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mischiefmanifold · 9 months

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Diagnostic Criteria Examples Masterpost

This is a series of posts that I'm hoping eventually covers all the disorders in the DSM-5-TR.

**This will be periodically updated as more posts are made. Please come back to the original post to see these updates**

NEURODEVELOPMENTAL DISORDERS

Intellectual Developmental Disorder (Intellectual Disability)

Global Develolmental Delay

Unspecified Intellectual Developmental Disorder (Intellectual Disability)

Language Disorder

Speech Sound Disorder

Childhood-Onset Fluency Disorder (Stuttering)

Social (Pragmatic) Communication Disorder

Unspecified Communication Disorder

Autism Spectrum Disorder (Levels System)

Attention-Deficit/Hyperactivity Disorder

Other Specified Attention-Deficit/Hyperactivity Disorder

Unspecified Attention-Deficit/Hyperactivity Disorder

Specific Learning Disorder

Developmental Coordination Disorder

Stereotypic Movement Disorder

Tourette's Disorder [Tourette Syndrome]

Persistent (Chronic) Motor or Vocal Tic Disorder

Provisional Tic Disorder

Other Specified Tic Disorder

Unspecified Tic Disorder

Other Specified Neurodevelopmental Disorder

Unspecified Neurodevelopmental Disorder

SCHIZOPHRENIA SPECTRUM AND OTHER PSYCHOTIC DISORDERS

Delusional Disorder

Brief Psychotic Disorder

Schizophreniform Disorder

Schizophrenia

Schizoaffective Disorder

Substance/Medication-Induced Psychotic Disorder

Psychotic Disorder Due to Another Medical Condition

Catatonia Associated With Another Mental Disorder (Catatonia Specifier)

Catatonic Disorder Due to Another Medical Condition

Unspecified Catatonia

Other Specified Schizophrenia Spectrum and Other Psychotic Disorder

Unspecified Schizophrenia Spectrum and Other Psychotic Disorder

BIPOLAR AND RELATED DISORDERS

Bipolar I Disorder [Includes criteria for manic episodes and major depressive episodes]

Bipolar II Disorder [Includes criteria for hypomanic episodes and major depressive episodes]

Cyclothymic Disorder

Substance/Medication-Induced Bipolar and Related Disorder

Bipolar and Related Disorder Due to Another Medical Condition

Other Specified Bipolar and Related Disorder

Unspecified Bipolar and Related Disorder

Unspecified Mood Disorder

Specifiers for Bipolar and Related Disorders

DEPRESSIVE DISORDERS

Disruptive Mood Dysregulation Disorder

Major Depressive Disorder

Persistent Depressive Disorder

Premenstrual Dysphoric Disorder

Substance/Medication-Induced Depressive Disorder

Depressive Disorder Due to Another Medical Condition

Other Specified Depressive Disorder

Unspecified Depressive Disorder

Specifiers for Depressive Disorders

ANXIETY DISORDERS

Separation Anxiety Disorder

Selective Mutism

Specific Phobia

Social Anxiety Disorder

Panic Disorder

Panic Attack Specifier

Agoraphobia

Generalized Anxiety Disorder

Substance/Medication-Induced Anxiety Disorder

Anxiety Disorder Due to Another Medical Condition

Other Specified Anxiety Disorder

Unspecified Anxiety Disorder

OBSESSIVE-COMPULSIVE AND RELATED DISORDERS

Obsessive-Compulsive Disorder

Body Dysmorphic Disorder

Hoarding Disorder

Trichotillomania (Hair-Pulling Disorder)

Excoriation (Skin-Picking) Disorder [Also called Dermatillomania]

