of ASD using DSM-5 criteria. RESULTS Among the 6577 children classified by the ADDM Network as having ASD based on the DSM-IV-TR, 5339 (81.2%) met DSM-5 ASD criteria. This percentage was similar for boys and girls but higher for those with than without intellectual disability (86.6% and 72.5%, respectively; P < .001). A total of 304 children met DSM-5 ASD criteria but not current ADDM Network ASD case status. Based on these findings, ASD prevalence per 1000 for 2008 would have been 10.0 (95% CI, 9.6–10.3) using DSM-5 criteria compared with the reported prevalence based on DSM-IV-TR criteria of 11.3 (95% CI, 11.0–11.7). CONCLUSIONS AND RELEVANCE Autism spectrum disorder prevalence estimates will likely be lower under DSM-5 than under DSM-IV-TR diagnostic criteria, although this effect could be tempered by future adaptation of diagnostic practices and documentation of behaviors to fit the new criteria. PMID:24452504

DSM-IV and DSM-5 alcohol use disorder among young Swiss men.

PubMed

Mohler-Kuo, Meichun; Foster, Simon; Gmel, Gerhard; Dey, Michelle; Dermota, Petra

2015-03-01

Previous studies suggest that the new DSM-5 criteria for alcohol use disorder (AUD) will increase the apparent prevalence of AUD. This study estimates the 12-month prevalence of AUD using both DSM-IV and DSM-5 criteria and compares the characteristics of men in a high risk sample who meet both, only one and neither sets of diagnostic criteria. 5943 Swiss men aged 18-25 years who participated in the Cohort Study on Substance Use Risk Factors (C-SURF), a population-based cohort study recruited from three of the six military recruitment centres in Switzerland (response rate = 79.2%). DSM-IV and DSM-5 criteria, alcohol use patterns, and other substance use were assessed. Approximately 31.7% (30.5-32.8) of individuals met DSM-5 AUD criteria [21.2% mild (20.1-22.2); 10.5% moderate/severe (9.7-11.3)], which was less than the total rate when DSM-IV criteria for alcohol abuse (AA) and alcohol dependence (AD) were combined [36.8% overall (35.5-37.9); 26.6% AA (25.4-27.7); 10.2% AD (9.4-10.9)]. Of 2479 respondents meeting criteria for either diagnoses, 1585 (63.9%) met criteria for both. For those meeting DSM-IV criteria only (n = 598, 24.1%), hazardous use was most prevalent, whereas the criteria larger/longer use than intended and tolerance to alcohol were most prevalent for respondents meeting DSM-5 criteria only (n = 296, 11.9%). Two in five DSM-IV alcohol abuse cases and one-third of DSM-5 mild AUD individuals fulfilled the diagnostic criteria due to the hazardous use criterion. The addition of the craving and excluding of legal criterion, respectively, did not affect estimated AUD prevalence. In a high-risk sample of young Swiss males, prevalence of alcohol use disorder as diagnosed by DSM-5 was slightly lower than prevalence of DSM-IV diagnosis of dependence plus abuse; 63.9% of those who met either criterion met criteria for both. © 2014 Society for the Study of Addiction.

Classification of body dysmorphic disorder - what is the advantage of the new DSM-5 criteria?

PubMed

Schieber, Katharina; Kollei, Ines; de Zwaan, Martina; Martin, Alexandra

2015-03-01

In DSM-5 the diagnosis of body dysmorphic disorder (BDD) has been subjected to two important changes: Firstly, BDD has been assigned to the category of obsessive-compulsive and related disorders. Secondly, a new criterion has been defined requiring the presence of repetitive behaviors or mental acts in response to appearance concerns. The aims of this study were to report the prevalence rates of BDD based on a DSM-5 diagnosis, and to evaluate the impact of the recently introduced DSM-5 criteria for BDD by comparing the prevalence rates (DSM-5 vs. BDD-criteria (DSM-IV/DSM-5), dysmorphic concerns, and depressive symptoms, were assessed in a representative sample of the German general population (N=2129, aged 18-65years). The association between BDD case identification based on DSM-IV and DSM-5 was strong (Phi=.95, p<.001), although point prevalence of BDD according to DSM-5 was slightly lower (2.9%, n=62 vs. 3.2%, n=68). Approximately one third of the identified BDD (DSM-5) cases reported time-consuming behavioral acts in response to appearance concerns. In detail, 0.8% of the German general population fulfilled the BDD criteria and reported repetitive acts of at least one hour/day. The revised criteria of BDD in DSM-5 do not seem to have an impact on prevalence rates. However, the recently added B-criterion reflects more precisely the clinical symptoms of BDD, and may be useful for distinguishing between various severity levels related to repetitive behaviors/mental acts. Copyright © 2015 Elsevier Inc. All rights reserved.

Adolescents and substance-related disorders: research agenda to guide decisions on Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-V).

PubMed

Crowley, Thomas J

2006-09-01

Since the publication of the Diagnostic and Statistical Manual of Mental Disorders fourth edition (DSM-IV), many studies have addressed substance use disorders (SUD) in adolescents. Based on that adolescent literature, this paper suggests further research to help guide decisions about revising for DSM-V the SUD criteria in DSM-IV. The author has reviewed the 'Substance Related Disorders' section of DSM-IV-TR, recalled his experience in helping to draft that section, accessed relevant articles in PubMed and reviewed his own extensive file of literature citations. This paper suggests six questions for adolescent research to help guide the framers of DSM-V's 'Substance Related Disorders' section: (a) DSM-IV did not provide a diagnosis of cannabis withdrawal; should DSM-V continue that position? (b) Should SUD be included or referenced among 'Disorders Usually First Diagnosed in Infancy, Childhood, or Adolescence'? (c) Can inter-rater reliability of the substance abuse (SA) criteria be improved with altered example situations, text descriptions or phrasing of the current criteria? (d) Between ages 14 and 18 years is earlier onset of SUD a severity marker that could be incorporated into DSM-V as a predictor of worse course? (e) In DSM-V could a phenotypic descriptor of pathological multi-substance involvement document severity and predict course of SUD? (f) Could clinicians and patients benefit from DSM-V-related postpublication procedures for classifying emerging new drugs into DSM-V's categories? Without substantive changes in SA or substance dependence diagnostic criteria, research may improve the usefulness of those criteria for adolescents.

An Examination of a Proposed DSM-IV Pathological Gambling Hierarchy in a Treatment Seeking Population: Similarities with Substance Dependence and Evidence for Three Classification Systems.

PubMed

Christensen, Darren R; Jackson, Alun C; Dowling, Nicki A; Volberg, Rachel A; Thomas, Shane A

2015-09-01

Toce-Gerstein et al. (Addiction 98:1661-1672, 2003) investigated the distribution of Diagnostic and Statistical Manual for Mental Disorders, 4th edition (DSM-IV) pathological gambling criteria endorsement in a U.S. community sample for those people endorsing a least one of the DSM-IV criteria (n = 399). They proposed a hierarchy of gambling disorders where endorsement of 1-2 criteria were deemed 'At-Risk', 3-4 'Problem gamblers', 5-7 'Low Pathological', and 8-10 'High Pathological' gamblers. This article examines these claims in a larger Australian treatment seeking population. Data from 4,349 clients attending specialist problem gambling services were assessed for meeting the ten DSM-IV pathological gambling criteria. Results found higher overall criteria endorsement frequencies, three components, a direct relationship between criteria endorsement and gambling severity, clustering of criteria similar to the Toce-Gerstein et al. taxonomy, high accuracy scores for numerical and criteria specific taxonomies, and also high accuracy scores for dichotomous pathological gambling diagnoses. These results suggest significant complexities in the frequencies of criteria reports and relationships between criteria.

Mapping the Personality Psychopathology Five domains onto DSM-IV personality disorders in Dutch clinical and forensic samples: implications for DSM-5.

PubMed

Sellbom, Martin; Smid, Wineke; de Saeger, Hilde; Smit, Naomi; Kamphuis, Jan H

2014-01-01

The Personality Psychopathology Five (PSY-5) model represents 5 broadband dimensional personality domains that align with the originally proposed DSM-5 personality trait system, which was eventually placed in Section III for further study. The main objective of this study was to examine the associations between the PSY-5 model and personality disorder criteria. More specifically, we aimed to determine if the PSY-5 domain scales converged with the alternative DSM-5 Section III model for personality disorders, with a particular emphasis on the personality trait profiles proposed for each of the specific personality disorder types. Two samples from The Netherlands consisting of clinical patients from a personality disorder treatment program (n = 190) and forensic psychiatric hospital (n = 162) were used. All patients had been administered the MMPI-2 (from which MMPI-2-RF PSY-5 scales were scored) and structured clinical interviews to assess personality disorder criteria. Results based on Poisson or negative binomial regression models showed statistically significant and meaningful associations for the hypothesized PSY-5 domains for each of the 6 personality disorders, with a few minor exceptions that are discussed in detail. Implications for these findings are also discussed.

Understanding the DSM-5: stasis and change.

PubMed

Cooper, Rachel

2018-03-01

This paper aims to understand the DSM-5 through situating it within the context of the historical development of the DSM series. When one looks at the sets of diagnostic criteria, the DSM-5 is strikingly similar to the DSM-IV. I argue that at this level the DSM has become 'locked-in' and difficult to change. At the same time, at the structural, or conceptual, level there have been radical changes, for example in the definition of 'mental disorder', in the role of theory and of values, and in the abandonment of the multiaxial approach to diagnosis. The way that the DSM-5 was constructed means that the overall conceptual framework of the classification only barely constrains the sets of diagnostic criteria it contains.

Assessment of Pathological Traits in DSM-5 Personality Disorders by the DAPP-BQ: How Do These Traits Relate to the Six Personality Disorder Types of the Alternative Model?

PubMed

Berghuis, Han; Ingenhoven, Theo J M; van der Heijden, Paul T; Rossi, Gina M P; Schotte, Chris K W

2017-11-09

The six personality disorder (PD) types in DSM-5 section III are intended to resemble their DSM-IV/DSM-5 section II PD counterparts, but are now described by the level of personality functioning (criterion A) and an assigned trait profile (criterion B). However, concerns have been raised about the validity of these PD types. The present study examined the continuity between the DSM-IV/DSM-5 section II PDs and the corresponding trait profiles of the six DSM-5 section III PDs in a sample of 350 Dutch psychiatric patients. Facets of the Dimensional Assessment of Personality Pathology-Basic Questionnaire (DAPP-BQ) were presumed as representations (proxies) of the DSM-5 section III traits. Correlational patterns between the DAPP-BQ and the six PDs were consistent with previous research between DAPP-BQ and DSM-IV PDs. Moreover, DAPP-BQ proxies were able to predict the six selected PDs. However, the assigned trait profile for each PD didn't fully match the corresponding PD.

The dimensionality of alcohol use disorders and alcohol consumption in a cross-national perspective

PubMed Central

Borges, Guilherme; Ye, Yu; Bond, Jason; Cherpitel, Cheryl J.; Cremonte, Mariana; Moskalewicz, Jacek; Swiatkiewicz, Grazyna; Rubio-Stipec, Maritza

2009-01-01

Aims To replicate the finding that there is a single dimension trait in alcohol use disorders and to test whether usual 5+ drinks for men and/4+ drinks for women and other measures of alcohol consumption help to improve alcohol use disorder criteria in a series of diverse patients from Emergency Departments (EDs) in four countries. Design Cross-sectional surveys of patient 18 and older that reflected consecutive arrival at the ED. The Composite International Diagnostic Interview Core was used to obtain a diagnosis of DSM-IV alcohol dependence and alcohol abuse. Quantity and frequency of drinking and drunkenness as well as usual number of drinks consumed during the last year. Setting Participants were 5,195 injured and non-injured patients attending 7 EDs in 4 countries, Argentina, Mexico, Poland the U.S., (between 1995-2001). Findings Using exploratory factor analyses alcohol use disorders can be described as a single, unidimensional continuum without any clear cut distinction between the criterions for dependence and abuse in all sites. Results from item response theory analyses showed that the current DSM-IV criterions tap people in the middle-upper end of the alcohol use disorder continuum. Alcohol consumption (amount and frequency of use) can be used in all EDs with the current DSM-IV diagnostic criterions to help tap the middle-lower part of this continuum. Even though some specific diagnostic criterions and some alcohol consumption variables showed differential item function across sites, test response curves were invariant for ED sites and their inclusion would not impact the final (total) performance of the diagnostic system. Conclusions DSM-IV abuse and dependence form a unidimensional continuum in ED patients regardless of country of survey. Alcohol consumption variables, if added, would help to tap patients with more moderate severity. DSM diagnostic system for alcohol use disorders showed invariance and performed extremely well in these samples. PMID:20078482

Initial interpretation and evaluation of a profile-based classification system for the anxiety and mood disorders: Incremental validity compared to DSM-IV categories.

PubMed

Rosellini, Anthony J; Brown, Timothy A

2014-12-01

Limitations in anxiety and mood disorder diagnostic reliability and validity due to the categorical approach to classification used by the Diagnostic and Statistical Manual of Mental Disorders (DSM) have been long recognized. Although these limitations have led researchers to forward alternative classification schemes, few have been empirically evaluated. In a sample of 1,218 outpatients with anxiety and mood disorders, the present study examined the validity of Brown and Barlow's (2009) proposal to classify the anxiety and mood disorders using an integrated dimensional-categorical approach based on transdiagnostic emotional disorder vulnerabilities and phenotypes. Latent class analyses of 7 transdiagnostic dimensional indicators suggested that a 6-class (i.e., profile) solution provided the best model fit and was the most conceptually interpretable. Interpretation of the classes was further supported when compared with DSM diagnoses (i.e., within-class prevalence of diagnoses, using diagnoses to predict class membership). In addition, hierarchical multiple regression models were used to demonstrate the incremental validity of the profiles; class probabilities consistently accounted for unique variance in anxiety and mood disorder outcomes above and beyond DSM diagnoses. These results provide support for the potential development and utility of a hybrid dimensional-categorical profile approach to anxiety and mood disorder classification. In particular, the availability of dimensional indicators and corresponding profiles may serve as a useful complement to DSM diagnoses for both researchers and clinicians. (c) 2014 APA, all rights reserved.

Initial Interpretation and Evaluation of a Profile-Based Classification System for the Anxiety and Mood Disorders: Incremental Validity Compared to DSM-IV Categories

PubMed Central

Rosellini, Anthony J.; Brown, Timothy A.

2014-01-01

Limitations in anxiety and mood disorder diagnostic reliability and validity due to the categorical approach to classification used by the Diagnostic and Statistical Manual of Mental Disorders (DSM) have been long recognized. Although these limitations have led researchers to forward alternative classification schemes, few have been empirically evaluated. In a sample of 1,218 outpatients with anxiety and mood disorders, the present study examined the validity of Brown and Barlow's (2009) proposal to classify the anxiety and mood disorders using an integrated dimensional-categorical approach based on transdiagnostic emotional disorder vulnerabilities and phenotypes. Latent class analyses of seven transdiagnostic dimensional indicators suggested that a six-class (i.e., profile) solution provided the best model fit and was the most conceptually interpretable. Interpretation of the classes was further supported when compared with DSM-IV diagnoses (i.e., within-class prevalence of diagnoses, using diagnoses to predict class membership). In addition, hierarchical multiple regression models were used to demonstrate the incremental validity of the profiles; class probabilities consistently accounted for unique variance in anxiety and mood disorder outcomes above and beyond DSM diagnoses. These results provide support for the potential development and utility of a hybrid dimensional-categorical profile approach to anxiety and mood disorder classification. In particular, the availability of dimensional indicators and corresponding profiles may serve as a useful complement to DSM diagnoses for both researchers and clinicians. PMID:25265416

Should OCD leave the anxiety disorders in DSM-V? The case for obsessive compulsive-related disorders.

PubMed

Hollander, Eric; Braun, Ashley; Simeon, Daphne

2008-01-01

Recently in 2006, a group of experts in obsessive compulsive disorder (OCD) and obsessive compulsive-related disorders (OCRDs) convened in Washington, DC, to review existing data on the relationships between these various disorders, and to suggest approaches to address the gaps in our knowledge, in preparation for the upcoming Diagnostic and Statistical Manual (Fifth Edition) (DSM-V). As a result of this meeting, the Research Planning Agenda for DSM-V: OCRD Work Group suggested removing OCD from the anxiety disorders, where it is currently found. This proposal is in accordance with the current International Classification of Mental Disorders (ICD-10) classification of OCD as a separate category from the anxiety disorders. Although the ICD-10 places both OCD and the anxiety disorders under the umbrella category of "neurotic, stress-related, and somatoform disorders," they are two separate categories, distinct from one another. As OCD and other putative OCRDs share aspects of phenomenology, comorbidity, neurotransmitter/peptide systems, neurocircuitry, familial and genetic factors, and treatment response, it was proposed to create a new category in DSM-V entitled OCRDs. Alternatively, the OCRDs might be conceptualized as a new category within the broader category of anxiety disorders. Future studies are needed to better define the relationships among these disorders, and to study boundary issues for this proposed category. There are both advantages and disadvantages in creating a new diagnostic category in DSM-V, and these are discussed in this article.

Development of DSM-V and ICD-11: tendencies and potential of new classifications in psychiatry at the current state of knowledge.

PubMed

Möller, Hans-Jürgen

2009-10-01

A reason for the necessity to revise ICD-10 and DSM-IV is the increase of knowledge in the past 20 years, especially neurobiological knowledge. But is this increase of knowledge, for example in the field of neurogenetics, of such magnitude that a revision of the psychiatric classification is necessary and promises to be fruitful? The current plans for DSM-V or ICD-11, respectively, focus on different improvements. In this context also the introduction of a purely syndromatic/dimensional approach without including etiopathogenetic hypotheses, is discussed. A switch to such a dimensional approach, which was discussed among others in the DSM-V task force Deconstructing Psychosis, would be the most radical development. It could avoid many theoretical pre-assumptions about causal hypotheses, which are still associated with ICD-10 and DSM-IV. This would indeed increase the validity of psychiatric classification, but it would also reduce the information as compared to traditional diagnostic categories with all the current implications concerning etiopathogenesis, therapy and prognosis. Such a dimensional approach would also mean that the syndromes would have to be assessed in a standardized way for each person seeking help from the psychiatric service system or for each person undergoing psychiatric research. This would have to be a multi-dimensional assessment covering all syndromes existing within different psychiatric disorders. Based on the different aspects that must be considered in this context, a careful revision seems more advisable than a radical change of classification.

DSM 5 and child psychiatric disorders: what is new? What has changed?

PubMed

Eapen, Valsamma; Črnčec, Rudi

2014-10-01

The significant changes in DSM 5 as these relate to a number of the child psychiatric disorders are reviewed by several authors in this special issue: In this paper we address some of the changes in the conceptual organisation of DSM 5 and specifically focus on anxiety and related disorders. In the case of child and adolescent psychiatry, the most notable feature is that the chapter on Disorders Usually First Diagnosed in infancy, Childhood or Adolescence has been deleted. Instead, a new chapter in DSM 5 describes Neurodevelopmental Disorders which typically manifest early in development. Further, an expectation had been built that DSM would be based on the latest data in neuroscience and that a clear direction towards a mixed dimensional and categorical approach would be evident. This has been the case with some disorders and a notable example is the removal of Obsessive Compulsive Disorder (OCD) from the Anxiety Disorder chapter and placement with other related disorders that share similar neurobiology and treatment response. In this regard, the addition in DSM 5 of a new specifier "tic-related" to OCD is worth noting as there is emerging evidence that differential treatment response exists when tics are associated with OCD. The same situation applies to tics with ADHD, thus presenting the argument for a dimensional approach to Tic Spectrum Disorder (TSD) incorporating categories such as those with tics only, tics with OCD, tics with ADHD etc. to be given due consideration in the future. Another important change that clinicians in the field of child psychiatry will no doubt notice is the demise of the multiaxial classification. Instead, DSM 5 has moved back to a nonaxial documentation of diagnosis with separate notations for important psychosocial and contextual factors as well as level of functioning and disability. Clinicians are urged, however, to continue to recognise the need to understand how symptoms and behaviours might have arisen and assess relevant contextual factors such as the family relationships, quality of care, any history of abuse, and so on. Further, the move to harmonise DSM 5 with the structure of ICD 11 (scheduled for release in 2015) should make understanding and familiarising oneself with the two major classificatory systems easier in the future. Copyright © 2014 Elsevier B.V. All rights reserved.

Somatic symptom disorder, a new DSM-5 diagnosis of an old clinical challenge

PubMed Central

Rosic, Tea; Kalra, Sameer; Samaan, Zainab

2016-01-01

Somatic symptom disorder (SSD) is characterised by a dysfunctional preoccupation with one or more physical symptoms. Patients with SSD often pursue excessive and unnecessary investigations, hospitalisations and treatments that significantly affect quality of life and drain healthcare resources. Thus, appropriate diagnosis and careful management are required to mitigate the patient's distress and to reduce the burden to the healthcare system. SSD is a new disorder defined in the Diagnostic and Statistical Manual Fifth Edition (DSM-5), replacing somatoform and related disorders in the DSM-4-Text Revision with diagnostic criteria that are inclusive of a broad array of presentations. This report presents a detailed clinical case of an elderly man with a history of frequent hospital visits presenting with SSD. We discuss diagnostic challenges and evidence-based management in acute inpatient as well as in outpatient settings. We also review data on healthcare utilisation associated with SSD. PMID:26759438

Beyond DSM-5: an alternative approach to assessing Social Anxiety Disorder.

PubMed

Skocic, Sonja; Jackson, Henry; Hulbert, Carol

2015-03-01

This article focuses on the Diagnostic and Statistical Manual of Mental Disorders (DSM) classification of Social Anxiety Disorder (SAD). The article details the diagnostic criteria for SAD that have evolved in the various editions and demonstrates that whilst there have been some positive steps taken to more comprehensively define the disorder, further revision is necessary. It will be argued that the DSM-5 (APA, 2013) has made some changes to the diagnostic criteria of SAD that do not seem to be completely in line with theory and research and do not describe SAD effectively in terms of both diversity and presentation. This article concludes with the presentation of a proposed set of diagnostic criteria that address the concerns raised in the article. The proposed criteria reflect a hybrid categorical-dimensional system of classification. Copyright © 2014 Elsevier Ltd. All rights reserved.

Earth Science

NASA Image and Video Library

1996-01-13

The Near Earth Asteroid Rendezvous (NEAR) spacecraft undergoing preflight preparation in the Spacecraft Assembly Encapsulation Facility-2 (SAEF-2) at Kennedy Space Center (KSC). NEAR will perform two critical mission events - Mathilde flyby and the Deep-Space maneuver. NEAR will fly-by Mathilde, a 38-mile (61-km) diameter C-type asteroid, making use of its imaging system to obtain useful optical navigation images. The primary science instrument will be the camera, but measurements of magnetic fields and mass also will be made. The Deep-Space Maneuver (DSM) will be executed about a week after the Mathilde fly-by. The DSM represents the first of two major burns during the NEAR mission of the 100-pound bi-propellant (Hydrazine/nitrogen tetroxide) thruster. This maneuver is necessary to lower the perihelion distance of NEAR's trajectory. The DSM will be conducted in two segments to minimize the possibility of an overburn situation.

Brief Report: An Exploratory Study Comparing Diagnostic Outcomes for Autism Spectrum Disorders under DSM-IV-TR with the Proposed DSM-5 Revision

ERIC Educational Resources Information Center

Gibbs, Vicki; Aldridge, Fiona; Chandler, Felicity; Witzlsperger, Ellen; Smith, Karen

2012-01-01

The proposed revision for Autism spectrum disorders (ASDs) in the Diagnostic and Statistical Manual of Mental Disorders-Fifth Edition (DSM-5) represents a shift from the Diagnostic and Statistical Manual of Mental Disorders-Fourth Edition, Text Revision (DSM-IV-TR). As the proposed DSM-5 criteria require a higher minimum number of symptoms to be…

The myth of DSM's invention of new categories of disorder: Houts's diagnostic discontinuity thesis disconfirmed.

PubMed

Wakefield, J C

2001-05-01

Houts (2001) argues that increases in DSM diagnostic categories are due to the invention of new disorders that are discontinuous with old conceptions of disorder and would not have been previously diagnosed. He maintains that DSM category increases are not comparable in nature to ICD category increases, which are mainly refinements of recognized disorders. I survey categories of disorder introduced after DSM-II and assess whether they are discontinuous with old concepts and categories of disorder. Candidate categories are identified from: Houts and Follette (1998), Mentalism, mechanisms, and medical analogues: Reply to Wakefield. Journal of Consulting and Clinical Psychology; Kutchins and Kirk (1997) Making us crazy: DSM: The psychiatric bible and the creation of mental disorders. New York: Free Press; and my own list. The result is that virtually none of the candidate categories are invented, discontinuous categories. In almost every case, the newly labeled conditions were considered disorders at the time of DSM-II and would have been diagnosed under DSM-II categories. I also reexamine DSM-IV sleep disorder categories, which Houts claims are discontinuous with past diagnostic conceptions. The result is that all DSM-IV sleep disorders were recognized as disorders at the time of DSM-II, and most were recognized as mental disorders. I conclude that DSM category increases are comparable in nature to ICD category increases, and that the invention-of-disorder account cannot explain the vast majority of such increases.

Craving as a DSM-5 Symptom of Alcohol Use Disorder in Non-Treatment Seekers.

PubMed

Hartwell, Emily E; Ray, Lara A

2018-05-01

DSM-5 has added craving as a new criterion and changed the diagnostic structure of alcohol use disorder (AUD). Though craving has long been a target of intervention, less is known about the impact this addition will have on prevalence and factor structure of AUD, particularly in non-treatment seeker with alcohol problems. Non-treatment seeking individuals reporting alcohol-related problems (N = 296) completed a structured clinical interview and the Penn Alcohol Craving Scale (PACS). PACS scores greater than 20 were considered to meet diagnostic criteria for the alcohol craving symptom. This study examined DSM-IV to DSM-5 diagnostic conversion and conducted an exploratory factor analysis to test the factor structure of the DSM-5 symptoms, including craving. The mean PACS score was 13.1 and alcohol craving was strongly correlated with other measures of alcohol use. Using the proposed cut-off score of PACS > 20, 46 participants (16.2%) met criteria for alcohol craving. Craving loaded moderately (0.47) onto the retained DSM symptoms and produced a unidimensional factor structure. The majority of participants who met for a DSM-IV AUD also met for a DSM-5 AUD (98.8%). Craving prevalence using the PACS was relatively low compared to the remaining 10 DSM-5 symptoms, possibly due to the non-treatment seeking nature of the sample. Conversion of DSM-IV to DSM-5 in this sample led to a small increase in overall AUD prevalence. Craving loaded well onto a single factor structure for AUD.

Screening for DSM-5 Other Specified Feeding or Eating Disorder in a Weight-Loss Treatment–Seeking Obese Sample

PubMed Central

Gorman, Mark J.; Sogg, Stephanie; Lamont, Evan M.; Eddy, Kamryn T.; Becker, Anne E.; Thomas, Jennifer J.

2014-01-01

Objective: To evaluate the effectiveness of specific self-report questionnaires in detecting DSM-5 eating disorders identified via structured clinical interview in a weight-loss treatment–seeking obese sample, to improve eating disorder recognition in general clinical settings. Method: Individuals were recruited over a 3-month period (November 2, 2011, to January 10, 2012) when initially presenting to a hospital-based weight-management center in the northeastern United States, which offers evaluation and treatment for outpatients who are overweight or obese. Participants (N = 100) completed the Structured Clinical Interview for DSM-IV eating disorder module, a DSM-5 feeding and eating disorders interview, and a battery of self-report questionnaires. Results: Self-reports and interviews agreed substantially in the identification of bulimia nervosa (DSM-IV and DSM-5: tau-b = 0.71, P < .001) and binge-eating disorder (DSM-IV and DSM-5: tau-b = 0.60, P < .001), modestly for subthreshold binge-eating disorder (tau-b = 0.44, P < .001), and poorly for other subthreshold conditions (night-eating syndrome: tau-b = –0.04, P = .72, r = 0.06 [DSM-5]). Discussion: Current self-report assessments are likely to identify full syndrome DSM-5 eating disorders in treatment-seeking obese samples, but unlikely to detect DSM-5 other specified feeding or eating disorders. We propose specific content changes that might enhance clinical utility as suggestions for future evaluation. PMID:25667810

Handbook of evaluation of utility DSM programs

DOE Office of Scientific and Technical Information (OSTI.GOV)

Hirst, E.; Reed, J.; Bronfman, B.

Program evaluation has become a central issue in the world of utility integrated resource planning. The DSM programs that utilities were operating to meet federal requirements or to improve customer relations are now becoming big business. DSM is being considered an important resource in a utility`s portfolio of options. In the last five years, the amount of money that utilities have invested in DSM has grown exponentially in most regulatory jurisdictions. Market analysts are now talking about DSM being a $30 billion industry by the end of the decade. If the large volume of DSM-program investments was not enough tomore » highlight the importance of evaluation, then the introduction of regulatory incentives has really focused the spotlight. This handbook was developed through a process that involved many of those people who represent the diverse constituencies of DSM-program evaluation. We have come to recognize the many technical disciplines that must be employed to evaluate DSM programs. An analysis might start out based on the principles of utility load research to find out what happened, but a combination of engineering and statistical methods must be used to ``triangulate`` an estimate of what would have happened without the program. The difference, of course, is that elusive but prized result of evaluation: what happened as the direct result of the DSM program. Technical performance of DSM measures is not the sole determinant of the answer, either. We also recognize the importance of such behavioral attributes of DSM as persistence and free ridership. Finally, DSM evaluation is meaningless without attention to planning an approach, communicating results to relevant decision-makers, and focusing as much on the process as the impacts of the program. These topics are all covered in this handbook.« less

DSM-IV and DSM-5 Prevalence of Social Anxiety Disorder in a Population Sample of Older People.

PubMed

Karlsson, Björn; Sigström, Robert; Östling, Svante; Waern, Margda; Börjesson-Hanson, Anne; Skoog, Ingmar

2016-12-01

To examine the prevalence of social anxiety disorders (SAD) with (DSM-IV) and without (DSM-5) the person's own assessment that the fear was unreasonable, in a population sample of older adults. Further, to determine whether clinical and sociodemographic correlates of SAD differ depending on the criteria applied. Cross-sectional. General population in Gothenburg, Sweden. A random population-based sample of 75- and 85-year olds (N = 1200) without dementia. Psychiatric research nurses carried out a semi-structured psychiatric examination including the Comprehensive Psychopathological Rating Scale. DSM-IV SAD was diagnosed with the Mini International Neuropsychiatric Interview. SAD was diagnosed according to DSM-IV and DSM-5 criteria. The 6-month duration criterion in DSM-5 was not applied because of lack of information. Other assessments included the Global Assessment of Functioning (GAF), the Brief Scale for Anxiety (BSA), and the Montgomery Åsberg Depression Rating Scale (MADRS). The 1-month prevalence of SAD was 2.5% (N = 30) when the unreasonable fear criterion was defined in accordance with DSM-IV and 5.1% (N = 61) when the DSM-5 criterion was applied. Clinical correlates (GAF, MADRS, and BSA) were worse in SAD cases identified by either procedure compared with all others, and ratings for those reporting unreasonable fear suggested greater (albeit nonsignificant) overall psychopathology. Shifting the judgment of how reasonable the fear was, from the individual to the clinician, doubled the prevalence of SAD. This indicates that the DSM-5 version might increase prevalence rates of SAD in the general population. Further studies strictly applying all DSM-5 criteria are needed in order to confirm these findings. Copyright © 2016 American Association for Geriatric Psychiatry. Published by Elsevier Inc. All rights reserved.

Prevalence and severity of eating disorders: A comparison of DSM-IV and DSM-5 among German adolescents.

PubMed

Ernst, Verena; Bürger, Arne; Hammerle, Florian

2017-11-01

Changes in the DSM-5 eating disorders criteria sought to increase the clarity of the diagnostic categories and to decrease the preponderance of nonspecified eating disorders. The first objective of this study was to analyze how these revisions affect threshold and EDNOS/OSFED eating disorder diagnoses in terms of prevalence, sex ratios, and diagnostic distribution in a student sample. Second, we aimed to compare the impairment levels of participants with a threshold, an EDNOS/OSFED and no diagnosis using both DSM-IV and DSM-5. A sample of 1654 7th and 8th grade students completed self-report questionnaires to determine diagnoses and impairment levels in the context of an eating disorder prevention program in nine German secondary schools. Height and weight were measured. The prevalence of threshold disorders increased from .48% (DSM-IV) to 1.15% (DSM-5). EDNOS disorders increased from 2.90 to 6.23% when using OSFED-categories. A higher proportion of girls was found throughout all the diagnostic categories, and the sex ratios remained stable. The effect sizes of DSM-5 group differences regarding impairment levels were equal to or larger than those of the DSM-IV comparisons, ranging from small to medium. We provide an in-depth overview of changes resulting from the revisions of DSM eating disorder criteria in a German adolescent sample. Despite the overall increase in prevalence estimates, the results suggest that the DSM-5 criteria differentiate participants with threshold disorders and OSFED from those no diagnosis as well as or even more distinctly than the DSM-IV criteria. © 2017 Wiley Periodicals, Inc.

DSM-5 Gambling Disorder: Prevalence and Characteristics in a Substance Use Disorder Sample

PubMed Central

Rennert, Lior; Denis, Cécile; Peer, Kyle; Lynch, Kevin G.; Gelernter, Joel; Kranzler, Henry R.

2014-01-01

Background The fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) replaced the DSM-IV diagnosis of Pathological Gambling (PG) with Gambling Disorder (GD). GD requires four rather than five criteria for the diagnosis and excludes the “Illegal Acts” criterion. We examined the prevalence of GD and its characteristics and validity in a substance use disorder (SUD) sample. Methods Participants (N=6,613) in genetic studies of substance dependence underwent a semi-structured psychiatric interview. Individuals who reported ever having gambled $10 at least monthly (n = 1,507) were the focus of the analyses. Results Approximately one-third of acknowledged gamblers (n = 563; 8.5% of the total sample) received both PG (DSM-IV) and GD (DSM-5) diagnoses and 678 (10.3% of the total) received a DSM-5 diagnosis, representing an increase of 20.4% relative to DSM-IV. Although the three groups were comparable demographically, the DSM-5-Only group was intermediate between the other two groups on the prevalence of comorbid substance use disorders, the distribution of DSM-IV PG criteria endorsed, and the types of gambling reported. Multinomial logistic regression analysis showed that the DSM-5-Only group was more likely than the No-Diagnosis group and less likely than the Both-Diagnoses group to acknowledge a gambling problem. Conclusion There was a high prevalence of PG in this SUD sample. Analysis of non-DSM variables suggested that the increased sensitivity of the DSM-5 GD diagnosis successfully identifies a broader set of individuals with clinically significant gambling-related problems. Prospective studies of individuals with GD are needed to validate this finding. PMID:24490711

NS309 decreases rat detrusor smooth muscle membrane potential and phasic contractions by activating SK3 channels

PubMed Central

Parajuli, Shankar P; Hristov, Kiril L; Soder, Rupal P; Kellett, Whitney F; Petkov, Georgi V

2013-01-01

Background and Purpose Overactive bladder (OAB) is often associated with abnormally increased detrusor smooth muscle (DSM) contractions. We used NS309, a selective and potent opener of the small or intermediate conductance Ca2+-activated K+ (SK or IK, respectively) channels, to evaluate how SK/IK channel activation modulates DSM function. Experimental Approach We employed single-cell RT-PCR, immunocytochemistry, whole cell patch-clamp in freshly isolated rat DSM cells and isometric tension recordings of isolated DSM strips to explore how the pharmacological activation of SK/IK channels with NS309 modulates DSM function. Key Results We detected SK3 but not SK1, SK2 or IK channels expression at both mRNA and protein levels by RT-PCR and immunocytochemistry in DSM single cells. NS309 (10 μM) significantly increased the whole cell SK currents and hyperpolarized DSM cell resting membrane potential. The NS309 hyperpolarizing effect was blocked by apamin, a selective SK channel inhibitor. NS309 inhibited the spontaneous phasic contraction amplitude, force, frequency, duration and tone of isolated DSM strips in a concentration-dependent manner. The inhibitory effect of NS309 on spontaneous phasic contractions was blocked by apamin but not by TRAM-34, indicating no functional role of the IK channels in rat DSM. NS309 also significantly inhibited the pharmacologically and electrical field stimulation-induced DSM contractions. Conclusions and Implications Our data reveal that SK3 channel is the main SK/IK subtype in rat DSM. Pharmacological activation of SK3 channels with NS309 decreases rat DSM cell excitability and contractility, suggesting that SK3 channels might be potential therapeutic targets to control OAB associated with detrusor overactivity. PMID:23145946

Diagnostic and Prognostic Significance of DSM-5 Attenuated Psychosis Syndrome in Services for Individuals at Ultra High Risk for Psychosis.

