Written for an audience that includes private practitioners; counselors working in mental health centers, psychiatric hospitals, employee assistance programs, and other community settings; as well as counselor educators and their students, this helpful guide breaks down the concepts and terminology in theDSM-5and explains how this diagnostic tool translates to the clinical situations encountered most frequently by counselors.

After describing the major structural, philosophical, and diagnostic changes in theDSM-5, the book is organized into four parts, which are grouped by diagnostic similarity and relevance to counselors. Each chapter outlines the key concepts of each disorder, including major diagnostic changes; essential features; special considerations; differential diagnosis; coding, recording, and specifiers; and, where applicable, new or revised criteria. Clinical vignettes help both clinicians and students visualize and understandDSM-5 disorders. Author notes throughout the text assist readers in further understanding and applying new material.

*Requests for digital versions from ACA can be found onwww.wiley.com.*To purchase print copies, please visit the ACAhttps://imis.counseling.org/store/detail*Reproduction requests for material from books published by ACA should be directed topermissions@counseling.org.

Stephanie F. Dailey, EdD, LPC, NCC, ACS, is an assistant professor of counseling at Argosy University in Washington, DC. Dr. Dailey is a licensed professional counselor in Virginia as well as a national certified counselor and an approved clinical supervisor. She specializes in working with individuals and groups from a wide range of multicultural backgrounds on counseling issues ranging from normal situational and developmental issues to living and coping with severe and persistent mental illness. As a certified American Red Cross disaster mental health responder and liaison to the American Red Cross disaster mental health partners for the American Counseling Association (ACA), she is also trained to work with disaster survivors, first responders, and emergency preparedness personnel. Dr. Dailey has published and presented regionally and nationally on the American Psychiatric Association's 2013Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) as well as counseling assessment, diagnosis, and treatment planning. Dr. Dailey is a member of the ACA Ethics Committee; sits on the executive board for the Association for Spiritual, Ethical and Religious Values in Counseling (ASERVIC); and serves as chair of the ASERVIC Ethics Committee.

Carman S. Gill, PhD, LPC, NCC, ACS, is an associate professor and chair of the counselor education program at Argosy University, Washington, DC. She has worked with client populations, including individuals who are dually diagnosed, individuals with chronic mental illness, children, and those experiencing acute mental health crises. She has published book chapters and journal articles in the areas of spirituality, wellness, forgiveness, and assessment. Dr. Gill has served as a member of ACA's DSM-5 Task Force and as president of ASERVIC.

Shannon L. Karl, PhD, LMHC, NCC, CCMHC, is an associate professor with the Center for Psychological Studies at Nova Southeastern University. She has extensive clinical mental health experience and is a licensed mental health counselor in the state of Florida as well as a national certified counselor and a clinically certified mental health counselor. Dr. Karl has published and presented regionally, nationally, and internationally on the DSM-5. She was a member of the ACA DSM-5 Task Force from 2011 to 2013, an ACA DSM-5 Series webinar presenter, and has conducted numerous workshops and trainings on the DSM-5.

Casey A. Barrio Minton, PhD, NCC, is an associate professor and counseling program coordinator at the University of North Texas. Her clinical experiences include serving clients in a range of outpatient, residential, intensive outpatient, and inpatient mental health settings with a focus on crisis intervention and stabilization. She has authored multiple book chapters and journal articles focused on counselor preparation and mental health issues. Dr. Barrio Minton is founding editor of the Journal of Counselor Leadership and Advocacy and has served as president for the Association for Assessment and Research in Counseling and Chi Sigma Iota International.