Substance/Medication-Induced Obsessive-Compulsive and Related Disorder

Obsessive-Compulsive and Related Disorder Due to Another Medical Condition

Other Specified Obsessive-Compulsive and Related Disorder

Unspecified Obsessive-Compulsive and Related Disorder

TRAUMA- AND STRESSOR-RELATED DISORDERS

Reactive Attachment Disorder

Disinhibited Social Engagement Disorder

Posttraumatic Stress Disorder

Acute Stress Disorder

Adjustment Disorders

Prolonged Grief Disorder

Other Specified Trauma- and Stressor-Related Disorder

Unspecified Trauma- and Stressor-Related Disorder

DISSOCIATIVE DISORDERS

Dissociative Identity Disorder

Dissociative Amnesia

Depersonalization/Derealization Disorder

Other Specified Dissociative Disorder

Unspecified Dissociative Disorder

SOMATIC SYMPTOM AND RELATED DISORDERS

Somatic Symptom Disorder

Illness Anxiety Disorder [Hypochondria]

Functional Neurological Symptom Disorder (Conversion Disorder)

Psychological Factors Affecting Other Medical Conditions

Factitious Disorder Imposed on Self

Factitious Disorder Imposed on Another

Other Specified Somatic Symptom and Related Disorder

Unspecified Somatic Symptom and Related Disorder

FEEDING AND EATING DISORDERS

Pica

Rumination Disorder

Avoidant/Restrictive Food Intake Disorder

Anorexia Nervosa

Bulimia Nervosa

Binge-Eating Disorder

Other Specified Feeding or Eating Disorder

Unspecified Feeding or Eating Disorder

ELIMINATION DISORDERS

Enuresis

Encopresis

Other Specified Elimination Disorder

Unspecified Elimination Disorder

SLEEP-WAKE DISORDERS

Insomnia Disorder

Hypersomnolence Disorder

Narcolepsy

Obstructive Sleep Apnea Hypopnea

Central Sleep Apnea

Sleep-Related Hypoventilation

Circadian Rhythm Sleep-Wake Disorders

Non-Rapid Eye Movement Sleep Arousal Disorders [Sleepwalking and Sleep/Night Terrors]

Nightmare Disorder

Rapid Eye Movement Sleep Behavior Disorder

Restless Legs Syndrome

Substance/Medication-Induced Sleep Disorder

Other Specified Insomnia Disorder

Unspecified Insomnia Disorder

Other Specified Hypersomnolence Disorder

Unspecified Hypersomnolence Disorder

Other Specified Sleep-Wake Disorder

Unspecified Sleep-Wake Disorder

SEXUAL DYSFUNCTIONS

Delayed Ejaculation

Erectile Disorder [Erectile Dysfunction]