PubMed

Fusar-Poli, Paolo; De Micheli, Andrea; Cappucciati, Marco; Rutigliano, Grazia; Davies, Cathy; Ramella-Cravaro, Valentina; Oliver, Dominic; Bonoldi, Ilaria; Rocchetti, Matteo; Gavaghan, Lauren; Patel, Rashmi; McGuire, Philip

2018-02-15

The diagnostic and prognostic significance of the DSM-5-defined Attenuated Psychosis Syndrome (DSM-5-APS) in individuals undergoing an ultra high risk (UHR) clinical assessment for suspicion of psychosis risk is unknown. Prospective cohort study including all consecutive help-seeking individuals undergoing both a DSM-5-APS and a Comprehensive Assessment of At Risk Mental States (CAARMS 12/2006) assessment for psychosis risk at the Outreach and Support in South London (OASIS) UHR service (March 2013-April 2014). The diagnostic significance of DSM-5-APS was assessed with percent overall agreement, prevalence bias adjusted kappa, Bowker's test, Stuart-Maxwell test, residual analysis; the prognostic significance with Cox regression, Kaplan-Meier failure function, time-dependent area under the curve (AUC) and net benefits analysis. The impact of specific revisions of the DSM-5-APS was further tested. In 203 help-seeking individuals undergoing UHR assessment, the agreement between the DSM-5-APS and the CAARMS 12/2006 was only moderate (kappa 0.59). Among 142 nonpsychotic cases, those meeting DSM-5-APS criteria had a 5-fold probability (HR = 5.379) of developing psychosis compared to those not meeting DSM-5-APS criteria, with a 21-month cumulative risk of psychosis of 28.17% vs 6.49%, respectively. The DSM-5-APS prognostic accuracy was acceptable (AUC 0.76 at 24 months) and similar to the CAARMS 12/2006. The DSM-5-APS designation may be clinically useful to guide the provision of indicated interventions within a 7%-35% (2-year) range of psychosis risk. The removal of the criterion E or C of the DSM-5-APS may improve its prognostic performance and transdiagnostic value. The DSM-5-APS designation may be clinically useful in individuals accessing clinical services for psychosis prevention. © The Author 2017. Published by Oxford University Press on behalf of the Maryland Psychiatric Research Center. All rights reserved. For permissions, please email: journals.permissions@oup.com

Evaluating Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition Posttraumatic Stress Disorder Diagnostic Criteria in Older Children and Adolescents

PubMed Central

Scheeringa, Michael S.; Weems, Carl F.

2017-01-01

Abstract Objectives: Few studies have assessed how the diagnostic criteria for posttraumatic stress disorder (PTSD) apply to older children and adolescents. With the introduction of a new, developmentally sensitive set of criteria for very young children (age 6 years and younger) in Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5), this raises new questions about the validity of the criteria for older children and adolescents. The current study investigated how diagnostic changes in DSM-5 impact diagnosis rates in 7–18-year olds. Methods: PTSD, impairment, and comorbid psychopathology were assessed in 135 trauma-exposed, treatment-seeking participants. Children (ages 7–12) were examined separately from adolescents (ages 13–18) to assess for potential developmental differences. Results: A significantly higher proportion of 7–12-year-old children met criteria for DSM-5 diagnosis (53%) compared to Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV) (37%). However, among 13–18-year-old adolescents, the proportions diagnosed with DSM-5 (73%) and DSM-IV (74%) did not differ. Participants who met criteria for DSM-5 only (17%) did not differ from those diagnosed with DSM-IV in terms impairment or comorbidity. Using the newly accepted age 6 years and younger criteria resulted in a significantly higher proportion of 7–12-year-old (but not 13–18-year olds) children meeting criteria compared to DSM-IV or DSM-5. However, these children showed less impairment and comorbidity than those diagnosed with DSM-IV. Conclusion: These findings suggest that DSM-5 criteria may be more developmentally sensitive than DSM-IV criteria, and may lead to higher prevalence rates of PTSD for 7–12-year-old children, but not for adolescents. Using the very young children criteria for 7–12-year-old children may further increase prevalence, but capture children with less severe psychopathology. PMID:28170306

Evaluating Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition Posttraumatic Stress Disorder Diagnostic Criteria in Older Children and Adolescents.

PubMed

Mikolajewski, Amy J; Scheeringa, Michael S; Weems, Carl F

2017-05-01

Few studies have assessed how the diagnostic criteria for posttraumatic stress disorder (PTSD) apply to older children and adolescents. With the introduction of a new, developmentally sensitive set of criteria for very young children (age 6 years and younger) in Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5), this raises new questions about the validity of the criteria for older children and adolescents. The current study investigated how diagnostic changes in DSM-5 impact diagnosis rates in 7-18-year olds. PTSD, impairment, and comorbid psychopathology were assessed in 135 trauma-exposed, treatment-seeking participants. Children (ages 7-12) were examined separately from adolescents (ages 13-18) to assess for potential developmental differences. A significantly higher proportion of 7-12-year-old children met criteria for DSM-5 diagnosis (53%) compared to Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV) (37%). However, among 13-18-year-old adolescents, the proportions diagnosed with DSM-5 (73%) and DSM-IV (74%) did not differ. Participants who met criteria for DSM-5 only (17%) did not differ from those diagnosed with DSM-IV in terms impairment or comorbidity. Using the newly accepted age 6 years and younger criteria resulted in a significantly higher proportion of 7-12-year-old (but not 13-18-year olds) children meeting criteria compared to DSM-IV or DSM-5. However, these children showed less impairment and comorbidity than those diagnosed with DSM-IV. These findings suggest that DSM-5 criteria may be more developmentally sensitive than DSM-IV criteria, and may lead to higher prevalence rates of PTSD for 7-12-year-old children, but not for adolescents. Using the very young children criteria for 7-12-year-old children may further increase prevalence, but capture children with less severe psychopathology.

Novel mechanism of hydrogen sulfide-induced guinea pig urinary bladder smooth muscle contraction: role of BK channels and cholinergic neurotransmission

PubMed Central

Fernandes, Vítor S.; Xin, Wenkuan

2015-01-01

Hydrogen sulfide (H2S) is a key signaling molecule regulating important physiological processes, including smooth muscle function. However, the mechanisms underlying H2S-induced detrusor smooth muscle (DSM) contractions are not well understood. This study investigates the cellular and tissue mechanisms by which H2S regulates DSM contractility, excitatory neurotransmission, and large-conductance voltage- and Ca2+-activated K+ (BK) channels in freshly isolated guinea pig DSM. We used a multidisciplinary experimental approach including isometric DSM tension recordings, colorimetric ACh measurement, Ca2+ imaging, and patch-clamp electrophysiology. In isolated DSM strips, the novel slow release H2S donor, P-(4-methoxyphenyl)-p-4-morpholinylphosphinodithioic acid morpholine salt (GYY4137), significantly increased the spontaneous phasic and nerve-evoked DSM contractions. The blockade of neuronal voltage-gated Na+ channels or muscarinic ACh receptors with tetrodotoxin or atropine, respectively, reduced the stimulatory effect of GYY4137 on DSM contractility. GYY4137 increased ACh release from bladder nerves, which was inhibited upon blockade of L-type voltage-gated Ca2+ channels with nifedipine. Furthermore, GYY4137 increased the amplitude of the Ca2+ transients and basal Ca2+ levels in isolated DSM strips. GYY4137 reduced the DSM relaxation induced by the BK channel opener, NS11021. In freshly isolated DSM cells, GYY4137 decreased the amplitude and frequency of transient BK currents recorded in a perforated whole cell configuration and reduced the single BK channel open probability measured in excised inside-out patches. GYY4137 inhibited spontaneous transient hyperpolarizations and depolarized the DSM cell membrane potential. Our results reveal the novel findings that H2S increases spontaneous phasic and nerve-evoked DSM contractions by activating ACh release from bladder nerves in combination with a direct inhibition of DSM BK channels. PMID:25948731

Personality disorder in DSM-5: an oral history.

PubMed

Zachar, P; Krueger, R F; Kendler, K S

2016-01-01

As the revision process leading to DSM-5 began, the domain of personality disorder embodied the highest aspirations for major change. After an initial prototype-based proposal failed to gain acceptance, the Personality and Personality Disorders Work Group (P&PDWG) developed a hybrid model containing categorical and dimensional components. A clash of perspectives both within the P&PDWG and between the P&PDWG and DSM-5 oversight committees led to the rejection of this proposal from the main body of DSM-5. Major issues included conflicting ways of conceptualizing validation, differences of opinion from personality disorder experts outside the P&PDWG, divergent concepts of the magnitude of evidence needed to support substantial changes, and the disagreements about clinical utility of the hybrid model. Despite these setbacks, the 'Alternative DSM-5 Model of Personality Disorder' is presented in Section III of the DSM-5. Further research should clarify its performance relative to the DSM-IV criteria reprinted in the main DSM-5 text.

How should we revise diagnostic criteria for substance use disorders in the DSM-V?

PubMed

Martin, Christopher S; Chung, Tammy; Langenbucher, James W

2008-08-01

This article reviews literature on the validity and performance characteristics of the Diagnostic and Statistical Manual of Mental Disorders (4th ed.; DSM-IV; American Psychiatric Association, 1994) diagnostic criteria for substance use disorders (SUDs) and recommends changes in these criteria that should be considered for the next edition of the DSM (DSM-V). Substantial data indicate that DSM-IV substance abuse and substance dependence are not distinct categories and that SUD criteria are best modeled as reflecting a unidimensional continuum of substance-problem severity. The conceptually and empirically problematic substance abuse diagnosis should be abandoned in the DSM-V, with substance dependence defined by a single set of criteria. Data also indicate that various individual SUD criteria should be revised, dropped, or considered for inclusion in the DSM-V. The DSM-V should provide a framework that allows the integration of categorical and dimensional approaches to diagnosis. Important areas for further research are noted. Copyright (c) 2008 APA, all rights reserved.

An analysis of the factors influencing demand-side management activity in the electric utility industry

NASA Astrophysics Data System (ADS)

Bock, Mark Joseph

Demand-side management (DSM), defined as the "planning, implementation, and monitoring of utility activities designed to encourage consumers to modify their pattern of electricity usage, including the timing and level of electricity demand," is a relatively new concept in the U.S. electric power industry. Nevertheless, in twenty years since it was first introduced, utility expenditures on DSM programs, as well as the number of such programs, have grown rapidly. At first glance, it may seem peculiar that a firm would actively attempt to reduce demand for its primary product. There are two primary explanations as to why a utility might pursue DSM: regulatory mandate, and self-interest. The purpose of this dissertation is to determine the impact these influences have on the amount of DSM undertaken by utilities. This research is important for two reasons. First, it provides insight into whether DSM will continue to exist as competition becomes more prevalent in the industry. Secondly, it is important because no one has taken a comprehensive look at firm-level DSM activity on an industry-wide basis. The primary data set used in this dissertation is the U.S. Department of Energy's Annual Electric Utility Report, Form EIA-861, which represents the most comprehensive data set available for analyzing DSM activity in the U.S. There are four measures of DSM activity in this data set: (1) utility expenditures on DSM programs; (2) energy savings by DSM program participants; and (3) the actual and (4) the potential reductions in peak load resulting from utility DSM measures. Each is used as the dependent variable in an econometric analysis where independent variables include various utility characteristics, regulatory characteristics, and service territory and customer characteristics. In general, the results from the econometric analysis suggest that in 1993, DSM activity was primarily the result of regulatory pressure. All of the evidence suggests that if DSM continues to exist in a deregulated environment, it will be at a greatly reduced level. This conclusion holds unless utilities see advantages to DSM as a marketing tool to increase customer satisfaction and loyalty.

Estimating the Prevalence of Binge Eating Disorder in a Community Sample From the United States: Comparing DSM-IV-TR and DSM-5 Criteria.

PubMed

Cossrow, Nicole; Pawaskar, Manjiri; Witt, Edward A; Ming, Eileen E; Victor, Timothy W; Herman, Barry K; Wadden, Thomas A; Erder, M Haim

2016-08-01

To estimate binge eating disorder (BED) prevalence according to DSM-5 and DSM-IV-TR criteria in US adults and to estimate the proportion of individuals meeting DSM-5 BED criteria who reported being formally diagnosed. A representative sample of US adults who participated in the National Health and Wellness Survey were asked to respond to an Internet survey (conducted in October 2013). Assessments included 3-month, 12-month, and lifetime BED prevalence based on DSM-5 and DSM-IV-TR criteria and demographics, psychiatric comorbidities, and self-esteem (Rosenberg Self-Esteem Scale). Descriptive statistics are provided. Prevalence estimates were calculated using poststratification sampling weights. Of 22,397 respondents, 344 (women, n = 242; men, n = 102) self-reported symptoms consistent with DSM-5 BED symptom criteria. The 3-month, 12-month, and lifetime DSM-5 prevalence estimates (95% CIs) projected to the US population were 1.19% (1.04%-1.37%), 1.64% (1.45%-1.85%), and 2.03% (1.83%-2.26%), respectively. The 12-month and lifetime projected DSM-IV-TR prevalence estimates were 1.15% (1.00%-1.32%) and 1.52% (1.35%-1.70%), respectively. Of respondents meeting DSM-5 BED criteria in the past 12 months, 3.2% (11/344) reported receiving a formal diagnosis. Compared with non-BED respondents, respondents meeting DSM-5 BED criteria in the past 12 months were younger (mean ± SD age = 46.01 ± 14.32 vs 51.59 ± 15.80 years; P < .001), had a higher body mass index (mean ± SD = 33.71 ± 9.36 vs 27.96 ± 6.68 kg/m²; P < .001), and had lower self-esteem (mean ± SD score = 16.47 ± 6.99 vs 23.33 ± 6.06; P < .001). DSM-5 BED criteria resulted in higher BED prevalence estimates than with DSM-IV-TR criteria. Most BED respondents did not report being formally diagnosed, indicating an unmet need in BED recognition and diagnosis. © Copyright 2016 Physicians Postgraduate Press, Inc.

[Critical evaluation of the first draft of DSM-V].

PubMed

Frances, A

2011-02-16

Critical evaluation of DSM-V first draft This is an evaluation of the first DSM-V (Diagnostic and Statistical Manual of Mental Disorders-V) draft from the DSM-IV chairman. First, a brief history of DSM is reported. Then, major reasons for present controversies and the threat they raise to APA leadership in the field are discussed. Third point is careful recollection of the several conflicting aspects of the DSM-V draft, paying attention to drawbacks and their implications for future clinical practice, research and forensic activity. Comment is finally provided about APA (American Psychiatric Association) decisions aimed at reaching more consensus about this basic instrument of American psychiatry.

System Operations Studies for Automated Gateway Transit Systems - Detailed Station Model Programmer's Manual.

DOT National Transportation Integrated Search

1982-01-01

The Detailed Station Model (DSM) provides operational and performance measures of alternative station configurations and management policies with respect to vehicle and passenger capabilities. It provides an analytic tool to support tradeoff studies ...

[Autism Spectrum Disorder in DSM-5 - concept, validity, and reliability, impact on clinical care and future research].

PubMed

Freitag, Christine M

2014-05-01

Autism Spectrum Disorder (ASD) in DSM-5 comprises the former DSM-IV-TR diagnoses of Autistic Disorder, Asperger's Disorder and PDD-nos. The criteria for ASD in DSM-5 were considerably revised from those of ICD-10 and DSM-IV-TR. The present article compares the diagnostic criteria, presents studies on the validity and reliability of ASD, and discusses open questions. It ends with a clinical and research perspective.

Disqualified qualifiers: evaluating the utility of the revised DSM-5 definition of potentially traumatic events among area youth following the Boston marathon bombing.

PubMed

Chou, Tommy; Carpenter, Aubrey L; Kerns, Caroline E; Elkins, R Meredith; Green, Jennifer Greif; Comer, Jonathan S

2017-04-01

The DSM-5 includes a revised definition of the experiences that qualify as potentially traumatic events. This revised definition now offers a clearer and more exclusive definition of what qualifies as a traumatic exposure, but little is known about the revision's applicability to youth populations. The present study evaluated the predictive utility of the revised DSM definitional boundaries of traumatic exposure in a sample of youth exposed to the 2013 Boston Marathon bombing and related events METHODS: Caregivers (N = 460) completed surveys 2 to 6 months postbombing about youth experiences during the events and youth posttraumatic stress (PTS) symptoms RESULTS: Experiencing DSM-5 qualifying traumatic events (DSM-5 QTEs) significantly predicted child PTS symptoms (PTSS), whereas DSM-5 nonqualifying stressful experiences (DSM-5 non-QSEs) did not after accounting for DSM-5 QTEs. Importantly, child age moderated the relationship between DSM-5 QTEs and PTSS such that children 7 and older who experienced DSM-5 QTEs showed greater postbombing PTSS, whereas there was no such relationship in children ages 6 and below CONCLUSIONS: Data largely support the revised posttraumatic stress disorder (PTSD) definition of QTEs in older youth, and also highlight the need for further refinement of the QTE definition for children ages 6 and below. © 2016 Wiley Periodicals, Inc.

Building Change Detection from Harvey using Unmanned Aerial System (UAS)

NASA Astrophysics Data System (ADS)

Chang, A.; Yeom, J.; Jung, J.; Choi, I.

2017-12-01

Unmanned Aerial System (UAS) is getting to be the most important technique in recent days since the fine spatial and high temporal resolution data previously unobtainable from traditional remote sensing platforms. Advanced UAS data can provide a great opportunity for disaster monitoring. Especially, building change detection is the one of the most important topics for damage assessment and recovery from disasters. This study is proposing a method to monitor building change with UAS data for Holiday Beach in Texas, where was directly hit by Harvey on 25 August 2017. This study adopted 3D change detection to monitor building damage and recovery levels with building height as well as natural color information. We used a rotorcraft UAS to collect RGB data twice on 9 September and 18 October 2017 after the hurricane. The UAS data was processed using Agisoft Photoscan Pro Software to generate super high resolution dataset including orthomosaic, DSM (Digital Surface Model), and 3D point cloud. We compared the processed dataset with an airborne image considerable as before-hurricane data, which was acquired on January 2016. Building damage and recovery levels were determined by height and color change. The result will show that UAS data is useful to assess building damage and recovery for affected area by the natural disaster such as Harvey.

Classification of Depressive Disorders in DSM-V: Proposal for a Two-Dimension System

PubMed Central

Klein, Daniel N.

2011-01-01

The number of categories and specifiers for mood disorders has increased with each successive edition of the Diagnostic and Statistical Manual for Mental Disorders (DSM). Many of these categories and specifiers can be viewed as an effort to map the various permutations of severity and chronicity that characterize the depressive disorders. However, this has resulted in a system that is unnecessarily complex and unwieldy, and created problems with artificial distinctions between categories and artifactual comorbidity, and at the same time obscures what may be more fundamental distinctions. A potentially useful and more parsimonious approach to capturing much of the heterogeneity of depressive disorders is to classify the depressive disorders along two dimensions, one reflecting severity and the other chronicity. Considerations in the development of these dimensions are discussed, and a set of examples is presented. Although further research and discussion are needed to determine the optimal form of these dimensions, the next edition of the DSM should consider replacing many of the existing categories and specifiers for depressive disorders with the simpler approach of classifying depressive disorders using the two dimensions of severity and chronicity. PMID:18729608

Prevalence of Autism Spectrum Disorder Among Children Aged 8 Years — Autism and Developmental Disabilities Monitoring Network, 11 Sites, United States, 2014

PubMed Central

Wiggins, Lisa; Christensen, Deborah L.; Maenner, Matthew J; Daniels, Julie; Warren, Zachary; Kurzius-Spencer, Margaret; Zahorodny, Walter; Robinson Rosenberg, Cordelia; White, Tiffany; Durkin, Maureen S.; Imm, Pamela; Nikolaou, Loizos; Yeargin-Allsopp, Marshalyn; Lee, Li-Ching; Harrington, Rebecca; Lopez, Maya; Fitzgerald, Robert T.; Hewitt, Amy; Pettygrove, Sydney; Constantino, John N.; Vehorn, Alison; Shenouda, Josephine; Hall-Lande, Jennifer; Van Naarden Braun, Kim; Dowling, Nicole F.

2018-01-01

Problem/Condition Autism spectrum disorder (ASD). Period Covered 2014. Description of System The Autism and Developmental Disabilities Monitoring (ADDM) Network is an active surveillance system that provides estimates of the prevalence of autism spectrum disorder (ASD) among children aged 8 years whose parents or guardians reside within 11 ADDM sites in the United States (Arizona, Arkansas, Colorado, Georgia, Maryland, Minnesota, Missouri, New Jersey, North Carolina, Tennessee, and Wisconsin). ADDM surveillance is conducted in two phases. The first phase involves review and abstraction of comprehensive evaluations that were completed by professional service providers in the community. Staff completing record review and abstraction receive extensive training and supervision and are evaluated according to strict reliability standards to certify effective initial training, identify ongoing training needs, and ensure adherence to the prescribed methodology. Record review and abstraction occurs in a variety of data sources ranging from general pediatric health clinics to specialized programs serving children with developmental disabilities. In addition, most of the ADDM sites also review records for children who have received special education services in public schools. In the second phase of the study, all abstracted information is reviewed systematically by experienced clinicians to determine ASD case status. A child is considered to meet the surveillance case definition for ASD if he or she displays behaviors, as described on one or more comprehensive evaluations completed by community-based professional providers, consistent with the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR) diagnostic criteria for autistic disorder; pervasive developmental disorder–not otherwise specified (PDD-NOS, including atypical autism); or Asperger disorder. This report provides updated ASD prevalence estimates for children aged 8 years during the 2014 surveillance year, on the basis of DSM-IV-TR criteria, and describes characteristics of the population of children with ASD. In 2013, the American Psychiatric Association published the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), which made considerable changes to ASD diagnostic criteria. The change in ASD diagnostic criteria might influence ADDM ASD prevalence estimates; therefore, most (85%) of the records used to determine prevalence estimates based on DSM-IV-TR criteria underwent additional review under a newly operationalized surveillance case definition for ASD consistent with the DSM-5 diagnostic criteria. Children meeting this new surveillance case definition could qualify on the basis of one or both of the following criteria, as documented in abstracted comprehensive evaluations: 1) behaviors consistent with the DSM-5 diagnostic features; and/or 2) an ASD diagnosis, whether based on DSM-IV-TR or DSM-5 diagnostic criteria. Stratified comparisons of the number of children meeting either of these two case definitions also are reported. Results For 2014, the overall prevalence of ASD among the 11 ADDM sites was 16.8 per 1,000 (one in 59) children aged 8 years. Overall ASD prevalence estimates varied among sites, from 13.1–29.3 per 1,000 children aged 8 years. ASD prevalence estimates also varied by sex and race/ethnicity. Males were four times more likely than females to be identified with ASD. Prevalence estimates were higher for non-Hispanic white (henceforth, white) children compared with non-Hispanic black (henceforth, black) children, and both groups were more likely to be identified with ASD compared with Hispanic children. Among the nine sites with sufficient data on intellectual ability, 31% of children with ASD were classified in the range of intellectual disability (intelligence quotient [IQ] <70), 25% were in the borderline range (IQ 71–85), and 44% had IQ scores in the average to above average range (i.e., IQ >85). The distribution of intellectual ability varied by sex and race/ethnicity. Although mention of developmental concerns by age 36 months was documented for 85% of children with ASD, only 42% had a comprehensive evaluation on record by age 36 months. The median age of earliest known ASD diagnosis was 52 months and did not differ significantly by sex or race/ethnicity. For the targeted comparison of DSM-IV-TR and DSM-5 results, the number and characteristics of children meeting the newly operationalized DSM-5 case definition for ASD were similar to those meeting the DSM-IV-TR case definition, with DSM-IV-TR case counts exceeding DSM-5 counts by less than 5% and approximately 86% overlap between the two case definitions (kappa = 0.85). Interpretation Findings from the ADDM Network, on the basis of 2014 data reported from 11 sites, provide updated population-based estimates of the prevalence of ASD among children aged 8 years in multiple communities in the United States. The overall ASD prevalence estimate of 16.8 per 1,000 children aged 8 years in 2014 is higher than previously reported estimates from the ADDM Network. Because the ADDM sites do not provide a representative sample of the entire United States, the combined prevalence estimates presented in this report cannot be generalized to all children aged 8 years in the United States. Consistent with reports from previous ADDM surveillance years, findings from 2014 were marked by variation in ASD prevalence when stratified by geographic area, sex, and level of intellectual ability. Differences in prevalence estimates between black and white children have diminished in most sites, but remained notable for Hispanic children. For 2014, results from application of the DSM-IV-TR and DSM-5 case definitions were similar, overall and when stratified by sex, race/ethnicity, DSM-IV-TR diagnostic subtype, or level of intellectual ability. Public Health Action Beginning with surveillance year 2016, the DSM-5 case definition will serve as the basis for ADDM estimates of ASD prevalence in future surveillance reports. Although the DSM-IV-TR case definition will eventually be phased out, it will be applied in a limited geographic area to offer additional data for comparison. Future analyses will examine trends in the continued use of DSM-IV-TR diagnoses, such as autistic disorder, PDD-NOS, and Asperger disorder in health and education records, documentation of symptoms consistent with DSM-5 terminology, and how these trends might influence estimates of ASD prevalence over time. The latest findings from the ADDM Network provide evidence that the prevalence of ASD is higher than previously reported estimates and continues to vary among certain racial/ethnic groups and communities. With prevalence of ASD ranging from 13.1 to 29.3 per 1,000 children aged 8 years in different communities throughout the United States, the need for behavioral, educational, residential, and occupational services remains high, as does the need for increased research on both genetic and nongenetic risk factors for ASD. PMID:29701730

Brief Report: Investigating the Implications of Applying the New DSM-5 Criteria for Diagnosing Autism Spectrum Disorder in a Preschool Population in Singapore

ERIC Educational Resources Information Center

Wong, Chui Mae; Koh, Hwan Cui

2016-01-01

Diagnostic reports for 206 children who underwent an assessment for autism spectrum disorder (ASD) using the DSM-IV-TR criteria, were re-evaluated using the DSM-5 criteria. Mean age of the children at time of diagnosis was 3 years 10 months. Of the 202 children diagnosed with ASD on the DSM-IV-TR, 184 (91.1%) also met the DSM-5 criteria for ASD.…

Objected-oriented remote sensing image classification method based on geographic ontology model

NASA Astrophysics Data System (ADS)

Chu, Z.; Liu, Z. J.; Gu, H. Y.

2016-11-01

Nowadays, with the development of high resolution remote sensing image and the wide application of laser point cloud data, proceeding objected-oriented remote sensing classification based on the characteristic knowledge of multi-source spatial data has been an important trend on the field of remote sensing image classification, which gradually replaced the traditional method through improving algorithm to optimize image classification results. For this purpose, the paper puts forward a remote sensing image classification method that uses the he characteristic knowledge of multi-source spatial data to build the geographic ontology semantic network model, and carries out the objected-oriented classification experiment to implement urban features classification, the experiment uses protégé software which is developed by Stanford University in the United States, and intelligent image analysis software—eCognition software as the experiment platform, uses hyperspectral image and Lidar data that is obtained through flight in DaFeng City of JiangSu as the main data source, first of all, the experiment uses hyperspectral image to obtain feature knowledge of remote sensing image and related special index, the second, the experiment uses Lidar data to generate nDSM(Normalized DSM, Normalized Digital Surface Model),obtaining elevation information, the last, the experiment bases image feature knowledge, special index and elevation information to build the geographic ontology semantic network model that implement urban features classification, the experiment results show that, this method is significantly higher than the traditional classification algorithm on classification accuracy, especially it performs more evidently on the respect of building classification. The method not only considers the advantage of multi-source spatial data, for example, remote sensing image, Lidar data and so on, but also realizes multi-source spatial data knowledge integration and application of the knowledge to the field of remote sensing image classification, which provides an effective way for objected-oriented remote sensing image classification in the future.

Utility of the 3Di Short Version for the Diagnostic Assessment of Autism Spectrum Disorder and Compatibility with DSM-5.

PubMed

Slappendel, Geerte; Mandy, William; van der Ende, Jan; Verhulst, Frank C; van der Sijde, Ad; Duvekot, Jorieke; Skuse, David; Greaves-Lord, Kirstin

2016-05-01

The Developmental Diagnostic Dimensional Interview-short version (3Di-sv) provides a brief standardized parental interview for diagnosing autism spectrum disorder (ASD). This study explored its validity, and compatibility with DSM-5 ASD. 3Di-sv classifications showed good sensitivity but low specificity when compared to ADOS-2-confirmed clinical diagnosis. Confirmatory factor analyses found a better fit against a DSM-5 model than a DSM-IV-TR model of ASD. Exploration of the content validity of the 3Di-sv for the DSM-5 revealed some construct underrepresentation, therefore we obtained data from a panel of 3Di-trained clinicians from ASD-specialized centers to recommend items to fill these gaps. Taken together, the 3Di-sv provides a solid basis to create a similar instrument suitable for DSM-5. Concrete recommendations are provided to improve DSM-5 compatibility.

Do gender and directness of trauma exposure moderate PTSD's latent structure?

PubMed

Frankfurt, Sheila B; Armour, Cherie; Contractor, Ateka A; Elhai, Jon D

2016-11-30

The PTSD diagnosis and latent structure were substantially revised in the transition from DSM-IV to DSM-5. However, three alternative models (i.e., anhedonia model, externalizing behavior model, and hybrid model) of PTSD fit the DSM-5 symptom criteria better than the DSM-5 factor model. Thus, the psychometric performance of the DSM-5 and alternative models' PTSD factor structure needs to be critically evaluated. The current study examined whether gender or trauma directness (i.e., direct or indirect trauma exposure) moderates the PTSD latent structure when using the DSM-5 or alternative models. Model performance was evaluated with measurement invariance testing procedures on a large undergraduate sample (n=455). Gender and trauma directness moderated the DSM-5 PTSD and externalizing behavior model and did not moderate the anhedonia and hybrid models' latent structure. Clinical implications and directions for future research are discussed. Published by Elsevier Ireland Ltd.

A proposal for including nomophobia in the new DSM-V

PubMed Central

Bragazzi, Nicola Luigi; Del Puente, Giovanni

2014-01-01

The Diagnostic and Statistical Manual of Mental Disorders (DSM) is considered to be the gold standard manual for assessing the psychiatric diseases and is currently in its fourth version (DSM-IV), while a fifth (DSM-V) has just been released in May 2013. The DSM-V Anxiety Work Group has put forward recommendations to modify the criteria for diagnosing specific phobias. In this manuscript, we propose to consider the inclusion of nomophobia in the DSM-V, and we make a comprehensive overview of the existing literature, discussing the clinical relevance of this pathology, its epidemiological features, the available psychometric scales, and the proposed treatment. Even though nomophobia has not been included in the DSM-V, much more attention is paid to the psychopathological effects of the new media, and the interest in this topic will increase in the near future, together with the attention and caution not to hypercodify as pathological normal behaviors. PMID:24876797

[Neurocognitive disorders in DSM-5: pervasive changes in the diagnostics of dementia].

PubMed

Maier, W; Barnikol, U B

2014-05-01

The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) proposes an innovative chapter on neurocognitive disorders (NCD) as a substitute for the dementia, delirium and amnestic disorders chapter in DSM-IV. This NCD chapter promotes a most innovative change compared to DSM-IV. While the term delirium is preserved, the commonly used term dementia does not occur as a diagnostic entity. Neurocognitive disorders are more inclusive than dementias; they also cover early prodromal stages of dementias below the DSM-IV threshold. The diagnosis of NCDs requires essentially neuropsychological testing preferentially with standardized instruments. Special focus is given to etiological subtyping taking former diagnostic consensus processes by expert groups into consideration. The subsequent more extensive concept of NCD also allows the diagnosis of etiological-specific prodromal states of cognitive impairments. The changes from DSM-IV to DSM-5 are critically discussed.

A proposal for including nomophobia in the new DSM-V.

PubMed

Bragazzi, Nicola Luigi; Del Puente, Giovanni

2014-01-01

The Diagnostic and Statistical Manual of Mental Disorders (DSM) is considered to be the gold standard manual for assessing the psychiatric diseases and is currently in its fourth version (DSM-IV), while a fifth (DSM-V) has just been released in May 2013. The DSM-V Anxiety Work Group has put forward recommendations to modify the criteria for diagnosing specific phobias. In this manuscript, we propose to consider the inclusion of nomophobia in the DSM-V, and we make a comprehensive overview of the existing literature, discussing the clinical relevance of this pathology, its epidemiological features, the available psychometric scales, and the proposed treatment. Even though nomophobia has not been included in the DSM-V, much more attention is paid to the psychopathological effects of the new media, and the interest in this topic will increase in the near future, together with the attention and caution not to hypercodify as pathological normal behaviors.

Dynamic spectrum management: an impact on EW systems

NASA Astrophysics Data System (ADS)

Gajewski, P.; Łopatka, J.; Suchanski, M.

2017-04-01

Rapid evolution of wireless systems caused an enormous growth of data streams transmitted through the networks and, as a consequence, an accompanying demand concerning spectrum resources (SR). An avoidance of advisable disturbances is one of the main demands in military communications. To solve the interference problems, dynamic spectrum management (DSM) techniques can be used. Two main techniques are possible: centralized Coordinated Dynamic Spectrum Access (CDSA) and distributed Opportunistic Spectrum Access (OSA). CDSA enables the wireless networks planning automation, and systems dynamic reaction to random changes of Radio Environment (RE). For OSA, cognitive radio (CR) is the most promising technology that enables avoidance of interference with the other spectrum users due to CR's transmission parameters adaptation to the current radio situation, according to predefined Radio Policies rules. If DSM techniques are used, the inherent changes in EW systems are also needed. On one hand, new techniques of jamming should be elaborated, on the other hand, the rules and protocols of cooperation between communication network and EW systems should be developed.

A view of personality disorder from the colonial periphery.

PubMed

Hickling, F W; Walcott, G

2013-01-01

To examine the history of personality disorder in the context of contemporary post-colonial Jamaican society. The literature outlining the development and classification of personality disorder is reviewed. The social, psychiatric and epidemiological studies of personality disorder in Jamaica are presented. A categorical classification system of personality disorder has been in use by the International Classification of Diseases (ICD) and the Diagnostic and Statistical Manual of Mental Disorders (DSM) from the mid 20th century. Challenging that approach is the Minnesota Multiphasic Personality Inventory (MMPI), which represents the dimensional method, which views pathology as a continuum from normal personality traits. Both systems suffer from an absence of cultural flexibility, an absence of a a system of severity, and a lack of treatment specificity, which foster misdiagnosis while making treatment planning difficult and unreliable. The proposed DSM-5 attempts to integrate a prototypematching system and identification of personality traits promises disappointing outcomes. The University of the West Indies, Section of Psychiatry, proposes a phenomenological nosological approach, advocating an alternate DSM Axis I category called Shakatani derived from Swahili shaka (problem), tani (power), and developing a 38-item Jamaica Personality Disorder Inventory (JPDI) screening questionnaire for diagnosing this condition. The epidemiological results using this instrument are reviewed, and the Jamaican print, broadcast and social media responses to this research in Jamaica are described. The heritage of slavery and colonial oppression in Jamaica has resulted in maladaptive personality disorders that have led to extremely high rates of homicide, violence and transgressive behaviour.

Brief Report: Comparability of DSM-IV and DSM-5 ASD Research Samples

ERIC Educational Resources Information Center

Mazefsky, C. A.; McPartland, J. C.; Gastgeb, H. Z.; Minshew, N. J.

2013-01-01

Diagnostic and Statistical Manual (DSM-5) criteria for ASD have been criticized for being too restrictive, especially for more cognitively-able individuals. It is unclear, however, if high-functioning individuals deemed eligible for research via standardized diagnostic assessments would meet DSM-5 criteria. This study investigated the impact of…

78 FR 77384 - DSM Nutritional Products; Filing of Food Additive Petition (Animal Use)

Federal Register 2010, 2011, 2012, 2013, 2014

2013-12-23

.... FDA-2013-F-1540] DSM Nutritional Products; Filing of Food Additive Petition (Animal Use) AGENCY: Food... (FDA) is announcing that DSM Nutritional Products has filed a petition proposing that the food additive...)), notice is given that a food additive petition (FAP 2277) has been filed by DSM Nutritional Products, 45...

A numerical calculation method of environmental impacts for the deep sea mining industry - a review.

PubMed

Ma, Wenbin; van Rhee, Cees; Schott, Dingena

2018-03-01

Since the gradual decrease of mineral resources on-land, deep sea mining (DSM) is becoming an urgent and important emerging activity in the world. However, until now there has been no commercial scale DSM project in progress. Together with the reasons of technological feasibility and economic profitability, the environmental impact is one of the major parameters hindering its industrialization. Most of the DSM environmental impact research focuses on only one particular aspect ignoring that all the DSM environmental impacts are related to each other. The objective of this work is to propose a framework for the numerical calculation methods of the integrated DSM environmental impacts through a literature review. This paper covers three parts: (i) definition and importance description of different DSM environmental impacts; (ii) description of the existing numerical calculation methods for different environmental impacts; (iii) selection of a numerical calculation method based on the selected criteria. The research conducted in this paper provides a clear numerical calculation framework for DSM environmental impact and could be helpful to speed up the industrialization process of the DSM industry.

The interpersonal core of personality pathology

PubMed Central

Hopwood, Christopher J.; Wright, Aidan G.C.; Ansell, Emily B.; Pincus, Aaron L.

