The Vermont Psychological Association Presents: DSM-5: Controversies, Changes, and Clinical Implications
Six (6) Continuing Education Credits
Friday, February 8, 2013
Time: 9:00 AM – 4:00 PM
Registration: 8:30 A.M.
Location: Capitol Plaza Hotel, Montpelier, Vermont
Who Should Attend: Psychologists, mental health counselors, social workers, & other mental health professionals.
Course Description: Changes are coming to the DSM-5, due out in May 2013, that will significantly alter diagnosis in clinical practice. More importantly, the changes represent claimed advances in how we understand the nature of our patients’ problems. The will be some entirely new diagnostic categories (e.g., disruptive mood dysregulation disorder in children, hoarding disorder), categories that were previously in the research appendix and are newly elevated to full “disorder” status (e.g., binge eating disorder, premenstrual dysphoric disorder), and many important changes to the diagnostic criteria for existing categories (e.g., elimination of the bereavement exclusion of major depression, substance use disorder replacing substance dependence and substance abuse, autism spectrum disorder uniting autism and Asperger’s categories). There will also be major changes to the overall structure of the Manual (e.g., collapse of the multiaxial system, end of child and adolescent disorders chapter with developmental considerations spread throughout the manual, new chapter organization). Some of the most controversial proposals were either eliminated at the last minute (e.g., new sexual paraphilia categories for paraphilic coercive disorder and hebephilia [sexual preference for adolescents]) or placed in the research appendix for further consideration (e.g., persistent complex bereavement disorder, a dimensional system for diagnosing personality disorders), but these proposals will likely continue to be discussed for future revisions that are now expected to take place on a regular basis.
Many of the proposed DSM-5 changes are highly controversial even among experts. In many cases, internal controversies have spilled over and been aired in the public media. The controversies raise fundamental questions, especially about the normal/disorder boundary. This workshop will present an overview of the major changes and their rationales and clinical implications. We will then delve in greater depth into selected controversies over proposed changes in specific areas (e.g., depression and grief, sexual paraphilias, substance disorders, personality disorders) in order to understand the “why” in addition to the “what” of DSM Task Force decisions, and grapple for ourselves with some of the perplexing issues that faced DSM-5 work groups. Concerns, criticisms, and limitations of which the clinician should be aware will be emphasized along with the details of the new rules themselves.
Objectives- Participants will:
- Develop a better understanding of the history and goals of the DSM diagnostic manuals, and the process that led up to DSM-5;
- Understand the new structure and organization of the DSM, including changes to the multiaxial system and their implications for diagnosis;
- Learn about the relations between depression and grief, the changes to DSM-5 in diagnosing depression and grief disorders, and the latest research concerning the validity of these changes;
- Learn about the controversy over proposals for new sexual paraphilia diagnoses and the forensic implications of the debate;
- Understand the DSM-5 proposal for revising personality disorder diagnosis (now to be introduced into the DSM-5 appendix), the objections mounted against these proposals by critics, and the disputes over the nature of personality disorders that underlie the controversy over the proposal;
- Learn about the new substance use disorder diagnostic criteria, the rationale for the change, and concerns about these changes expressed by critics; and
- Learn about the broad variety of other changes to be introduced to specific diagnostic criteria in the DSM-5, and the controversies they have triggered.
Presenter:
Jerome C. Wakefield, PhD, DSW, LCSW
University Professor, Professor of Social Work, & Professor of Psychiatry, New York University
Jerome C. Wakefield is University Professor, Professor of Social Work, Professor of Psychiatrye, and Affiliate Faculty in Bioethics, at New York University. Prior to coming to NYU in 2003, he held faculty positionsat University of Chicago, Columbia University, and Rutgers University. With doctorates in Clinical Social Work and in Philosophy (both from UC Berkeley), he has written extensively on the conceptual foundations of clinical diagnosis.