Female Orgasmic Disorder

Female Sexual Interest/Arousal Disorder

Genito-Pelvic Pain/Penetration Disorder

Male Hypoactive Sexual Desire Disorder

Premature (Early) Ejaculation

Substance/Medication-Induced Sexual Dysfunction

Other Specified Sexual Dysfunction

Unspecified Sexual Dysfunction

GENDER DYSPHORIA

Gender Dysphoria

Other Specified Gender Dysphoria

Unspecified Gender Dysphoria

DISRUPTIVE, IMPULSE-CONTROL, AND CONDUCT DISORDERS

Oppositional Defiant Disorder

Intermittent Explosive Disorder

Conduct Disorder

Pyromania

Kleptomania

Other Specified Disruptive, Impulse-Control, and Conduct Disorder

Unspecified Disruptive, Impulse-Control, and Conduct Disorder

SUBSTANCE-RELATED AND ADDICTIVE DISORDERS

Alcohol Use Disorder

Alcohol Intoxication

Alcohol Withdrawal

Unspecified Alcohol-Related Disorder

Caffeine Intoxication

Caffeine Withdrawal

Unspecified Caffeine-Related Disorder

Cannabis Use Disorder

Cannabis Intoxication

Cannabis Withdrawal

Unspecified Cannabis-Related Disorder

Phencyclidine Use Disorder

Other Hallucinogen Use Disorder

Phencyclidine Intoxication

Other Hallucination Intoxication

Hallucinogen Persisting Perception Disorder

Unspecified Phencyclidine-Related Disorder

Unspecified Hallucinogen-Related Disorder

Inhalant Use Disorder

Inhalant Intoxication

Unspecified Inhalant-Related Disorder

Opioid Use Disorder

Opioid Intoxication

Opioid Withdrawal

Unspecified Opioid-Related Disorder

Sedative, Hypnotic, or Anxiolytic Use Disorder

Sedative, Hypnotic, or Anxiolytic Intoxication

Sedative, Hypnotic, or Anxiolytic Withdrawal

Unspecified Sedative-, Hypnotic-, or Anxiolytic-Related Disorder

Stimulant Use Disorder

Stimulant Intoxication

Stimulant Withdrawal

Unspecified Stimulant-Related Disorder

Tobacco Use Disorder

Tobacco Withdrawal

Unspecified Tobacco-Related Disorder

Other (or Unknown) Substance Use Disorder

Other (or Unknown) Substance Intoxication

Other (or Unknown) Substance Withdrawal

Unspecified Other (or Unknown) Substance-Related Disorder

Gambling Disorder

NEUROCOGNITIVE DISORDERS

Delirium

Other Specified Delirium

Unspecified Delirium

Major Neurocognitive Disorder

Minor Neurocognitive Disorder

Major or Mild Neurocognitive Disorder Due to Alzheimer's Disease

Mild or Major Frontotemporal Neurocognitive Disorder

Mild or Major Neurocognitive Disorder With Lewy Bodies

Major or Mild Vascular Neurocognitive Disorder

Major or Mild Neurocognitive Disorder Due to Traumatic Brain Injury

Substance/Medication-Induced Major or Mild Neurocognitive Disorder

Major or Mild Neurocognitive Disorder Due to HIV Infection

Major or Mild Neurocognitive Disorder Due to Prion Disease

Major or Mild Neurocognitive Disorder Due to Parkinson's Disease

Major or Mild Neurocognitive Disorder Due to Huntington's Disease

Major or Mild Neurocognitive Disorder Due to Another Medical Condition

Major or Mild Neurocognitive Disorder Due to Multiple Etiologies

Unspecified Neurocognitive Disorder

PERSONALITY DISORDERS

General Personality Disorder

Paranoid Personality Disorder

Schizoid Personality Disorder

Schizotypal Personality Disorder

Antisocial Personality Disorder

Borderline Personality Disorder

Histrionic Personality Disorder

Narcissistic Personality Disorder

Avoidant Personality Disorder

Dependent Personality Disorder

Obsessive-Compulsive Personality Disorder [Anankastic Personality Disorder]

Personality Change Due to Another Medical Condition

Other Specified Personality Disorder

Unspecified Personality Disorder

PARAPHILIC DISORDERS

Voyeuristic Disorder

Exhibitionistic Disorder

Frotteuristic Disorder

Sexual Masochism Disorder

Sexual Sadism Disorder

Pedophilic Disorder

Fetishistic Disorder

Transvestic Disorder

Other Specified Paraphilic Disorder

Unspecified Paraphilic Disorder

OTHER MENTAL DISORDERS AND ADDITIONAL CODES

Other Specified Mental Disorder Due to Another Medical Condition

Unspecified Mental Disorder Due to Another Medical Condition

Other Specified Mental Disorder

Unspecified Mental Disorder

MEDICATION-INDUCED MOVEMENT DISORDERS AND OTHER ADVERSE EFFECTS OF MEDICATION

Medication-Induced Parkinsonism

Neuroleptic Malignant Syndrome

Medication-Induced Acute Dystonia

Medication-Induced Acute Akathisia

Tardive Dyskinesia

Tardive Dystonia [and] Tardive Akathisia

Medication-Induced Postural Tremor

Other Medication-Induced Movement Disorder

Antidepressant Discontinuation Syndrome

Other Adverse Effect of Medication

#diagnostic criteria #masterpost #long post #super long post #dsm 5 tr #dsm 5 #mental disorders

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hauntedselves · 1 year

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I think we need to focus less on the arbitrary division that's been created with PDs when it comes to clusters. The DSM itself notes that the grouping of PDs into clusters is only for research purposes. This is what the DSM-5-TR says in the PD section:

"It should be noted that this clustering system, although useful in some research and educational situations, has serious limitations and has not been consistently validated. For instance, two or more disorders from different clusters, or traits from several of them, can often co-occur and vary in intensity and pervasiveness."