2013-01-01

The purpose of this paper is to demonstrate that personality pathology is, at its core, fundamentally interpersonal. We review the proposed DSM-5 Section 3 redefinition of personality pathology involving self and interpersonal dysfunction, which we regard as a substantial improvement over the DSM-IV (and DSM-5 Section 2) definition. We note similarities between the proposed scheme and contemporary interpersonal theory and interpret the DSM-5 Section 3 definition using the underlying assumptions and evidence base of the interpersonal paradigm in clinical psychology. We describe how grounding the proposed DSM-5 Section 3 definition in interpersonal theory, and in particular a focus on the “interpersonal situation”, adds to its theoretical texture, empirical support, and clinical utility. We provide a clinical example that demonstrates the ability of contemporary interpersonal theory to augment the DSM-5 definition of personality pathology. We conclude with directions for further research that could clarify the core of personality pathology, and how interpersonal theory can inform research aimed at enhancing the DSM-5 Section 3 proposal and ultimately justify its migration to DSM-5 Section 2. PMID:23735037

a Novel Image Acquisition and Processing Procedure for Fast Tunnel Dsm Production

NASA Astrophysics Data System (ADS)

Roncella, R.; Umili, G.; Forlani, G.

2012-07-01

In mining operations the evaluation of the stability condition of the excavated front are critic to ensure a safe and correct planning of the subsequent activities. The procedure currently used to this aim has some shortcomings: safety for the geologist, completeness of data collection and objective documentation of the results. In the last decade it has been shown that the geostructural parameters necessary to the stability analysis can be derived from high resolution digital surface models (DSM) of rock faces. With the objective to overcome the limitation of the traditional survey and to minimize data capture times, so reducing delays on mining site operations, a photogrammetric system to generate high resolution DSM of tunnels has been realized. A fast, effective and complete data capture method has been developed and the orientation and restitution phases have been largely automated. The survey operations take no more than required to the traditional ones; no additional topographic measurements other than those available are required. To make the data processing fast and economic our Structure from Motion procedure has been slightly modified to adapt to the peculiar block geometry while, the DSM of the tunnel is created using automatic image correlation techniques. The geomechanical data are sampled on the DSM, by using the acquired images in a GUI and a segmentation procedure to select discontinuity planes. To allow an easier and faster identification of relevant features of the surface of the tunnel, using again an automatic procedure, an orthophoto of the tunnel is produced. A case study where a tunnel section of ca. 130 m has been surveyed is presented.

The history of generalized anxiety disorder as a diagnostic category.

PubMed

Crocq, Marc-Antoine

2017-06-01

From the 19th century into the 20th century, the terms used to diagnose generalized anxiety included "pantophobia" and "anxiety neurosis." Such terms designated paroxysmal manifestations (panic attacks) as well as interparoxysmal phenomenology (the apprehensive mental state). Also, generalized anxiety was considered one of numerous symptoms of neurasthenia, a vaguely defined illness. Generalized anxiety disorder (GAD) appeared as a diagnostic category in the third edition of the Diagnostic and Statistical Manual of Mental Disorders ( DSM-III ) in 1980, when anxiety neurosis was split into GAD and panic disorder. The distinct responses these two disorders had to imipramine therapy was one reason to distinguish between the two. Since the revised DSM-III ( DSM-III-R ), worry about a number of life circumstances has been gradually emphasized as the distinctive symptom of GAD. Thus, a cognitive aspect of anxiety has become the core criterion of GAD. The validity of GAD as an independent category has been questioned from DSM-III up to preparation of DSM-5 . Areas of concern have included the difficulty to establish clear boundaries between GAD and (i) personality dimensions, (ii) other anxiety-spectrum disorders, and (iii) nonbipolar depression. The National Institute of Mental Health has recently proposed the Research Domain Criteria (RDoC), a framework destined to facilitate biological research into the etiology of mental symptoms. Within the RDoC framework, generalized anxiety might be studied as a dimension denominated "anxious apprehension" that would typically fit into the research domain called "negative valence systems" and the more specific construct termed "potential threat."

Psychometric Properties and Clinical Usefulness of the Youth Self-Report DSM-Oriented Scales: A Field Study among Detained Male Adolescents

PubMed Central

Colins, Olivier F.

2016-01-01

It is unknown if the DSM-oriented (DSM) scales of the Youth Self-Report (YSR) are useful to determine what kind of narrowly-focused psychiatric assessment is needed, and how well these scales serve as a triage tool in real-world forensic settings. To address this knowledge gap, the YSR and diagnostic interviews were administered to 405 detained boys as part of a clinical protocol. Continuous DSM scale scores (e.g., Conduct Problems) were moderately to highly accurate in predicting their corresponding disorder (e.g., conduct disorder), whereas dichotomized DSM scale scores were not. To test the DSM scales’ usefulness for triage purposes, the sensitivity and specificity of being in the borderline range of one or more DSM scales were calculated. Almost all boys who did not have a disorder were in the normal range of at least one DSM scale (high specificity). However, many boys with a disorder would have been missed if such a decision rule was used for triage purposes (low sensitivity). In conclusion, their relations with the corresponding disorders support the construct validity of the DSM scales in an applied forensic setting. Nevertheless, the findings also warrant against the use of these scales for planning further narrowly-focused assessment or for triage purposes. PMID:27657102

Development of a screening questionnaire for DSM-5 intermittent explosive disorder (IED-SQ).

PubMed

Coccaro, Emil F; Berman, Mitchell E; McCloskey, Michael S

2017-04-01

This study was designed to develop and test a screening approach to identify individuals with DSM-5 Intermittent Explosive Disorder (IED), a disorder of recurrent, problematic, impulsive aggression. A screening approach to diagnose DSM-5 IED (IED-SQ) was developed by combining items related to life history of aggression and items related to the DSM-5 diagnostic criteria for IED. In study 1, the IED-SQ was studied in 72 adult participants; 33 that met DSM-5 criteria for lifetime IED and 39 that did not. In study 2, the IED-SQ was given to 740 undergraduates at a US university. Measures of aggression and anger expression and anger control were assessed in both studies. In study 1, the IED-SQ demonstrated strong concordance with the best estimate diagnoses (Kappa =.80) for lifetime IED by DSM-5 criteria and good test-retest reliability (kappa =0.71). In study 2, the IED-SQ identified 4.3% of the undergraduate sample as meeting DSM-5 criteria for lifetime IED, a rate comparable to that in recent epidemiological studies. Participants identified as meeting DSM-5 criteria for lifetime IED, in both studies, had higher aggression scores, and higher anger expression, and lower anger control scores, compared to participants that did not meet DSM-5 criteria for lifetime IED. These data suggest that the IED-SQ is a useful screening tool that can quickly identify the presence of IED by DSM-5 criteria in adults. Copyright © 2016 Elsevier Inc. All rights reserved.

A Comparison of DSM-IV PDD and DSM-5 ASD Prevalence in an Epidemiologic Sample

PubMed Central

Kim, Young Shin; Fombonne, Eric; Koh, Yun-Joo; Kim, Soo-Jeong; Cheon, Keun-Ah; Leventhal, Bennett

2014-01-01

Objective Changes in autism diagnostic criteria found in DSM5 may affect Autism Spectrum Disorder (ASD) prevalence, research findings, diagnostic processes and eligibility for clinical and other services. Utilizing our published, total-population Korean prevalence data, we compute DSM5 ASD and Social Communication Disorder (SCD) prevalence and compare them to DSMIV Pervasive Developmental Disorder (PDD) prevalence estimates. We also describe individuals previously diagnosed with DSMIV PDD when diagnoses change with DSM-5 criteria. Method The target population was all 7-12-year-old children in a South Korean community (N= 55,266), those in regular and special education schools and a disability registry. We utilized the Autism Spectrum Screening Questionnaire for systematic, multi-informant screening. Parents of screen-positive children were offered comprehensive assessments using standardized diagnostic procedures, including the Autism Diagnostic Interview-Revised and Autism Diagnostic Observation Schedule. Best estimate clinical diagnoses were made using DSMIV PDD and DSM5 ASD and SCD criteria. Results DSM5 ASD estimated prevalence is 2.20% (CI: 1.77-3.64). Combined DSM-5 ASD and SCD prevalence is virtually same as DSM-IV PDD prevalence (2.64%). Most children with Autistic Disorder (99%), Asperger Disorder (92%), and PDD NOS (63%) met DSM-5 ASD criteria, whereas 1%, 8% and 32%, respectively, met SCD criteria. All remaining children (2% ) had other psychopathology, principally Attention Deficit Hyperactivity Disorder and anxiety disorder. Conclusion Our findings suggest that most individuals with a prior DSMIV PDD meet DSM5 diagnostic criteria for ASD and SCD. PDD, ASD or SCD, extant diagnostic criteria identify a large, clinically meaningful group of individuals and families who require evidence-based services. PMID:24745950

Clinical consequences of the revised DSM-5 definition of agoraphobia in treatment-seeking anxious youth

PubMed Central

Cornacchio, Danielle; Chou, Tommy; Sacks, Hayley; Pincus, Donna; Comer, Jonathan

2015-01-01

Background In DSM-5, the agoraphobia core symptom criterion has been revised to require fear about multiple situations from across at least two distinct domains in which escape might be difficult or panic-like symptoms might develop. The present study examined patterns and correlates of the recent change in a sample of anxious youth with symptom presentations consistent with the DSM-IV agoraphobia definition and/or specific phobia (SP) to consider how the recent diagnostic change impacts the prevalence and composition of agoraphobia in children and adolescents. Method Analyses (N=151) evaluated impairment and correlates of agoraphobic youth who no longer meet the DSM-5 agoraphobia criteria relative to agoraphobic youth who do meet the new DSM-5 criteria. Secondary analyses compared agoraphobic youth not meeting DSM-5 criteria to SP youth. Results One-quarter of youth with symptom presentations consistent with the DSM-IV agoraphobia definition no longer met criteria for DSM-5 agoraphobia, but showed comparable severity and impairment across most domains to youth who do meet criteria for DSM-5 agoraphobia. Further, these youth showed higher levels of anxiety sensitivity and internalizing psychopathology relative to youth with SP. Conclusions A substantial proportion of impaired youth with considerable agoraphobic symptom presentations have been left without a specified anxiety diagnosis by the DSM-5, which may affect their ability to receive and/or get coverage for services and their representation in treatment evaluations. Future DSM iterations may do well to include a “circumscribed” agoraphobia specifier that would characterize presentations of fear or anxiety about multiple situations, but that do not span across at least two distinct situational domains. PMID:25845579

CLINICAL CONSEQUENCES OF THE REVISED DSM-5 DEFINITION OF AGORAPHOBIA IN TREATMENT-SEEKING ANXIOUS YOUTH.

PubMed

Cornacchio, Danielle; Chou, Tommy; Sacks, Hayley; Pincus, Donna; Comer, Jonathan

2015-07-01

In DSM-5, the agoraphobia core symptom criterion has been revised to require fear about multiple situations from across at least two distinct domains in which escape might be difficult or panic-like symptoms might develop. The present study examined patterns and correlates of the recent change in a sample of anxious youth with symptom presentations consistent with the DSM-IV agoraphobia definition and/or specific phobia (SP) to consider how the recent diagnostic change impacts the prevalence and composition of agoraphobia in children and adolescents. Analyses (N = 151) evaluated impairment and correlates of agoraphobic youth who no longer meet the DSM-5 agoraphobia criteria relative to agoraphobic youth who do meet the new DSM-5 criteria. Secondary analyses compared agoraphobic youth not meeting DSM-5 criteria to SP youth. One-quarter of youth with symptom presentations consistent with the DSM-IV agoraphobia definition no longer met criteria for DSM-5 agoraphobia, but showed comparable severity and impairment across most domains to youth who do meet criteria for DSM-5 agoraphobia. Further, these youth showed higher levels of anxiety sensitivity and internalizing psychopathology relative to youth with SP. A substantial proportion of impaired youth with considerable agoraphobic symptom presentations have been left without a specified anxiety diagnosis by the DSM-5, which may affect their ability to receive and/or get coverage for services and their representation in treatment evaluations. Future DSM iterations may do well to include a "circumscribed" agoraphobia specifier that would characterize presentations of fear or anxiety about multiple situations, but that do not span across at least two distinct situational domains. © 2015 Wiley Periodicals, Inc.

Prevalence and correlates of DSM-5 eating disorders in patients with bipolar disorder.

PubMed

McElroy, Susan L; Crow, Scott; Blom, Thomas J; Biernacka, Joanna M; Winham, Stacey J; Geske, Jennifer; Cuellar-Barboza, Alfredo B; Bobo, William V; Prieto, Miguel L; Veldic, Marin; Mori, Nicole; Seymour, Lisa R; Bond, David J; Frye, Mark A

2016-02-01

To determine prevalence rates and clinical correlates of current DSM-5 eating disorders in patients with bipolar disorder (BP). Prevalence rates of current DSM-5- and DSM-IV-defined binge eating disorder (BED), bulimia nervosa (BN), and anorexia nervosa (AN) were assessed with the Eating Disorder Diagnostic Scale (EDDS) in 1092 patients with BP. Psychiatric illness burden was evaluated with five proxy measures of BP illness severity. Medical illness burden was evaluated with the Cumulative Index Rating Scale (CIRS). Twenty-seven percent of patients had a current DSM-5 eating disorder: 12% had BED, 15% had BN, and 0.2% had AN. Rates of DSM-5-defined BED and BN were higher than clinical diagnosis rates and rates of DSM-IV-defined BED and BN. Compared with BP patients without an eating disorder, BP patients with a DSM-5 eating disorder were younger and more likely to be women; had an earlier age of onset of BP; had higher EDDS composite scores and higher degrees of suicidality, mood instability, and anxiety disorder comorbidity; and had a higher mean BMI, higher rate of obesity, and higher CIRS total scores. In a logistic regression model controlling for previously identified correlates of an eating disorder, younger age, female gender, and higher BMI remained significantly associated with an eating disorder. The EDDS has not been validated in BP patients. DSM-5-defined BED and BN are common in BP patients, possibly more common than DSM-IV-defined BED and BN, and associated with greater psychiatric and general medical illness burden. Further studies assessing DSM-5 eating disorders in people with BP are greatly needed. Copyright © 2015 Elsevier B.V. All rights reserved.

On the road to DSM-V and ICD-11.

PubMed

Kupfer, David J; Regier, Darrel A; Kuhl, Emily A

2008-11-01

Development of the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-V) has been ongoing since 1994, though official release will not occur for another 4 years. Potential revisions are being derived from multiple sources, including building on perceived limitations of DSM-IV; broad-based literature reviews; secondary and primary data analyses; and discussions between global members of the mental health community. The current focus on aligning DSM with the International Classification of Diseases-11 (ICD-11) speaks to the importance of creating a unified text that embraces cross-cutting issues of diagnostics, such as developmental, age-related, and cultural phenomena. International discourse is vital to this process and has been fostered by a National Institutes of Health-sponsored conference series on diagnosis-specific topics. From this series, the DSM-V Task Force developed the following set of revision principals to guide the efforts of the DSM-V Work Groups: grounding recommendations in empirical evidence; maintaining continuity with previous editions of DSM; removing a priori limitations on the amount of changes DSM-V may incur; and maintaining DSM's status as a living document. With work group formation complete, members are currently carrying out the research and revision recommendations proposed during the conference series. Ongoing activities include adding specialized advisors to each work group; completing literature reviews and planning data analyses; and forming study groups to discuss integration of cross-cutting issues (e.g., developmental lifespan factors; formation of diagnostic spectra). The road to DSM-V and ICD-11 has been challenging, but members continue to work diligently in their goal of constructing the most harmonious, scientifically sound, and clinically relevant DSM to date.

DSM-5 cannabis use disorder, substance use and DSM-5 specific substance-use disorders: Evaluating comorbidity in a population-based sample.

PubMed

Hayley, Amie C; Stough, Con; Downey, Luke A

2017-08-01

Cannabis use disorder (CUD) is frequently associated with concurrent substance use and/or comorbid substance use disorders (SUDs); however there is little specificity with regard to commonly abused individual drug types/classes. This study therefore aimed to provide insight into the degree of these co-occurring relationships across several specific newer and older generation illicit and prescription drugs. 36,309 adults aged 18+ from wave 3 of the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC-III) were assessed. Weighted cross-tabulations and multivariable logistic regression analyses were used to evaluate comorbidity between current DSM-5 CUD, substance use and DSM-5 SUD. Current DSM-5 CUD is associated with greater lifetime use of all examined drug classes, and previous 12-month use of several newer-class illicit and prescription stimulant-based substances (all p< 0.05). Current DSM-5 CUD was similarly associated with increased incidence of a range of DSM-5 SUDs and was independently associated with concurrently reporting current DSM-5; sedative (Adjusted OR= 5.1, 95%CI 2.9-9.0), cocaine (AOR= 9.3, 95%CI 5.6-15.5), stimulant (AOR= 4.3, 95%CI 2.3-7.9), club drug (AOR= 16.1, 95%CI 6.3-40.8), opioid (AOR= 4.6, 95%CI 3.0-6.8) and alcohol-use disorder (AOR= 3.0, 95%CI 2.5-3.7); but not heroin or 'other' drug use disorder (both p>0.05). High comorbidity exists between DSM-5 CUD and many specific DSM-5 SUDs. Newer-class illicit and prescription stimulant-based drug use disorders are overrepresented among those with DSM-5 CUD. These findings underscore the need for tailored treatment programs for those presenting with DSM-5 CUD, and for greater treatment specification where poly-drug use is evident. Copyright © 2017 Elsevier B.V. and ECNP. All rights reserved.

Do β3-adrenergic receptors play a role in guinea pig detrusor smooth muscle excitability and contractility?

PubMed Central

Afeli, Serge A. Y.; Hristov, Kiril L.

2012-01-01

In many species, β3-adrenergic receptors (β3-ARs) have been reported to play a primary role in pharmacologically induced detrusor smooth muscle (DSM) relaxation. However, their role in guinea pig DSM remains controversial. The aim of this study was to investigate whether β3-ARs are expressed in guinea pig DSM and to evaluate how BRL37344 and L-755,507, two selective β3-AR agonists, modulate guinea pig DSM excitability and contractility. We used a combined experimental approach including RT-PCR, patch-clamp electrophysiology, and isometric DSM tension recordings. β3-AR mRNA message was detected in freshly isolated guinea pig DSM single cells. BRL37344 but not L-755,507 caused a slight decrease in DSM spontaneous phasic contraction amplitude and frequency in a concentration-dependent manner. In the presence of atropine (1 μM), only the spontaneous phasic contractions frequency was inhibited by BRL37344 at higher concentrations. Both BRL37344 and L-755,507 significantly decreased DSM carbachol-induced phasic and tonic contractions in a concentration-dependent manner. However, only BRL37344 inhibitory effect was partially antagonized by SR59230A (10 μM), a β3-AR antagonist. In the presence of atropine, BRL37344 and L-755,507 had no inhibitory effect on electrical field stimulation-induced contractions. Patch-clamp experiments showed that BRL37344 (100 μM) did not affect the DSM cell resting membrane potential and K+ conductance. Although β3-ARs are expressed at the mRNA level, they play a minor to no role in guinea pig DSM spontaneous contractility without affecting cell excitability. However, BRL37344 and L-755,507 have pronounced inhibitory effects on guinea pig DSM carbachol-induced contractions. The study outlines important DSM β3-ARs species differences. PMID:21993887

Molecular expression and pharmacological evidence for a functional role of kv7 channel subtypes in Guinea pig urinary bladder smooth muscle.

PubMed

Afeli, Serge A Y; Malysz, John; Petkov, Georgi V

2013-01-01

Voltage-gated Kv7 (KCNQ) channels are emerging as essential regulators of smooth muscle excitability and contractility. However, their physiological role in detrusor smooth muscle (DSM) remains to be elucidated. Here, we explored the molecular expression and function of Kv7 channel subtypes in guinea pig DSM by RT-PCR, qRT-PCR, immunohistochemistry, electrophysiology, and isometric tension recordings. In whole DSM tissue, mRNAs for all Kv7 channel subtypes were detected in a rank order: Kv7.1~Kv7.2Kv7.3~Kv7.5Kv7.4. In contrast, freshly-isolated DSM cells showed mRNA expression of: Kv7.1~Kv7.2Kv7.5Kv7.3~Kv7.4. Immunohistochemical confocal microscopy analyses of DSM, conducted by using co-labeling of Kv7 channel subtype-specific antibodies and α-smooth muscle actin, detected protein expression for all Kv7 channel subtypes, except for the Kv7.4, in DSM cells. L-364373 (R-L3), a Kv7.1 channel activator, and retigabine, a Kv7.2-7.5 channel activator, inhibited spontaneous phasic contractions and the 10-Hz electrical field stimulation (EFS)-induced contractions of DSM isolated strips. Linopiridine and XE991, two pan-Kv7 (effective at Kv7.1-Kv7.5 subtypes) channel inhibitors, had opposite effects increasing DSM spontaneous phasic and 10 Hz EFS-induced contractions. EFS-induced DSM contractions generated by a wide range of stimulation frequencies were decreased by L-364373 (10 µM) or retigabine (10 µM), and increased by XE991 (10 µM). Retigabine (10 µM) induced hyperpolarization and inhibited spontaneous action potentials in freshly-isolated DSM cells. In summary, Kv7 channel subtypes are expressed at mRNA and protein levels in guinea pig DSM cells. Their pharmacological modulation can control DSM contractility and excitability; therefore, Kv7 channel subtypes provide potential novel therapeutic targets for urinary bladder dysfunction.

A comparison of DSM-IV-TR and DSM-5 definitions for sexual dysfunctions: critiques and challenges.

PubMed

Sungur, Mehmet Z; Gündüz, Anil

2014-02-01

The diagnostic criteria of sexual dysfunctions (SDs) are paramount for the development of sexual medicine as reliable diagnoses are essential to guide treatment plans. Prior Diagnostic and Statistical Manual of Mental Disorders (DSM) classifications based definitions of SD mostly on expert opinions and included imprecise terms. The validity of diagnoses of SD has only recently been challenged, and efforts are made to make more operational definitions. This paper aims to compare and contrast the recently released Diagnostic and Statistical Manual of Mental Disorders-Fifth Edition (DSM-5) diagnostic criteria of SD with that of Diagnostic and Statistical Manual of Mental Disorders-Fourth Edition Text Revision (DSM-IV-TR) and explains the rationale for making changes in the new DSM-5. It also aims to address some issues to be considered further for the future. Online proposed American Psychiatric Association website DSM-5, the new released DSM-5, and DSM-IV-TR diagnostic criteria for SD were thoroughly inspected, and an extensive literature search was performed for comparative reasons. Changes in diagnostic criteria of DSM-5 were detected, and DSM-IV-TR and DSM-5 diagnostic criteria for SD were compared and contrasted. Diagnostic criteria were more operationalized, and explicit duration and frequency criteria were set up in DSM-5 for purposes of good clinical research. Classifications based on simple linear sexual response were abandoned, and diagnostic classifications were separately made for males and females. Desire and arousal disorders in women were merged. Drifting apart from linear sexual response cycle may be an advancement in establishing specific diagnostic criteria for different genders. However, it is still a question of debate whether there is enough evidence to lump sexual interest and arousal disorders in females. Making more precise definitions is important to differentiate disorders from other transient conditions. However, there is still room to improve our definitions and find a way to include gay and lesbian individuals. Further discussions and debates are expected to be continued in the future. © 2013 International Society for Sexual Medicine.

The DSM-IV nosology of chronic pain: a comparison of pain disorder and multiple somatization syndrome.

PubMed

Hiller, W; Heuser, J; Fichter, M M

2000-01-01

This study evaluates the classification of pain from the perspective of the DSM-IV system. Of 60 in-patients with long-standing and disabling pain syndromes, 29 with pain disorder (PD) and 31 with pain as part of a multiple somatization syndrome (MSS) were compared before and after a structured cognitive-behavioral treatment. It was hypothesized that MSS patients show more psychological distress, are more severely disabled, and respond less to the treatment. Both groups were similar with respect to sociodemographic status, history of pain symptomatology and comorbidity with DSM-IV mental disorders. The results show that MSS patients had higher levels of affective and sensoric pain sensations as well as more pain-related disabilities. They were also less successful during treatment to reduce their pain-related depression and anxiety. Psychosocial functioning was improved only by PD patients, but remained almost unchanged in the MSS group. However, there were no group differences concerning general depression and hypochondriasis, dysfunctional attitudes towards body and health, and use of pain coping strategies. It is concluded that the DSM-IV distinction between 'pure' pain disorder and syndromes involving pain plus multiple somatoform symptoms cannot generally be confirmed, but further studies of validation are needed. Copyright 2000 European Federation of Chapters of the International Association for the Study of Pain.

Dynamic Power Distribution System Management With a Locally Connected Communication Network

DOE Office of Scientific and Technical Information (OSTI.GOV)

Dall-Anese, Emiliano; Zhang, Kaiqing; Basar, Tamer

Coordinated optimization and control of distribution-level assets can enable a reliable and optimal integration of massive amount of distributed energy resources (DERs) and facilitate distribution system management (DSM). Accordingly, the objective is to coordinate the power injection at the DERs to maintain certain quantities across the network, e.g., voltage magnitude, line flows, or line losses, to be close to a desired profile. By and large, the performance of the DSM algorithms has been challenged by two factors: i) the possibly non-strongly connected communication network over DERs that hinders the coordination; ii) the dynamics of the real system caused by themore » DERs with heterogeneous capabilities, time-varying operating conditions, and real-time measurement mismatches. In this paper, we investigate the modeling and algorithm design and analysis with the consideration of these two factors. In particular, a game theoretic characterization is first proposed to account for a locally connected communication network over DERs, along with the analysis of the existence and uniqueness of the Nash equilibrium (NE) therein. To achieve the equilibrium in a distributed fashion, a projected-gradient-based asynchronous DSM algorithm is then advocated. The algorithm performance, including the convergence speed and the tracking error, is analytically guaranteed under the dynamic setting. Extensive numerical tests on both synthetic and realistic cases corroborate the analytical results derived.« less

Application of Water Evaluation and Planning Model for Integrated Water Resources Management: Case Study of Langat River Basin, Malaysia

NASA Astrophysics Data System (ADS)

Leong, W. K.; Lai, S. H.

2017-06-01

Due to the effects of climate change and the increasing demand on water, sustainable development in term of water resources management has become a major challenge. In this context, the application of simulation models is useful to duel with the uncertainty and complexity of water system by providing stakeholders with the best solution. This paper outlines an integrated management planning network is developed based on Water Evaluation and Planning (WEAP) to evaluate current and future water management system of Langat River Basin, Malaysia under various scenarios. The WEAP model is known as an integrated decision support system investigate major stresses on demand and supply in terms of water availability in catchment scale. In fact, WEAP is applicable to simulate complex systems including various sectors within a single catchment or transboundary river system. To construct the model, by taking account of the Langat catchment and the corresponding demand points, we defined the hydrological model into 10 sub-hydrological catchments and 17 demand points included the export of treated water to the major cities outside the catchment. The model is calibrated and verified by several quantitative statistics (coefficient of determination, R2; Nash-Sutcliffe efficiency, NSE and Percent bias, PBIAS). The trend of supply and demand in the catchment is evaluated under three scenarios to 2050, 1: Population growth rate, 2: Demand side management (DSM) and 3: Combination of DSM and reduce non-revenue water (NRW). Results show that by reducing NRW and proper DSM, unmet demand able to reduce significantly.

[Classification of enuresis/encopresis according to DSM-5].

PubMed

von Gontard, Alexander

2014-03-01

Elimination disorders are common in childhood and adolescence. Enuresis is traditionally defined as wetting from the age of 5 years and encopresis as soiling from 4 years onwards - after all organic causes have been excluded. In the past decades, many subtypes of elimination disorders have been identified with different symptoms, etiologies, and specific treatment options. Unfortunately, the DSM-5 criteria did not integrate these new approaches. In contrast, classification systems of the International Children's Incontinence Society (ICCS) for enuresis and urinary incontinence as well as the ROME-III criteria for fecal incontinence offer new and relevant suggestions for both clinical and research purposes.

Commentary on the Inclusion of Persistent Complex Bereavement-Related Disorder in DSM-5

ERIC Educational Resources Information Center

Boelen, Paul A.; Prigerson, Holly G.

2012-01-01

The DSM-5 Anxiety, Obsessive-Compulsive Spectrum, Posttraumatic, and Dissociative Disorders Work Group has proposed criteria for Persistent Complex Bereavement-Related Disorder (PCBRD) for inclusion in the appendix of DSM-5. The authors feel that it is important that dysfunctional grief will become a formal condition in DSM-5 because that would…

Exploring the Proposed DSM-5 Criteria in a Clinical Sample

ERIC Educational Resources Information Center

Taheri, Azin; Perry, Adrienne

2012-01-01

The proposed DSM-5 criteria for Autism Spectrum Disorder (ASD) depart substantially from the previous DSM-IV criteria. In this file review study of 131 children aged 2-12, previously diagnosed with either Autistic Disorder or Pervasive Developmental Disorder-Not Otherwise Specified (PDD-NOS), 63% met the new DSM-5 ASD criteria, including 81%…

Reliability of DSM-IV Symptom Ratings of ADHD: Implications for DSM-V

ERIC Educational Resources Information Center

Solanto, Mary V.; Alvir, Jose

2009-01-01

Objective: The objective of this study was to examine the intrarater reliability of "DSM-IV" ADHD symptoms. Method: Two-hundred-two children referred for attention problems and 49 comparison children (all 7-12 years) were rated by parents and teachers on the identical "DSM-IV" items presented in two different formats, the…

Autism Spectrum Disorders in the DSM-V: Better or Worse than the DSM-IV?

ERIC Educational Resources Information Center

Wing, Lorna; Gould, Judith; Gillberg, Christopher

2011-01-01

The DSM-V-committee has recently published proposed diagnostic criteria for autism spectrum disorders. We examine these criteria in some detail. We believe that the DSM-committee has overlooked a number of important issues, including social imagination, diagnosis in infancy and adulthood, and the possibility that girls and women with autism may…

78 FR 77384 - DSM Nutritional Products; Filing of Food Additive Petition (Animal Use)

Federal Register 2010, 2011, 2012, 2013, 2014

2013-12-23

.... FDA-2013-F-1539] DSM Nutritional Products; Filing of Food Additive Petition (Animal Use) AGENCY: Food... (FDA) is announcing that DSM Nutritional Products has filed a petition proposing that the food additive... U.S.C. 348(b)(5)), notice is given that a food additive petition (FAP 2276) has been filed by DSM...

77 FR 71750 - DSM Nutritional Products; Filing of Food Additive Petition (Animal Use)

Federal Register 2010, 2011, 2012, 2013, 2014

2012-12-04

.... FDA-2012-F-1100] DSM Nutritional Products; Filing of Food Additive Petition (Animal Use) AGENCY: Food... (FDA) is announcing that DSM Nutritional Products has filed a petition proposing that the food additive...) (21 U.S.C. 348(b)(5))), notice is given that a food additive petition (FAP 2273) has been filed by DSM...

Airborne LiDAR : a new source of traffic flow data.

DOT National Transportation Integrated Search

2005-10-01

LiDAR (or airborne laser scanning) systems became a dominant player in high-precision spatial data acquisition : to efficiently create DEM/DSM in the late 90's. With increasing point density, new systems are now able to : support object extraction, s...

Airborne LiDAR : a new source of traffic flow data.

DOT National Transportation Integrated Search

2005-10-01

LiDAR (or airborne laser scanning) systems became a dominant player in high-precision spatial data acquisition : to efficiently create DEM/DSM in the late 90s. With increasing point density, new systems are now able to : support object extraction, ...

[Personality disorders--different outlooks and attempts at their integration].

PubMed

Grabski, Bartosz; Gierowski, Józef Krzysztof

2012-01-01

The paper presents different approaches to personality disorders. The authors critically discuss the contemporary categorical psychiatrie (medical) classification and also present psychological approaches with the special attention put to personality trait theories and stemming from them the Five Factor Model (FFM). Due to the coming time of the publication of a new revision of the American classification DSM- 5 the detailed description of the proposals for the new system has been presented. The authors included the most updated version which has just recently been published on the DSM-5 APA web site on 11h June 2011. The proposed changes go forward to the voices of critique of present solutions, and create a hybrid system which will incorporate some elements of the dimensional approach to personality disorders.

Tobacco industry influence on the definition of tobacco related disorders by the American Psychiatric Association.

PubMed

Neuman, M D; Bitton, A; Glantz, S A

2005-10-01

The Diagnostic and statistical manual of mental disorders, third edition (DSM-III), published by the American Psychiatric Association (APA) in 1980, included the first official definitions by the APA of tobacco dependence and tobacco withdrawal. Tobacco industry efforts to influence the DSM-III were investigated. Searches of previously secret tobacco industry documents, primarily the University of California San Francisco Legacy Tobacco Documents Library and British American Tobacco collections. Additional information was collected through discussions with editors of DSM-III, and library and general internet searches. The tobacco companies regarded the inclusion of tobacco dependence as a diagnosis in DSM-III as an adverse event. It worked to influence the content of the DSM-III and its impact following publication. These efforts included public statements and private lobbying of DSM-III editors and high ranking APA officers by prominent US psychiatrists with undisclosed ties to the tobacco industry. Following publication of DSM-III, tobacco companies contracted with two US professors of psychiatry to organise a conference and publish a monograph detailing controversies surrounding DSM-III. The tobacco industry and its allies lobbied to narrow the definition of tobacco dependence in serial revisions of DSM-III. Following publication of DSM-III, the industry took steps to try to mitigate its impact. These actions mirror industry tactics to influence medical research and policy in various contexts worldwide. Such tactics slow the spread of a professional and public understanding of smoking and health that otherwise would reduce smoking, smoking induced disease, and tobacco company profits.

Sensitivity and specificity of proposed DSM-5 diagnostic criteria for autism spectrum disorder Running Head: DSM-5 ASD

PubMed Central

McPartland, James C.; Reichow, Brian; Volkmar, Fred R.

2012-01-01

Objective This study evaluated the potential impact of proposed DSM-5 diagnostic criteria for autism spectrum disorder (ASD). Method This study focused on a sample of 977 participants evaluated during the DSM-IV field trial; 657 carried a clinical diagnosis of an ASD, and 276 were diagnosed with a non-autistic disorder. Sensitivity and specificity for proposed DSM-5 diagnostic criteria were evaluated using field trial symptom checklists as follows: (a) individual field trial checklist items (e.g., nonverbal communication), (b) checklist items grouped together as described by a single DSM-5 symptom (e.g., nonverbal and verbal communication), (c) individual DSM-5 criterion (e.g., social-communicative impairment), and (d) overall diagnostic criteria. Results When applying proposed DSM-5 diagnostic criteria for ASD, 60.6% (95% confidence interval: 57–64%) of cases with a clinical diagnosis of an ASD met revised DSM-5 diagnostic criteria for ASD. Overall specificity was high, with 94.9% (95% confidence interval: 92–97%) of individuals accurately excluded from the spectrum. Sensitivity varied by diagnostic subgroup (Autistic Disorder =.76; Asperger’s Disorder = .25; PDD-NOS = .28) and cognitive ability (IQ < 70 = .70; IQ ≥ 70 = .46). Conclusions Proposed DSM-5 criteria substantially alter the composition of the autism spectrum. Revised criteria improve specificity, but exclude a substantial portion of cognitively able individuals and those with ASDs other than Autistic Disorder. A more stringent diagnostic rubric holds significant public health ramifications regarding service eligibility and compatibility of historical and future research. PMID:22449643

A Test of the Empirical Profile and Coherence of the DSM-5 Psychopathy Specifier.

PubMed

Miller, Joshua D; Lamkin, Joanna; Maples-Keller, Jessica L; Sleep, Chelsea E; Lynam, Donald R

2017-11-13

The Diagnostic and Statistical Manual of Mental Disorders-5th edition (DSM-5; American Psychiatric Association, 2013) introduced a psychopathy specifier (DSM-5 PS) as part of the Section III diagnostic model of antisocial personality disorder. Designed to capture the construct of fearless dominance/boldness, the DSM-5 PS is assessed on the basis of the presence of low scores on traits of withdrawal and anxiousness, and high scores on attention seeking. These constructs have garnered attention in the past decade but are the subject of substantial debate as to their role in the conceptualization and assessment of psychopathy, given their limited relations to the maladaptive outcomes typically associated with this personality disorder. In the current study (N = 340 undergraduates; 170 informants), we examined the DSM-5 PS, both in composite form and its trait subscales, to investigate the degree to which the DSM-5 PS manifested empirical profiles associated with psychopathy and its maladaptive correlates. Consistent with prior fearless dominance/boldness research, the DSM-5 PS manifested limited relations with other components of psychopathy, symptoms of DSM-5 Section II and III antisocial personality disorder, and self- and informant-related impairment scores. When examined at the individual subscale level, the 3 DSM-5 PS subscales manifested only partially overlapping profiles and only 1 of the 3-Attention Seeking-demonstrated an association with maladaptivity (e.g., externalizing behaviors). These findings raise important concerns about the coherence and utility of the DSM-5 PS as a diagnostic specifier included in a psychiatric nosology. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Tobacco industry influence on the definition of tobacco related disorders by the American Psychiatric Association

PubMed Central

Neuman, M; Bitton, A; Glantz, S

2005-01-01

Objective: The Diagnostic and statistical manual of mental disorders, third edition (DSM-III), published by the American Psychiatric Association (APA) in 1980, included the first official definitions by the APA of tobacco dependence and tobacco withdrawal. Tobacco industry efforts to influence the DSM-III were investigated. Method: Searches of previously secret tobacco industry documents, primarily the University of California San Francisco Legacy Tobacco Documents Library and British American Tobacco collections. Additional information was collected through discussions with editors of DSM-III, and library and general internet searches. Results: The tobacco companies regarded the inclusion of tobacco dependence as a diagnosis in DSM-III as an adverse event. It worked to influence the content of the DSM-III and its impact following publication. These efforts included public statements and private lobbying of DSM-III editors and high ranking APA officers by prominent US psychiatrists with undisclosed ties to the tobacco industry. Following publication of DSM-III, tobacco companies contracted with two US professors of psychiatry to organise a conference and publish a monograph detailing controversies surrounding DSM-III. Conclusions: The tobacco industry and its allies lobbied to narrow the definition of tobacco dependence in serial revisions of DSM-III. Following publication of DSM-III, the industry took steps to try to mitigate its impact. These actions mirror industry tactics to influence medical research and policy in various contexts worldwide. Such tactics slow the spread of a professional and public understanding of smoking and health that otherwise would reduce smoking, smoking induced disease, and tobacco company profits. PMID:16183984

Sex and age differences in attention-deficit/hyperactivity disorder symptoms and diagnoses: implications for DSM-V and ICD-11.