Foreword xi

Acknowledgments xiii

About the Authors xv

Chapter 1

Introduction and Overview 1

Counseling Identity and Diagnosis 2

Why We Wrote This Learning Companion 2

The Revision Process 3

Revision Feedback 4

Organization of the DSM-5 Learning Companion for Counselors 5

References 6

Chapter 2

Structural, Philosophical, and Major Diagnostic Changes 9

History of the DSM 9

DSM-5 Structural Changes 11

DSM-5 Philosophical Changes 16

Major Diagnostic Highlights 20

Implications of the DSM-5 22

Future of the DSM-5: Where Will It Go From Here? 24

References 24

Introduction to Diagnostic Changes

Part One to Part Four Overview 29

Part One

Changes and Implications Involving Mood, Anxiety, and Stressor-Related Concerns

Part One Introduction 31

Chapter 3

Depressive Disorders 33

Major Changes From DSM-IV-TR to DSM-5 33

Differential Diagnosis 34

Etiology and Treatment 34

Implications for Counselors 34

Disruptive Mood Dysregulation Disorder 35

Major Depressive Disorder, Single Episode and Recurrent Episodes 38

Persistent Depressive Disorder (Dysthymia) 41

Premenstrual Dysphoric Disorder 44

Substance/Medication-Induced Depressive Disorder 47

Depressive Disorder Due to Another Medical Condition 48

Other Specified and Unspecified Depressive Disorders 49

Specifiers for Depressive Disorders 49

Chapter 4

Bipolar and Related Disorders 53

Major Changes From DSM-IV-TR to DSM-5 53

Differential Diagnosis 54

Etiology and Treatment 54

Implications for Counselors 54

Bipolar I Disorder 55

Bipolar II Disorder 58

Cyclothymic Disorder 61

Substance/Medication-Induced Bipolar and Related Disorder 63

Bipolar and Related Disorder Due to Another Medical Condition 63

Other Specified and Unspecifi ed Bipolar and Related Disorders 64

Specifi ers for Bipolar and Related Disorders 65

Chapter 5

Anxiety Disorders 69

Major Changes From DSM-IV-TR to DSM-5 70

Differential Diagnosis 70

Etiology and Treatment 70

Implications for Counselors 71

Separation Anxiety Disorder 71

Selective Mutism 73

Specific Phobia 74

Social Anxiety Disorder (Social Phobia) 75

Panic Disorder 78

Panic Attack Specifi er 79

Agoraphobia 80

Generalized Anxiety Disorder 81

Substance/Medication-Induced Anxiety Disorder 83

Anxiety Disorder Due to Another Medical Condition 84

Other Specifi ed and Unspecifi ed Anxiety Disorders 85

Chapter 6

Obsessive-Compulsive and Related Disorders 87

Major Changes From DSM-IV-TR to DSM-5 88

Differential Diagnosis 88

Etiology and Treatment 89

Implications for Counselors 89

Obsessive-Compulsive Disorder 90

Body Dysmorphic Disorder 93

Hoarding Disorder 95

Trichotillomania (Hair-Pulling Disorder) 98

Excoriation (Skin-Picking) Disorder 99

Substance/Medication-Induced Obsessive-Compulsive and Related Disorder 101

Obsessive-Compulsive and Related Disorder Due to Another Medical Condition 102

Other Specifi ed and Unspecifi ed Obsessive-Compulsive and Related Disorders 104

Chapter 7:

Trauma- and Stressor-Related Disorders 105

Major Changes From DSM-IV-TR to DSM-5 105

Essential Features 106

Differential Diagnosis 107

Etiology and Treatment 107

Implications for Counselors 107

Reactive Attachment Disorder 108

Disinhibited Social Engagement Disorder 109

Posttraumatic Stress Disorder 111

Acute Stress Disorder 119

Adjustment Disorders 122

Other Specified and Unspecifi ed Trauma- and Stressor-Related Disorders 124

Chapter 8

Gender Dysphoria in Children, Adolescents, and Adults 125

Major Changes From DSM-IV-TR to DSM-5 126

Essential Features 128

Differential Diagnosis 130

Etiology and Treatment 131

Implications for Counselors 132

Coding, Recording, and Specifiers 133

Part One References 135

Part Two

Changes and Implications Involving Addictive, Impulse-Control, and Specifi c Behavior-Related Concerns

