DSM-IV vs. DSM-IV-TR

The DSM-IV was published in 1992, but as it became apparent that a new edition wouldn’t be in the works for quite awhile, the decision was made to  create an updated version of the DSM -IV.  This updated version was labeled the DSM-IV-TR, and is the edition currently in use today.  Most of the changes made were to descriptions and literature reviews that needed to be updated.  There were a few disorders that had changes made to their diagnostic criteria, as well as some diagnostic codes being changed to reflect updates that had been made to the ICD-9-CM coding system (International Classification of Diseases).

One of the diagnostic criteria changes that were made were to PTSD.  Posttraumatic Stress Disorder had been added to the DSM in the DSM-III, and the criteria for it had remained the same in the DSM-IV.  However, some changes that were considered significant were made in the DSM-IV-TR.  The new criteria stated that for a PTSD diagnoses a patient must have been exposed to a traumatic event, must have “re-experiencing” episodes of the event (such as dreams, intrusive thoughts, or acting out as if the event was re-occurring), and have numbing/avoidant symptoms such as avoiding people, places,or conversations that remind them of the traumatic event, or having a restricted range of affect.  There must also be at least two symptoms of increased arousal such as difficulty sleeping or outbursts of anger, and all symptoms must last more than two months.  The main differences between this and the DSM-IV’s definition are that in the DSM-IV it states that the traumatic experience must be outside the “normal” human experience,  this qualification was taken away in the DSM-IV-TR to include things that may be in  the “normal” human experience, such as car accidents.  Another difference was that the DSM-IV-TR placed a greater emphasis on the patient needing to have an intense emotional reaction to the event.

In conclusion, while there were some changes in diagnostic criteria in the DSM-IV-TR, the prominent change was that of updating the diagnostic codes to be compatible with the ICD-9.

References: United States Department of Veterans Affairs.   DSM-IV-TR Criteria for PTSD.  http://www.ptsd.va.gov/professional/pages/dsm-iv-tr-ptsd.asp. 2010.

American Psychiatric Association.  DSM-IV vs DSM-IV-TR. http://www.psych.org/MainMenu/Research/DSMIV/DSMIVTR/DSMIVvsDSMIVTR.aspx. 2011.

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