PubMed

Ramtekkar, Ujjwal P; Reiersen, Angela M; Todorov, Alexandre A; Todd, Richard D

2010-03-01

To examine gender and age differences in attention-deficit/hyperactivity disorder (ADHD) symptom endorsement in a large community-based sample. Families with four or more full siblings ascertained from Missouri birth records completed telephone interviews regarding lifetime DSM-IV ADHD symptoms and the Strengths and Weaknesses of ADHD-Symptoms and Normal-behavior (SWAN) questionnaire for current ADHD symptoms. Complete data were available for 9,380 subjects aged 7 through 29 years. Lifetime and current DSM-IV-like ADHD diagnoses were assigned by the DSM-IV symptom criteria. Linear regression was used to examine sex and age effects on SWAN ADHD symptom scores. Logistic regression was used to examine sex and age effects on specific ADHD diagnoses. Fractional polynomial graphs were used to examine ADHD symptom count variations across age. Overall prevalence of current DSM-IV-like ADHD was 9.2% with a male:female ratio of 2.28:1. The prevalence of DSM-IV-like ADHD was highest in children. Gender differences in DSM-IV-like ADHD subtype prevalences were highest in adolescents. On average, individuals with lifetime DSM-IV-like ADHD diagnoses had elevated current ADHD symptoms even as adolescents or adults. Lower male:female ratios than reported in some clinic-based studies suggest that females are underdiagnosed in the community. Although they may no longer meet the full symptom criteria, young adults with a history of lifetime DSM-IV-like ADHD maintain higher levels of ADHD symptoms compared with the general population. The use of age-specific diagnostic criteria should be considered for DSM-V and ICD-11.

Values and assumptions in the development of DSM-III and DSM-III-R: an insider's perspective and a belated response to Sadler, Hulgus, and Agich's "On values in recent American psychiatric classification".

PubMed

Spitzer, R L

2001-06-01

It is widely acknowledged that the approach taken in the development of a classification of mental disorders is guided by various values and assumptions. The author, who played a central role in the development of DSM-III (American Psychiatric Association [1980] Diagnostic and statistical manual of mental disorders, 3rd ed. Washington, DC:Author) and DSM-III-R (American Psychiatric Association [1987] Diagnostic and statistical manual of mental disorders, 3rd ed, rev. Washington, DC:Author) will explicate the basic values and assumptions that guided the development of these two diagnostic manuals. In so doing, the author will respond to the critique of DSM-III and DSM-III-R made by Sadler et al. in their 1994 paper (Sadler JZ, Hulgus YF, Agich GJ [1994] On values in recent American psychiatric classification. JMed Phil 19:261-277). The author will attempt to demonstrate that the stated goals of DSM-III and DSM-III-R are not inherently in conflict and are easily explicated by appealing to widely held values and assumptions, most of which appeared in the literature during the development of the manuals. Furthermore, we will demonstrate that it is not true that DSM-III places greater emphasis on reliability over validity and is covertly committed to a biological approach to explaining psychiatric disturbance.

The underlying dimensionality of PTSD in the diagnostic and statistical manual of mental disorders: where are we going?

PubMed

Armour, Cherie

2015-01-01

There has been a substantial body of literature devoted to answering one question: Which latent model of posttraumatic stress disorder (PTSD) best represents PTSD's underlying dimensionality? This research summary will, therefore, focus on the literature pertaining to PTSD's latent structure as represented in the fourth (DSM-IV, 1994) to the fifth (DSM-5, 2013) edition of the DSM. This article will begin by providing a clear rationale as to why this is a pertinent research area, then the body of literature pertaining to the DSM-IV and DSM-IV-TR will be summarised, and this will be followed by a summary of the literature pertaining to the recently published DSM-5. To conclude, there will be a discussion with recommendations for future research directions, namely that researchers must investigate the applicability of the new DSM-5 criteria and the newly created DSM-5 symptom sets to trauma survivors. In addition, researchers must continue to endeavour to identify the "correct" constellations of symptoms within symptom sets to ensure that diagnostic algorithms are appropriate and aid in the development of targeted treatment approaches and interventions. In particular, the newly proposed DSM-5 anhedonia model, externalising behaviours model, and hybrid models must be further investigated. It is also important that researchers follow up on the idea that a more parsimonious latent structure of PTSD may exist.

Accuracy of DSM based on digital aerial image matching. (Polish Title: Dokładność NMPT tworzonego metodą automatycznego dopasowania cyfrowych zdjęć lotniczych)

NASA Astrophysics Data System (ADS)

Kubalska, J. L.; Preuss, R.

2013-12-01

Digital Surface Models (DSM) are used in GIS data bases as single product more often. They are also necessary to create other products such as3D city models, true-ortho and object-oriented classification. This article presents results of DSM generation for classification of vegetation in urban areas. Source data allowed producing DSM with using of image matching method and ALS data. The creation of DSM from digital images, obtained by Ultra Cam-D digital Vexcel camera, was carried out in Match-T by INPHO. This program optimizes the configuration of images matching process, which ensures high accuracy and minimize gap areas. The analysis of the accuracy of this process was made by comparison of DSM generated in Match-T with DSM generated from ALS data. Because of further purpose of generated DSM it was decided to create model in GRID structure with cell size of 1 m. With this parameter differential model from both DSMs was also built that allowed determining the relative accuracy of the compared models. The analysis indicates that the generation of DSM with multi-image matching method is competitive for the same surface model creation from ALS data. Thus, when digital images with high overlap are available, the additional registration of ALS data seems to be unnecessary.

Method matters: Understanding diagnostic reliability in DSM-IV and DSM-5.

PubMed

Chmielewski, Michael; Clark, Lee Anna; Bagby, R Michael; Watson, David

2015-08-01

Diagnostic reliability is essential for the science and practice of psychology, in part because reliability is necessary for validity. Recently, the DSM-5 field trials documented lower diagnostic reliability than past field trials and the general research literature, resulting in substantial criticism of the DSM-5 diagnostic criteria. Rather than indicating specific problems with DSM-5, however, the field trials may have revealed long-standing diagnostic issues that have been hidden due to a reliance on audio/video recordings for estimating reliability. We estimated the reliability of DSM-IV diagnoses using both the standard audio-recording method and the test-retest method used in the DSM-5 field trials, in which different clinicians conduct separate interviews. Psychiatric patients (N = 339) were diagnosed using the SCID-I/P; 218 were diagnosed a second time by an independent interviewer. Diagnostic reliability using the audio-recording method (N = 49) was "good" to "excellent" (M κ = .80) and comparable to the DSM-IV field trials estimates. Reliability using the test-retest method (N = 218) was "poor" to "fair" (M κ = .47) and similar to DSM-5 field-trials' estimates. Despite low test-retest diagnostic reliability, self-reported symptoms were highly stable. Moreover, there was no association between change in self-report and change in diagnostic status. These results demonstrate the influence of method on estimates of diagnostic reliability. (c) 2015 APA, all rights reserved).

Lung Cancer Diagnosis and Treatment as a Traumatic Stressor in DSM-IV and DSM-5: Prevalence and Relationship to Mental Health Outcomes.

PubMed

Andrykowski, Michael A; Steffens, Rachel F; Bush, Heather M; Tucker, Thomas C

2015-06-01

Little research has examined how lung cancer survivors whose cancer experience met the Diagnostic and Statistical Manual of Mental Disorders (DSM) traumatic stressor criterion differ with regard to posttreatment mental health status from survivors whose cancer experience did not. No research of which we are aware has examined the impact of the revised DSM-5 traumatic stressor criterion on this question. Non-small-cell (NSC) lung cancer survivors (N = 189) completed a telephone interview and questionnaire assessing distress and growth/benefit-finding. Survivors were categorized into Trauma and No Trauma groups using both the DSM-IV and DSM-5 stressor criterion. Using the DSM-IV criterion, the Trauma group (n = 70) reported poorer status than the No Trauma group (n = 119) on 10 of 10 distress indices (mean ES = 0.57 SD) and better status on all 7 growth/benefit-finding indices (mean ES = 0.30 SD). Using the DSM-5 stressor criterion, differences between the Trauma (n = 108) and No Trauma (n = 81) groups for indices of distress (mean ES = 0.26 SD) and growth/benefit-finding (mean ES = 0.17 SD) were less pronounced. Those who experience cancer as a traumatic stressor show greater distress and growth/benefit-finding, particularly when the more restrictive DSM-IV stressor criterion defines trauma exposure. Copyright © 2015 Wiley Periodicals, Inc., A Wiley Company.

The underlying dimensionality of PTSD in the diagnostic and statistical manual of mental disorders: where are we going?

PubMed Central

Armour, Cherie

2015-01-01

There has been a substantial body of literature devoted to answering one question: Which latent model of posttraumatic stress disorder (PTSD) best represents PTSD's underlying dimensionality? This research summary will, therefore, focus on the literature pertaining to PTSD's latent structure as represented in the fourth (DSM-IV, 1994) to the fifth (DSM-5, 2013) edition of the DSM. This article will begin by providing a clear rationale as to why this is a pertinent research area, then the body of literature pertaining to the DSM-IV and DSM-IV-TR will be summarised, and this will be followed by a summary of the literature pertaining to the recently published DSM-5. To conclude, there will be a discussion with recommendations for future research directions, namely that researchers must investigate the applicability of the new DSM-5 criteria and the newly created DSM-5 symptom sets to trauma survivors. In addition, researchers must continue to endeavour to identify the “correct” constellations of symptoms within symptom sets to ensure that diagnostic algorithms are appropriate and aid in the development of targeted treatment approaches and interventions. In particular, the newly proposed DSM-5 anhedonia model, externalising behaviours model, and hybrid models must be further investigated. It is also important that researchers follow up on the idea that a more parsimonious latent structure of PTSD may exist. PMID:25994027

Implications of "DSM"-IV to "DSM"-5 Substance Use Disorder Diagnostic Changes in Adolescents Enrolled in a School-Based Intervention

ERIC Educational Resources Information Center

Stewart, David G.; Arlt, Virginia K.; Siebert, Erin C.; Chapman, Meredith K.; Hu, Emily M.

2016-01-01

This study aimed to examine (a) the impact of the change in the "Diagnostic and Statistical Manual of Mental Disorders" ("DSM") from a categorical to dimensional classification of substance use diagnoses, (b) the elimination of the legal criterion, and (c) the inclusion of a craving criterion in the "DSM"-5.…

From CBCL to DSM: A Comparison of Two Methods to Screen for DSM-IV Diagnoses Using CBCL Data

ERIC Educational Resources Information Center

Krol, Nicole P. C. M.; De Bruyn, Eric E. J.; Coolen, Jolanda C.; van Aarle, Edward J. M.

2006-01-01

The screening efficiency of 2 methods to convert Child Behavior Checklist (CBCL) assessment data into Diagnostic and Statistical Manual of Mental Disorders (4th ed. [DSM-IV]; American Psychiatric Association, 1994) diagnoses was compared. The Machine-Aided Diagnosis (MAD) method converts CBCL input data directly into DSM-IV symptom criteria. The…

Should DSM-V include dimensional diagnostic criteria for alcohol use disorders?

PubMed

Helzer, John E; Bucholz, Kathleen K; Bierut, Laura Jean; Regier, Darrel A; Schuckit, Marc A; Guth, Sarah E

2006-02-01

This program calls attention to the upcoming timetable for the revision of the Diagnostic and Statistical Manual (DSM)-IV and the publication of DSM-V. It is vitally important for Research Society of Alcoholism members to be aware of the current discussions of the important scientific questions related to the next DSM revision and to use the opportunity for input. The title of the symposium highlights 1 key question, i.e., whether the DSM definitions should remain strictly categorical as in the past or whether a dimensional component should be included in this revision. Two substantive and 1 conceptual paper are included in this portion of the symposium. The fourth and final presentation detailing the revision timetable and the opportunities for input is by Dr. Darrel Regier. Dr. Regier is the director of American Psychiatric Institute for Research and Education the research and education branch of the American Psychiatric Association and the organization within the APA that will oversee the DSM revision. The discussion is by Marc Schuckit, who was chair of the Substance Use disorders (SUD) Committee for DSM-IV and cochair of the international group of experts reviewing the SUD definitions for DSM-V.

The Impact of DSM-5 A-Criteria Changes on Parent Ratings of ADHD in Adolescents.

PubMed

Sibley, Margaret H; Yeguez, Carlos E

2018-01-01

Diagnostic and Statistical Manual of Mental Disorders (5th ed.; DSM-5) A-criteria for ADHD were expanded to include new descriptors referencing adolescent and adult symptom manifestations. This study examines the effect of these changes on symptom endorsement in a sample of adolescents with ADHD (N = 259; age range = 10.72-16.70). Parent ratings were collected and Diagnostic and Statistical Manual of Mental Disorders (4th ed., text rev.; DSM-IV-TR) and DSM-5 endorsement of ADHD symptoms were compared. Under the DSM-5, there were significant increases in reported inattention, but not hyperactivity/impulsivity (H/I) symptoms, with specific elevations for certain symptoms. The average adolescent met criteria for less than one additional symptom under the DSM-5, but the correlation between ADHD symptoms and impairment was attenuated when using the DSM-5 items. Impulsivity items appeared to represent adolescent deficits better than hyperactivity items. Results were not moderated by demographic factors. In a sample of adolescents with well-diagnosed DSM-IV-TR ADHD, developmental symptom descriptors led parents to endorse slightly more symptoms of inattention, but this elevation is unlikely to be clinically meaningful.

[DSM-5 and old age psychiatry].

PubMed

Calvet, Benjamin; Clément, Jean-Pierre

2014-03-01

The fifth version of the Diagnostic and statistical manual of mental disorders (DSM -5) was released in May 2013 after 14 years of development. Originally announced as an integrative version of the latest data in neuroscience, this manual should be more based on pathophysiology than the previous versions. Mixed dimensional and categorical mental disorder approach would also take the place of categorical approach which was considered obsolete. Before its release, the DSM-5 proposed revision has been criticized from many psychiatrists across the world. Some felt that paradigm change towards a dimensional approach turned out to be too complex and inadapted for practice. Others pointed out that DSM-5 tended to turn any behavior that deviates from normality into psychiatric diagnoses and thus make everybody ill. Previous DSM versions had left little space for elderly psychiatry. Indeed, few topics took into account clinical characteristics of mental disorders in the elderly. This review provides an overview of the changes in the DSM-in the field of old age psychiatry. We try to identify the DSM-5 key points for clinical practice and elderly psychiatric care. Various past and recent controversies that have been issued on this new DSM version will also be discussed.

Parametric Thermal and Flow Analysis of ITER Diagnostic Shield Module

DOE Office of Scientific and Technical Information (OSTI.GOV)

Khodak, A.; Zhai, Y.; Wang, W.

As part of the diagnostic port plug assembly, the ITER Diagnostic Shield Module (DSM) is designed to provide mechanical support and the plasma shielding while allowing access to plasma diagnostics. Thermal and hydraulic analysis of the DSM was performed using a conjugate heat transfer approach, in which heat transfer was resolved in both solid and liquid parts, and simultaneously, fluid dynamics analysis was performed only in the liquid part. ITER Diagnostic First Wall (DFW) and cooling tubing were also included in the analysis. This allowed direct modeling of the interface between DSM and DFW, and also direct assessment of themore » coolant flow distribution between the parts of DSM and DFW to ensure DSM design meets the DFW cooling requirements. Design of the DSM included voids filled with Boron Carbide pellets, allowing weight reduction while keeping shielding capability of the DSM. These voids were modeled as a continuous solid with smeared material properties using analytical relation for thermal conductivity. Results of the analysis lead to design modifications improving heat transfer efficiency of the DSM. Furthermore, the effect of design modifications on thermal performance as well as effect of Boron Carbide will be presented.« less

Latent Factor Structure of DSM-5 Posttraumatic Stress Disorder

PubMed Central

Gentes, Emily; Dennis, Paul A.; Kimbrel, Nathan A.; Kirby, Angela C.; Hair, Lauren P.; Beckham, Jean C.; Calhoun, Patrick S.

2015-01-01

The current study examined the latent factor structure of posttraumatic stress disorder (PTSD) based on DSM-5 criteria in a sample of participants (N = 374) recruited for studies on trauma and health. Confirmatory factor analyses (CFA) were used to compare the fit of the previous 3-factor DSM-IV model of PTSD to the 4-factor model specified in DSM-5 as well as to a competing 4-factor “dysphoria” model (Simms, Watson, & Doebbeling, 2002) and a 5-factor (Elhai et al., 2011) model of PTSD. Results indicated that the Elhai 5-factor model (re-experiencing, active avoidance, emotional numbing, dysphoric arousal, anxious arousal) provided the best fit to the data, although substantial support was demonstrated for the DSM-5 4-factor model. Low factor loadings were noted for two of the symptoms in the DSM-5 model (psychogenic amnesia and reckless/self-destructive behavior), which raises questions regarding the adequacy of fit of these symptoms with other core features of the disorder. Overall, the findings from the present research suggest the DSM-5 model of PTSD is a significant improvement over the previous DSM-IV model of PTSD. PMID:26366290

Somatoform disorders and rheumatic diseases: from DSM-IV to DSM-V.

PubMed

Alciati, A; Atzeni, F; Sgiarovello, P; Sarzi-Puttini, P

2014-06-06

Medically unexplained symptoms are considered 'somatoform disorders' in the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV). The introduction of this nosographic category has been helpful in drawing attention to a previously neglected area, but has not been successful in promoting an understanding of the disorders' biological basis and treatment implications, probably because of a series of diagnostic shortcomings. The newly proposed DSM-V diagnostic criteria try to overcome the limitations of the DSM-IV definition, which was organised centrally around the concept of medically unexplained symptoms, by emphasising the extent to which a patient's thoughts, feelings and behaviours concerning their somatic symptoms are disproportionate or excessive. This change is supported by a growing body of evidence showing that psychological and behavioural features play a major role in causing patient disability and maintaining high level of health care use. Pain disorders is the sub-category of DSM-IV somatoform disorders that most closely resembles fibromyalgia. Regardless of the diagnostic changes recently brought about by DSM-V, neuroimaging studies have identified important components of the mental processes associated with a DSM- IV diagnosis of pain disorder.

Parametric Thermal and Flow Analysis of ITER Diagnostic Shield Module

DOE PAGES

Khodak, A.; Zhai, Y.; Wang, W.; ...

2017-06-19

As part of the diagnostic port plug assembly, the ITER Diagnostic Shield Module (DSM) is designed to provide mechanical support and the plasma shielding while allowing access to plasma diagnostics. Thermal and hydraulic analysis of the DSM was performed using a conjugate heat transfer approach, in which heat transfer was resolved in both solid and liquid parts, and simultaneously, fluid dynamics analysis was performed only in the liquid part. ITER Diagnostic First Wall (DFW) and cooling tubing were also included in the analysis. This allowed direct modeling of the interface between DSM and DFW, and also direct assessment of themore » coolant flow distribution between the parts of DSM and DFW to ensure DSM design meets the DFW cooling requirements. Design of the DSM included voids filled with Boron Carbide pellets, allowing weight reduction while keeping shielding capability of the DSM. These voids were modeled as a continuous solid with smeared material properties using analytical relation for thermal conductivity. Results of the analysis lead to design modifications improving heat transfer efficiency of the DSM. Furthermore, the effect of design modifications on thermal performance as well as effect of Boron Carbide will be presented.« less

Measures of Narcissism and Their Relations to DSM-5 Pathological Traits: A Critical Reappraisal.

PubMed

Miller, Joshua D; Lynam, Donald R; Campbell, W Keith

2016-02-01

There exists substantial debate about how to best assess pathological narcissism with a variety of measures designed to assess grandiose and vulnerable narcissism, as well as the DSM-IV and DSM-5 based conceptualizations of narcissistic personality disorder (NPD). Wright and colleagues published correlations between several narcissism measures (Narcissistic Personality Inventory [NPI]; Pathological Narcissism Inventory [PNI]; Personality Diagnostic Questionnaire [PDQ] NPD) with the traits comprising the DSM-5 Section III personality trait model. In the current study, we examine the agreement manifested by Wright and colleagues' narcissism-DSM-5 trait profiles with expert ratings of the DSM-5 traits most relevant to descriptions of DSM-IV NPD. Despite concerns regarding the NPI's ability to measure pathological narcissism, its trait profile was strongly correlated with expert ratings, as was PDQ NPD's profile. Conversely, the trait profiles associated with the PNI were primarily uncorrelated with the expert rated NPD profile. The implications of these findings with regard to the assessment of narcissism are discussed. © The Author(s) 2014.

Hierarchical Structure and Cross-Cultural Measurement Invariance of the Norwegian Version of the Personality Inventory for DSM-5.

PubMed

Thimm, Jens C; Jordan, Stian; Bach, Bo

2017-01-01

The Personality Inventory for DSM-5 (PID-5) was created to aid a trait-based diagnostic system for personality disorders (PDs) in the Diagnostic and Statistical Manual of Mental Disorders (5th ed. [DSM-5]; American Psychiatric Association, 2013a ). In this study, we aimed to evaluate the Norwegian version of the PID-5 by examining its score reliability, hierarchical structure, congruency with international findings, and cross-cultural measurement invariance with a matched U.S. For this purpose, 503 university students (76% females) were administered the PID-5. The Norwegian PID-5 showed good score reliability and structural validity from 1 to 5 factors. The 5-factor structure was generally congruent with international findings, and support for measurement invariance across the Norwegian and a matched U.S. sample was found. Conclusively, the results indicate that scores on the Norwegian PID-5 have sound psychometric properties, which are substantially comparable with the original U.S. version, supporting its use in a Norwegian population.

Exclusion of overlapping symptoms in DSM-5 mixed features specifier: heuristic diagnostic and treatment implications.

PubMed

Malhi, Gin S; Byrow, Yulisha; Outhred, Tim; Fritz, Kristina

2017-04-01

This article focuses on the controversial decision to exclude the overlapping symptoms of distractibility, irritability, and psychomotor agitation (DIP) with the introduction of the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) mixed features specifier. In order to understand the placement of mixed states within the current classification system, we first review the evolution of mixed states. Then, using Kraepelin's original classification of mixed states, we compare and contrast his conceptualization with modern day definitions. The DSM-5 workgroup excluded DIP symptoms, arguing that they lack the ability to differentiate between manic and depressive states; however, accumulating evidence suggests that DIP symptoms may be core features of mixed states. We suggest a return to a Kraepelinian approach to classification-with mood, ideation, and activity as key axes-and reintegration of DIP symptoms as features that are expressed across presentations. An inclusive definition of mixed states is urgently needed to resolve confusion in clinical practice and to redirect future research efforts.

What is a mental/psychiatric disorder? From DSM-IV to DSM-V.

PubMed

Stein, D J; Phillips, K A; Bolton, D; Fulford, K W M; Sadler, J Z; Kendler, K S

2010-11-01

The distinction between normality and psychopathology has long been subject to debate. DSM-III and DSM-IV provided a definition of mental disorder to help clinicians address this distinction. As part of the process of developing DSM-V, researchers have reviewed the concept of mental disorder and emphasized the need for additional work in this area. Here we review the DSM-IV definition of mental disorder and propose some changes. The approach taken here arguably takes a middle course through some of the relevant conceptual debates. We agree with the view that no definition perfectly specifies precise boundaries for the concept of mental/psychiatric disorder, but in line with a view that the nomenclature can improve over time, we aim here for a more scientifically valid and more clinically useful definition.

A Proposal for a Dimensional Classification System Based on the Shared Features of the DSM-IV Anxiety and Mood Disorders: Implications for Assessment and Treatment

PubMed Central

Brown, Timothy A.; Barlow, David H.

2010-01-01

A wealth of evidence attests to the extensive current and lifetime diagnostic comorbidity of the DSM-IV anxiety and mood disorders. Research has shown that the considerable cross-sectional covariation of DSM-IV emotional disorders is accounted for by common higher-order dimensions such as neuroticism/behavioral inhibition (N/BI) and low positive affect/behavioral activation. Longitudinal studies have indicated that the temporal covariation of these disorders can be explained by changes in N/BI and in some cases, initial levels of N/BI are predictive of the temporal course of emotional disorders. Moreover, the marked phenotypal overlap of the DSM-IV anxiety and mood disorder constructs is a frequent source of diagnostic unreliability (e.g., temporal overlap in the shared features of generalized anxiety disorder and mood disorders, situation specificity of panic attacks in panic disorder and specific phobia). Although dimensional approaches have been considered as a method to address the drawbacks associated with the extant prototypical nosology (e.g., inadequate assessment of individual differences in disorder severity), these proposals do not reconcile key problems in current classification such as modest reliability and high comorbidity. The current paper considers an alternative approach that emphasizes empirically supported common dimensions of emotional disorders over disorder-specific criteria sets. The selection and assessment of these dimensions are discussed along with how these methods could be implemented to promote more reliable and valid diagnosis, prognosis, and treatment planning. For instance, the advantages of this classification system are discussed in context of current transdiagnostic treatment protocols that are efficaciously applied to a variety of disorders by targeting their shared features. PMID:19719339

A genome-wide study of two-component signal transduction systems in eight newly sequenced mutans streptococci strains

PubMed Central

2012-01-01

Background Mutans streptococci are a group of gram-positive bacteria including the primary cariogenic dental pathogen Streptococcus mutans and closely related species. Two component systems (TCSs) composed of a signal sensing histidine kinase (HK) and a response regulator (RR) play key roles in pathogenicity, but have not been comparatively studied for these oral bacterial pathogens. Results HKs and RRs of 8 newly sequenced mutans streptococci strains, including S. sobrinus DSM20742, S. ratti DSM20564 and six S. mutans strains, were identified and compared to the TCSs of S. mutans UA159 and NN2025, two previously genome sequenced S. mutans strains. Ortholog analysis revealed 18 TCS clusters (HK-RR pairs), 2 orphan HKs and 2 orphan RRs, of which 8 TCS clusters were common to all 10 strains, 6 were absent in one or more strains, and the other 4 were exclusive to individual strains. Further classification of the predicted HKs and RRs revealed interesting aspects of their putative functions. While TCS complements were comparable within the six S. mutans strains, S. sobrinus DSM20742 lacked TCSs possibly involved in acid tolerance and fructan catabolism, and S. ratti DSM20564 possessed 3 unique TCSs but lacked the quorum-sensing related TCS (ComDE). Selected computational predictions were verified by PCR experiments. Conclusions Differences in the TCS repertoires of mutans streptococci strains, especially those of S. sobrinus and S. ratti in comparison to S. mutans, imply differences in their response mechanisms for survival in the dynamic oral environment. This genomic level study of TCSs should help in understanding the pathogenicity of these mutans streptococci strains. PMID:22475007

Chemical Composition and in Vitro Antimicrobial, Cytotoxic, and Central Nervous System Activities of the Essential Oils of Citrus medica L. cv. 'Liscia' and C. medica cv. 'Rugosa' Cultivated in Southern Italy.

PubMed

Aliberti, Luigi; Caputo, Lucia; De Feo, Vincenzo; De Martino, Laura; Nazzaro, Filomena; Souza, Lucéia Fátima

2016-09-18

Citrus medica cv. 'liscia' and C. medica cv. 'rugosa' are two taxa of citron, belonging to the biodiversity of South Italy, in particular of Amalfi Coast, in the Campania region. The chemical composition of the essential oils (EOs) from fruit peels of both C. medica cultivars was studied by gas chromatography (GC) and gas chromatography-mass spectrometry (GC-MS) analyses. In all, 100 compounds were identified, 82 for C. medica cv. 'liscia', accounting for 91.4% of the total oil, and 88 for C. medica cv. 'rugosa', accounting for 92.0% of the total oil. Monoterpene hydrocarbons are the main constituents in both oils of C. medica cv. 'liscia' (79.1%) and C. medica cv. 'rugosa' (80.2%). In both oils, limonene (67.2%-62.8%) and camphene (8.5%-10.9%) are the main constituents. The antimicrobial activity of the EOs was assayed against some bacterial strains: Bacillus cereus (DSM 4313), Bacillus cereus (DSM 4384), Staphylococcus aureus (DSM 25693), Pseudomonas aeruginosa (ATCC 50071), and Escherichia coli (DSM 8579). Low concentrations of C. medica cv. 'rugosa' EO showed an inhibitory effect on P. aeruginosa and higher concentrations inhibited more B. cereus (4384) and E. coli than S. aureus. The cytotoxicity of the EO was evaluated against SH-SY5Y cell line. The influence of the EO on the expression of adenylate cyclase 1 (ADCY1) was also studied. The antimicrobial activity registered confirm their traditional uses as food preserving agents and led us to hypothesize the possible use of these oils as antimicrobials. The alterations in ADCY1 expression suggested a role for limonene in effects on the central nervous system.

Five systems of psychiatric classification for preschool children: do differences in validity, usefulness and reliability make for competitive or complimentary constellations?

PubMed

Postert, Christian; Averbeck-Holocher, Marlies; Beyer, Thomas; Müller, Jörg; Furniss, Tilman

2009-03-01

DSM-IV and ICD-10 have limitations in the diagnostic classification of psychiatric disorders at preschool age (0-5 years). The publication of the Diagnostic Classification 0-3 (DC:0-3) in 1994, its basically revised second edition (DC:0-3R) in 2005 and the Research Diagnostic Criteria-Preschool Age (RDC-PA) in 2004 have provided several modifications of these manuals. Taking into account the growing empirical evidence highlighting the need for a diagnostic classification system for psychiatric disorders in preschool children, the main categorical classification systems in preschool psychiatry will be presented and discussed. The paper will focus on issues of validity, usefulness and reliability in DSM-IV, ICD-10, RDC-PA, DC:0-3, and DC:0-3R. The reasons for including or excluding postulated psychiatric disorder categories for preschool children with variable degrees of empirical evidence into the different diagnostic systems will be discussed.

The Effects of DSM-5 Criteria on Number of Individuals Diagnosed with Autism Spectrum Disorder: A Systematic Review

ERIC Educational Resources Information Center

Smith, Isaac C.; Reichow, Brian; Volkmar, Fred R.

2015-01-01

A growing body of research has raised concerns about the number of individuals diagnosed with autism spectrum disorder (ASD) according to DSM-IV-TR who may no longer qualify for diagnoses under the new DSM-5 criteria, published in May 2013. The current study systematically reviews 25 articles evaluating samples according to both DSM-IV-TR and…

The New DSM-5 Impairment Criterion: A Challenge to Early Autism Spectrum Disorder Diagnosis?

ERIC Educational Resources Information Center

Zander, Eric; Bölte, Sven

2015-01-01

The possible effect of the DSM-5 impairment criterion on diagnosing autism spectrum disorder (ASD) in young children was examined in 127 children aged 20-47 months with a DSM-IV-TR clinical consensus diagnosis of ASD. The composite score of the Vineland Adaptive Behavior Scales (VABS) served as a proxy for the DSM-5 impairment criterion. When…

Expression and function of K(V)2-containing channels in human urinary bladder smooth muscle.

PubMed

Hristov, Kiril L; Chen, Muyan; Afeli, Serge A Y; Cheng, Qiuping; Rovner, Eric S; Petkov, Georgi V

2012-06-01

The functional role of the voltage-gated K(+) (K(V)) channels in human detrusor smooth muscle (DSM) is largely unexplored. Here, we provide molecular, electrophysiological, and functional evidence for the expression of K(V)2.1, K(V)2.2, and the electrically silent K(V)9.3 subunits in human DSM. Stromatoxin-1 (ScTx1), a selective inhibitor of K(V)2.1, K(V)2.2, and K(V)4.2 homotetrameric channels and of K(V)2.1/9.3 heterotetrameric channels, was used to examine the role of these channels in human DSM function. Human DSM tissues were obtained during open bladder surgeries from patients without a history of overactive bladder. Freshly isolated human DSM cells were studied using RT-PCR, immunocytochemistry, live-cell Ca(2+) imaging, and the perforated whole cell patch-clamp technique. Isometric DSM tension recordings of human DSM isolated strips were conducted using tissue baths. RT-PCR experiments showed mRNA expression of K(V)2.1, K(V)2.2, and K(V)9.3 (but not K(V)4.2) channel subunits in human isolated DSM cells. K(V)2.1 and K(V)2.2 protein expression was confirmed by Western blot analysis and immunocytochemistry. Perforated whole cell patch-clamp experiments revealed that ScTx1 (100 nM) inhibited the amplitude of the voltage step-induced K(V) current in freshly isolated human DSM cells. ScTx1 (100 nM) significantly increased the intracellular Ca(2+) level in DSM cells. In human DSM isolated strips, ScTx1 (100 nM) increased the spontaneous phasic contraction amplitude and muscle force, and enhanced the amplitude of the electrical field stimulation-induced contractions within the range of 3.5-30 Hz stimulation frequencies. These findings reveal that ScTx1-sensitive K(V)2-containing channels are key regulators of human DSM excitability and contractility and may represent new targets for pharmacological or genetic intervention for bladder dysfunction.

Molecular Expression and Pharmacological Evidence for a Functional Role of Kv7 Channel Subtypes in Guinea Pig Urinary Bladder Smooth Muscle

PubMed Central

Afeli, Serge A. Y.; Malysz, John; Petkov, Georgi V.

2013-01-01

Voltage-gated Kv7 (KCNQ) channels are emerging as essential regulators of smooth muscle excitability and contractility. However, their physiological role in detrusor smooth muscle (DSM) remains to be elucidated. Here, we explored the molecular expression and function of Kv7 channel subtypes in guinea pig DSM by RT-PCR, qRT-PCR, immunohistochemistry, electrophysiology, and isometric tension recordings. In whole DSM tissue, mRNAs for all Kv7 channel subtypes were detected in a rank order: Kv7.1~Kv7.2Kv7.3~Kv7.5Kv7.4. In contrast, freshly-isolated DSM cells showed mRNA expression of: Kv7.1~Kv7.2Kv7.5Kv7.3~Kv7.4. Immunohistochemical confocal microscopy analyses of DSM, conducted by using co-labeling of Kv7 channel subtype-specific antibodies and α-smooth muscle actin, detected protein expression for all Kv7 channel subtypes, except for the Kv7.4, in DSM cells. L-364373 (R-L3), a Kv7.1 channel activator, and retigabine, a Kv7.2-7.5 channel activator, inhibited spontaneous phasic contractions and the 10-Hz electrical field stimulation (EFS)-induced contractions of DSM isolated strips. Linopiridine and XE991, two pan-Kv7 (effective at Kv7.1-Kv7.5 subtypes) channel inhibitors, had opposite effects increasing DSM spontaneous phasic and 10 Hz EFS-induced contractions. EFS-induced DSM contractions generated by a wide range of stimulation frequencies were decreased by L-364373 (10 µM) or retigabine (10 µM), and increased by XE991 (10 µM). Retigabine (10 µM) induced hyperpolarization and inhibited spontaneous action potentials in freshly-isolated DSM cells. In summary, Kv7 channel subtypes are expressed at mRNA and protein levels in guinea pig DSM cells. Their pharmacological modulation can control DSM contractility and excitability; therefore, Kv7 channel subtypes provide potential novel therapeutic targets for urinary bladder dysfunction. PMID:24073284

Validation of Proposed DSM-5 Criteria for Autism Spectrum Disorder

PubMed Central

Frazier, Thomas W.; Youngstrom, Eric A.; Speer, Leslie; Embacher, Rebecca; Law, Paul; Constantino, John; Findling, Robert L.; Hardan, Antonio Y.; Eng, Charis

2011-01-01

Objective The primary aim of the present study was to evaluate the validity of proposed DSM-5 criteria for Autism Spectrum Disorder (ASD). Method We analyzed symptoms from 14,744 siblings (8,911 ASD; 5,863 non-ASD) included in a national registry, the Interactive Autism Network. Youth aged 2–18 were included if at least one child in the family was diagnosed with ASD. Caregivers reported symptoms using the Social Responsiveness Scale and the Social Communication Questionnaire. The structure of autism symptoms was examined using latent variable models that included categories, dimensions, or hybrid models specifying categories and sub-dimensions. Diagnostic efficiency statistics evaluated the proposed DSM-5 algorithm in identifying ASD. Results A hybrid model that included both a category (ASD vs. non-ASD) and two symptom dimensions (social communication/interaction and restricted/repetitive behaviors) was more parsimonious than all other models and replicated across measures and sub-samples. Empirical classifications from this hybrid model closely mirrored clinical ASD diagnoses (90% overlap), implying a broad ASD category distinct from non-ASD. DSM-5 criteria had superior specificity relative to DSM-IV-TR criteria (.97 vs. .86), however sensitivity was lower (.81 vs. .95). Relaxing DSM-5 criteria by requiring one less symptom criterion increased sensitivity (.93 vs. .81), with minimal reduction in specificity (.95 vs. .97). Conclusions Results supported the validity of proposed DSM-5 criteria for ASD as provided in Phase I field trials criteria. Increased specificity of DSM-5 relative to DSM-IV-TR may reduce false positive diagnoses, a particularly relevant consideration for low base rate clinical settings. Phase II testing of DSM-5 should consider a relaxed algorithm, without which as many as 12% of ASD-affected individuals, particularly females, will be missed. Relaxed DSM-5 criteria may improve identification of ASD, decreasing societal costs through appropriate early diagnosis and maximizing intervention resources. PMID:22176937

Differential diagnosis of "Religious or Spiritual Problem" - possibilities and limitations implied by the V-code 62.89 in DSM-5.