Dr. Wakefield’s recent work has focused on the validity of DSM diagnostic criteria, the proposed changes to DSM-5, and the boundary between normal distress and mental disorder. His work has been featured in many media outlets, including NPR, The New York Times, and NBC Nightly News with Brian Williams.
Dr. Wakefield is the coauthor (with Allan Horwitz) of “The Loss of Sadness: How Psychiatry Transformed Normal Sorrow into Depressive Disorder” which was named the best psychology book of 2007 by the Association of Professional and Scholarly Publishers, and “All We Have to Fear: How Psychiatry Transforms Natural Fear into
Mental Disorder”.
Conference Schedule- 8:30 Registration
9:00 Introduction
- Evolution of the DSM: History, goals, limitations, and importance
- The DSM-5: rationale, goals, and aspirations
- The DSM-5 revision process
- Controversies over the revision process
- Structural Changes in the DSM-5’s organization
- Elimination of the multiaxial system: implications for assessment
- New chapters and regroupings of disorders
- Anxiety disorders, OCD spectrum, and trauma and stressor-related disorders separated
- Child and adolescent disorders reframed as neurodevelopmental disorders
- Controversy over impairment and clinical significance criteria
- From NOS to NEC (not elsewhere classified)
- Severity measures and the use of dimensions instead of categories as goals
10:00 – 10:15 Break
10:15 The concept of mental disorder
- New Categories of Disorder
- Disruptive mood dysregulation disorder
- Binge eating disorder
- Hoarding Disorder
- Disinhibited Social Engagement Disorder
- Minor Neurocognitive Disorder
- Excoriation (skin-picking) disorder
- Autism spectrum disorder/elimination of
- Aspergers
- Changing thresholds: ADHD, PTSD, and GAD
- In-depth analysis: the controversy over the diagnosis of personality disorders using personality trait dimensions or prototypes
12:00– 1:00 Lunch
1:00 In-depth analysis:
- Mood disorders, grief disorders, and the bereavement-exclusion controversy
- Substance Use Disorder encompassing abuse and dependence
- Behavioral Addictions (gambling disorder)
New Section 3 Disorders
• Attenuated psychosis syndrome (rejection of psychosis risk syndrome)
• Internet use gaming disorder
• Non-suicidal self-injury
• Suicidal behavioral disorder
• Persistent complex bereavement disorder
• Short duration hypomania
• Caffeine use disorder
• Neurobehavioral disorder associated with prenatal alcohol exposure
2:30 – 2:45 Break
2:45 In depth analysis: Sexual Paraphlias:
- The controversy over “hebephlia” (sexual desire for teenagers) and “coercive” (rape) disorder, and their forensic implications
- Gender Dysphoria disorder
4:00 Collection of evaluations and awarding of CE certificates.
Registration Form- February 8. 2013
We do not mail a registration confirmation.
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Please apply a $20 administrative charge to the fees below if you are registering after February 1st:
- VPA Member $145
- Student Member (full-time) $105
- Non-Member $195
- Student Non-Member (full-time) $125
Note: Copy of Student ID required.
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Please make check payable to “VPA” and mail to: P.O. Box 1017, Montpelier, VT 05601-1017.
Continuing Education Credits: The Vermont Psychological Association is approved by: The American Psychological Association and The Vermont Board of Psychological Examiners to sponsor continuing education for psychologists.
VPA maintains responsibility for this program and its content. CE Certificates for six (6) continuing education credits will be awarded to participants who attend the entire workshop and complete the evaluation form. Partial credits will not beawarded. Late arrival or early departure will preclude receipt of a certificate.
Registration/Refund Policy: Registrations after February1, 2013 require an additional $20 fee and are on a space available basis only. No refunds will be offered for this program.
Directions to Capitol Plaza: I-89 to Exit 8. At 2nd light, turn left (over bridge). Turn right at light onto State Street. The Capitol Plaza is on your right down the street. Complimentary parking permits are issued at the registration table for public & hotel parking behind the hotel.