Fall 2025 SOWK 581 Week 04 - Understanding and Using the DSM-5

title: Fall 2025 SOWK 581 Week 04 - Understanding and Using the DSM-5 date: 2025-09-13 11:42:27 location: Heritage University tags:

  • Heritage University
  • MSW Program
  • SOWK 581 presentation_video: > “” description: >

Week five is a synchronous class week, with class on Saturday (09/20/25). Students are asked to read Segal et al. (2019), a chapter that provides a discussion regarding diagnostic interviews and considerations for different settings, client expectations, and clinician approach. I also ask students to watch a video by Kinter (2020), who provides a broad overview of the DMS. There are forums for students to share about how they engage in the diagnostic process and other materials related to the DSM, and ask questions they might have. During class, we will spend time demonstrating and discussing how to use the DSM for diagnostic interviews, as well as an opportunity to respond to the questions posed in the forums in an AMA format. The agenda for the in-class session includes:

  • General content in diagnoses
  • Using the DSM
  • AMA - DMS-5-TR Edition

The learning objectives this week include:

  • Reflect on the structure, purpose, and challenges of the clinical diagnostic interview process across different practice settings.
  • Explore the organization and diagnostic criteria of the DSM-5-TR through guided media and independent resource discovery.
  • Identify and describe diagnostic features and symptom patterns of specific mental health conditions using DSM-based sources.
  • Identify key elements of diagnosis, including symptom types, duration, frequency, intensity, and cultural/contextual considerations.
  • Practice locating diagnostic criteria in the DSM.
  • Evaluate how screening tools and assessment measures can support clinical judgment and diagnosis.

Week 04 Plan

Agenda

  • General content in diagnoses
  • Using the DSM
  • AMA - DMS-5-TR Edition

Learning Objectives

  • Identify key elements of diagnosis, including symptom types, duration, frequency, intensity, and cultural/contextual considerations.
  • Practice locating diagnostic criteria in the DSM.
  • Evaluate how screening tools and assessment measures can support clinical judgment and diagnosis.

Symptoms and Diagnosis

When I first started studying the DSM, I wrote a blog post about panic attacks and love.

It made me start to wonder, Do we all have the conditions and symptoms in the DSM?

  • The tendency of students to self-diagnose based on classroom learning is sometimes referred to as intern syndrome or medical students’ disorder (Aaiz & Stephen, 2017). (study in India looking at psychology students and diagnosis)

  • Attitudes towards those who self-diagnose are a highly contentious practice, with individuals stating emotional and moral arguments both for and against self-diagnosis, with arguments about perceived benefits and harms (Underhill & Foulkes, 2025). (study on Reddit looking at general perceptions)

  • Common symptoms do not mean a clinical diagnosis.
  • Individuals may experience clinically relevant symptoms without meeting full criteria.
  • Cultural norms and individual differences influence what is considered “normal.”

Reference

Aaiz, A., & Stephen, S. (2017). Self-diagnosis in psychology students. International Journal of Indian Psychology, 4(2), 3. https://doi.org/10.25215/0402.035

Underhill, R., & Foulkes, L. (2025). Self-diagnosis of mental disorders: A qualitative study of attitudes on Reddit. Qualitative Health Research, 35(7), 779-792. https://doi.org/10.1177/10497323241288785

General Areas Considered for Diagnoses

So then, what do we think about when we think about diagnoses? Most diagnoses include specific symptoms, a time-related connection, some frequency, and a description of intensity for a diagnosis to meet the threshold for a given diagnosis.

  • Symptoms can impact people in a variety of ways, including:
    • Beliefs (e.g., delusions in psychotic disorders, or “I’m not good enough” in MDD) or Experiences (experience of a traumatic experience in PTSD)
    • thoughts (“People will negatively judge me” in generalized anxiety)
    • feelings (feeling down or depressed in MDD)
    • behaviors (often losing things in ADHD)
  • Different measures of time are often given within a diagnosis
    • Taking place over a period of time (e.g., depressive symptoms being present during a two-week time period in MDD)
    • Include age related requirements (eg., symptoms evident before age of 5 in RAD)
    • Have an associated duration(e.g., compulsions are time-consuming taking an more than one hour per day in OCD)
  • The frequency is discussed (e.g., “often argues with authority figures” in ODD)
  • The intensity is also required in diagnostic criteria (e.g., causes clinically significant distress, the impact symptoms have on areas of life, judgment, or mood)

(American Psychiatric Association, 2022)

My development of this slide and thinking around this was informed by D for Therapy’s (2022).

Reference

American Psychiatric Association. (2022). Diagnostic and statistical manual of mental disorders: DSM-5-TR (5th ed.). American Psychiatric Association

D for Therapy (2022 August 1) How to diagnose with DSM-5-TR [Video]. YouTube. https://youtu.be/CnFNx5edlWo?si=JAQfiqtKUpnbZfUk

How Much Do You About the DSM-5

I want to do quick game of kahoot. You will need a device and to go to kahoot.it

Sorry, my free account only allows 10 participants, so it’s first-come, first-served. Feel free to work with a partner

Winner gets a copy of the DSM-5

[Whole Group Activity] Have Students do Kahoot on the DSM-5 w/ 22 Questions

Standard DSM Diagnostic Entry Sections

I want to quickly provide how we tend to use the DSM. If your work includes clinical assessment, you will start to become very familiar with some of the sections.