PubMed

Prusak, Jacek

2016-01-01

Introduction : Work over preparation of DSM-5 has been a stimulus for research and reflection over the impact of religious/spiritual factors on phenomenology, differential diagnosis, course, outcome and prognosis of mental disorders. The aim of this paper is to present the attitude of DSM towards religion and spirituality in the clinical context. Even though DSM is not in use in Poland, in contrast to ICD, it gives a different, not only psychopathological, look at religious or spiritual problems. The paper is based on in-depth analysis of V-code 62.89 ("Religious or spiritual problem") from historical, theoretical and clinical perspective. The introduction of non-reductive approach to religious and spiritual problems to DSM can be considered as a manifestation of the development of this psychiatric classification with regard to the differential diagnosis between religion and spirituality and psychopathology. By placing religion and spirituality mainly in the category of culture, the authors of DSM-5 have established their solution to the age-old debate concerning the significance of religion/spirituality in clinical practice. Even though, DSM-5 offers an expanded understanding of culture and its impact on diagnosis, the V-code 62.89 needs to be improved taking into account some limitations of DSM classification. The development of DSM, from its fourth edition, brought a change into the approach towards religion and spirituality in the context of clinical diagnosis. Introducing V-code 62.89 has increased the possibility of differential diagnosis between religion/spirituality and health/psychopathology. The emphasis on manifestation of cultural diversity has enabled non-reductive and non-pathologising insight into the problems of religious and spirituality. On the other hand, medicalisation and psychiatrisation of various existential problems, which can be seen in subsequent editions of the DSM, encourages pathologising approach towards religious or spiritual problems. Clinical look at religion and spirituality should therefore go beyond the limitations of DSM.

Psychopathological characteristics of patients seeking for bariatric surgery, either affected or not by binge eating disorder following the criteria of the DSM IV TR and of the DSM 5.

PubMed

Vinai, Piergiuseppe; Da Ros, Annalisa; Speciale, Maurizio; Gentile, Nicola; Tagliabue, Anna; Vinai, Paolo; Bruno, Cecilia; Vinai, Luisa; Studt, Stacia; Cardetti, Silvia

2015-01-01

We evaluate whether there are any significant differences in psychopathology between severe obese patients affected by Binge Eating Disorder diagnosed following both the DSM IV TR and the DSM5 criteria, and severe obese patients not having an eating disorder. 118 severe obese patients seeking treatment at a center for bariatric surgery in northern Italy were asked to take part in the current study for a period of six months. Average participant age was 44.27 years, SD 12.42. Age ranged from 18 to 67 years. Average patient BMI was 45.03, SD 7.11, ranging from 32.14 to 66.16 kg/m(2). Seventy seven of the patients (65.3%) were females and 41 (34.7%) were males. BED diagnosis was determined following the diagnostic criteria of both the DSM IV TR and the DSM 5. The presence of other eating disorders was excluded through a clinical screening using the Eating Disorder Inventory (EDI). Patient eating habits and the presence of emotional eating were appraised using the Three-Factor Eating Questionnaire. Levels of depression and anxiety were evaluated using the Beck Depression Inventory and the State Trait Anxiety Inventory. 57 out of 118 patients were found to be affected by BED following the DSM 5 criteria; among them 24 followed those of the DSM IV TR. BED patients scored higher on four subscales of the Eating Disorders Inventory: Drive for thinness (DT), Bulimia (B), Body dissatisfaction (BD) and Interoceptive awareness (IA) on the STAI and on the Disinhibition and Hunger subscales of the TFEQ. The results confirm the presence of high levels of psychopathology among patients diagnosed with BED, even if they have been diagnosed following the criteria of the DSM 5. There is a great overlap in psychopathology between BED patients diagnosed following the DSM IV TR and the DSM 5 criteria. Copyright © 2014 Elsevier Ltd. All rights reserved.

BK Channel-Mediated Relaxation of Urinary Bladder Smooth Muscle: A Novel Paradigm for Phosphodiesterase Type 4 Regulation of Bladder Function

PubMed Central

Xin, Wenkuan; Li, Ning; Cheng, Qiuping

2014-01-01

Elevation of intracellular cAMP and activation of protein kinase A (PKA) lead to activation of large conductance voltage- and Ca2+-activated K+ (BK) channels, thus attenuation of detrusor smooth muscle (DSM) contractility. In this study, we investigated the mechanism by which pharmacological inhibition of cAMP-specific phosphodiesterase 4 (PDE4) with rolipram or Ro-20-1724 (C15H22N2O3) suppresses guinea pig DSM excitability and contractility. We used high-speed line-scanning confocal microscopy, ratiometric fluorescence Ca2+ imaging, and perforated whole-cell patch-clamp techniques on freshly isolated DSM cells, along with isometric tension recordings of DSM isolated strips. Rolipram caused an increase in the frequency of Ca2+ sparks and the spontaneous transient BK currents (TBKCs), hyperpolarized the cell membrane potential (MP), and decreased the intracellular Ca2+ levels. Blocking BK channels with paxilline reversed the hyperpolarizing effect of rolipram and depolarized the MP back to the control levels. In the presence of H-89 [N-[2-[[3-(4-bromophenyl)-2-propenyl]amino]ethyl]-5-isoquinolinesulfonamide dihydrochloride], a PKA inhibitor, rolipram did not cause MP hyperpolarization. Rolipram or Ro-20-1724 reduced DSM spontaneous and carbachol-induced phasic contraction amplitude, muscle force, duration, and frequency, and electrical field stimulation-induced contraction amplitude, muscle force, and tone. Paxilline recovered DSM contractility, which was suppressed by pretreatment with PDE4 inhibitors. Rolipram had reduced inhibitory effects on DSM contractility in DSM strips pretreated with paxilline. This study revealed a novel cellular mechanism whereby pharmacological inhibition of PDE4 leads to suppression of guinea pig DSM contractility by increasing the frequency of Ca2+ sparks and the functionally coupled TBKCs, consequently hyperpolarizing DSM cell MP. Collectively, this decreases the global intracellular Ca2+ levels and DSM contractility in a BK channel-dependent manner. PMID:24459245

Psychiatric disorders in people with intellectual disability (intellectual developmental disorder): forensic aspects.

PubMed

Hauser, Mark J; Olson, Erick; Drogin, Eric Y

2014-03-01

Persons with intellectual disability come into frequent and underreported contact with the legal system. Advances in forensic psychiatry help better identify persons with intellectual disability in forensic contexts, inform evaluation and treatment, and elucidate unique characteristics of this population. With the release of Diagnostic and Statistical Manual of Mental Disorders (DSM-5), forensic psychiatrists must adjust to changes in the diagnostic process. This review examines the past year's contributions to the literature, including predictors among offenders with intellectual disability, concurrent diagnoses, efficacy of competence restoration, means of studying individuals with intellectual disability, and impact of DSM-5. Impoverished personal relationships are found to be an important predictor of offense among persons with intellectual disability. A Personality Disorder Characteristics Checklist allows screening for personality disorders (indicative of increased risk of violence) among intellectual disability offenders. Referrals to specialists for treatment more often occur for violent and sexual offenses than for other offenses. Competence restoration is historically low among those with intellectual disability, specially compared with those referred for substance abuse and personality disorders. However, the Slater Method results in higher rates of restoration than traditional training methods. DSM-5 alters the definition of intellectual disability, moving from an IQ-oriented diagnosis system to a multifaceted approach, introducing more flexibility and nuance.

Growth requirements of hyperthermophilic sulfur-dependent heterotrophic archaea isolated from a shallow submarine geothermal system with reference to their essential amino acids.

PubMed Central

Hoaki, T; Nishijima, M; Kato, M; Adachi, K; Mizobuchi, S; Hanzawa, N; Maruyama, T

1994-01-01

Three hyperthermophilic sulfur-dependent heterotrophs were isolated from a shallow submarine hydrothermal system at an inlet of Kodakara-jima island, Kagoshima, Japan. The isolates grew at 60 to 97 degrees C, with the optimum temperatures at 85 to 90 degrees C. Sensitivity to rifampin and the existence of ether lipids indicated that the isolates are hyperthermophilic archaea. Partial sequencing of the genes coding for 16S rRNA showed that the three isolates are closely related to the genus Thermococcus. They grew on proteinaceous mixtures, such as yeast extract, Casamino Acids, and purified proteins (e.g., casein and gelatin), but not on carbohydrates or organic acids as sole carbon and energy sources. Nine amino acids were essential for growth of isolate KS-1 (Thr, Leu, Ile, Val, Met, Phe, His, Tyr, and Arg). Isolate KS-2 required Lys in addition to the nine amino acids, and KS-8 required Lys instead of Tyr. In comparative studies, it was shown that Thermococcus celer DSM 2476 required 10 amino acids (Thr, Leu, Ile, Val, Met, Phe, Tyr, Trp, Lys, and Arg) while Pyrococcus furiosus DSM 3638 required only Ile and Val. The hyperthermophilic fermentative eubacterium Thermotoga neapolitana DSM 4359 did not require any amino acids for growth. Images PMID:8085828

Values and DSM-5: looking at the debate on attenuated psychosis syndrome.

PubMed

Gonçalves, Arthur Maciel Nunes; Dantas, Clarissa de Rosalmeida; Banzato, Claudio E M

2016-01-20

Although values have increasingly received attention in psychiatric literature over the last three decades, their role has been only partially acknowledged in psychiatric classification endeavors. The review process of the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) received harsh criticism, and was even considered secretive by some authors. Also, it lacked an official discussion of values at play. In this perspective paper we briefly discuss the interplay of some values in the scientific and non-scientific debate around one of the most debated DSM-5 category proposals, the Attenuated Psychosis Syndrome (APS). Then, we point out some ethical consequences of a facts-plus-values perspective in psychiatric classification. Different stakeholders participated in the APS-debate and for analytical purposes we divided them into four groups: (i) researchers in the field of high-risk mental states; (ii) the DSM-5 Psychotic Disorders Work Group; (iii) patient, carers and advocacy groups; and (iv) external stakeholders, not related to the previous groups, but which also publicly expressed their opinions about APS inclusion in DSM-5. We found that each group differently stressed the role of values we examined in the APS-debate. These values were ethical, but also epistemic, political, economic and ontological. The prominence given to some values, and the lack of discussion about others, generated divergent positions among stakeholders in the debate. As exemplified by the APS discussion, although medicine is primarily an ethical endeavor, values of different kinds that take part in it also shape to a large extent the profession. Thus, it may be strategic to openly discuss values at play in the elaboration of diagnostic tools and classificatory systems. This task, more than scientifically or politically significant, is ethically important.

Epidemiological and clinical relevance of insomnia diagnosis algorithms according to the DSM-IV and the International Classification of Sleep Disorders (ICSD).

PubMed

Ohayon, Maurice M; Reynolds, Charles F

2009-10-01

Although the epidemiology of insomnia in the general population has received considerable attention in the past 20 years, few studies have investigated the prevalence of insomnia using operational definitions such as those set forth in the ICSD and DSM-IV, specifying what proportion of respondents satisfied the criteria to reach a diagnosis of insomnia disorder. This is a cross-sectional study involving 25,579 individuals aged 15 years and over representative of the general population of France, the United Kingdom, Germany, Italy, Portugal, Spain and Finland. The participants were interviewed on sleep habits and disorders managed by the Sleep-EVAL expert system using DSM-IV and ICSD classifications. At the complaint level, too short sleep (20.2%), light sleep (16.6%), and global sleep dissatisfaction (8.2%) were reported by 37% of the subjects. At the symptom level (difficulty initiating or maintaining sleep and non-restorative sleep at least 3 nights per week), 34.5% of the sample reported at least one of them. At the criterion level, (symptoms+daytime consequences), 9.8% of the total sample reported having them. At the diagnostic level, 6.6% satisfied the DSM-IV requirement for positive and differential diagnosis. However, many respondents failed to meet diagnostic criteria for duration, frequency and severity in the two classifications, suggesting that multidimensional measures are needed. A significant proportion of the population with sleep complaints do not fit into DSM-IV and ICSD classifications. Further efforts are needed to identify diagnostic criteria and dimensional measures that will lead to insomnia diagnoses and thus provide a more reliable, valid and clinically relevant classification.

Intensity of Daily Drinking and its Relation to Alcohol Use Disorders.

PubMed

Vergés, Alvaro; Ellingson, Jarrod M; Schroder, Stephanie A; Slutske, Wendy S; Sher, Kenneth J

2018-06-12

Daily drinking is an important public health concern and informative for evaluating diagnostic classification. In particular, daily binge drinkers might be considered as the prototype of some forms of alcoholism, as this drinking pattern may drive many alcohol use disorder (AUD) symptoms. However, daily drinking potentially captures a wide range of drinkers, including light-moderate daily drinkers who exhibit presumed control over their drinking behavior and might benefit from salutary effects on health. The current study examined the heterogeneity of daily drinkers in detail. Data from the two waves of the National Epidemiological Survey of Alcohol and Related Conditions were used. Participants who reported drinking "every day" during the last 12 months were classified as daily drinkers. A series of regression and logistic regression analyses were conducted to investigate the association between daily drinking and various outcomes. Daily drinkers were found to vary considerably from each other with respect to diagnostic status, level of consumption, demographic composition, and a range of drinking and health correlates. Further, a substantial number of daily binge drinkers were not diagnosed with AUD under the DSM-IV or DSM-5, although in most groups the DSM-5 criteria diagnosed a larger percentage of participants. Daily drinkers represents a highly heterogeneous group, and the correlates of daily drinking depend on the usual quantity of daily drinks and the frequency of alcohol-related problems in a given sample. Moreover, AUD, defined both according to DSM-IV and DSM-5, did not capture more than 68% of daily binge drinkers. Given that daily binge drinking is an extremely high threshold for use, this finding may present a challenge for our current classification system. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

Cannabis Use and Disorder From Childhood to Adulthood in a Longitudinal Community Sample With American Indians.

PubMed

Copeland, William E; Hill, Sherika; Costello, E Jane; Shanahan, Lilly

2017-02-01

Recent changes in DSM criteria require new documentation of the prevalence and developmental sequences of cannabis use disorder (CUD). The goal of this study was to investigate the early course of DSM-5 CUD and its overlap with DSM-IV and consumption constructs in a community-representative sample of American Indians. Data came from the prospective, longitudinal, population-based Great Smoky Mountains Study in North Carolina (N = 1,420, including 349 American Indians). Cannabis use and disorder were assessed during yearly interviews from 9 to 16 years of age and at 19, 21, 26, and 30 years of age (up to 11 assessments per participant from 1993 through 2015). By 30 years of age, approximately 70% of participants had used cannabis, 34% had used cannabis daily, and 18% had met criteria for DSM-5 CUD. Approximately 1 in 4 cannabis users met criteria for CUD at some point. Those who met criteria initiated use more than 2 years previously (at 13.3 years old) compared with other users. Despite higher risks from increased poverty, American Indians' patterns of use were similar to those of the rest of the sample. Concordance between DSM-5 CUD and DSM-IV abuse or dependence was substantial but was even higher between DSM-5 CUD and daily use. It was common to have used cannabis daily or to have met criteria for DSM-5 CUD by adulthood. DSM-5 CUD was an improvement over DSM-IV diagnostic constructs by raising the threshold for diagnosis. Copyright © 2016 American Academy of Child and Adolescent Psychiatry. Published by Elsevier Inc. All rights reserved.

The impact of DSM-5 on the diagnosis and severity indicator of eating disorders in a treatment-seeking sample.

PubMed

Nakai, Yoshikatsu; Nin, Kazuko; Noma, Shun'ichi; Teramukai, Satoshi; Fujikawa, Kei; Wonderlich, Stephen A

2017-11-01

To examine the impact of the DSM-5 on the diagnoses and severity indicators of eating disorders, we conducted a comparative study on the classification of eating disorders including subtypes of anorexia nervosa (AN) between the DSM-IV and DSM-5 criteria. In addition, we studied the association of the DSM-5 severity criteria and clinical variables. Participants were 304 outpatients, aged 16-45 years, with eating disorders, diagnosed using semi-structured clinical interviews and the eating disorder examination questionnaire (EDE-Q). The severity of AN, bulimia nervosa (BN), and binge-eating disorder (BED) was rated from mild to extreme using the DSM-5 severity criteria. The DSM-5 remarkably reduced the number of diagnoses in the residual category from 37.5% to 9.2% and effectively differentiated the diagnostic groups in eating disorder psychopathology. Unexpectedly, however, the scores of all the EDE-Q subscales significantly decreased as severity ratings increased in the DSM-5 AN. Furthermore, while the AN binge-eating/purging group reported significantly lower severity ratings than the AN restricting group, the former displayed more severe eating disorder psychopathology than the latter. In the BN and BED groups, the level of eating concern increased as severity ratings increased, but the severity groups did not differ on other eating pathology variables. The DSM-5 effectively reduced the reliance on residual categories and differentiated the diagnostic groups in eating disorder psychopathology. However, our findings show limited support for the DSM-5 severity specifiers for eating disorders. It is necessary to test additional clinical or functional variables for severity specifiers across eating disorders. © 2017 Wiley Periodicals, Inc.

Reassessment of patients with Eating Disorders after moving from DSM-IV towards DSM-5: a retrospective study in a clinical sample.

PubMed

Gualandi, Malvina; Simoni, Marzia; Manzato, Emilia; Scanelli, Giovanni

2016-12-01

To compare the relative prevalence of eating disorders moving from DSM-IV to DSM-5, and to reassess the overall medical impairment in the revised diagnostic classes. We applied DSM-5 to 206 patients (age 15-56 years) previously studied and classified according to DSM-IV. Medical impairment was classified as low, medium, or high, based on a cumulative score of clinical severity (SCS), computed as the sum of specific weights assigned to different pathological conditions and their ascertained prognostic impact. Application of DSM-5 produced a decrease in Eating Disorders Not Otherwise Specified (EDNOS) by 17 %, an increase in anorexia (AN) by 14 % and bulimia (BN) by 2.4 %; 44.6 % of EDNOS migrated to AN, 8 % to BN, and 30.8 % was reclassified as Other Specified Feeding and Eating Disorders (OSFED). Mean SCS was higher in AN than in other diagnoses independent of classification. Differently from EDNOS, no high score was found in OSFED. BMI (OR 0.74, 95 % CI 0.56-0.98) and duration of amenorrhea >1 year (OR 6.63, 95 % CI 1.29-34.16) resulted significantly associated with the risk for medium-high SCS level in AN classified with DSM-5. The results confirmed that DSM-5 reduces the number of EDNOS. DSM-5 seems to better represent the clinical picture in OSFED than in EDNOS. The clinical relevance of BMI and duration of amenorrhea should be considered even more now that they are no longer used as diagnostic hallmarks of AN.

Characterization and complete genome sequences of L. rhamnosus DSM 14870 and L. gasseri DSM 14869 contained in the EcoVag® probiotic vaginal capsules.

PubMed

Marcotte, Harold; Krogh Andersen, Kasper; Lin, Yin; Zuo, Fanglei; Zeng, Zhu; Larsson, Per Göran; Brandsborg, Erik; Brønstad, Gunnar; Hammarström, Lennart

2017-12-01

Lactobacillus rhamnosus DSM 14870 and Lactobacillus gasseri DSM 14869 were previously isolated from the vaginal epithelial cells (VEC) of healthy women and selected for the development of the vaginal EcoVag ® probiotic capsules. EcoVag ® was subsequently shown to provide long-term cure and reduce relapse of bacterial vaginosis (BV) as an adjunct to antibiotic therapy. To identify genes potentially involved in probiotic activity, we performed genome sequencing and characterization of the two strains. The complete genome analysis of both strains revealed the presence of genes encoding functions related to adhesion, exopolysaccharide (EPS) biosynthesis, antimicrobial activity, and CRISPR adaptive immunity but absence of antibiotic resistance genes. Interesting features of L. rhamnosus DSM 14870 genome include the presence of the spaCBA-srtC gene encoding spaCBA pili and interruption of the gene cluster encoding long galactose-rich EPS by integrases. Unique to L. gasseri DSM 14869 genome was the presence of a gene encoding a putative (1456 amino acid) new adhesin containing two rib/alpha-like repeats. L. rhamnosus DSM 14870 and L. gasseri DSM 14869 showed acidification of the culture medium (to pH 3.8) and a strong adhesion capability to the Caco-2 cell line and VEC. L. gasseri DSM 14869 could produce a thick (40nm) EPS layer and hydrogen peroxide. L. rhamnosus DSM 14870 was shown to produce SpaCBA pili and a 20nm EPS layer, and could inhibit the growth of Gardnerella vaginalis, a bacterium commonly associated with BV. The genome sequences provide a basis for further elucidation of the molecular basis for their probiotic functions. Copyright © 2017 Elsevier GmbH. All rights reserved.

Eating disorders in adolescents: how does the DSM-5 change the diagnosis?

PubMed

Fisher, Martin; Gonzalez, Marisol; Malizio, Joan

2015-11-01

This study aimed to determine the changes in diagnosis that occur in making the transition from Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) to Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) criteria in an adolescent medicine eating disorder program. During the months of September 2011 through December 2012, a data sheet was completed at the end of each new outpatient eating disorder evaluation listing the patient's gender, age, ethnicity, weight, height, DSM-IV diagnosis, and proposed DSM-5 diagnosis. Distributions were calculated using the Mann-Whitney and Wilcoxon rank sum analyses to determine differences between diagnostic groups. There were 309 patients evaluated during the 16-month period. DSM-IV diagnoses were as follows: anorexia nervosa, 81 patients (26.2%); bulimia nervosa, 29 patients (9.4%); binge eating disorder, 1 patient (0.3%); and eating disorder not otherwise specified (EDNOS), 198 patients (64.6%). By contrast, DSM-5 diagnoses were as follows: anorexia nervosa, 100 patients; atypical anorexia nervosa, 93 patients; avoidant/restrictive food intake disorder, 60 patients; bulimia nervosa, 29 patients; purging disorder, 18 patients; unspecified feeding or eating disorder, 4 patients; subthreshold bulimia nervosa, 2 patients; subthreshold binge eating disorder, 2 patients; and binge eating disorder, 1 patient. Almost two thirds (64.6%) of the 309 patients had a diagnosis of EDNOS based on the DSM-IV criteria. By contrast, only four patients had a diagnosis of unspecified feeding or eating disorder based on the DSM-5 criteria. These data demonstrate that the goal of providing more specific diagnoses for patients with eating disorders has been accomplished very successfully by the new DSM-5 criteria.

Bipolar mixed features - Results from the comparative effectiveness for bipolar disorder (Bipolar CHOICE) study.

PubMed

Tohen, Mauricio; Gold, Alexandra K; Sylvia, Louisa G; Montana, Rebecca E; McElroy, Susan L; Thase, Michael E; Rabideau, Dustin J; Nierenberg, Andrew A; Reilly-Harrington, Noreen A; Friedman, Edward S; Shelton, Richard C; Bowden, Charles L; Singh, Vivek; Deckersbach, Thilo; Ketter, Terence A; Calabrese, Joseph R; Bobo, William V; McInnis, Melvin G

2017-08-01

DSM-5 changed the criteria from DSM-IV for mixed features in mood disorder episodes to include non-overlapping symptoms of depression and hypomania/mania. It is unknown if, by changing these criteria, the same group would qualify for mixed features. We assessed how those meeting DSM-5 criteria for mixed features compare to those meeting DSM-IV criteria. We analyzed data from 482 adult bipolar patients in Bipolar CHOICE, a randomized comparative effectiveness trial. Bipolar diagnoses were confirmed through the MINI International Neuropsychiatric Interview (MINI). Presence and severity of mood symptoms were collected with the Bipolar Inventory of Symptoms Scale (BISS) and linked to DSM-5 and DSM-IV mixed features criteria. Baseline demographics and clinical variables were compared between mood episode groups using ANOVA for continuous variables and chi-square tests for categorical variables. At baseline, the frequency of DSM-IV mixed episodes diagnoses obtained with the MINI was 17% and with the BISS was 20%. Using DSM-5 criteria, 9% of participants met criteria for hypomania/mania with mixed features and 12% met criteria for a depressive episode with mixed features. Symptom severity was also associated with increased mixed features with a high rate of mixed features in patients with mania/hypomania (63.8%) relative to those with depression (8.0%). Data on mixed features were collected at baseline only and thus do not reflect potential patterns in mixed features within this sample across the study duration. The DSM-5 narrower, non-overlapping definition of mixed episodes resulted in fewer patients who met mixed criteria compared to DSM-IV. Copyright © 2017. Published by Elsevier B.V.

TRPM4 channel: a new player in urinary bladder smooth muscle function in rats

PubMed Central

Smith, Amy C.; Parajuli, Shankar P.; Hristov, Kiril L.; Cheng, Qiuping; Soder, Rupal P.; Afeli, Serge A. Y.; Earley, Scott; Xin, Wenkuan; Malysz, John

2013-01-01

The TRPM4 channel is a Ca2+-activated, monovalent cation-selective channel of the melastatin transient receptor potential (TRPM) family. The TRPM4 channel is implicated in the regulation of many cellular processes including the immune response, insulin secretion, and pressure-induced vasoconstriction of cerebral arteries. However, the expression and function of the TRPM4 channels in detrusor smooth muscle (DSM) have not yet been explored. Here, we provide the first molecular, electrophysiological, and functional evidence for the presence of TRPM4 channels in rat DSM. We detected the expression of TRPM4 channels at mRNA and protein levels in freshly isolated DSM single cells and DSM tissue using RT-PCR, Western blotting, immunohistochemistry, and immunocytochemistry. 9-Hydroxyphenanthrene (9-phenanthrol), a novel selective inhibitor of TRPM4 channels, was used to examine their role in DSM function. In perforated patch-clamp recordings using freshly isolated rat DSM cells, 9-phenanthrol (30 μM) decreased the spontaneous inward current activity at −70 mV. Real-time DSM live-cell Ca2+ imaging showed that selective inhibition of TRPM4 channels with 9-phenanthrol (30 μM) significantly reduced the intracellular Ca2+ levels. Isometric DSM tension recordings revealed that 9-phenanthrol (0.1–30 μM) significantly inhibited the amplitude, muscle force integral, and frequency of the spontaneous phasic and pharmacologically induced contractions of rat DSM isolated strips. 9-Phenanthrol also decreased the amplitude and muscle force integral of electrical field stimulation-induced contractions. In conclusion, this is the first study to examine the expression and provide evidence for TRPM4 channels as critical regulators of rat DSM excitability and contractility. PMID:23283997

Incorrect Match Detection Method for Arctic Sea-Ice Reconstruction Using Uav Images

NASA Astrophysics Data System (ADS)

Kim, J.-I.; Kim, H.-C.

2018-05-01

Shapes and surface roughness, which are considered as key indicators in understanding Arctic sea-ice, can be measured from the digital surface model (DSM) of the target area. Unmanned aerial vehicle (UAV) flying at low altitudes enables theoretically accurate DSM generation. However, the characteristics of sea-ice with textureless surface and incessant motion make image matching difficult for DSM generation. In this paper, we propose a method for effectively detecting incorrect matches before correcting a sea-ice DSM derived from UAV images. The proposed method variably adjusts the size of search window to analyze the matching results of DSM generated and distinguishes incorrect matches. Experimental results showed that the sea-ice DSM produced large errors along the textureless surfaces, and that the incorrect matches could be effectively detected by the proposed method.

A review of somatoform disorders in DSM-IV and somatic symptom disorders in proposed DSM-V.

PubMed

Ghanizadeh, Ahmad; Firoozabadi, Ali

2012-12-01

Psychiatric care providers should be trained to use current changes in the somatoform disorders criteria. New diagnostic criteria for Somatic Symptom disorders in the proposed DSM-V is discussed and compared with its older counterpart in DSM-IV. A new category called Somatic Syndrome Disorders is suggested. It includes new subcategories such as "Complex Somatic Symptom Disorder" (CSSD) and "Simple Somatic Symptom Disorder" (SSSD). Some of the subcategories of DSM-IV derived disorders are included in CSSD. While there are some changes in diagnostic criteria, there are concerns and limitations about the new classification needed to be more discussed before implementation. Functional somatic disturbance, the counterpart of converion disorder in DSM-IV, can be highly dependet on the developmental level of children. However, the role of developmental level needs to be considered.

The DSM-5 Dimensional Anxiety Scales in a Dutch non-clinical sample: psychometric properties including the adult separation anxiety disorder scale.

PubMed

Möller, Eline L; Bögels, Susan M

2016-09-01

With DSM-5, the American Psychiatric Association encourages complementing categorical diagnoses with dimensional severity ratings. We therefore examined the psychometric properties of the DSM-5 Dimensional Anxiety Scales, a set of brief dimensional scales that are consistent in content and structure and assess DSM-5-based core features of anxiety disorders. Participants (285 males, 255 females) completed the DSM-5 Dimensional Anxiety Scales for social anxiety disorder, generalized anxiety disorder, specific phobia, agoraphobia, and panic disorder that were included in previous studies on the scales, and also for separation anxiety disorder, which is included in the DSM-5 chapter on anxiety disorders. Moreover, they completed the Screen for Child Anxiety Related Emotional Disorders Adult version (SCARED-A). The DSM-5 Dimensional Anxiety Scales demonstrated high internal consistency, and the scales correlated significantly and substantially with corresponding SCARED-A subscales, supporting convergent validity. Separation anxiety appeared present among adults, supporting the DSM-5 recognition of separation anxiety as an anxiety disorder across the life span. To conclude, the DSM-5 Dimensional Anxiety Scales are a valuable tool to screen for specific adult anxiety disorders, including separation anxiety. Research in more diverse and clinical samples with anxiety disorders is needed. © 2016 The Authors International Journal of Methods in Psychiatric Research Published by John Wiley & Sons Ltd. © 2016 The Authors International Journal of Methods in Psychiatric Research Published by John Wiley & Sons Ltd.

Impact of using DSM-5 criteria for diagnosing binge eating disorder in bariatric surgery candidates: change in prevalence rate, demographic characteristics, and scores on the Minnesota Multiphasic Personality Inventory--2 restructured form (MMPI-2-RF).

PubMed

Marek, Ryan J; Ben-Porath, Yossef S; Ashton, Kathleen; Heinberg, Leslie J

2014-07-01

Binge eating disorder (BED) was recently included in the DSM-5. The prevalence rate for BED using the DSM-IV-TR research criteria tends to be higher in bariatric surgery candidates than the normative population; however, no studies have examined how many more bariatric surgery candidates will meet the new, less conservative criteria of DSM-5. We explore the current BED prevalence rate change in a sample of bariatric surgery candidates. Data were obtained for 1,283 bariatric surgery candidates. 84 men and 213 women were diagnosed with current BED using DSM-IV-TR research criteria. A semi-structured interview, the binge eating scale (BES), and a Minnesota Multiphasic Personality Inventory-2 Restructured Form (MMPI-2-RF) were given to every patient as part of standard procedures mandated by the facility. An additional 3.43% (p < .001) of bariatric surgery candidates met the diagnostic threshold for BED when using DSM-5 criteria. These individuals were demographical similar and produced similar MMPI-2-RF and BES scores when compared with patients who met DSM-IV-TR criteria for BED. Thus, the current investigation indicates that individuals meeting BED criteria based on DSM-5 are similar to those meeting the more conservative diagnostic threshold outlined in DSM-IV-TR in a sample of bariatric surgery candidates. © 2014 Wiley Periodicals, Inc.

Contention Modeling for Multithreaded Distributed Shared Memory Machines: The Cray XMT

DOE Office of Scientific and Technical Information (OSTI.GOV)

Secchi, Simone; Tumeo, Antonino; Villa, Oreste

Distributed Shared Memory (DSM) machines are a wide class of multi-processor computing systems where a large virtually-shared address space is mapped on a network of physically distributed memories. High memory latency and network contention are two of the main factors that limit performance scaling of such architectures. Modern high-performance computing DSM systems have evolved toward exploitation of massive hardware multi-threading and fine-grained memory hashing to tolerate irregular latencies, avoid network hot-spots and enable high scaling. In order to model the performance of such large-scale machines, parallel simulation has been proved to be a promising approach to achieve good accuracy inmore » reasonable times. One of the most critical factors in solving the simulation speed-accuracy trade-off is network modeling. The Cray XMT is a massively multi-threaded supercomputing architecture that belongs to the DSM class, since it implements a globally-shared address space abstraction on top of a physically distributed memory substrate. In this paper, we discuss the development of a contention-aware network model intended to be integrated in a full-system XMT simulator. We start by measuring the effects of network contention in a 128-processor XMT machine and then investigate the trade-off that exists between simulation accuracy and speed, by comparing three network models which operate at different levels of accuracy. The comparison and model validation is performed by executing a string-matching algorithm on the full-system simulator and on the XMT, using three datasets that generate noticeably different contention patterns.« less

Airborne camera and spectrometer experiments and data evaluation

NASA Astrophysics Data System (ADS)

Lehmann, F. F.; Bucher, T.; Pless, S.; Wohlfeil, J.; Hirschmüller, H.

2009-09-01

New stereo push broom camera systems have been developed at German Aerospace Centre (DLR). The new small multispectral systems (Multi Functional Camerahead - MFC, Advanced Multispectral Scanner - AMS) are light weight, compact and display three or five RGB stereo lines of 8000, 10 000 or 14 000 pixels, which are used for stereo processing and the generation of Digital Surface Models (DSM) and near True Orthoimage Mosaics (TOM). Simultaneous acquisition of different types of MFC-cameras for infrared and RGB data has been successfully tested. All spectral channels record the image data in full resolution, pan-sharpening is not necessary. Analogue to the line scanner data an automatic processing chain for UltraCamD and UltraCamX exists. The different systems have been flown for different types of applications; main fields of interest among others are environmental applications (flooding simulations, monitoring tasks, classification) and 3D-modelling (e.g. city mapping). From the DSM and TOM data Digital Terrain Models (DTM) and 3D city models are derived. Textures for the facades are taken from oblique orthoimages, which are created from the same input data as the TOM and the DOM. The resulting models are characterised by high geometric accuracy and the perfect fit of image data and DSM. The DLR is permanently developing and testing a wide range of sensor types and imaging platforms for terrestrial and space applications. The MFC-sensors have been flown in combination with laser systems and imaging spectrometers and special data fusion products have been developed. These products include hyperspectral orthoimages and 3D hyperspectral data.

Impact of the DSM-5 attention-deficit/hyperactivity disorder age-of-onset criterion in the US adolescent population.

PubMed

Vande Voort, Jennifer L; He, Jian-Ping; Jameson, Nicole D; Merikangas, Kathleen R

2014-07-01

The present study aims to compare the prevalence and clinical correlates of DSM-IV versus DSM-5-defined attention-deficit/hyperactivity disorder (ADHD) and subtypes in a nationally representative sample of US youth based on the age-of-onset criterion. The sample includes 1,894 participants 12 to 15 years of age from cross-sectional National Health and Nutrition Examination Survey (NHANES) surveys conducted from 2001 to 2004. Data on DSM-IV and DSM-5 criteria for ADHD were derived from administration of the parental ADHD module of the National Institute of Mental Health (NIMH) Diagnostic Interview Schedule for Children, Version IV (DISC-IV). Extension of the age-of-onset criterion from 7 to 12 years led to an increase in the prevalence rate of ADHD from 7.38% (DSM-IV) to 10.84% (DSM-5). Youth with later age of onset did not differ from those with earlier age of onset in terms of severity and patterns of comorbidity. However, the group with later age of onset was more likely to be from lower income and ethnic minority families. The comparability of the clinical significance of the early and later age-of-onset groups supports the DSM-5 extension of the age-of-onset criterion in ADHD. Published by Elsevier Inc.