Part Two Introduction 147

Chapter 9

Substance-Related and Addictive Disorders 149

Major Changes From DSM-IV-TR to DSM-5 150

Substance-Related Disorders 151

Substance Intoxication and Withdrawal 153

Specific Substance-Related Disorders Overview 157

Gambling Disorder 161

Chapter 10

Disruptive, Impulse-Control, and Conduct Disorders 165

Major Changes From DSM-IV-TR to DSM-5 166

Differential Diagnosis 167

Etiology and Treatment 168

Implications for Counselors 169

Oppositional Defi ant Disorder 170

Intermittent Explosive Disorder 172

Conduct Disorder 173

Pyromania 175

Kleptomania 177

Chapter 11

Specific Behavioral Disruptions 179

Feeding and Eating Disorders 179

Specific Feeding Disorders 184

Pica 184

Rumination Disorder 186

Avoidant/Restrictive Food Intake Disorder 187

Specific Eating Disorders 188

Anorexia Nervosa 188

Bulimia Nervosa 191

Binge-Eating Disorder 194

Elimination Disorders 196

Enuresis 197

Encopresis 199

Sleep-Wake Disorders 199

Insomnia Disorder 200

Hypersomnolence Disorder and Narcolepsy 201

Breathing-Related Sleep Disorders 202

Parasomnias 203

Circadian Rhythm Sleep-Wake Disorders 204

Restless Legs Syndrome 205

Substance/Medication-Induced Sleep Disorder 205

Additional Resources for Sleep Disorders 205

Sexual Dysfunctions 205

Delayed Ejaculation 208

Erectile Disorder 209

Female Orgasmic Disorder 210

Female Sexual Interest/Arousal Disorder 211

Genito-Pelvic Pain/Penetration Disorder 211

Male Hypoactive Sexual Desire Disorder 212

Premature (Early) Ejaculation 213

Substance/Medication-Induced Sexual Dysfunction 214

Paraphilic Disorders 214

Pedophilic Disorder 216

Exhibitionistic Disorder 218

Voyeuristic Disorder 220

Frotteuristic Disorder 220

Sexual Masochism Disorder and Sexual Sadism Disorder 221

Fetishistic Disorder 223

Transvestic Disorder 223

Part Two References 225

Part Three

Changes and Implications Involving Diagnoses

Commonly Made by Other Professionals

Part Three Introduction 235

Chapter 12

Neurodevelopmental and Neurocognitive Disorders 239

Neurodevelopmental Disorders 239

Intellectual Disabilities 241

Intellectual Disability (Intellectual Developmental Disorder) 242

Global Developmental Delay 242

Communication Disorders 242

Language Disorder 243

Speech Sound Disorder 243

Childhood-Onset Fluency Disorder (Stuttering) 243

Social (Pragmatic) Communication Disorder 244

Autism Spectrum Disorder 244

Attention-Deficit/Hyperactivity Disorder 247

Specific Learning Disorder 249

Motor Disorders 249

Developmental Coordination Disorder 249

Sterotypic Movement Disorder 250

Tic Disorders 250

Neurocognitive Disorders 251

Delirium 252

Major Neurocognitive Disorder 253

Mild Neurocognitive Disorder 254

Major and Mild Neurocognitive Disorders 254

Chapter 13

Schizophrenia Spectrum and Other Psychotic Disorders 257

Major Changes From DSM-IV-TR to DSM-5 258

Differential Diagnosis 259

Etiology and Treatment 260

Implications for Counselors 262

Delusional Disorder 263

Brief Psychotic Disorder 263

Schizophreniform Disorder 264

Schizophrenia 265

Schizoaffective Disorder 265

Substance/Medication-Induced Psychotic Disorder 266

Psychotic Disorder Due to Another Medical Condition 266

Catatonia 267

Chapter 14

Dissociative Disorders 269

Major Changes From DSM-IV-TR to DSM-5 270

Differential Diagnosis 270

Etiology and Treatment 271

Implications for Counselors 272

Dissociative Identity Disorder 273

Dissociative Amnesia 273

Depersonalization/Derealization Disorder 274

Chapter 15

Somatic Symptom and Related Disorders 277

Major Changes From DSM-IV-TR to DSM-5 277

Differential Diagnosis 278

Etiology and Treatment 279

Implications for Counselors 280

Somatic Symptom Disorder 280

Illness Anxiety Disorder 281

Conversion Disorder (Functional Neurological Symptom Disorder) 281

Psychological Factors Aff ecting Other Medical Conditions 282

Factitious Disorder 282

Part Three References 285

Part Four

Future Changes and Practice Implications for Counselors

Part Four Introduction 291

Chapter 16

Looking Ahead: Personality Disorders 293

Major Changes From DSM-IV-TR to DSM-5 295

Essential Features 295

Special Considerations 295

Differential Diagnosis 296

Paranoid Personality Disorder 296

Schizoid Personality Disorder 297

Schizotypal Personality Disorder 298

Antisocial Personality Disorder 299

Borderline Personality Disorder 300

Histrionic Personality Disorder 302

Narcissistic Personality Disorder 303

Avoidant Personality Disorder 304

Dependent Personality Disorder 305

Obsessive-Compulsive Personality Disorder 306

Summary 307

Alternative Model for Diagnosing Personality Disorders 308

Using the Alternative DSM-5 Model 313

Conclusion 315

Chapter 17

Practice Implications for Counselors 317

Diagnosis and the Counseling Profession 317

Other Specified and Unspecifi ed Diagnoses 320

Coding and Recording 320

Diagnostic Assessment and Other Screening Tools 323

Cultural Formulation Interview 324

The Future of the DSM 325

Part Four References 327

Index 331