[Whole Group Activity] Use document projector to show an overview of the DMS and talk briefly over the following ways we as clinicians tend to use the DSM.

  • Find in the Table of Contents
  • Use the Diagnostic Criteria
  • Review Further Information (when we are unsure or need more information)

-> Further information about each topic

􀋴 Find in the Table of Contents

Diagnoses can be sorted into the following broader categories:

  • Neurodevelopmental Disorders
  • Schizophrenia Spectrum and Other Psychotic Disorders
  • Bipolar and Related Disorders
  • Depressive Disorders
  • Anxiety Disorders
  • Obsessive-Compulsive and Related Disorders
  • Trauma- and Stressor-Related Disorders
  • Dissociative Disorders
  • Somatic Symptom and Related Disorders
  • Feeding and Eating Disorders
  • Elimination Disorders
  • Sleep-Wake Disorders
  • Sexual Dysfunctions
  • Gender Dysphoria
  • Disruptive, Impulse-Control, and Conduct Disorders
  • Substance-Related and Addictive Disorders
  • Neurocognitive Disorders
  • Personality Disorders
  • Paraphilic Disorders
  • Other Mental Disorders and Additional Codes
  • Medication-Induced Movement Disorders and Other Adverse Effects of Medication
  • Other Conditions That May Be a Focus of Clinical Attention

􀯩 Use the Diagnostic Criteria

You will likely spend most of your time in the criteria in your direct practice, which is why having just the small book is an acceptable option. We often will review the criteria for what we are assessing in our client and help elicit guided questions helping us understand if they meet the threshold for the diagnosis.

Diagnostic Criteria: The specific list of symptoms and conditions required for diagnosis, including duration and exclusion criteria.

􀱢 Review Further Information

If you have the big book, you have access

  • Diagnostic Features: A narrative description of core features that define the disorder and help differentiate it from others.
  • Associated Features: Common but non-essential symptoms, behaviors, or conditions that often accompany the disorder.
  • Prevalence: : Information on how common the disorder is in the general population and/or specific subgroups.
  • Development and Course: Typical age of onset, how the disorder progresses over time, and lifespan considerations.
  • Risk and Prognostic Factors: Factors that increase the likelihood of developing a disorder or influence its course and outcome. Divided into:
    • Temperamental: Individual personality traits or emotional tendencies that predispose someone to a disorder
    • Environmental: External life events or conditions—like trauma, stress, or upbringing—that affect risk or progression.
    • Genetic and Physiological: Inherited or biological traits that influence vulnerability to the disorder.
    • Course Modifiers: Factors that change the severity, persistence, or expression of the disorder once it has developed.
  • Culture-Related Diagnostic Issues: How cultural context may influence the presentation, interpretation, or stigma of symptoms.
  • Sex and Gender-Related Diagnostic Issues: Differences in prevalence, presentation, or course across genders.
  • Association with Suicidal thoughts or Behaviors: Information about elevated risk and considerations for safety assessment.
  • Functional Consequences of the Disorder: The impact of the disorder on a person’s daily life, work, relationships, etc.
  • Differential Diagnosis: Other disorders or conditions that should be ruled out before making the diagnosis.
  • Comorbidity: Other disorders that commonly co-occur with the diagnosis.

Some Entries include other information such as specifiers (e.g., severity, subtype, course), recording procedures, changes from DSM-IV, and ICD-10-CM Codes

(American Psychiatric Association, 2022)

Practice Using the DSM-5-TR

Lets look at one of these as an examples:

[Whole Group Activity] Demonstrate reviewing a diagnosis using document projector (Oppositional Defiant Disorder)

  • Find using table of contents
  • Talk though criteria
  • Show additional sections

[Small Group Activity] Review other diagnostic criteria

Talk in groups about the following and what the diagnostic criteria mean:

  • Reactive Attachment Disorder
  • Generalized anxiety disorder
  • Borderline Personality Disorder

Using a Screening Tool

Screening tools can be helpful in assessing and determining what needs a person might have.

  • My experience using the GAIN-SS

Show website for DSM-5-TR Online Assessment Measures which provides:

  • Level 1 Cross-Cutting Symptom Measures
  • Level 2 Cross-Cutting Symptom Measures
  • Disorder-Specific Severity Measures
  • Disability Measures
  • Personality Inventories
  • Early Development and Home Background
  • Cultural Formulation Interviews

Writing a Diagnosis

F33.3 Major Depressive Disorder, Recurrent, Severe with Psychotic Features with Anxious Distress;

Include the code:

  • F Codes — Mental and Behavioral Disorders
  • Z Codes — Other Conditions That May Be a Focus of Clinical Attention

Some also include: R, G, and N…

Write out the whole diagnosis (discuss varying levels of meaning from this diagnosis…)

At a minimum, you documentation when ascribing a diagnosis should probably include:

  • Diagnosis (with DSM code)
  • Date of diagnosis
  • Any differential diagnoses considered
  • Supporting symptoms and evidence
  • Plan for reevaluation, if needed

#AMA - The DSM Edition

In the forums, I asked you to ask any questions about the DSM you might have.

Lets go though and review them

Q1 Placeholder

Add Slides with Questions from Forums Here

Further Practice Using the Diagnostic Manual

If there is still time, we can do some more small group discussion.

Talk in groups about the following and what the diagnostic criteria mean:

  • Posttraumatic Stress Disorder
  • Major Depressive Disorder
  • Schizophrenia