Out of DSM: Depathologizing Homosexuality.

PubMed

Drescher, Jack

2015-12-04

In 1973, the American Psychiatric Association (APA) removed the diagnosis of "homosexuality" from the second edition of its Diagnostic and Statistical Manual (DSM). This resulted after comparing competing theories, those that pathologized homosexuality and those that viewed it as normal. In an effort to explain how that decision came about, this paper reviews some historical scientific theories and arguments that first led to the placement of homosexuality in DSM-I and DSM-II as well as alternative theories that eventually led to its removal from DSM III and subsequent editions of the manual. The paper concludes with a discussion of the sociocultural aftermath of that 1973 decision.

Out of DSM: Depathologizing Homosexuality

PubMed Central

Drescher, Jack

2015-01-01

In 1973, the American Psychiatric Association (APA) removed the diagnosis of “homosexuality” from the second edition of its Diagnostic and Statistical Manual (DSM). This resulted after comparing competing theories, those that pathologized homosexuality and those that viewed it as normal. In an effort to explain how that decision came about, this paper reviews some historical scientific theories and arguments that first led to the placement of homosexuality in DSM-I and DSM-II as well as alternative theories that eventually led to its removal from DSM III and subsequent editions of the manual. The paper concludes with a discussion of the sociocultural aftermath of that 1973 decision. PMID:26690228

Autism spectrum disorders in the DSM-V: better or worse than the DSM-IV?

PubMed

Wing, Lorna; Gould, Judith; Gillberg, Christopher

2011-01-01

The DSM-V-committee has recently published proposed diagnostic criteria for autism spectrum disorders. We examine these criteria in some detail. We believe that the DSM-committee has overlooked a number of important issues, including social imagination, diagnosis in infancy and adulthood, and the possibility that girls and women with autism may continue to go unrecognised or misdiagnosed under the new manual. We conclude that a number of changes need to be made in order that the DSM-V-criteria might be used reliably and validly in clinical practice and research. Copyright © 2010 Elsevier Ltd. All rights reserved.

A systematic literature review of PTSD's latent structure in the Diagnostic and Statistical Manual of Mental Disorders: DSM-IV to DSM-5.

PubMed

Armour, Cherie; Műllerová, Jana; Elhai, Jon D

2016-03-01

The factor structure of posttraumatic stress disorder (PTSD) has been widely researched, but consensus regarding the exact number and nature of factors is yet to be reached. The aim of the current study was to systematically review the extant literature on PTSD's latent structure in the Diagnostic and Statistical Manual of Mental Disorders (DSM) in order to identify the best-fitting model. One hundred and twelve research papers published after 1994 using confirmatory factor analysis and DSM-based measures of PTSD were included in the review. In the DSM-IV literature, four-factor models received substantial support, but the five-factor Dysphoric arousal model demonstrated the best fit, regardless of gender, measurement instrument or trauma type. The recently proposed DSM-5 PTSD model was found to be a good representation of PTSD's latent structure, but studies analysing the six- and seven-factor models suggest that the DSM-5 PTSD factor structure may need further alterations. Copyright © 2015 Elsevier Ltd. All rights reserved.

Feasibility and acceptability of the DSM-5 Field Trial procedures in the Johns Hopkins Community Psychiatry Programs†

PubMed Central

Clarke, Diana E.; Wilcox, Holly C.; Miller, Leslie; Cullen, Bernadette; Gerring, Joan; Greiner, Lisa H.; Newcomer, Alison; Mckitty, Mellisha V.; Regier, Darrel A.; Narrow, William E.

2014-01-01

The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) contains criteria for psychiatric diagnoses that reflect advances in the science and conceptualization of mental disorders and address the needs of clinicians. DSM-5 also recommends research on dimensional measures of cross-cutting symptoms and diagnostic severity, which are expected to better capture patients’ experiences with mental disorders. Prior to its May 2013 release, the American Psychiatric Association (APA) conducted field trials to examine the feasibility, clinical utility, reliability, and where possible, the validity of proposed DSM-5 diagnostic criteria and dimensional measures. The methods and measures proposed for the DSM-5 field trials were pilot tested in adult and child/adolescent clinical samples, with the goal to identify and correct design and procedural problems with the proposed methods before resources were expended for the larger DSM-5 Field Trials. Results allowed for the refinement of the protocols, procedures, and measures, which facilitated recruitment, implementation, and completion of the DSM-5 Field Trials. These results highlight the benefits of pilot studies in planning large multisite studies. PMID:24615761

How do clinicians actually use the Diagnostic and Statistical Manual of Mental Disorders in clinical practice and why we need to know more.

PubMed

First, Michael B; Bhat, Venkat; Adler, David; Dixon, Lisa; Goldman, Beth; Koh, Steve; Levine, Bruce; Oslin, David; Siris, Sam

2014-12-01

The clinical use of the Diagnostic and Statistical Manual of Mental Disorders (DSM) is explicitly stated as a goal for both the DSM Fourth Edition and DSM Fifth Edition (DSM-5) revisions. Many uses assume a relatively faithful application of the DSM diagnostic definitions. However, studies demonstrate significant discrepancies between clinical psychiatric diagnoses with those made using structured interviews suggesting that clinicians do not systematically apply the diagnostic criteria. The limited information regarding how clinicians actually use the DSM raises important questions: a) How can the clinical use be improved without first having a baseline assessment? b) How can potentially significant shifts in practice patterns based on wording changes be assessed without knowing the extent to which the criteria are used as written? Given the American Psychiatric Association's plans for interim revisions to the DSM-5, the value of a detailed exploration of its actual use in clinical practice remains a significant ongoing concern and deserves further study including a number of survey and in vivo studies.

A review of American psychiatry through its diagnoses: the history and development of the Diagnostic and Statistical Manual of Mental Disorders.

PubMed

Fischer, Bernard A

2012-12-01

The history of the Diagnostic and Statistical Manual of Mental Disorders (DSM) reflects the larger history of American psychiatry. As the field anticipates DSM-5, it is useful to take stock of this history and consider not only how diagnosis impacts our understanding of mental illness but also how contemporary thought influences diagnosis. Before the DSM, the field was disjointed. The publication of the first American diagnostic manual, the precursor of the DSM, mirrored society's interest in organized record keeping and prevention rather than treatment of mental illness. The first and second editions of DSM brought a common language to diagnosis and were largely the work of outpatient and academic psychiatrists rather than those based in large state hospitals. The third edition of the DSM saw the shift in American psychiatry's leadership from the eminent clinician to the researcher, whereas the fourth edition reflected the rise of "evidence-based medicine." DSM-5 will likewise represent the current status of the field-not only with regard to science but also reflecting the place of American psychiatry in medicine today.

Should OCD be classified as an anxiety disorder in DSM-V?

PubMed

Stein, Dan J; Fineberg, Naomi A; Bienvenu, O Joseph; Denys, Damiaan; Lochner, Christine; Nestadt, Gerald; Leckman, James F; Rauch, Scott L; Phillips, Katharine A

2010-06-01

In DSM-III, DSM-III-R, and DSM-IV, obsessive-compulsive disorder (OCD) was classified as an anxiety disorder. In ICD-10, OCD is classified separately from the anxiety disorders, although within the same larger category as anxiety disorders (as one of the "neurotic, stress-related, and somatoform disorders"). Ongoing advances in our understanding of OCD and other anxiety disorders have raised the question of whether OCD should continue to be classified with the anxiety disorders in DSM-V. This review presents a number of options and preliminary recommendations to be considered for DSM-V. Evidence is reviewed for retaining OCD in the category of anxiety disorders, and for moving OCD to a separate category of obsessive-compulsive (OC)-spectrum disorders, if such a category is included in DSM-V. Our preliminary recommendation is that OCD be retained in the category of anxiety disorders but that this category also includes OC-spectrum disorders along with OCD. If this change is made, the name of this category should be changed to reflect this proposed change. (c) 2010 Wiley-Liss, Inc.

Research Domain Criteria versus DSM V: How does this debate affect attempts to model corticostriatal dysfunction in animals?

PubMed

Young, Jared W; Winstanley, Catharine A; Brady, Anne Marie; Hall, Frank Scott

2017-05-01

For decades, the nosology of mental illness has been based largely upon the descriptions in the Diagnostic and Statistical Manual of the American Psychiatric Association (DSM). A recent challenge to the DSM approach to psychiatric nosology from the National Institute on Mental Health (USA) defines Research Domain Criteria (RDoC) as an alternative. For RDoC, psychiatric illnesses are not defined as discrete categories, but instead as specific behavioral dysfunctions irrespective of DSM diagnostic categories. This approach was driven by two primary weaknesses noted in the DSM: (1) the same symptoms occur in very different disease states; and (2) DSM criteria lack grounding in the underlying biological causes of mental illness. RDoC intends to ground psychiatric nosology in those underlying mechanisms. This review addresses the suitability of RDoC vs. DSM from the view of modeling mental illness in animals. A consideration of all types of psychiatric dysfunction is beyond the scope of this review, which will focus on models of conditions associated with frontostriatal dysfunction. Copyright © 2016. Published by Elsevier Ltd.

Role of potassium ion channels in detrusor smooth muscle function and dysfunction

PubMed Central

Petkov, Georgi V.

2013-01-01

Contraction and relaxation of the detrusor smooth muscle (DSM), which makes up the wall of the urinary bladder, facilitates the storage and voiding of urine. Several families of K+ channels, including voltage-gated K+ (KV) channels, Ca2+-activated K+ (KCa) channels, inward-rectifying ATP-sensitive K+ (Kir, KATP) channels, and two-pore-domain K+ (K2P) channels, are expressed and functional in DSM. They control DSM excitability and contractility by maintaining the resting membrane potential and shaping the action potentials that determine the phasic nature of contractility in this tissue. Defects in DSM K+ channel proteins or in the molecules involved in their regulatory pathways may underlie certain forms of bladder dysfunction, such as overactive bladder. K+ channels represent an opportunity for novel pharmacological manipulation and therapeutic intervention in human DSM. Modulation of DSM K+ channels directly or indirectly by targeting their regulatory mechanisms has the potential to control urinary bladder function. This Review summarizes our current state of knowledge of the functional role of K+ channels in DSM in health and disease, with special emphasis on current advancements in the field. PMID:22158596

['Barbie Doll Syndrome'. A case report of body dysmorphic disorder].

PubMed

Gruber, Maria; Jahn, Rebecca; Stolba, Karin; Ossege, Michael

2018-03-01

This case report aims to present a 37-year-old women striving to shape her body like a Barbie doll of which she has been fascinated since childhood. She could hardly tolerate any deviation from this beauty ideal. She has been admitted to the psychosomatic ward due to an eating disorder. The ICD-10 and DSM-5 criteria were established for axis I disorders and the German version of the SCID II interview (for DSM-4) was applied for axis II disorders. Additionally, the "modified Yale-Brown Obsessive Compulsive Scale for body dysmorphic disorder" was carried out. The diagnosis of dysmorphophobia (ICD-10: F45.21) or body dysmorphic disorder (DSM-5: 300.7) and bulimia nervosa (ICD-10: F50.2; DSM-5: 307.51) was confirmed. The patient fulfilled criteria of an avoidant, depressive and histrionic personality disorder. Psychopharmacological treatment with Fluoxetine was started and the patient participated in an intensive inpatient psychosomatic program. The body image, self-concept and the sense of shame were therapeutic key topics. The present case report focuses on body dysmorphic disorder as a distinctive entity with high prevalence. Diagnostic criteria of different classification systems were contrasted and comorbidity with eating disorders was discussed. In clinical praxis, body dysmorphic disorder remains underdiagnosed, especially when cooccurring with an eating disorder. However, the correct diagnosis could be relevant for therapy planning.

Issues on the diagnosis and etiopathogenesis of mood disorders: reconsidering DSM-5.

PubMed

Ogasawara, Kazuyoshi; Nakamura, Yukako; Kimura, Hiroyuki; Aleksic, Branko; Ozaki, Norio

2018-02-01

The authors present a narrative review from the diagnostic and nosologic viewpoints of mood disorders (bipolar and depressive ones) by revisiting the revision from the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders, Text Revision to DSM-5, including the following: the separation of the bipolar and depressive sections; the addition of increased energy and continuation of symptoms to the hypo/manic criteria; the elimination of mixed episodes; the creation of new categories and specifiers ("other specified bipolar and related disorder", "disruptive mood dysregulation disorder", "with anxious distress", "with mixed features", "with peripartum onset"); the categorization of hypo/manic episodes during antidepressant treatment into bipolar disorder; the elimination of the "bereavement exclusion"; the ambiguous separation between bipolar I and II; the insufficient distinction between "other specified bipolar and related disorders" and major depressive disorder; the differentiation regarding borderline personality disorder; agitation; premenstrual dysphoric disorder; and society and psychiatry. Through this analysis, we point out both the achievements and limitations of DSM-5. In addition, to examine the future direction of psychiatry, we introduce our cohort study regarding maternal depression and an outline of the National Institute of Mental Health's Research Domain Criteria project in the US. Finally, we advocate the importance of elucidating etiopathogeneses by starting from or going beyond the DSM operational diagnostic system, which has shown great efficacy.

The deformable secondary mirror of VLT: final electro-mechanical and optical acceptance test results

NASA Astrophysics Data System (ADS)

Briguglio, Runa; Biasi, Roberto; Xompero, Marco; Riccardi, Armando; Andrighettoni, Mario; Pescoller, Dietrich; Angerer, Gerald; Gallieni, Daniele; Vernet, Elise; Kolb, Johann; Arsenault, Robin; Madec, Pierre-Yves

2014-07-01

The Deformable Secondary Mirror (DSM) for the VLT ended the stand-alone electro-mechanical and optical acceptance process, entering the test phase as part of the Adaptive Optics Facility (AOF) at the ESO Headquarter (Garching). The VLT-DSM currently represents the most advanced already-built large-format deformable mirror with its 1170 voice-coil actuators and its internal metrology based on co-located capacitive sensors to control the shape of the 1.12m-diameter 2mm-thick convex shell. The present paper reports the final results of the electro-mechanical and optical characterization of the DSM executed in a collaborative effort by the DSM manufacturing companies (Microgate s.r.l. and A.D.S. International s.r.l.), INAF-Osservatorio Astrofisico di Arcetri and ESO. The electro-mechanical acceptance tests have been performed in the company premises and their main purpose was the dynamical characterization of the internal control loop response and the calibration of the system data that are needed for its optimization. The optical acceptance tests have been performed at ESO (Garching) using the ASSIST optical test facility. The main purpose of the tests are the characterization of the optical shell flattening residuals, the corresponding calibration of flattening commands, the optical calibration of the capacitive sensors and the optical calibration of the mirror influence functions.

Development and validation of a premature ejaculation diagnostic tool.

PubMed

Symonds, Tara; Perelman, Michael A; Althof, Stanley; Giuliano, François; Martin, Mona; May, Kathryn; Abraham, Lucy; Crossland, Anna; Morris, Mark

2007-08-01

Diagnosis of premature ejaculation (PE) for clinical trial purposes has typically relied on intravaginal ejaculation latency time (IELT) for entry, but this parameter does not capture the multidimensional nature of PE. Therefore, the aim was to develop a brief, multidimensional, psychometrically validated instrument for diagnosing PE status. The questionnaire development involved three stages: (1) Five focus groups and six individual interviews were conducted to develop the content; (2) psychometric validation using three different groups of men; and (3) generation of a scoring system. For psychometric validation/scoring system development, data was collected from (1) men with PE based on clinician diagnosis, using DSM-IV-TR, who also had IELTs < or =2 min (n=292); (2) men self-reporting PE (n=309); and (3) men self-reporting no-PE (n=701). Standard psychometric analyses were conducted to produce the final questionnaire. Sensitivity/specificity analysis was used to determine an appropriate scoring system. The qualitative research identified 9 items to capture the essence of DSM-IV-TR PE classification. The psychometric validation resulted in a 5-item, unidimensional, measure, which captures the essence of DSM-IV-TR: control, frequency, minimal stimulation, distress, and interpersonal difficulty. Sensitivity/specificity analyses suggested a score of < or =8 indicated no-PE, 9 and 10 probable PE, and > or =11 PE. The development and validation of this new PE diagnostic tool has resulted in a new, user-friendly, and brief self-report questionnaire for use in clinical trials to diagnose PE.

The potential of small unmanned aircraft systems and structure-from-motion for topographic surveys: A test of emerging integrated approaches at Cwm Idwal, North Wales

NASA Astrophysics Data System (ADS)

Tonkin, T. N.; Midgley, N. G.; Graham, D. J.; Labadz, J. C.

2014-12-01

Novel topographic survey methods that integrate both structure-from-motion (SfM) photogrammetry and small unmanned aircraft systems (sUAS) are a rapidly evolving investigative technique. Due to the diverse range of survey configurations available and the infancy of these new methods, further research is required. Here, the accuracy, precision and potential applications of this approach are investigated. A total of 543 images of the Cwm Idwal moraine-mound complex were captured from a light (< 5 kg) semi-autonomous multi-rotor unmanned aircraft system using a consumer-grade 18 MP compact digital camera. The images were used to produce a DSM (digital surface model) of the moraines. The DSM is in good agreement with 7761 total station survey points providing a total vertical RMSE value of 0.517 m and vertical RMSE values as low as 0.200 m for less densely vegetated areas of the DSM. High-precision topographic data can be acquired rapidly using this technique with the resulting DSMs and orthorectified aerial imagery at sub-decimetre resolutions. Positional errors on the total station dataset, vegetation and steep terrain are identified as the causes of vertical disagreement. Whilst this aerial survey approach is advocated for use in a range of geomorphological settings, care must be taken to ensure that adequate ground control is applied to give a high degree of accuracy.

Should Relational Aggression Be Included in DSM-V?

ERIC Educational Resources Information Center

Keenan, Kate; Coyne, Claire; Lahey, Benjamin B.

2008-01-01

The study examines whether relational aggression should be included in DSM-V disruptive behavior disorders. The results conclude that some additional information is gathered from assessing relational aggression but not enough to be included in DSM-V.

The Relationship between the "Childhood Autism Rating Scale: Second Edition" and Clinical Diagnosis Utilizing the DSM-IV-TR and the DSM-5

ERIC Educational Resources Information Center

Dawkins, Tamara; Meyer, Allison T.; Van Bourgondien, Mary E.

2016-01-01

"The Childhood Autism Rating Scale, Second Edition" (CARS2; 2010) includes two rating scales; the CARS2-Standard Version (CARS2-ST) and the newly developed CARS2-High Functioning Version (CARS2-HF). To assess the diagnostic agreement between the CARS2 and DSM-IV-TR versus DSM-5 criteria for Autism Spectrum Disorder (ASD), clinicians at…

An Interpersonal Analysis of Pathological Personality Traits in DSM-5

PubMed Central

Wright, Aidan G.C.; Pincus, Aaron L.; Hopwood, Christopher J.; Thomas, Katherine M.; Markon, Kristian E.; Krueger, Robert F.

2012-01-01

The proposed changes to the personality disorder section of the DSM-5 places an increased focus on interpersonal impairment as one of the defining features of personality psychopathology. In addition, a proposed trait model has been offered to provide a means of capturing phenotypic variation on the expression of personality disorder. In this study, we subject the proposed DSM-5 traits to interpersonal analysis using the Inventory of Interpersonal Problems – Circumplex scales via the structural summary method for circumplex data. DSM-5 traits were consistently associated with generalized interpersonal dysfunction suggesting that they are maladaptive in nature, the majority of traits demonstrated discriminant validity with prototypical and differentiated interpersonal problem profiles, and conformed well to a priori hypothesized associations. These results are discussed in the context of the DSM-5 proposal and contemporary interpersonal theory, with a particular focus on potential areas for expansion of the DSM-5 trait model. PMID:22589411

The impact of endorsing Spitzer's proposed criteria for PTSD in the forthcoming DSM-V on male and female Veterans.

PubMed

Miller, Lyndsey N; Chard, Kathleen M; Schumm, Jeremiah A; O'Brien, Carol

2011-06-01

This study explored differences between Spitzer's proposed model of posttraumatic stress disorder (PTSD) and the current DSM-IV diagnostic classification scheme in 353 Veterans. The majority of Veterans (89%) diagnosed with PTSD as specified in the DSM-IV also met Spitzer's proposed criteria. Veterans who met both DSM-IV and Spitzer's proposed criteria had significantly higher Clinician Administered PTSD Scale severity scores than Veterans only meeting DSM-IV criteria. Logistic regression indicated that being African American and having no comorbid diagnosis of major depressive disorder or history of a substance use disorder were found to predict those Veterans who met current, but not proposed criteria. These findings have important implications regarding proposed changes to the diagnostic classification criteria for PTSD in the forthcoming DSM-V. Copyright © 2011 Elsevier Ltd. All rights reserved.

Cow biological type affects ground beef colour stability.

PubMed

Raines, Christopher R; Hunt, Melvin C; Unruh, John A

2009-12-01

To determine the effects of cow biological type on colour stability of ground beef, M. semimembranosus from beef-type (BSM) and dairy-type (DSM) cows was obtained 5d postmortem. Three blends (100% BSM, 50% BSM+50% DSM, 100% DSM) were adjusted to 90% and 80% lean points using either young beef trim (YBT) or beef cow trim (BCT), then packaged in high oxygen (High-O(2); 80% O(2)) modified atmosphere (MAP). The BSM+YBT patties had the brightest colour initially, but discoloured rapidly. Although DSM+BCT patties had the darkest colour initially, they discoloured least during display. Metmyoglobin reducing ability of ground DSM was up to fivefold greater than ground BSM, and TBARS values of BSM was twofold greater than DSM by the end of display (4d). Though initially darker than beef cow lean, dairy cow lean has a longer display colour life and may be advantageous to retailers using High-O(2) MAP.

Emended descriptions of the genus Micrococcus, Micrococcus luteus (Cohn 1872) and Micrococcus lylae (Kloos et al. 1974).

PubMed

Wieser, Monika; Denner, Ewald B M; Kämpfer, Peter; Schumann, Peter; Tindall, Brian; Steiner, Ulrike; Vybiral, Dietmar; Lubitz, Werner; Maszenan, A M; Patel, B K C; Seviour, Robert J; Radax, Christian; Busse, Hans-Jürgen

2002-03-01

Nine yellow-pigmented, spherical bacterial strains isolated from a medieval wall painting (strain D7), from indoor air (strains 3, 6, 7, 13C2, 38, 83 and 118) and from an activated-sludge plant (strain Ballarat) were classified by a polyphasic approach. Analyses of the 16S rRNA gene sequences of three representatives (strains D7, 118 and Ballarat) indicated that they all belong to the genus Micrococcus. The three isolates shared the highest sequence similarities with Micrococcus luteus DSM 20030T (97.9-98%), Micrococcus antarcticus AS 1.2372T (97.9-98.3%) and Micrococcus lylae DSM 20315T (97.5-97.9%). DNA-DNA reassociation studies clearly demonstrated that all nine isolates belong to the species M. luteus. However, neither their chemotaxonomic features nor their physiological and biochemical properties were consistent with those of M. luteus DSM 20030T. In contrast to M. luteus DSM 20030T, all isolates investigated possessed MK-8(H2) as the major respiratory quinone, and strain Ballarat had an A4alpha peptidoglycan type. On the basis of analyses of their Fourier transform-infrared spectroscopy spectra, isolates D7, 3, 6, 7, 13C2, 38, 83 and 118 could be grouped into a single cluster separate from M. luteus DSM 20030T, strain Ballarat and M. lylae DSM 20315T. In addition, all these isolates could be distinguished from M. luteus DSM 20030T by their ability to assimilate D-maltose, D-trehalose, DL-3-hydroxybutyrate, DL-lactate, pyruvate and L-histidine and to hydrolyse casein. Strains D7, 3, 6, 7, 13C2, 38, 83 and 118 differed from both M. luteus DSM 20030T and strain Ballarat by their ability to assimilate acetate, L-phenylalanine, L-serine and phenylacetate. Furthermore, REP-PCR fingerprinting yielded one common band for these strains, whereas this band was not observed for M. luteus DSM 20030T, strain Ballarat or M. lylae DSM 20315T. On the basis of these data, the species M. luteus can be divided into three biovars that are distinguished by several chemotaxonomic and biochemical traits: biovar I, represented by M. luteus DSM 20030T; biovar II, represented by strains D7 (= DSM 14234 = CCM 4959), 3, 6, 7, 13C2, 38, 83 and 118; and biovar III, represented by strain Ballarat (= DSM 14235 = CCM 4960). On the basis of the results generated in this study, emended descriptions of the genus Micrococcus and the species M. luteus and M. lylae are given.

Comparative genomic analysis of single-molecule sequencing and hybrid approaches for finishing the Clostridium autoethanogenum JA1-1 strain DSM 10061 genome

DOE Office of Scientific and Technical Information (OSTI.GOV)

Brown, Steven D; Nagaraju, Shilpa; Utturkar, Sagar M

Background Clostridium autoethanogenum strain JA1-1 (DSM 10061) is an acetogen capable of fermenting CO, CO2 and H2 (e.g. from syngas or waste gases) into biofuel ethanol and commodity chemicals such as 2,3-butanediol. A draft genome sequence consisting of 100 contigs has been published. Results A closed, high-quality genome sequence for C. autoethanogenum DSM10061 was generated using only the latest single-molecule DNA sequencing technology and without the need for manual finishing. It is assigned to the most complex genome classification based upon genome features such as repeats, prophage, nine copies of the rRNA gene operons. It has a low G +more » C content of 31.1%. Illumina, 454, Illumina/454 hybrid assemblies were generated and then compared to the draft and PacBio assemblies using summary statistics, CGAL, QUAST and REAPR bioinformatics tools and comparative genomic approaches. Assemblies based upon shorter read DNA technologies were confounded by the large number repeats and their size, which in the case of the rRNA gene operons were ~5 kb. CRISPR (Clustered Regularly Interspaced Short Paloindromic Repeats) systems among biotechnologically relevant Clostridia were classified and related to plasmid content and prophages. Potential associations between plasmid content and CRISPR systems may have implications for historical industrial scale Acetone-Butanol-Ethanol (ABE) fermentation failures and future large scale bacterial fermentations. While C. autoethanogenum contains an active CRISPR system, no such system is present in the closely related Clostridium ljungdahlii DSM 13528. A common prophage inserted into the Arg-tRNA shared between the strains suggests a common ancestor. However, C. ljungdahlii contains several additional putative prophages and it has more than double the amount of prophage DNA compared to C. autoethanogenum. Other differences include important metabolic genes for central metabolism (as an additional hydrogenase and the absence of a phophoenolpyruvate synthase) and substrate utilization pathway (mannose and aromatics utilization) that might explain phenotypic differences between C. autoethanogenum and C. ljungdahlii. Conclusions Single molecule sequencing will be increasingly used to produce finished microbial genomes. The complete genome will facilitate comparative genomics and functional genomics and support future comparisons between Clostridia and studies that examine the evolution of plasmids, bacteriophage and CRISPR systems.« less

Concordance of DSM-5 and DSM-IV-TR classifications for autism spectrum disorder.

PubMed

Ohashi, Kei; Mizuno, Yoshifumi; Miyachi, Taishi; Asai, Tomoko; Imaeda, Masayuki; Saitoh, Shinji

2015-12-01

The fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) was published in May 2013. Autism spectrum disorder (ASD) has been structured for the three subtypes of pervasive developmental disorder (PDD), but the number of impairment in social and communication dimension is not stated. The subjects were 68 children who visited the Department of Psychology and Development at Nagoya City University Hospital for the first time between the ages of 6 and 15 years old. We retrospectively re-examined the subjects using DSM-IV-TR criteria and DSM-5 criteria with two rules (two of three and one of three on the social and communication dimension) and examined the concordance rate. Forty subjects were diagnosed with PDD, and 28 were not. The mean PDD subject age was 9.4 years, and mean IQ was 84.0 on the Wechsler Intelligence Scale for Children III or 62.7 on the Tanaka-Binet test. Twenty-seven (68%) of the PDD subjects were classified with ASD using DSM-5 criteria when the two of three rule was applied, while 32 (80%) were classified with ASD when the one of three rule was applied. All subjects without PDD were not diagnosed with ASD on DSM-5 criteria. DSM-5 criteria may exclude high functioning and older subjects from ASD because they tend to be atypical. The diagnostic procedure for DSM-5 criteria is ambiguous, especially in high functioning subjects and those diagnosed at an older age. © 2015 Japan Pediatric Society.

DSM-5 illness anxiety disorder and somatic symptom disorder: Comorbidity, correlates, and overlap with DSM-IV hypochondriasis.

PubMed

Newby, Jill M; Hobbs, Megan J; Mahoney, Alison E J; Wong, Shiu Kelvin; Andrews, Gavin

2017-10-01

To investigate the reliability, validity and utility of DSM-5 illness anxiety disorder (IAD) and somatic symptom disorder (SSD), and explore their overlap with DSM-IV Hypochondriasis in a health anxious sample. Treatment-seeking patients with health anxiety (N=118) completed structured diagnostic interviews to assess DSM-IV Hypochondriasis, DSM-5 IAD, SSD, and comorbid mental disorders, and completed self-report measures of health anxiety, comorbid symptoms, cognitions and behaviours, and service utilization. IAD and SSD were more reliable diagnoses than Hypochondriasis (kappa estimates: IAD: 0.80, SSD: 0.92, Hypochondriasis: 0.60). 45% of patients were diagnosed with SSD, 47% with IAD, and 8% with comorbid IAD/SSD. Most patients with IAD fluctuated between seeking and avoiding care (61%), whereas care-seeking (25%) and care-avoidant subtypes were less common (14%). Half the sample met criteria for DSM-IV Hypochondriasis; of those, 56% met criteria for SSD criteria, 36% for IAD, and 8% for comorbid IAD/SSD. Compared to IAD, SSD was characterized by more severe health anxiety, somatic symptoms, depression, and higher health service use, and higher rates of major depressive disorder, panic disorder and agoraphobia. DSM-5 IAD and SSD classifications reliably detect more cases of clinically significant health anxiety than DSM-IV Hypochondriasis. The differences between IAD and SSD appear to be due to severity. Future research should explore the generalizability of these findings to other samples, and whether diagnostic status predicts treatment response and long-term outcome. Copyright © 2017 Elsevier Inc. All rights reserved.

Continuity between DSM-5 Categorical Criteria and Traits Criteria for Borderline Personality Disorder.

PubMed

Bach, Bo; Sellbom, Martin

2016-08-01

Borderline personality disorder (BPD) includes a heterogeneous constellation of symptoms operationalized with 9 categorical criteria. As the field of personality disorder (PD) research moves to emphasize dimensional traits in its operationalization, it is important to delineate continuity between the 9 DSM-IV/Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) categorical criteria for BPD and the trait dimensions in DSM-5 Section III. To date, no study has attempted such validation. We examined the associations between the 9 categorical DSM-IV/DSM-5 criteria for BPD and the trait dimensions of the alternative DSM-5 model for PDs in consecutively recruited psychiatric outpatients (N = 142; 68% female; age: mean 29.02, SD 8.38). This was investigated by means of bivariate correlations, followed by multiple logistic regression analysis. The categorical BPD criteria were associated with conceptually related DSM-5 Section III traits (P > 0.001), except for the criterion of chronic feelings of emptiness. Consistent with the proposed traits criteria for BPD in DSM-5 Section III, we found Emotional lability, Anxiousness, Separation insecurity, Depressivity, Impulsivity, Risk taking, and Hostility to capture conceptually coherent BPD categorical criteria, while Suspiciousness was also strongly associated with BPD criteria. At the domain level, this applied to Negative affectivity, Disinhibition, and Psychoticism. Notably, Emotional lability, Impulsivity, and Suspiciousness emerged as unique predictors of BPD (P > 0.05). In addition to the proposed BPD traits criteria, Suspiciousness and features of Psychoticism also augment BPD features. Provided that these findings are replicated in forthcoming research, a modified traits operationalization of BPD is warranted. © The Author(s) 2016.

Initial Construction of a Maladaptive Personality Trait Model and Inventory for DSM-5

PubMed Central

Krueger, Robert F.; Derringer, Jaime; Markon, Kristian E.; Watson, David; Skodol, Andrew E.

2012-01-01

Background DSM-IV-TR suggests that clinicians should assess clinically relevant personality traits that do not necessarily constitute a formal personality disorder, and should note these traits on Axis II, but DSM-IV-TR does not provide a trait model to guide the clinician. Our goal was to provide a provisional trait model and a preliminary corresponding assessment instrument, in our roles as members of the DSM-5 personality and personality disorders workgroup and workgroup advisors. Methods An initial list of specific traits and domains (broader groups of traits) was derived from DSM-5 literature reviews and workgroup deliberations, with a focus on capturing maladaptive personality characteristics deemed clinically salient, including those related to the criteria for DSM-IV-TR personality disorders (PDs). The model and instrument were then developed iteratively using data from community samples of treatment seeking participants. The analytic approach relied on tools of modern psychometrics (e.g., item response theory models). Results Twenty-five reliably measured core elements of personality description emerged that, together, delineate five broad domains of maladaptive personality variation: negative affect, detachment, antagonism, disinhibition, and psychoticism. Conclusions We developed a maladaptive personality trait model and corresponding instrument as a step on the path toward helping users of DSM-5 assess traits that may or may not constitute a formal PD. The inventory we developed is reprinted in its entirety in the supplementary materials, with the goal of encouraging additional refinement and development by other investigators prior to the finalization of DSM-5. Continuing discussion should focus on various options for integrating personality traits into DSM-5. PMID:22153017

A systematic review of the Diagnostic and Statistical Manual diagnostic criteria for nicotine dependence.

PubMed

DiFranza, Joseph; Ursprung, W W Sanouri; Lauzon, Béatrice; Bancej, Christina; Wellman, Robert J; Ziedonis, Douglas; Kim, Sun S; Gervais, André; Meltzer, Bruce; McKay, Colleen E; O'Loughlin, Jennifer; Okoli, Chizimuzo T C; Fortuna, Lisa R; Tremblay, Michèle

2010-05-01

The Diagnostic and Statistical Manual diagnostic criteria for nicotine dependence (DSM-ND) are based on the proposition that dependence is a syndrome that can be diagnosed only when a minimum of 3 of the 7 proscribed features are present. The DSM-ND criteria are an accepted research measure, but the validity of these criteria has not been subjected to a systematic evaluation. To systematically review evidence of validity and reliability for the DSM-ND criteria, a literature search was conducted of 16 national and international databases. Each article with original data was independently reviewed by two or more reviewers. In total, 380 potentially relevant articles were examined and 169 were reviewed in depth. The DSM-ND criteria have seen wide use in research settings, but sensitivity and specificity are well below the accepted standards for clinical applications. Predictive validity is generally poor. The 7 DSM-ND criteria are regarded as having face validity, but no data support a 3-symptom ND diagnostic threshold, or a 4-symptom withdrawal syndrome threshold. The DSM incorrectly states that daily smoking is a prerequisite for withdrawal symptoms. The DSM shows poor to modest concurrence with all other measures of nicotine dependence, smoking behaviors and biological measures of tobacco use. The data support the DSM-ND criteria as a valid measure of nicotine dependence severity for research applications. However, the data do not support the central premise of a 3-symptom diagnostic threshold, and no data establish that the DSM-ND criteria provide an accurate diagnosis of nicotine dependence. Copyright (c) 2009 Elsevier Ltd. All rights reserved.

Brain Regions Associated With Internalizing and Externalizing Psychiatric Symptoms in Patients With Penetrating Traumatic Brain Injury.

PubMed

Huey, Edward D; Lee, Seonjoo; Lieberman, Jeffrey A; Devanand, D P; Brickman, Adam M; Raymont, Vanessa; Krueger, Frank; Grafman, Jordan

2016-01-01

A factor structure underlying DSM-IV diagnoses has been previously reported in neurologically intact patients. The authors determined the brain regions associated with factors underlying DSM-IV diagnoses and compared the ability of DSM-IV diagnoses, factor scores, and self-report measures to account for the neuroanatomical findings in patients with penetrating brain injuries. This prospective cohort study included 254 Vietnam War veterans: 199 with penetrating brain injuries and 55 matched control participants. Measures include DSM-IV diagnoses (from a Structured Clinical Interview for DSM), self-report measures of depression and anxiety, and CT scans. Factors underlying DSM-IV diagnoses were determined using an exploratory factor analysis and correlated with percent of brain regions affected. The ability of the factor scores, DSM-IV diagnoses, and the self-report psychiatric measures to account for the anatomical variance was compared with multiple regressions. Internalizing and externalizing factors were identified in these brain-injured patients. Damage to the left amygdala and bilateral basal ganglia was associated with lower internalizing factor scores, and damage to the left medial orbitofrontal cortex (OFC) with higher, and bilateral hippocampi with lower, externalizing factor scores. Factor scores best predicted left amygdala and bilateral hippocampal involvement, whereas DSM-IV diagnoses best predicted bilateral basal ganglia and left OFC involvement. Damage to the limbic areas involved in the processing of emotional and reward information, including structures involved in the National Institute of Mental Health's Research Domain Criteria Negative Valence Domain, influences the development of internalizing and externalizing psychiatric symptoms. Self-report measures underperformed DSM-IV and factor scores in predicting neuroanatomical findings.

DSM-5 somatic symptom disorder in patients with vertigo and dizziness symptoms.

