DSM-5 in Action

SOPHIA F. DZIEGIELEWSKI, PHD, LCSW is Professor and Associate Director for Research in the School of Social Work at the University of Central Florida where she also serves as Chair of the University Institutional Review Board. She is also the Editor of the Journal of Social Service Research. She is the recipient of numerous awards and supports her research and practice activity with over 120 publications, including seven textbooks, seventy-nine articles, numerous book chapters, and over 400 workshops and community presentations. Her research focuses on the areas of health and mental health. As a licensed social worker, she also remains active in clinical practice.

"This book is a thoroughly researched and organized approach to understanding the DSM-5 and how to use its diagnostic criteria to create a treatment plan/practice strategy. It is easy to read and understand, and the case examples and treatment plans are well done." (Doody 2016)

• Preface xiiiAcknowledgments xviiQuick Reference List xixSECTION IUtilizing the DSM-5: Assessment, Planning, and Practice StrategyChapter 1 Getting Started 3Introduction 3Beginning the Process 3Making the Diagnostic Assessment: Tools That Facilitate the Assessment Process 4Role of Social Workers and Other Mental Health Professionals 4Development of the DSM Classification System: History and Reservations 6Diagnostic Labels 14Another Mental Health Assessment Measure 16Professional Training in the Professional Counseling Fields 18Summary 19Questions for Further Thought 20References 20Chapter 2 Basics and Application 23Utilizing the DSM-5 in the Practice Setting 23Working as Part of a Team: Connections and Collaborations 25Diagnosis and Assessment: Is There a Difference? 28A Combination Approach: The Diagnostic Assessment 33DSM-5 Updates and Structural Changes 35DSM-5: Sections and Appendices 39Important Sections in the DSM-5 45Culture, Age, and Gender-Related Information 47Concepts of Distress 53Culture and Other Diagnostic Assessment Factors Related to Age 57Culture and Other Diagnostic Assessment Factors Related to Gender 59Summary 66Questions for Further Thought 67References 67Chapter 3 Completing the Diagnostic Assessment 70Basics for Completing a Comprehensive Diagnostic Assessment 70DSM-5 and Completing the Diagnostic Assessment 74The Principal Diagnosis 76Subtypes and Course Specifiers 86Ethical and Legal Considerations 101Pulling It All Together 102Summary 104Questions for Further Thought 105References 105Chapter 4 Applications 107Documentation, Treatment Planning, and Practice Strategy 107Treatment and Intervention Planning 116Developing the Treatment Plan 120Selecting an Intervention Framework 123Practice Strategy and Application 127Types of Time-Limited Therapy in Mental Health Practice 131Summary 140Questions for Further Thought 143References 143SECTION IIDiagnostic and Treatment ApplicationsChapter 5 Schizophrenia Spectrum and the Other Psychotic Disorders 149Sophia F. DziegielewskiIntroduction 149Toward a Basic Understanding of the Conditions 150Understanding Individuals Who Suffer From the Psychotic Disorders 151Important Features Related to the Psychotic Disorders 153DSM-5: Assessment of Symptoms Measurement 157Overview of Schizophrenia Spectrum and Other Psychotic Disorders 160Schizophrenia 167Beginning the Diagnostic Assessment 173Schizophrenia and Factors for Consideration in the Diagnostic Assessment 174Case Application of the Diagnostic Assessment 181Treatment Planning and Intervention Strategy 186Special Topics 195Summary and Future Directions 196References 197Chapter 6 Bipolar and Related Disorders 202Sophia F. Dziegielewski and Olga MolinaIntroduction 202Toward a Basic Understanding of the Bipolar and Related Disorders 202Understanding Individuals Who Suffer From Bipolar and Related Disorders 204Overview of the Bipolar and Related Disorders 212Summary of Bipolar Disorders 221Diagnostic Assessment in Adults With Bipolar Disorder 222General Intervention Strategies: Models and Treatment Modalities for the Bipolar Disorders 232Special Topics 236Summary