DSM V - horroris causa

http://psiquiatrianet.wordpress.com/2010/04/19/criticas-al-dsm-v/

qué horror...

Temper Dysregulation Disorder with Dysphoria

A. The disorder is characterized by severe recurrent temper outbursts in response to common stressors.

1. The temper outbursts are manifest verbally and/or behaviorally, such as in the form of verbal rages, or physical aggression towards people or property.

2. The reaction is grossly out of proportion in intensity or duration to the situation or provocation.

3. The responses are inconsistent with developmental level.

B. Frequency: The temper outbursts occur, on average, three or more times per week.

C. Mood between temper outbursts:

1. Nearly every day, the mood between temper outbursts is persistently negative (irritable, angry, and/or sad).

2. The negative mood is observable by others (e.g., parents, teachers, peers).

D. Duration: Criteria A-C have been present for at least 12 months. Throughout that time, the person has never been without the symptoms of Criteria A-C for more than 3 months at a time.

E. The temper outbursts and/or negative mood are present in at least two settings (at home, at school, or with peers) and must be severe in at least in one setting.

F. Chronological age is at least 6 years (or equivalent developmental level).

G. The onset is before age 10 years.

H. In the past year, there has never been a distinct period lasting more than one day during which abnormally elevated or expansive mood was present most of the day for most days, and the abnormally elevated or expansive mood was accompanied by the onset, or worsening, of three of the “B” criteria of mania (i.e., grandiosity or inflated self esteem, decreased need for sleep, pressured speech, flight of ideas, distractibility, increase in goal directed activity, or excessive involvement in activities with a high potential for painful consequences; see pp. XX). Abnormally elevated mood should be differentiated from developmentally appropriate mood elevation, such as occurs in the context of a highly positive event or its anticipation.

I. The behaviors do not occur exclusively during the course of a Psychotic or Mood Disorder (e.g., Major Depressive Disorder, Dysthymic Disorder, Bipolar Disorder) and are not better accounted for by another mental disorder (e.g., Pervasive Developmental Disorder, post-traumatic stress disorder, separation anxiety disorder). (Note: This diagnosis can co-exist with Oppositional Defiant Disorder, ADHD, Conduct Disorder, and Substance Use Disorders.) The symptoms are not due to the direct physiological effects of a drug of abuse, or to a general medical or neurological condition.

Paraphilic Coercive Disorder

A. Over a period of at least six months, recurrent, and intense sexual arousal from sexual coercion, as manifested by fantasies, urges, or behaviors. [23]

B. The person has clinnically significant distress or impairment in important areas of functioning, or has sought sexual stimulation from forcing sex on three or more nonconsenting persons on separate occasions. [24]

C. The diagnosis of Paraphilic Coercive Disorder is not made if the patient meets criteria for a diagnosis of Sexual Sadism Disorder.[25]

Specify if:

In Remission (No Distress, Impairment, or Recurring Behavior and in an Uncontrolld Environment): State duration of remission in months:____

In a Controlled Environment

Hypersexual Disorder [14]

A. Over a period of at least six months, recurrent and intense sexual fantasies, sexual urges, and sexual
behavior in association with four or more of the following five criteria:
(1) Excessive time is consumed by sexual fantasies and urges, and by planning for and engaging in
sexual behavior. [15]
(2) Repetitively engaging in these sexual fantasies, urges, and behavior in response to dysphoric mood
states (e.g., anxiety, depression, boredom, irritability). [16]
(3) Repetitively engaging in sexual fantasies, urges, and behavior in response to stressful life events.
[17]
(4) Repetitive but unsuccessful efforts to control or significantly reduce these sexual fantasies, urges,
and behavior. [18]
(5) Repetitively engaging in sexual behavior while disregarding the risk for physical or emotional harm
to self or others. [19]
B. There is clinically significant personal distress or impairment in social, occupational or other important
areas of functioning associated with the frequency and intensity of these sexual fantasies, urges, and
behavior. [20]
C. These sexual fantasies, urges, and behavior are not due to direct physiological effects of exogenous
substances (e.g., drugs of abuse or medications) or to Manic Episodes. [21]
D. The person is at least 18 years of age.
Specify if: [22]
Masturbation
Pornography
Sexual Behavior With Consenting Adults
Cybersex
Telephone Sex
Strip Clubs
Other:
Specify if:
In Remission (No Distress, Impairment, or Recurring Behavior and in an Uncontrolled Environment): State duration of
remission in months:____
In a Controlled Environment