PubMed

Limburg, Karina; Sattel, Heribert; Radziej, Katharina; Lahmann, Claas

2016-12-01

DSM-5 somatic symptom disorder (SSD) could potentially be a highly relevant diagnosis for patients with vertigo and dizziness. The criteria of SSD, particularly the B-criterion with its three components (cognitive, affective, behavioral), have however not yet been investigated in this patient group. We evaluated a large sample (n=399) of outpatients presenting in a neurological setting. Physical examinations and a psychometric assessment (SCID-I) were conducted; patients completed self-report questionnaires. The diagnosis of SSD was assigned retrospectively. The prevalence of SSD, its diagnostic criteria, and its overlap with former DSM-IV somatoform disorders were evaluated; comparisons were drawn between (1) patients fulfilling different components of the B-criterion and (2) patients with diagnoses after DSM-IV vs. DSM-5. SSD was almost twice as common as DSM-IV somatoform disorders. Patients with all three components of the B-criterion reported the highest impairment levels. Patients with both DSM-IV somatoform disorders and DSM-5 SSD were more impaired compared to groups with one of the diagnoses; patients with DSM-IV somatoform disorders only were more impaired than those with SSD only. Our findings demonstrate that SSD is highly prevalent in patients with vertigo and dizziness. The classification of severity based on the number of psychological symptoms appears valid and may assist in finding suitable treatment options according to clinical practice guidelines. Future studies should investigate the overlap of SSD and other psychiatric disorders, this may assist in better defining the diagnostic criteria of SSD. Copyright © 2016 Elsevier Inc. All rights reserved.

A Dual System Model of Preferences under Risk

ERIC Educational Resources Information Center

Mukherjee, Kanchan

2010-01-01

This article presents a dual system model (DSM) of decision making under risk and uncertainty according to which the value of a gamble is a combination of the values assigned to it independently by the affective and deliberative systems. On the basis of research on dual process theories and empirical research in Hsee and Rottenstreich (2004) and…

Utility competition, DSM, and piano bars: The fatal flaw

DOE Office of Scientific and Technical Information (OSTI.GOV)

Studness, C.M.

1993-08-01

This article is an economic analysis of demand side management (DSM). The author contends that utilities and regulators have lost sight of their primary mission of providing electric power as efficiently as possible; DSM conflicts with this mission. DSM measures have not be submitted to a market test, so utilities are not necessarily providing the customers with what they want. This situation is compared to the airline industry before deregulation, when airlines provided expensive services that customers did not want. Also, with present technology, DSM measures consume more in total resources than it what it costs to produce electricity, therebymore » depleting the nation's resources at a greater rate.« less

Clinical application of the five-factor model.

PubMed

Widiger, Thomas A; Presnall, Jennifer Ruth

2013-12-01

The Five-Factor Model (FFM) has become the predominant dimensional model of general personality structure. The purpose of this paper is to suggest a clinical application. A substantial body of research indicates that the personality disorders included within the American Psychiatric Association's (APA) Diagnostic and Statistical Manual of Mental Disorders (DSM) can be understood as extreme and/or maladaptive variants of the FFM (the acronym "DSM" refers to any particular edition of the APA DSM). In addition, the current proposal for the forthcoming fifth edition of the DSM (i.e., DSM-5) is shifting closely toward an FFM dimensional trait model of personality disorder. Advantages of this shifting conceptualization are discussed, including treatment planning. © 2012 Wiley Periodicals, Inc.

Functional cream cheese supplemented with Bifidobacterium animalis subsp. lactis DSM 10140 and Lactobacillus reuteri DSM 20016 and prebiotics.

PubMed

Speranza, Barbara; Campaniello, Daniela; Monacis, Noemi; Bevilacqua, Antonio; Sinigaglia, Milena; Corbo, Maria Rosaria

2018-06-01

The aim of this study was to develop a functional fresh cream cheese with Bifidobacterium animalis subsp. lactis DSM 10140 or Lactobacillus reuteri DSM 20016 and prebiotics (inulin, FOS and lactulose). The research was divided into two steps: in vitro evaluation of the effects of prebiotic compounds; validation at laboratory level with production of functional cream mini-cheeses. Prebiotics showed a protective effect: B. animalis subsp. lactis DSM 10140 cultivability on Petri dishes was positively influenced by lactulose, whereas fructooligosaccharides (FOS) were the prebiotic compounds able to prolong Lb. reuteri DSM 20016 cultivability. At 30 °C, a prolongation of the death time (more than 300 days) was observed, while the controls showed death time values about 100 days. At 45 °C, death time values increased from 32.2 (control) to 33, 35, and 38 days in the samples added with FOS, inulin and lactulose, respectively. Lactulose and FOS were chosen to be added to cream mini-cheeses inoculated with B. animalis subsp. lactis DSM 10140 and Lb. reuteri DSM 20016, respectively; the proposed functional cream cheese resulted in a product with favourable conditions for the viability of both probiotics which maintained cultivable cells above the recommended level during 28 days of storage at 4 °C with good sensory characteristics. Copyright © 2017 Elsevier Ltd. All rights reserved.

The Clinical Features of Paranoia in the 20th Century and Their Representation in Diagnostic Criteria From DSM-III Through DSM-5

PubMed Central

2017-01-01

Abstract This review traces, through psychiatric textbooks, the history of the Kraepelinian concept of paranoia in the 20th century and then relates the common reported symptoms and signs to the diagnostic criteria for paranoia/delusional disorder in DSM-III through DSM-5. Clinical descriptions of paranoia appearing in 10 textbooks, published 1899 to 1970, revealed 11 prominent symptoms and signs reported by 5 or more authors. Three symptoms (systematized delusions, minimal hallucinations, and prominent ideas of reference) and 2 signs (chronic course and minimal affective deterioration) were reported by 8 or 9 of the authors. Four textbook authors rejected the Kraepelinian concept of paranoia. A weak relationship was seen between the frequency with which the clinical features were reported and the likelihood of their inclusion in modern DSM manuals. Indeed, the diagnostic criteria for paranoia/delusional disorder shifted substantially from DSM-III to DSM-5. The modern operationalized criteria for paranoia/delusional disorder do not well reflect the symptoms and signs frequently reported by historical experts. In contrast to results of similar reviews for depression, schizophrenia and mania, the clinical construct of paranoia/delusional disorder has been somewhat unstable in Western Psychiatry since the turn of the 20th century as reflected in both textbooks and the DSM editions. PMID:28003468

The psychopathology of James Bond and its implications for the revision of the DSM-(00)7.

PubMed

Alrutz, Anna Stowe; Kool, Bridget; Robinson, Tom; Moyes, Simon; Huggard, Peter; Hoare, Karen; Arroll, Bruce

2015-12-14

To develop a more concise, user-friendly edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM). The DSM advisory board is probably already hard at work on the DSM-6, so this study is focused on the DSM-(00)7 edition. We conducted an observational study, using a mixed methods approach to analyse the 50th edition boxset of James Bond experiences. James Bond was selected as a suitably complex subject for the basis of a trial of simplifying the DSM. Researchers' televisions and computers from late January to mid-April in Auckland, New Zealand. Following a review of the 23 James Bond video observations, we identified 32 extreme behaviours exhibited by the subject; these could be aggregated into 13 key domains. A Delphi process identified a cluster of eight behaviours that comprise the Bond Adequacy Disorder (BAD). A novel screening scale was then developed, the Bond Additive Descriptors of Anti-Sociality Scale (BADASS), with a binary diagnostic outcome, BAD v Normality Disorder. We propose that these new diagnoses be adopted as the foundation of the DSM-(00)7. The proposed DSM-(00)7 has benefits for both patients and clinicians. Patients will experience reduced stigma, as most individuals will meet the criteria for Normality Disorder. This parsimonious diagnostic approach will also mean clinicians have more time to focus on patient management.

Test-retest reliability of the proposed DSM-5 eating disorder diagnostic criteria

PubMed Central

Sysko, Robyn; Roberto, Christina A.; Barnes, Rachel D.; Grilo, Carlos M.; Attia, Evelyn; Walsh, B. Timothy

2012-01-01

The proposed DSM-5 classification scheme for eating disorders includes both major and minor changes to the existing DSM-IV diagnostic criteria. It is not known what effect these modifications will have on the ability to make reliable diagnoses. Two studies were conducted to evaluate the short-term test-retest reliability of the proposed DSM-5 eating disorder diagnoses: anorexia nervosa, bulimia nervosa, binge eating disorder, and feeding and eating conditions not elsewhere classified. Participants completed two independent telephone interviews with research assessors (n=70 Study 1; n=55 Study 2). Fair to substantial agreements (κ= 0.80 and 0.54) were observed across eating disorder diagnoses in Study 1 and Study 2, respectively. Acceptable rates of agreement were identified for the individual eating disorder diagnoses, including DSM-5 anorexia nervosa (κ’s of 0.81 to 0.97), bulimia nervosa (κ=0.84), binge eating disorder (κ’s of 0.75 and 0.61), and feeding and eating disorders not elsewhere classified (κ’s of 0.70 and 0.46). Further, improved short-term test-retest reliability was noted when using the DSM-5, in comparison to DSM-IV, criteria for binge eating disorder. Thus, these studies found that trained interviewers can reliably diagnose eating disorders using the proposed DSM-5 criteria; however, additional data from general practice settings and community samples are needed. PMID:22401974

The Novel KV7.2/KV7.3 Channel Opener ICA-069673 Reveals Subtype-Specific Functional Roles in Guinea Pig Detrusor Smooth Muscle Excitability and Contractility

PubMed Central

Provence, Aaron; Malysz, John

2015-01-01

The physiologic roles of voltage-gated KV7 channel subtypes (KV7.1–KV7.5) in detrusor smooth muscle (DSM) are poorly understood. Here, we sought to elucidate the functional roles of KV7.2/KV7.3 channels in guinea pig DSM excitability and contractility using the novel KV7.2/KV7.3 channel activator ICA-069673 [N-(2-chloro-5-pyrimidinyl)-3,4-difluorobenzamide]. We employed a multilevel experimental approach using Western blot analysis, immunocytochemistry, isometric DSM tension recordings, fluorescence Ca2+ imaging, and perforated whole-cell patch-clamp electrophysiology. Western blot experiments revealed the protein expression of KV7.2 and KV7.3 channel subunits in DSM tissue. In isolated DSM cells, immunocytochemistry with confocal microscopy further confirmed protein expression for KV7.2 and KV7.3 channel subunits, where they localize within the vicinity of the cell membrane. ICA-069673 inhibited spontaneous phasic, pharmacologically induced, and nerve-evoked contractions in DSM isolated strips in a concentration-dependent manner. The inhibitory effects of ICA-069673 on DSM spontaneous phasic and tonic contractions were abolished in the presence of the KV7 channel inhibitor XE991 [10,10-bis(4-pyridinylmethyl)-9(10H)-anthracenone dihydrochloride]. Under conditions of elevated extracellular K+ (60 mM), the effects of ICA-069673 on DSM tonic contractions were significantly attenuated. ICA-069673 decreased the global intracellular Ca2+ concentration in DSM cells, an effect blocked by the L-type Ca2+ channel inhibitor nifedipine. ICA-069673 hyperpolarized the membrane potential and inhibited spontaneous action potentials of isolated DSM cells, effects that were blocked in the presence of XE991. In conclusion, using the novel KV7.2/KV7.3 channel activator ICA-069673, this study provides strong evidence for a critical role for the KV7.2- and KV7.3-containing channels in DSM function at both cellular and tissue levels. PMID:26087697

The Novel KV7.2/KV7.3 Channel Opener ICA-069673 Reveals Subtype-Specific Functional Roles in Guinea Pig Detrusor Smooth Muscle Excitability and Contractility.

PubMed

Provence, Aaron; Malysz, John; Petkov, Georgi V

2015-09-01

The physiologic roles of voltage-gated KV7 channel subtypes (KV7.1-KV7.5) in detrusor smooth muscle (DSM) are poorly understood. Here, we sought to elucidate the functional roles of KV7.2/KV7.3 channels in guinea pig DSM excitability and contractility using the novel KV7.2/KV7.3 channel activator ICA-069673 [N-(2-chloro-5-pyrimidinyl)-3,4-difluorobenzamide]. We employed a multilevel experimental approach using Western blot analysis, immunocytochemistry, isometric DSM tension recordings, fluorescence Ca(2+) imaging, and perforated whole-cell patch-clamp electrophysiology. Western blot experiments revealed the protein expression of KV7.2 and KV7.3 channel subunits in DSM tissue. In isolated DSM cells, immunocytochemistry with confocal microscopy further confirmed protein expression for KV7.2 and KV7.3 channel subunits, where they localize within the vicinity of the cell membrane. ICA-069673 inhibited spontaneous phasic, pharmacologically induced, and nerve-evoked contractions in DSM isolated strips in a concentration-dependent manner. The inhibitory effects of ICA-069673 on DSM spontaneous phasic and tonic contractions were abolished in the presence of the KV7 channel inhibitor XE991 [10,10-bis(4-pyridinylmethyl)-9(10H)-anthracenone dihydrochloride]. Under conditions of elevated extracellular K(+) (60 mM), the effects of ICA-069673 on DSM tonic contractions were significantly attenuated. ICA-069673 decreased the global intracellular Ca(2+) concentration in DSM cells, an effect blocked by the L-type Ca(2+) channel inhibitor nifedipine. ICA-069673 hyperpolarized the membrane potential and inhibited spontaneous action potentials of isolated DSM cells, effects that were blocked in the presence of XE991. In conclusion, using the novel KV7.2/KV7.3 channel activator ICA-069673, this study provides strong evidence for a critical role for the KV7.2- and KV7.3-containing channels in DSM function at both cellular and tissue levels. Copyright © 2015 by The American Society for Pharmacology and Experimental Therapeutics.

Variability in the prevalence of adult ADHD in treatment seeking substance use disorder patients: results from an international multi-center study exploring DSM-IV and DSM-5 criteria.

PubMed

van de Glind, Geurt; Konstenius, Maija; Koeter, Maarten W J; van Emmerik-van Oortmerssen, Katelijne; Carpentier, Pieter-Jan; Kaye, Sharlene; Degenhardt, Louisa; Skutle, Arvid; Franck, Johan; Bu, Eli-Torild; Moggi, Franz; Dom, Geert; Verspreet, Sofie; Demetrovics, Zsolt; Kapitány-Fövény, Máté; Fatséas, Melina; Auriacombe, Marc; Schillinger, Arild; Møller, Merete; Johnson, Brian; Faraone, Stephen V; Ramos-Quiroga, J Antoni; Casas, Miguel; Allsop, Steve; Carruthers, Susan; Schoevers, Robert A; Wallhed, Sara; Barta, Csaba; Alleman, Peter; Levin, Frances R; van den Brink, Wim

2014-01-01

Available studies vary in their estimated prevalence of attention deficit/hyperactivity disorder (ADHD) in substance use disorder (SUD) patients, ranging from 2 to 83%. A better understanding of the possible reasons for this variability and the effect of the change from DSM-IV to DSM-5 is needed. A two stage international multi-center, cross-sectional study in 10 countries, among patients form inpatient and outpatient addiction treatment centers for alcohol and/or drug use disorder patients. A total of 3558 treatment seeking SUD patients were screened for adult ADHD. A subsample of 1276 subjects, both screen positive and screen negative patients, participated in a structured diagnostic interview. Prevalence of DSM-IV and DSM-5 adult ADHD varied for DSM-IV from 5.4% (CI 95%: 2.4-8.3) for Hungary to 31.3% (CI 95%:25.2-37.5) for Norway and for DSM-5 from 7.6% (CI 95%: 4.1-11.1) for Hungary to 32.6% (CI 95%: 26.4-38.8) for Norway. Using the same assessment procedures in all countries and centers resulted in substantial reduction of the variability in the prevalence of adult ADHD reported in previous studies among SUD patients (2-83%→5.4-31.3%). The remaining variability was partly explained by primary substance of abuse and by country (Nordic versus non-Nordic countries). Prevalence estimates for DSM-5 were slightly higher than for DSM-IV. Given the generally high prevalence of adult ADHD, all treatment seeking SUD patients should be screened and, after a confirmed diagnosis, treated for ADHD since the literature indicates poor prognoses of SUD in treatment seeking SUD patients with ADHD. Copyright © 2013 The Authors. Published by Elsevier Ireland Ltd.. All rights reserved.

Variability in the prevalence of adult ADHD in treatment seeking substance use disorder patients: Results from an international multi-center study exploring DSM-IV and DSM-5 criteria☆☆

PubMed Central

van de Glind, Geurt; Konstenius, Maija; Koeter, Maarten W.J.; van Emmerik-van Oortmerssen, Katelijne; Carpentier, Pieter-Jan; Kaye, Sharlene; Degenhardt, Louisa; Skutle, Arvid; Franck, Johan; Bu, Eli-Torild; Moggi, Franz; Dom, Geert; Verspreet, Sofie; Demetrovics, Zsolt; Kapitány-Fövény, Máté; Fatséas, Melina; Auriacombe, Marc; Schillinger, Arild; Møller, Merete; Johnson, Brian; Faraone, Stephen V.; Ramos-Quiroga, J. Antoni; Casas, Miguel; Allsop, Steve; Carruthers, Susan; Schoevers, Robert A.; Wallhed, Sara; Barta, Csaba; Alleman, Peter; Levin, Frances R.; van den Brink, Wim

2014-01-01

Background Available studies vary in their estimated prevalence of attention deficit/hyperactivity disorder (ADHD) in substance use disorder (SUD) patients, ranging from 2 to 83%. A better understanding of the possible reasons for this variability and the effect of the change from DSM-IV to DSM-5 is needed. Methods A two stage international multi-center, cross-sectional study in 10 countries, among patients form inpatient and outpatient addiction treatment centers for alcohol and/or drug use disorder patients. A total of 3558 treatment seeking SUD patients were screened for adult ADHD. A subsample of 1276 subjects, both screen positive and screen negative patients, participated in a structured diagnostic interview. Results Prevalence of DSM-IV and DSM-5 adult ADHD varied for DSM-IV from 5.4% (CI 95%: 2.4–8.3) for Hungary to 31.3% (CI 95%:25.2–37.5) for Norway and for DSM-5 from 7.6% (CI 95%: 4.1–11.1) for Hungary to 32.6% (CI 95%: 26.4–38.8) for Norway. Using the same assessment procedures in all countries and centers resulted in substantial reduction of the variability in the prevalence of adult ADHD reported in previous studies among SUD patients (2–83%→ 5.4–31.3%). The remaining variability was partly explained by primary substance of abuse and by country (Nordic versus non-Nordic countries). Prevalence estimates for DSM-5 were slightly higher than for DSM-IV. Conclusions Given the generally high prevalence of adult ADHD, all treatment seeking SUD patients should be screened and, after a confirmed diagnosis, treated for ADHD since the literature indicates poor prognoses of SUD in treatment seeking SUD patients with ADHD. PMID:24156882

The 10/66 Dementia Research Group's fully operationalised DSM-IV dementia computerized diagnostic algorithm, compared with the 10/66 dementia algorithm and a clinician diagnosis: a population validation study

PubMed Central

Prince, Martin J; de Rodriguez, Juan Llibre; Noriega, L; Lopez, A; Acosta, Daisy; Albanese, Emiliano; Arizaga, Raul; Copeland, John RM; Dewey, Michael; Ferri, Cleusa P; Guerra, Mariella; Huang, Yueqin; Jacob, KS; Krishnamoorthy, ES; McKeigue, Paul; Sousa, Renata; Stewart, Robert J; Salas, Aquiles; Sosa, Ana Luisa; Uwakwa, Richard

2008-01-01

Background The criterion for dementia implicit in DSM-IV is widely used in research but not fully operationalised. The 10/66 Dementia Research Group sought to do this using assessments from their one phase dementia diagnostic research interview, and to validate the resulting algorithm in a population-based study in Cuba. Methods The criterion was operationalised as a computerised algorithm, applying clinical principles, based upon the 10/66 cognitive tests, clinical interview and informant reports; the Community Screening Instrument for Dementia, the CERAD 10 word list learning and animal naming tests, the Geriatric Mental State, and the History and Aetiology Schedule – Dementia Diagnosis and Subtype. This was validated in Cuba against a local clinician DSM-IV diagnosis and the 10/66 dementia diagnosis (originally calibrated probabilistically against clinician DSM-IV diagnoses in the 10/66 pilot study). Results The DSM-IV sub-criteria were plausibly distributed among clinically diagnosed dementia cases and controls. The clinician diagnoses agreed better with 10/66 dementia diagnosis than with the more conservative computerized DSM-IV algorithm. The DSM-IV algorithm was particularly likely to miss less severe dementia cases. Those with a 10/66 dementia diagnosis who did not meet the DSM-IV criterion were less cognitively and functionally impaired compared with the DSMIV confirmed cases, but still grossly impaired compared with those free of dementia. Conclusion The DSM-IV criterion, strictly applied, defines a narrow category of unambiguous dementia characterized by marked impairment. It may be specific but incompletely sensitive to clinically relevant cases. The 10/66 dementia diagnosis defines a broader category that may be more sensitive, identifying genuine cases beyond those defined by our DSM-IV algorithm, with relevance to the estimation of the population burden of this disorder. PMID:18577205

Cross-cultural and comparative epidemiology of insomnia: the Diagnostic and statistical manual (DSM), International classification of diseases (ICD) and International classification of sleep disorders (ICSD).

PubMed

Chung, Ka-Fai; Yeung, Wing-Fai; Ho, Fiona Yan-Yee; Yung, Kam-Ping; Yu, Yee-Man; Kwok, Chi-Wa

2015-04-01

To compare the prevalence of insomnia according to symptoms, quantitative criteria, and Diagnostic and Statistical Manual of Mental Disorders, 4th and 5th Edition (DSM-IV and DSM-5), International Classification of Diseases, 10th Revision (ICD-10), and International Classification of Sleep Disorders, 2nd Edition (ICSD-2), and to compare the prevalence of insomnia disorder between Hong Kong and the United States by adopting a similar methodology used by the America Insomnia Survey (AIS). Population-based epidemiological survey respondents (n = 2011) completed the Brief Insomnia Questionnaire (BIQ), a validated scale generating DSM-IV, DSM-5, ICD-10, and ICSD-2 insomnia disorder. The weighted prevalence of difficulty falling asleep, difficulty staying asleep, waking up too early, and non-restorative sleep that occurred ≥3 days per week was 14.0%, 28.3%, 32.1%, and 39.9%, respectively. When quantitative criteria were included, the prevalence dropped the most from 39.9% to 8.4% for non-restorative sleep, and the least from 14.0% to 12.9% for difficulty falling asleep. The weighted prevalence of DSM-IV, ICD-10, ICSD-2, and any of the three insomnia disorders was 22.1%, 4.7%, 15.1%, and 22.1%, respectively; for DSM-5 insomnia disorder, it was 10.8%. Compared with 22.1%, 3.9%, and 14.7% for DSM-IV, ICD-10, and ICSD-2 in the AIS, cross-cultural difference in the prevalence of insomnia disorder is less than what is expected. The prevalence is reduced by half from DSM-IV to DSM-5. ICD-10 insomnia disorder has the lowest prevalence, perhaps because excessive concern and preoccupation, one of its diagnostic criteria, is not always present in people with insomnia. Copyright © 2014 Elsevier B.V. All rights reserved.

Continuity Between DSM-5 Section II and III Personality Disorders in a Dutch Clinical Sample.

PubMed

Orbons, Irene M J; Rossi, Gina; Verheul, Roel; Schoutrop, Mirjam J A; Derksen, Jan L L; Segal, Daniel L; van Alphen, Sebastiaan P J

2018-05-14

The goal of this study was to evaluate the continuity across the Section II personality disorders (PDs) and the proposed Section III model of PDs in the Diagnostic and Statistical Manual of Mental Disorders (5th ed. [DSM-5]; American Psychiatric Association, 2013a ). More specifically, we analyzed association between the DSM-5 Section III pathological trait facets and Section II PDs among 110 Dutch adults (M age = 35.8 years, range = 19-60 years) receiving mental health care. We administered the Structured Clinical Interview for DSM-IV Axis II Disorders to all participants. Participants also completed the self-report Personality Inventory for DSM-5 (PID-5) as a measure of pathological trait facets. The distributions underlying the dependent variable were modeled as criterion counts, using negative binomial regression. The results provided some support for the validity of the PID-5 and the DSM-5 Section III Alternative Model, although analyses did not show a perfect match. Both at the trait level and the domain level, analyses showed mixed evidence of significant relationships between the PID-5 trait facets and domains with the traditional DSM-IV PDs.

Feasibility and acceptability of the DSM-5 Field Trial procedures in the Johns Hopkins Community Psychiatry Programs.

PubMed

Clarke, Diana E; Wilcox, Holly C; Miller, Leslie; Cullen, Bernadette; Gerring, Joan; Greiner, Lisa H; Newcomer, Alison; McKitty, Mellisha V; Regier, Darrel A; Narrow, William E

2014-06-01

The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) contains criteria for psychiatric diagnoses that reflect advances in the science and conceptualization of mental disorders and address the needs of clinicians. DSM-5 also recommends research on dimensional measures of cross-cutting symptoms and diagnostic severity, which are expected to better capture patients' experiences with mental disorders. Prior to its May 2013 release, the American Psychiatric Association (APA) conducted field trials to examine the feasibility, clinical utility, reliability, and where possible, the validity of proposed DSM-5 diagnostic criteria and dimensional measures. The methods and measures proposed for the DSM-5 field trials were pilot tested in adult and child/adolescent clinical samples, with the goal to identify and correct design and procedural problems with the proposed methods before resources were expended for the larger DSM-5 Field Trials. Results allowed for the refinement of the protocols, procedures, and measures, which facilitated recruitment, implementation, and completion of the DSM-5 Field Trials. These results highlight the benefits of pilot studies in planning large multisite studies. Copyright © 2013, American Psychiatric Association. All rights reserved.

How does relaxing the algorithm for autism affect DSM-V prevalence rates?

PubMed

Matson, Johnny L; Hattier, Megan A; Williams, Lindsey W

2012-08-01

Although it is still unclear what causes autism spectrum disorders (ASDs), over time researchers and clinicians have become more precise with detecting and diagnosing ASD. Many diagnoses, however, are based on the criteria established within the Diagnostic and Statistical Manual of Mental Disorders (DSM); thus, any change in these diagnostic criteria can have a great effect upon children with ASD and their families. It is predicted that the prevalence of ASD diagnoses will dramatically decrease with the adoption of the proposed DSM-5 criteria in 2013. The aim of this current study was to inspect the changes in prevalence first using a diagnostic criteria set which was modified slightly from the DSM-5 criteria (Modified-1 criteria) and again using a set of criteria which was relaxed even a bit more (Modified-2 criteria). Modified-1 resulted in 33.77 % fewer toddlers being diagnosed with ASD compared to the DSM-IV, while Modified-2 resulted in only a 17.98 % decrease in ASD diagnoses. Children diagnosed with the DSM-5 criteria exhibited the greatest levels of autism symptomatology, but the Mod-1, Mod-2, and DSM-IV groups still demonstrated significant impairments. Implications of these findings are discussed.

Computerized content analysis of some adolescent writings of Napoleon Bonaparte: a test of the validity of the method.

PubMed

Gottschalk, Louis A; DeFrancisco, Don; Bechtel, Robert J

2002-08-01

The aim of this study was to test the validity of a computer software program previously demonstrated to be capable of making DSM-IV neuropsychiatric diagnoses from the content analysis of speech or verbal texts. In this report, the computer program was applied to three personal writings of Napoleon Bonaparte when he was 12 to 16 years of age. The accuracy of the neuropsychiatric evaluations derived from the computerized content analysis of these writings of Napoleon was independently corroborated by two biographers who have described pertinent details concerning his life situations, moods, and other emotional reactions during this adolescent period of his life. The relevance of this type of computer technology to psychohistorical research and clinical psychiatry is suggested.

Scientific Forum on the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-V)-An Invitation.

PubMed

Aboraya, Ahmed

2010-11-01

The publication of the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-V) is anticipated in May 2013 with many new additions and changes. In this article, the author summarizes the phases of psychiatric classification from the turn of the 20th century until today. Psychiatry 2010 offers a DSM-V Scientific Forum and invites readers to submit comments, recommendations, and articles to Psychiatry 2010 and DSM-V Task Force.

Testosterone decreases urinary bladder smooth muscle excitability via novel signaling mechanism involving direct activation of the BK channels

PubMed Central

Hristov, Kiril L.; Parajuli, Shankar P.; Provence, Aaron

2016-01-01

In addition to improving sexual function, testosterone has been reported to have beneficial effects in ameliorating lower urinary tract symptoms by increasing bladder capacity and compliance, while decreasing bladder pressure. However, the cellular mechanisms by which testosterone regulates detrusor smooth muscle (DSM) excitability have not been elucidated. Here, we used amphotericin-B perforated whole cell patch-clamp and single channel recordings on inside-out excised membrane patches to investigate the regulatory role of testosterone in guinea pig DSM excitability. Testosterone (100 nM) significantly increased the depolarization-induced whole cell outward currents in DSM cells. The selective pharmacological inhibition of the large-conductance voltage- and Ca2+-activated K+ (BK) channels with paxilline (1 μM) completely abolished this stimulatory effect of testosterone, suggesting a mechanism involving BK channels. At a holding potential of −20 mV, DSM cells exhibited transient BK currents (TBKCs). Testosterone (100 nM) significantly increased TBKC activity in DSM cells. In current-clamp mode, testosterone (100 nM) significantly hyperpolarized the DSM cell resting membrane potential and increased spontaneous transient hyperpolarizations. Testosterone (100 nM) rapidly increased the single BK channel open probability in inside-out excised membrane patches from DSM cells, clearly suggesting a direct BK channel activation via a nongenomic mechanism. Live-cell Ca2+ imaging showed that testosterone (100 nM) caused a decrease in global intracellular Ca2+ concentration, consistent with testosterone-induced membrane hyperpolarization. In conclusion, the data provide compelling mechanistic evidence that under physiological conditions, testosterone at nanomolar concentrations directly activates BK channels in DSM cells, independent from genomic testosterone receptors, and thus regulates DSM excitability. PMID:27605581

Development and psychometric analysis of the Brief DSM-5 Alcohol Use Disorder Diagnostic Assessment: Towards effective diagnosis in college students.

PubMed

Hagman, Brett T

2017-11-01

The Diagnostic and Statistical Manual of Mental Disorders (5th edition) Alcohol Use Disorder (DSM-5 AUD) criteria have been modified to reflect a single, continuous disorder. It is critical that we develop brief assessment measures that can accurately assess for DSM-5 AUD criteria in college students to assist in screening, referral, and brief intervention services implemented on college campuses. The present study sought to develop and assess for the psychometric properties of a brief 13-item measure designed to capture the full spectrum of the DSM-5 AUD criteria in a sample of college students. Participants were past-year drinkers (N = 923) between the ages of 18 to 30 enrolled at 3 universities. Respondents completed a 30-min anonymous battery of questionnaires online. The Brief DSM-5 AUD Assessment consisted of 13 items designed to reflect the DSM-5 AUD criteria. Results indicated a high degree of internal consistency reliability with high item-to-scale correlations. Confirmatory factor analyses indicated that a dominant single factor emerged with good model fit. The Item Response Theory (IRT) analyses indicated that the difficulty parameters for each criterion were intermixed along the upper portion of the underlying AUD severity continuum, and the discrimination parameters were all high. Additional analysis indicated that those with a DSM-5 AUD had greater levels of alcohol and other drug use and problem severity in comparison to those without a DSM-5 AUD. Study findings provide empirical support for the reliability and validity of the Brief 13-item DSM-5 Assessment. It should be routinely included into research and clinical practice efforts. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

DSM-5 Tobacco Use Disorder and Sleep Disturbance: Findings from the National Epidemiologic Survey on Alcohol and Related Conditions-III (NESARC-III).

PubMed

Hayley, Amie C; Stough, Con; Downey, Luke A

2017-12-06

The DSM-5 Tobacco use disorder diagnosis incorporates tobacco misuse, addictive behaviors and withdrawal symptomology. Tobacco use is bidirectionally associated with sleep pathology; however, no epidemiological studies have yet evaluated the associations between DSM-5 Tobacco use disorder and self-reported sleep disturbance. The current study aimed to evaluate health, medical and sleep-related factors among individuals within this diagnostic stratum. A total of N = 36,177 adults who participated in the 2012-2013 National Epidemiologic Survey on Alcohol and Related Conditions (NESARC-III) were included for analyses. The adjusted odd ratios (AOR) for individual classifications of DSM-5 Tobacco use disorder among those with subjective sleep disturbances were used as the primary outcome measure and relevant demographic, clinical and medical factors were considered in all univariate and multivariable analyses. Current and lifetime DSM-5 tobacco use disorder diagnoses were associated with poorer health and medical outcomes and higher rates of subjective sleep disturbances (all p < 0.001). Associations between current and lifetime DSM-5 tobacco use disorder and subjective sleep disturbances were maintained in multivariable analyses following adjustment for a range of health, lifestyle, and psychiatric factors (adjusted OR 1.11, 95%CI 1.00-1.23 and adjusted OR = 1.24, 95%CI 1.15-1.34, respectively); however, these relationships were fully explained by diagnoses of DSM-5 alcohol use disorder. Data from this large, representative survey indicate that the association between DSM-5 Tobacco use disorder and sleep disturbance is explained by underlying diagnoses of DSM-5 alcohol use disorder. Multifaceted substance abuse treatment protocols may improve treatment outcomes for affected patient groups.

DSM-IV diagnosis in depressed primary care patients with previous psychiatric ICD-10 bipolar disorder.

PubMed

Angst, Jules; Hantouche, Elie; Caci, Hervé; Gaillard, Raphael; Lancrenon, Sylvie; Azorin, Jean-Michel

2014-01-01

In the past 20 years, much evidence has accumulated against the overly restrictive diagnostic concepts of hypomania in DSM-IV and DSM-IV-TR. We tested DSM-IV-TR and a broader modified version (DSM-IV-TRm) for their ability to detect bipolarity in patients who had been treated for bipolar disorders (BD) in psychiatric settings, and who now consulted general practitioners (GPs) for new major depressive episodes (MDE). Bipolact II was an observational, single-visit survey involving 390 adult patients attending primary care for MDE (DSM-IV-TR criteria) in 201 GP offices in France. The participating GPs (53.3 ± 6.5 years old, 80.1% male) were trained by the Bipolact Educational Program, and were familiar with the medical care of depressive patients. Of the 390 patients with MDE, 129 (33.1%) were previously known as bipolar patients (ICD-10 criteria). Most of the latter bipolar patients (89.7%) had previously been treated with antidepressants. Only 9.3% of them met DMS-IV-TR criteria for BD. Conversely, 79.1% of the 129 bipolar patients met DMS-IV-TRm criteria for BD and showed strong associations with impulse control disorders and manic/hypomanic switches during antidepressant treatment. Limited training of participating GPs, recall bias of patients, and the study not being representative for untreated bipolar patients. Very few ICD-10 bipolar patients consulting French GPs for MDE met DSM-IV-TR criteria for bipolar diagnosis, which suggests that DSM-IV-TR criteria are insufficient and too restrictive for the diagnosis of BD. DSM-IV-TRm was more sensitive, but 20% of bipolar patients were undetected. © 2013 Elsevier B.V. All rights reserved.

Lactobacillus amylovorus DSM 19280 as a novel food-grade antifungal agent for bakery products.

PubMed

Ryan, Liam A M; Zannini, Emanuele; Dal Bello, Fabio; Pawlowska, Agata; Koehler, Peter; Arendt, Elke K

2011-04-29

Mould spoilage is the main cause of substantial economic loss in bakery industry and might also cause public health problems due to the production of mycotoxins. The reduction of mould growth in bakery products is thus of crucial importance and there is great interest to develop safe and efficient strategies for this purpose. In this study Lactobacillus amylovorus DSM19280 has been shown to produce a wide spectrum of antifungal compounds active against common bread spoilage fungi. Among the indicator moulds, Aspergillus fumigatus and Fusarium culmorum were the most sensitive organisms. Several antifungal compounds were found to be present in synthetic medium inoculated with L. amylovorus DSM19280 strain, some of them being reported here for the first time. Wheat doughs fermented with L. amylovorus DSM19280 had good rheological properties and the breads thereof were of high quality as shown by rheofermentometer and texture analyser measurements. The results were compared with those obtained with a control non-antifungal L. amylovorus DSM20531(T) strain, a non-acidified and a chemically acidified dough. The quality of sourdough and bread fermented with L. amylovorus DSM 19280 was comparable to that obtained by using L. amylovorus DSM20531 (T). Additionally, breads were evaluated for the ability to retard the growth of Fusarium culmorum FST 4.05, Aspergillus niger FST4.21, Penicillium expansum FST 4.22, Penicillium roqueforti FST 4.11 and fungal flora from the bakery environment. The biological preservation of bread with L. amylovorus DSM 19280 was also compared to the most commonly used antifungal agent Calcium propionate. Breads containing sourdough fermented with L. amylovorus DSM 19280 were more effective in extending the shelf life of bread than the calcium propionate. Copyright © 2011 Elsevier B.V. All rights reserved.