and Future Directions 238References 239Chapter 7 Depressive Disorders 242Sophia F. DziegielewskiIntroduction 242Toward a Basic Understanding of the Disorders 243Important Features Related to the Depressive Disorders 244Endogenous and Exogenous Depression: Making a Distinction 246Overview of the Depressive Disorders 247The Depressive Disorders and the Diagnostic Assessment 259Special Topics 270Assessment of Danger to Self or Others 271Summary and Future Directions 272References 273Chapter 8 Obsessive-Compulsive and Related Disorders 278Sophia F. Dziegielewski and Barbara F. TurnageIntroduction 278Toward a Basic Understanding of the Obsessive-Compulsive and Related Disorders 278Understanding Individuals Who Suffer From the OCD Spectrum Disorders: When Urges Become Overwhelming 280Important Features Related to the Obsessive-Compulsive and Related Disorders 281Overview of the Obsessive-Compulsive and Related Disorders 283Toward a Better Understanding of Obsessive-Compulsive Disorder 289Obsessive-Compulsive Disorders and the Factors for Consideration in the Diagnostic Assessment 291Summary and Future Directions 306References 306Chapter 9 Trauma- and Stressor-Related Disorders 309Sophia F. Dziegielewski and Barbara F. TurnageIntroduction 309Toward a Basic Understanding of Trauma- and Stressor-Related Disorders 309Understanding Individuals Who Suffer From the Trauma- and Stressor-Related Disorders 310Important Features Related to the Trauma- and Stressor-Related Disorders 311Overview of the Trauma- and Stressor-Related Disorders 313Beginning the Diagnostic Assessment 321Pulling It All Together: An Integrated Approach 333Summary and Future Directions 335References 335Chapter 10 Sexual Dysfunctions 338Sophia F. Dziegielewski and Joshua KirvenIntroduction 338Toward a Basic Understanding of the Sexual Dysfunctions 338Individuals Who Suffer From a Sexual Dysfunction 340Important Features and Terms Related to the Sexual Dysfunctions 341Overview of the Sexual Dysfunctions 343Sexual Dysfunctions and the Diagnostic Assessment 353Completing the Diagnostic Assessment 353Overview of Treatment Methods for the Sexual Disorders 358Selected Assessment Scales and Methods for Treating the Sexual Disorders 361Special Topics 364Applying a Cultural Competence Lens to Diagnosis 367Summary and Future Directions 369References 370Chapter 11 Disruptive Impulse-Control and Conduct Disorders 375Sophia F. Dziegielewski and Ana M. LeonIntroduction 375Living With Problematic Self-Control of Emotions and Behavior 376Overview of the Disruptive, Impulse-Control, and Conduct Disorders 377The Diagnostic Assessment: Application Basics 387General Intervention Strategies: Models and Treatment Modalities 403Summary and Future Directions 411References 412Chapter 12 Substance-Related and Addictive Disorders 417Sophia F. DziegielewskiToward a Basic Understanding of the Substance-Related and Addictive Disorders 418Understanding the Individuals Who Suffer From the Substance Disorders 419Overview of the Substance-Related and Addictive Disorders 425Beginning the Diagnostic Assessment: Alcohol-Related Disorders 436Treatment Planning and Intervention Strategy 445Brief Interventions in Primary Care Settings 453Topics of Interest 456Misuse of Prescription Medications 461Summary and Future Directions 462References 463Chapter 13 Personality Disorders 467Sophia F. Dziegielewski and George A. JacintoIntroduction 467Toward a Basic Understanding of the Personality Disorders 468Understanding Individuals Suffering From a Personality Disorder 468What Is a Personality Disorder? 471Cluster A Personality Disorders 471Cluster B Personality Disorders 475Cluster C Personality Disorders 482Other Personality Disorders 485Summary of the Personality Disorders 487Borderline Personality Disorder (BPD) 487Strategies for Individual Therapy and Intervention 500Section III: Alternative DSM-5 Model for the Personality Disorders 502Summary and Future Directions 503References 504Appendix: Quick References: Selected Disorders—Criteria and Treatment Plans 507Author Index 545Subject Index 561About the Author 583