Before we delve into the different categories and disorders, it may be wise to pause and reflect on the impact of names. To some, changing the name of a particular category or disorder, is merely a superficial change, however, changing a name has a wide reaching impact on how we view and conceptualize a cluster of disorders, or disorders themselves. Barret (2009) states that words are powerful in science. She states that: …”[if] scientists understand and use the word in a similar way, they agree on what to search for” (Barret, 2009, 329). In the table below I summarize, and analyse examples of how significant changes in names (of both categories and names) in the DSM-5, have changed the categorization of disorders, as well as how this may change our conceptualisation of disorders.
Table 1: Examples of name changes in DSM-5
Old name |
New name |
Implication |
Disorders first identified in infancy, childhood and infancy | Neurodevelopmental Disorders |
|
Schizophrenia Spectrum and other Psychotic Disorders | Schizophrenia Spectrum and other Psychotic Disorders |
|
Mood Disorders |
Bipolar and Related Disorders Depressive Disorders |
|
Anxiety Disorders |
Anxiety Disorders Obsessive-Compulsive and related disorders Trauma- and Stressor-Related disorders |
|
The decision for inclusion of disorders in a specific category was based on a number of shared criteria, i.e.: genetic and environmental risk factors; neural substrates; biomarkers; temperamental antecedents; abnormalities of cognitive or emotional processing and symptoms. In addition to these co-morbidity, course of illness as well as treatment responses were also considered. For many the name changes in DSM-5 are merely cosmetic, however, the name of a category influences the way that view and describe particular disorders, as well as the questions we ask about them. Barret (2009) states that science always starts with common sense categories, and arguably previous editions of the DSM reflected common sense, rather than scientifically based categories. The progress made in Neuroscience necessitates that we re-think these categories and that we start including new findings in the way that we categorise and describe disorders. As we continue our exploration of the DSM-5, the rationale of the name changes will become clearer.
References
Barret, L.F. (2009). The Future of Psychology: Connecting Mind to Brain. Perspectives on Psychological Science, 4 (4), 326 – 339.