Application of the Chinese Version of the Whiteley Index-7 for Detecting DSM-5 Somatic Symptom and Related Disorders.

PubMed

Tu, Chao-Ying; Liao, Shih-Cheng; Liu, Chao-Yu; Chen, Tzu-Ting; Chen, I-Ming; Lin, Kuan-Fu; Huang, Wei-Lieh

2016-01-01

The Whiteley Index-7 (WI-7) is frequently used for evaluating patients with suspected hypochondriasis. However, information about its use on somatic symptom and related disorders in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) is still lacking. This study investigated the psychometric properties of the Mandarin Chinese version of the WI-7 and its application to evaluation of somatic symptom and related disorders. Participants completed the WI-7 and received diagnostic interview based on both Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) and DSM-5 criteria. Exploratory factor analysis was performed, and the test-retest reliability and the internal consistency of the WI-7 were assessed. Receiver Operating Characteristic curves were established, and the area under the curve was calculated to determine the cutoff point to distinguish DSM-IV somatoform disorders and DSM-5 somatic symptom and related disorders, respectively. A total of 471 subjects were recruited for this study. The exploratory factor analysis of the WI-7 identified a single factor. The internal consistency and test-retest reliability of the WI-7 were 0.829 and 0.836, respectively. The area under Receiver Operating Characteristic curve using WI-7 to distinguish DSM-5 somatic symptom and related disorders is 0.660, higher than that when applying to distinguish DSM-IV somatoform disorders. The sensitivity and specificity at an optimal cutoff point of 0/1 are 0.645 and 0.675, respectively. The Mandarin Chinese version of the WI-7 is a potentially useful tool to detect individuals with DSM-5 somatic symptom and related disorders. Copyright © 2016 The Academy of Psychosomatic Medicine. Published by Elsevier Inc. All rights reserved.

Novel role for the transient potential receptor melastatin 4 channel in guinea pig detrusor smooth muscle physiology

PubMed Central

Smith, Amy C.; Hristov, Kiril L.; Cheng, Qiuping; Xin, Wenkuan; Parajuli, Shankar P.; Earley, Scott; Malysz, John

2013-01-01

Members of the transient receptor potential (TRP) channel superfamily, including the Ca2+-activated monovalent cation-selective TRP melastatin 4 (TRPM4) channel, have been recently identified in the urinary bladder. However, their expression and function at the level of detrusor smooth muscle (DSM) remain largely unexplored. In this study, for the first time we investigated the role of TRPM4 channels in guinea pig DSM excitation-contraction coupling using a multidisciplinary approach encompassing protein detection, electrophysiology, live-cell Ca2+ imaging, DSM contractility, and 9-phenanthrol, a recently characterized selective inhibitor of the TRPM4 channel. Western blot and immunocytochemistry experiments demonstrated the expression of the TRPM4 channel in whole DSM tissue and freshly isolated DSM cells with specific localization on the plasma membrane. Perforated whole cell patch-clamp recordings and real-time Ca2+ imaging experiments with fura 2-AM, both using freshly isolated DSM cells, revealed that 9-phenanthrol (30 μM) significantly reduced the cation current and decreased intracellular Ca2+ levels. 9-Phenanthrol (0.1–30 μM) significantly inhibited spontaneous, 0.1 μM carbachol-induced, 20 mM KCl-induced, and nerve-evoked contractions in guinea pig DSM-isolated strips with IC50 values of 1–7 μM and 70–80% maximum inhibition. 9-Phenanthrol also reduced nerve-evoked contraction amplitude induced by continuous repetitive electrical field stimulation of 10-Hz frequency and shifted the frequency-response curve (0.5–50 Hz) relative to the control. Collectively, our data demonstrate the novel finding that TRPM4 channels are expressed in guinea pig DSM and reveal their critical role in the regulation of guinea pig DSM excitation-contraction coupling. PMID:23302778

Social phobia and avoidant personality disorder: are they separate diagnostic entities or do they reflect a spectrum of social anxiety?

PubMed

Tillfors, Maria; Ekselius, Lisa

2009-01-01

The Axis I disorder social phobia and the Axis II disorder avoidant personality disorder were first introduced in the DSM nomenclature in 1980. Since then a major nosological theme in research has concerned whether or not social phobia and avoidant personality disorder represent distinct clinical categories. Our main aim was to summarize both the current situation regarding this conceptual debate, as well as what we still do not know. In the present review we describe the evolution of these disorders as they have been addressed over time, from their introduction in the DSM-III system to their current descriptions in the DSM-IV. Thereafter, earlier empirical literature concerning this conceptual debate is evaluated, with the main focus on comorbidity between social phobia and avoidant personality disorder. The PsycINFO and PubMed electronic databases were searched for studies, and complementary searches of references in articles and books were conducted. To conclude, the studies summarized provide support for the view that social phobia and avoidant personality disorder are more than arbitrary cutoffs along a continuum of social anxiety.

The General Assessment of Personality Disorder (GAPD): factor structure, incremental validity of self-pathology, and relations to DSM-IV personality disorders.

PubMed

Hentschel, Annett G; Livesley, W John

2013-01-01

Recent developments in the classification of personality disorder, especially moves toward more dimensional systems, create the need to assess general personality disorder apart from individual differences in personality pathology. The General Assessment of Personality Disorder (GAPD) is a self-report questionnaire designed to evaluate general personality disorder. The measure evaluates 2 major components of disordered personality: self or identity problems and interpersonal dysfunction. This study explores whether there is a single factor reflecting general personality pathology as proposed by the Diagnostic and Statistical Manual of Mental Disorders (5th ed.), whether self-pathology has incremental validity over interpersonal pathology as measured by GAPD, and whether GAPD scales relate significantly to Diagnostic and Statistical Manual of Mental Disorders (4th ed. [DSM-IV]) personality disorders. Based on responses from a German psychiatric sample of 149 participants, parallel analysis yielded a 1-factor model. Self Pathology scales of the GAPD increased the predictive validity of the Interpersonal Pathology scales of the GAPD. The GAPD scales showed a moderate to high correlation for 9 of 12 DSM-IV personality disorders.

DSM-flux: A new technology for reliable Combined Sewer Overflow discharge monitoring with low uncertainties.

PubMed

Maté Marín, Ainhoa; Rivière, Nicolas; Lipeme Kouyi, Gislain

2018-06-01

In the past ten years, governments from the European Union have been encouraged to collect volume and quality data for all the effluent overflows from separated stormwater and combined sewer systems that result in a significant environmental impact on receiving water bodies. Methods to monitor and control these flows require improvements, particularly for complex Combined Sewer Overflow (CSO) structures. The DSM-flux (Device for Stormwater and combined sewer flows Monitoring and the control of pollutant fluxes) is a new pre-designed and pre-calibrated channel that provides appropriate hydraulic conditions suitable for measurement of overflow rates and volumes by means of one water level gauge. In this paper, a stage-discharge relation for the DSM-flux is obtained experimentally and validated for multiple inflow hydraulic configurations. Uncertainties in CSO discharges and volumes are estimated within the Guide to the expression of Uncertainty in Measurement (GUM) framework. Whatever the upstream hydraulic conditions are, relative uncertainties are lower than 15% and 2% for the investigated discharges and volumes, respectively. Copyright © 2018 Elsevier Ltd. All rights reserved.

DSM-IV "criterion A" schizophrenia symptoms across ethnically different populations: evidence for differing psychotic symptom content or structural organization?

PubMed

McLean, Duncan; Thara, Rangaswamy; John, Sujit; Barrett, Robert; Loa, Peter; McGrath, John; Mowry, Bryan

2014-09-01

There is significant variation in the expression of schizophrenia across ethnically different populations, and the optimal structural and diagnostic representation of schizophrenia are contested. We contrasted both lifetime frequencies of DSM-IV criterion A (the core symptom criterion of the internationally recognized DSM classification system) symptoms and types/content of delusions and hallucinations in transethnic schizophrenia populations from Australia (n = 776), India (n = 504) and Sarawak, Malaysia (n = 259), to elucidate clinical heterogeneity. Differences in both criterion A symptom composition and symptom content were apparent. Indian individuals with schizophrenia reported negative symptoms more frequently than other sites, whereas individuals from Sarawak reported disorganized symptoms more frequently. Delusions of control and thought broadcast, insertion, or withdrawal were less frequent in Sarawak than Australia. Curiously, a subgroup of 20 Indian individuals with schizophrenia reported no lifetime delusions or hallucinations. These findings potentially challenge the long-held view in psychiatry that schizophrenia is fundamentally similar across cultural groups, with differences in only the content of psychotic symptoms, but equivalence in structural form.

Comorbidity of phobic disorders with alcoholism in a Canadian community sample.

PubMed

Sareen, J; Chartier, M; Kjernisted, K D; Stein, M B

2001-10-01

To examine the relation between phobic disorders and alcoholism in a Canadian community sample. Data came from the Mental Health Supplement of the Ontario Health Survey. The University of Michigan revision of the Composite International Diagnostic Interview (UM-CIDI) was used to diagnose DSM-III-R psychiatric disorders in 8116 Canadian respondents between ages 15 and 64 years. Since the cross-system agreement (ICD-10 and DSM-III-R or DSM-IV) on the diagnosis of alcohol abuse is much lower than that for alcohol dependence, we also examined a WHO category, "hazardous alcohol use." Logistic regression controlling for age and sex was used to determine odds ratios (ORs) for phobic disorders and alcohol-use diagnoses. Individuals with lifetime alcohol abuse or dependence had two- to threefold increased odds of having a phobic disorder. Simple phobia and social phobia with multiple fears were significantly associated (ORs 1.5 to 2) with hazardous alcohol use (which had a prevalence of approximately 10%). Given the early onset of most phobic disorders, the findings suggest that these are a risk factor for hazardous patterns of alcohol use.

DSM-III field trials: I. Initial interrater diagnostic reliability.

PubMed

Spitzer, R L; Forman, J B; Nee, J

1979-06-01

The interrater agreement for major diagnostic categories in studies using DSM-I and DSM-II was usually only fair or poor. In phase one of the DSM-III field trials the overall kappa coefficient of agreement for axis I diagnoses of 281 adult patients was .78 for joint interviews and .66 for diagnoses made after separate interviews; for axis II--personality disorders and specific developmental disorders--the coefficients of agreement were .61 and .54. The interrater reliability of DSM--III is, in general, higher than that previously achieved and may be due to changes in the classification itself, the separation of axis I from axis II conditions, the systematic description of the various disorders, and the inclusion of diagnostic criteria.

Mental disorders and DSM-IV paedophilia in 185 subjects convicted of sexual child abuse.

PubMed

Carlstedt, Anita; Innala, Sune; Brimse, Agneta; Söderström Anckarsäter, Henrik

2005-01-01

The objective of this study was to explore how sexual child abusers who meet the DSM-IV criteria for paedophilia differ from those who do not. We studied DSM-IV disorders and paedophilic interests in all cases of sexual child abuse referred to forensic psychiatric investigation in Sweden between 1993 and 1997 (n=185). Frequency and severity of other mental disorders did not differ between subjects with and without DSM-IV paedophilia. However, men with paedophilia had more previous paedophilia convictions, same-sex and younger victims and less often intoxicated status when committing the act. The concept of paedophilia as a mental disorder is not supported by the DSM-IV diagnosis, which primarily describes the acting out of attraction.

The diagnostic status of homosexuality in DSM-III: a reformulation of the issues.

PubMed

Spitzer, R L

1981-02-01

In 1973 homosexuality per se was removed from the DSM-II classification of mental disorders and replaced by the category Sexual Orientation Disturbance. This represented a compromise between the view that preferential homosexuality is invariably a mental disorder and the view that it is merely a normal sexual variant. While the 1973 DSM-II controversy was highly public, more recently a related but less public controversy involved what became the DSM-III category of Ego-dystonic Homosexuality. The author presents the DSM-III controversy and a reformulation of the issues involved in the diagnostic status of homosexuality. He argues that what is at issue is a value judgment about heterosexuality, rather than a factual dispute about homosexuality.

The history of nosology and the rise of the Diagnostic and Statistical Manual of Mental Disorders

PubMed Central

Shorter, Edward

2015-01-01

The current Diagnostic and Statistical Manual of Mental Disorders (DSM)-5 arose from a tradition filled with haphazard science and politically driven choices. The nosology of modern psychiatry began with the German classifiers of the late 19th century, especially Emil Kraepelin. Psychoanalysis then blotted out the classificatory vision for the next half-century, and most of this European psychopathological science failed to cross the Atlantic. The DSM series was a homegrown American product, beginning with Medical 203 in 1945, then guided by psychoanalytic insights through DSM-I in 1952 and DSM-II in 1968. In 1980, DSM-III represented a massive “turning of the page” in nosology, and it had the effect of steering psychoanalysis toward the exit in psychiatry and the beginning of a reconciliation of psychiatry with the rest of medicine. With the advent of DSM-5, however, questions are starting to be asked about whether this massive venture is on the right track. PMID:25987864

Influence of the Fruit Juice Carriers on the Ability of Lactobacillus plantarum DSM20205 to Improve in Vitro Intestinal Barrier Integrity and Its Probiotic Properties.

PubMed

Valero-Cases, Estefanía; Roy, Nicole C; Frutos, María José; Anderson, Rachel C

2017-07-19

This study investigates the influence of tomato and feijoa juices as fermentable carriers of Lactobacillus plantarum (LP DSM20205) on the ability of the bacterium to improve intestinal barrier function using the trans-epithelial electrical resistance (TEER) assay in an apical anaerobic model. The survival of LP DSM20205 in different fruit juices during in vitro digestion, its adhesion capacity, and potential cytotoxic effect on Caco-2 cells were also studied. The results showed that carrier fruit juices have a significant influence on LP DSM20205 growth, survival during in vitro digestion, adhesion capacity, and TEER. All fermented samples were not cytotoxic to Caco-2 cells. The fermented tomato juice showed the largest improvement to intestinal barrier integrity. The digested fermented juices did not increase TEER, although the LP DSM20205 in these samples adhered well. Therefore, LP DSM20205 has the potential to be used as a probiotic in the production of fermented tomato and feijoa juices.

The DSM diagnostic criteria for hypoactive sexual desire disorder in women.

PubMed

Brotto, Lori A

2010-04-01

Hypoactive Sexual Desire Disorder (HSDD) is one of two sexual desire disorders in the Diagnostic and Statistical Manual of Mental Disorders (DSM) and is defined by the monosymptomatic criterion "persistently or recurrently deficient (or absent) sexual fantasies and desire for sexual activity" that causes "marked distress or interpersonal difficulty." This article reviews the diagnosis of HSDD in prior and current (DSM-IV-TR) editions of the DSM, critiques the existing criteria, and proposes criteria for consideration in DSM-V. Problems in coming to a clear operational definition of desire, the fact that sexual activity often occurs in the absence of desire for women, conceptual issues in understanding untriggered versus responsive desire, the relative infrequency of unprovoked sexual fantasies in women, and the significant overlap between desire and arousal are reviewed and highlight the need for revised DSM criteria for HSDD that accurately reflect women's experiences. The article concludes with the recommendation that desire and arousal be combined into one disorder with polythetic criteria.

How Do DSM-5 Personality Traits Align With Schema Therapy Constructs?

PubMed

Bach, Bo; Lee, Christopher; Mortensen, Erik Lykke; Simonsen, Erik

2016-08-01

DSM-5 offers an alternative model of personality pathology that includes 25 traits. Although personality disorders are mostly treated with psychotherapy, the correspondence between DSM-5 traits and concepts in evidence-based psychotherapy has not yet been evaluated adequately. Suitably, schema therapy was developed for treating personality disorders, and it has achieved promising evidence. The authors examined associations between DSM-5 traits and schema therapy constructs in a mixed sample of 662 adults, including 312 clinical participants. Associations were investigated in terms of factor loadings and regression coefficients in relation to five domains, followed by specific correlations among all constructs. The results indicated conceptually coherent associations, and 15 of 25 traits were strongly related to relevant schema therapy constructs. Conclusively, DSM-5 traits may be considered expressions of schema therapy constructs, which psychotherapists might take advantage of in terms of case formulation and targets of treatment. In turn, schema therapy constructs add theoretical understanding to DSM-5 traits.

The history of nosology and the rise of the Diagnostic and Statistical Manual of Mental Disorders.

PubMed

Shorter, Edward

2015-03-01

The current Diagnostic and Statistical Manual of Mental Disorders (DSM)-5 arose from a tradition filled with haphazard science and politically driven choices. The nosology of modern psychiatry began with the German classifiers of the late 19th century, especially Emil Kraepelin. Psychoanalysis then blotted out the classificatory vision for the next half-century, and most of this European psychopathological science failed to cross the Atlantic. The DSM series was a homegrown American product, beginning with Medical 203 in 1945, then guided by psychoanalytic insights through DSM-I in 1952 and DSM-II in 1968. In 1980, DSM-III represented a massive "turning of the page" in nosology, and it had the effect of steering psychoanalysis toward the exit in psychiatry and the beginning of a reconciliation of psychiatry with the rest of medicine. With the advent of DSM-5, however, questions are starting to be asked about whether this massive venture is on the right track.

eHealth technologies to support nutrition and physical activity behaviors in diabetes self-management.

PubMed

Rollo, Megan E; Aguiar, Elroy J; Williams, Rebecca L; Wynne, Katie; Kriss, Michelle; Callister, Robin; Collins, Clare E

2016-01-01

Diabetes is a chronic, complex condition requiring sound knowledge and self-management skills to optimize glycemic control and health outcomes. Dietary intake and physical activity are key diabetes self-management (DSM) behaviors that require tailored education and support. Electronic health (eHealth) technologies have a demonstrated potential for assisting individuals with DSM behaviors. This review provides examples of technologies used to support nutrition and physical activity behaviors in the context of DSM. Technologies covered include those widely used for DSM, such as web-based programs and mobile phone and smartphone applications. In addition, examples of novel tools such as virtual and augmented reality, video games, computer vision for dietary carbohydrate monitoring, and wearable devices are provided. The challenges to, and facilitators for, the use of eHealth technologies in DSM are discussed. Strategies to support the implementation of eHealth technologies within practice and suggestions for future research to enhance nutrition and physical activity behaviors as a part of broader DSM are provided.

eHealth technologies to support nutrition and physical activity behaviors in diabetes self-management

PubMed Central

Rollo, Megan E; Aguiar, Elroy J; Williams, Rebecca L; Wynne, Katie; Kriss, Michelle; Callister, Robin; Collins, Clare E

2016-01-01

Diabetes is a chronic, complex condition requiring sound knowledge and self-management skills to optimize glycemic control and health outcomes. Dietary intake and physical activity are key diabetes self-management (DSM) behaviors that require tailored education and support. Electronic health (eHealth) technologies have a demonstrated potential for assisting individuals with DSM behaviors. This review provides examples of technologies used to support nutrition and physical activity behaviors in the context of DSM. Technologies covered include those widely used for DSM, such as web-based programs and mobile phone and smartphone applications. In addition, examples of novel tools such as virtual and augmented reality, video games, computer vision for dietary carbohydrate monitoring, and wearable devices are provided. The challenges to, and facilitators for, the use of eHealth technologies in DSM are discussed. Strategies to support the implementation of eHealth technologies within practice and suggestions for future research to enhance nutrition and physical activity behaviors as a part of broader DSM are provided. PMID:27853384

Disruptive behaviour disorders and DSM-5.

PubMed

Hawes, David J

2014-10-01

This article provides an overview of the revisions to the diagnoses of oppositional defiant disorder (ODD) and conduct disorder (CD) in DSM-5, and examines the key issues they raise. Particular attention is given to these changes in light of current treatment outcome evidence, including that published since the development of DSM-5. For both ODD and CD, DSM-5 retains the core features that previously defined the phenotypes for these diagnoses. DSM-5 nonetheless introduces a number of revisions pertaining to the guidelines for the application of these criteria, and markers for key individual differences in presentations of these disorders. These revisions reflect small but significant steps towards the perspective that children with disruptive behaviour problems are a highly heterogeneous population, and best characterised on the basis of both behavioural and emotional features. Importantly, there is growing evidence that the newly introduced changes to these diagnoses in DSM-5 may be better able to inform predictions regarding treatment response than previous diagnostic criteria. Copyright © 2014 Elsevier B.V. All rights reserved.

A Crystal Stratigraphy Approach to Deciphering the Petrogenesis of the Detroit Seamount

NASA Astrophysics Data System (ADS)

Simonetti, A.; Davenport, J.; Neal, C. R.

2012-12-01

The Detroit Seamount (DSM) erupted ~76-81 Ma ago, and is the northwestern terminus of the Hawaiian-Emperor Seamount chain. The Hawaiian-Emperor Seamount chain has drastically furthered our understanding of how and where mantle plumes originate, the dynamics of interactions between plumes and mantle, and plate movement in the recent past. DSM Basalts from Site 1203 of Leg 197 of the Ocean Drilling Program (ODP) contain, by rock volume, a large quantity of plagioclase and olivine phenocrysts. Previous investigations into magma chamber processes via phenocryst analysis such as those occurring at the DSM have largely relied solely on major and trace element analyses. However, since both are easily susceptible to post-solidification alteration processes, in this study we are undertaking a multi-faceted approach to deciphering the petrogenetic history of the DSM basalts via crystal stratigraphy, crystal size distributions (CSDs), electron microprobe analysis (EPMA), laser ablation and multi-collector inductively coupled plasma mass spectrometry (LA- and MC-ICP-MS), microdilling and phase separation, and isotope analysis of whole-rock, olivine and plagioclase phenocrysts and their associated melt inclusions. A preliminary Sr isotope and trace element investigation of DSM whole rock basalts from Site 884 yielded a range of values between 0.70262 and 0.70276, as well as MORB-like trace element patterns. Notably, the plagioclase rims analyzed possessed a more radiogenic (87Sr/86Sr)I than the core (0.70361 ± 2 vs. 0.70347 ± 2). Our initial interpretation of this radiogenic increase from core-to-rim was crystal growth in an OIB-rich magma source that was not cogenetic with its matrix. Eight olivine phenocrysts from DSM basalts were analyzed for major elements using scanning electron microscopy (SEM) and energy dispersive spectrum (EDS) techniques. Fosterite contents of the olivine phenocrysts range from 84-86. Olivines from basalt sample 10R-4 exhibit a well-defined correlation between Ni and Mn contents, whereas those from sample 10R-3 show a more limited range of Mn and Ni compositions. The trends defined by the data from the olivine phenocrysts clearly suggest that fractional crystallization was not the sole magma differentiation process to have occurred. Rare earth element (REE) abundances for the olivine phenocrysts are low, and generally range from 0.1 to 2 ppm, with those from basalt sample 10R-4 containing higher abundances than sample 10R-3. Melt inclusions from within plagioclase phenocrysts in DSM basalt sample 9R-2 from Site 884 were analyzed via laser ablation-ICP-MS. Results from the analyses indicate that the melt inclusions are LREE-enriched and negatively-sloped compared to the LREE-depleted basalt whole rock compositions from the DSM and the East Pacific Rise. Of interest, the La concentrations in the melt inclusions are notably similar to abundances found for the Manua Kea tholeiites. Trace element data and Sr isotope ratios for both melt inclusions and phenocrysts from the DSM basalts are all indicative of open system behavior and possibly consistent with magma mixing between at least two end-member mantle components.

Commercial vs professional UAVs for mapping

NASA Astrophysics Data System (ADS)

Nikolakopoulos, Konstantinos G.; Koukouvelas, Ioannis

2017-09-01

The continuous advancements in the technology behind Unmanned Aerial Vehicles (UAVs), in accordance with the consecutive decrease to their cost and the availability of photogrammetric software, make the use of UAVs an excellent tool for large scale mapping. In addition with the use of UAVs, the problems of increased costs, time consumption and the possible terrain accessibility problems, are significantly reduced. However, despite the growing number of UAV applications there has been a little quantitative assessment of UAV performance and of the quality of the derived products (orthophotos and Digital Surface Models). Here, we present results from field experiments designed to evaluate the accuracy of photogrammetrically-derived digital surface models (DSM) developed from imagery acquired with onboard digital cameras. We also show the comparison of the high resolution vs moderate resolution imagery for largescale geomorphic mapping. The acquired data analyzed in this study comes from a small commercial and a professional UAV. The test area was mapped using the same photogrammetric grid by the two UAVs. 3D models, DSMs and orthophotos were created using special software. Those products were compared to in situ survey measurements and the results are presented in this paper.

The proposed changes for DSM-5 for SLD and ADHD: international perspectives--Australia, Germany, Greece, India, Israel, Italy, Spain, Taiwan, United Kingdom, and United States.

PubMed

Al-Yagon, Michal; Cavendish, Wendy; Cornoldi, Cesare; Fawcett, Angela J; Grünke, Matthias; Hung, Li-Yu; Jiménez, Juan E; Karande, Sunil; van Kraayenoord, Christina E; Lucangeli, Daniela; Margalit, Malka; Montague, Marjorie; Sholapurwala, Rukhshana; Sideridis, Georgios; Tressoldi, Patrizio E; Vio, Claudio

2013-01-01

This article presents an international perspective of the proposed changes to the DSM-5 for learning disabilities (LD) and attention-deficit/hyperactivity disorders (ADHD) across ten countries: Australia, Germany, Greece, India, Israel, Italy, Spain, Taiwan, the United Kingdom, and the United States. We provide perspectives of the present situation for youth with LD and youth with ADHD and describe the legislation, prevalence rates, and educational systems that serve students with disabilities in the respective countries. We also present a discussion of the expected impact of the proposed changes for the diagnosis of LD and ADHD in each country.

Phenomenology of panic attacks: a descriptive study of panic disorder patients' self-reports.

PubMed

Aronson, T A; Logue, C M

1988-01-01

The phenomenology of panic disorder and panic attacks was systematically assessed in 46 consecutive patients. The results suggest that DSM-III criteria include several symptoms that are not frequently present during a panic attack and that DSM-III's characterization of a panic attack is imprecise and misleading. Panic attacks were found to vary in intensity, frequency, spontaneity, and associated symptoms. A panic attack typically presents as a unified symptom complex of psychic anxiety and multiple somatic symptoms in multiple body systems. It occurs in a crescendolike pattern, is self-limited, and often leaves the subject weak or shaken. The temporal course as much as the symptomatic presentation defines a panic attack.

GALACSI integration and functional tests

NASA Astrophysics Data System (ADS)

La Penna, P.; Ströbele, S.; Aller Carpentier, E.; Argomedo, J.; Arsenault, R.; Conzelmann, R. D.; Delabre, B.; Donaldson, R.; Duchateau, M.; Fedrigo, E.; Gago, F.; Hubin, N.; Quentin, J.; Jolley, P.; Kiekebusch, M.; Kirchbauer, J. P.; Klein, B.; Kolb, J.; Kuntschner, H.; Le Louarn, M.; Lizon, J. L.; Madec, P.-.; Manescau, A.; Mehrgan, L.; Sedghi, B.; Suarez Valles, M.; Soenke, C.; Tordo, S.; Vernet, J.; Zampieri, S.

2014-07-01

GALACSI is the Adaptive Optics (AO) modules of the ESO Adaptive Optics Facility (AOF) that will correct the wavefront delivered to the MUSE Integral Field Spectrograph. It will sense with four 40×40 subapertures Shack-Hartmann wavefront sensors the AOF 4 Laser Guide Stars (LGS), acting on the 1170 voice-coils actuators of the Deformable Secondary Mirror (DSM). GALACSI has two operating modes: in Wide Field Mode (WFM), with the four LGS at 64" off axis, the collected energy in a 0.2"×0.2" pixel will be enhanced by a factor 2 at 750 nm over a Field of View (FoV) of 1'×1' using the Ground Layer AO (GLAO) technique. The other mode, the Narrow Field Mode (NFM), provides an enhanced wavefront correction (Strehl Ratio (SR) of 5% (goal 10%) at 650 nm) but in a smaller FoV (7.5"×7.5"), using Laser Tomography AO (LTAO), with the 4 LGS located closer, at 10" off axis. Before being shipped to Paranal, GALACSI will be first integrated and fully tested in stand-alone, and then moved to a dedicated AOF facility to be tested with the DSM in Europe. At present the module is fully assembled, its main functionalities have been implemented and verified, and AO system tests with the DSM are starting. We present here the main system features and the results of the internal functional tests of GALACSI.

Effectiveness of Systems Training for Emotional Predictability and Problem Solving (STEPPS) for borderline personality problems in a 'real-world' sample: moderation by diagnosis or severity?

PubMed

Bos, Elisabeth H; van Wel, E Bas; Appelo, Martin T; Verbraak, Marc J P M

2011-01-01

Systems Training for Emotional Predictability and Problem Solving (STEPPS) is a group treatment for borderline personality disorder (BPD). Two prior randomized controlled trials (RCTs) have shown the efficacy of this training. In both RCTs, patients with borderline features who did not meet the DSM-IV criteria for BPD were excluded, which were many. We investigated the effectiveness of STEPPS in a sample representative of routine clinical practice and examined whether DSM-IV diagnosis and/or baseline severity were related to differential effectiveness. Patients whom their practicing clinician diagnosed with BPD were randomized to STEPPS plus adjunctive individual therapy (STEPPS, n = 84) or to treatment as usual (TAU, n = 84). STEPPS recipients showed more improvement on measures of general and BPD-specific psychopathology as well as quality of life than TAU recipients, both at the end of treatment and at a 6-month follow-up. Presence of DSM-IV-diagnosed BPD was not related to differential treatment effectiveness, but dimensional measures of symptom severity were; STEPPS was superior to TAU particularly in patients with higher baseline severity scores. The findings show the effectiveness of STEPPS in a 'real-world' sample, and underscore the importance of dimensional versus categorical measures of personality disturbance. Copyright © 2011 S. Karger AG, Basel.

Clinical psychopharmacology of borderline personality disorder: an update on the available evidence in light of the Diagnostic and Statistical Manual of Mental Disorders - 5.

PubMed

Ripoll, Luis H

2012-01-01

Clinical considerations for evidence-based treatment of borderline personality disorder (BPD) are outlined in the context of the best available evidence, discussed with reference to BPD traits currently identified in the upcoming Diagnostic and Statistical Manual of Mental Disorders - 5 (DSM-5) revision. The DSM-5 will highlight refractory affective, interpersonal, and identity symptoms in BPD as potential treatment targets. In addition to providing a framework for clinical decision-making, future research strategies will also focus on neurotransmitter systems of greater relevance to understanding overall personality functioning. Although only a few randomized controlled trials of psychopharmacological treatments for BPD have been published recently, several meta-analyses and systematic reviews converge on the consensus effectiveness of lamotrigine, topiramate, valproate, aripiprazole, olanzapine, and omega-3 fatty acid supplementation. Stronger evidence exists for treating disinhibition and antagonism than negative affectivity, particularly interpersonal facets of such traits. In addition, basic research suggests a future role for modifying glutamatergic, opioid, and oxytocinergic neurotransmitter systems to treat BPD. Clinicians should utilize omega-3, anticonvulsants, and atypical antipsychotic agents in treating specific DSM-5 BPD traits, notably disinhibition, antagonism, and some aspects of negative affectivity. Future research will focus on normalizing opioid and oxytocin dysregulation, as an adjunct to evidence-based psychotherapy, in an effort to improve interpersonal functioning.

The planning and implementation of a demand-side management/distribution automation system at Taiwan Power Company

DOE Office of Scientific and Technical Information (OSTI.GOV)

Liu, S.S.; Chen, Yun-Wu

1994-12-31

This paper would describe the Taipower`s experience of DSM/DAS development. For the past 5 years, the demand of electricity has maintained a high annual growth rate of 8.45% due to economic prosperity in Taiwan. As the environmental protection consciousness has recently made Taipower difficult to develope and construct new power plants, substations, transmission and distribution lines, and our power grid is an independent system, we do need to concern how to do DSM to manage the load problems. Since 1984, Taipower has established two pilot systems and these systems performed the functions of fault detect and isolation certainly good formore » Distribution Automation. With the rapid development of computer, communication and control technology, the concept of the DAS has gradually been implemented in real cases. Taipower organized an engineering task group to study DAS several years ago, and based on the operation experience of the existing systems, today Taipower is planning to launch a new DAS project for Tai-Chung area. According to Taipower requirements, the DAS will have the functions of feeder automation, automatic meter reading, load management and disteibution system analysis.« less

Pharmacokinetics and Histopathological Findings of Chemoembolization Using Cisplatin Powder Mixed with Degradable Starch Microspheres in a Rabbit Liver Tumor Model

DOE Office of Scientific and Technical Information (OSTI.GOV)

Sato, Takeshi; Tanaka, Toshihiro, E-mail: toshihir@bf6.so-net.ne.jp; Nishiofuku, Hideyuki

PurposeThe purpose of this study is to evaluate the pharmacokinetics and histopathological findings of transarterial chemoembolization (TACE) using cisplatin powder mixed with degradable starch microspheres (DSM) (Cis/DSM-TACE) compared with cisplatin arterial infusion (Cis-AI).Materials and MethodsEighteen rabbits with VX2 liver tumors were divided into two groups: Cis/DSM-TACE (n = 9) and Cis-AI (n = 9) groups. In the Cis/DSM-TACE group, a mixture of cisplatin powder and DSM was injected until stasis of hepatic arterial flow was achieved. In the Cis-AI group, cisplatin solution was infused.ResultsThe platinum concentrations in VX2 tumors in the Cis/DSM-TACE group at 24 and 72 h were significantly elevated compared with those inmore » the Cis-AI group (P = .016 and .019, respectively). There were no significant differences in the platinum concentrations in plasma. Histopathological examination revealed the presence of several microspheres inside the tumors at 1 h, which completely disappeared at 24 h. Tumor cell apoptosis at 1 h in the Cis/DSM-TACE group was more frequently observed compared with that in the Cis-AI group (P = .006).ConclusionsTACE using cisplatin powder mixed with DSM provides a higher drug concentration in tumors, thereby achieving stronger antitumor effects compared with arterial infusion of cisplatin solution.« less

The Clinical Features of Paranoia in the 20th Century and Their Representation in Diagnostic Criteria From DSM-III Through DSM-5.

PubMed

Kendler, Kenneth S

2017-03-01

This review traces, through psychiatric textbooks, the history of the Kraepelinian concept of paranoia in the 20th century and then relates the common reported symptoms and signs to the diagnostic criteria for paranoia/delusional disorder in DSM-III through DSM-5. Clinical descriptions of paranoia appearing in 10 textbooks, published 1899 to 1970, revealed 11 prominent symptoms and signs reported by 5 or more authors. Three symptoms (systematized delusions, minimal hallucinations, and prominent ideas of reference) and 2 signs (chronic course and minimal affective deterioration) were reported by 8 or 9 of the authors. Four textbook authors rejected the Kraepelinian concept of paranoia. A weak relationship was seen between the frequency with which the clinical features were reported and the likelihood of their inclusion in modern DSM manuals. Indeed, the diagnostic criteria for paranoia/delusional disorder shifted substantially from DSM-III to DSM-5. The modern operationalized criteria for paranoia/delusional disorder do not well reflect the symptoms and signs frequently reported by historical experts. In contrast to results of similar reviews for depression, schizophrenia and mania, the clinical construct of paranoia/delusional disorder has been somewhat unstable in Western Psychiatry since the turn of the 20th century as reflected in both textbooks and the DSM editions. © The Author 2017. Published by Oxford University Press on behalf of the Maryland Psychiatric Research Center. All rights reserved. For permissions, please email: journals.permissions@oup.com.

Comparing polysaccharide decomposition between the type strains Gramella echinicola KMM 6050T (DSM 19838T) and Gramella portivictoriae UST040801-001T (DSM 23547T), and emended description of Gramella echinicola Nedashkovskaya et al. 2005 emend. Shahina et al. 2014 and Gramella portivictoriae Lau et al. 2005

DOE PAGES

Panschin, Irina; Huang, Sixing; Meier-Kolthoff, Jan P.; ...

2016-06-03

Strains of the genus Gramella (family Flavobacteriacae, phylum Bacteroidetes) were isolated from marine habitats such as tidal flat sediments, coastal surface seawater and sea urchins. Flavobacteriaceae have been shown to be involved in the decomposition of plant and algal polysaccharides. However, the potential to decompose polysaccharides may differ tremendously even between species of the same genus. Gramella echinicola KMM 6050 T (DSM 19838 T ) and Gramella portivictoriae UST040801-001 T (DSM 23547 T ) have genomes of similar lengths, similar numbers of protein coding genes and RNA genes. Both genomes encode for a greater number of peptidases compared to 'G.more » forsetii'. In contrast to the genome of 'G. forsetii', both genomes comprised a smaller set of CAZymes. Seven polysaccharide utilization loci were identified in the genomes of DSM 19838 T and DSM 23547 T . Both Gramella strains hydrolyzed starch, galactomannan, arabinoxylan and hydroxyethyl-cellulose, but not pectin, chitosan and cellulose (Avicel). Galactan and xylan were hydrolyzed by strain DSM 19838 T , whereas strain DSM 23547 T hydrolyzed pachyman and carboxy-methyl cellulose. Conclusively, both Gramella type strains exhibit characteristic physiological, morphological and genomic differences that might be linked to their habitat. Furthermore, the identified enzymes mediating polysaccharide decomposition, are of biotechnological interest.« less