The PDs within each cluster have similarities, yes, but they're not dissimilar from the PDs in other clusters. SzPD has a lot in common with StPD but also with NPD and BPD and OCPD and AvPD - none of which are in the same cluster A. There is no significant meaning behind cluster groupings, don't treat them like there is.

#dogpost #pd clusters #cluster a #cluster b #cluster c #dsm #dsm 5 tr #personality disorders

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dikdikpronouncedxylophone · 7 months

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Luz Noceda in S3E1 + DSM-5-TR criteria for a Major Depressive Episode

(I know 9 is a bit of a stretch but the subtext is strong)

#the owl house #tw suicide mention #luz noceda #camila noceda #amity blight #dsm #dsm 5 #dsm 5 tr #depression #major depressive episode

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simpforcatsystem · 2 years

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Not to mention the fact that ASD is supposed to be a spectrum disorder. That's what it's supposed to be. And any and all spectrum disorders need to include that not all symptoms might be present/disabling. The recent change in the DSM-V-TR listing of ASD necessitated that all symptoms be present, which by design makes it not a spectrum disorder.

We can talk about why they did this, namely the large increase in self-awareness and diagnosis due to increased resources that have challenged the status quo in terms of the dominant neurotype, but I want to talk about the specific wording they used, and why this isn't the change they're looking for.

By doing this, they're essentially moving back to the DSM-IV, which listed Aspergers as a separate disorder from Autism due to relative lack of impairment, except this time we don't have Aspergers as a diagnosis. They're specifically and intentionally leaving out a body of people who are struggling and significantly disabled and in need of resources because they don't like what the numbers are saying they're doing to that population.

To specify the changes made, there is still the 2 of 4 required for the diagnostic section of repetitive behaviors. But the section for social defects, specifically the one that is often underscored in minorities and women due to masking and compensation, now requires all three, which makes even less sense than changing the criteria for repetitive behavior due to the discriminatory factors and the fact that they started out by saying they would use the TR to make it MORE inclusive and account for those who are divergent in their presentation due to other factors or variables.

The only way I can see to fix this while maintaining the changes made is to bring back the Aspergers profile in the DSM, likely under another name because there's little use in keeping a name that is after someone specifically discriminatory. The irony.

And all this because they couldn't handle the fact that our society is far more diverse than they thought or wanted. I remember being so excited at the update. Ridiculous.

#autism #actually autistic #dsm 5 #dsm 5 tr #psychiatry #psychology #im actually really mad about this #the previous post just reminded me #autistic pride #systematic oppression #what the fuck yall #they really said fuck the poor and marginalized

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tistje · 2 years

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Hello Tistje !!! Do you think or What do you think about Mark Zuckerberg is or can be lightly Autistic ?? Considering on a post you did about Elon Musk on your personal blog !!

It's a bit hard to say, as we only know him from his public life, but I would be very surprised if Mark Zuckerberg were autistic. If you asked me to bet on a DSM-code, I would put my money on one of the personality disorders or just eccentricity and talent of doing business.

#mark zuckerberg #dsm 5 tr #autism #aspergers #personality disorder #narcissist

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suspicious-potatoes · 6 months

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Btw, it's been a while, but if anybody was looking to criticize the dsm, there's been a text revision, so look for that newest edition

#dsm 5 #dsm 5 tr

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introvertistic · 10 months

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"Comorbid sleep disorders in ADHD are associated with daytime impairments in cognition (e.g., inattention). Many individuals with ADHD report daytime sleepiness that may meet criteria for hypersomnolence disorder. One quarter to one-half of individuals with ADHD report sleep difficulties; studies have shown an association of ADHD with insomnia, circadian rhythm sleep-wake disorder, sleep-disordered breathing, and restless legs syndrome."

American Psychiatric Association. (2022). Neurodevelopmental disorders. In Diagnostic and statistical manual of mental disorders (5th ed., text rev.).

#dsm-5-tr #psychology #adhd #attention-deficit/ hyperactivity disorder

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landlockedcorsair · 2 years

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So the newly proposed model of personality disorders is fascinating. The criteria has changed a bit so for example with aspd the violent or aggressive behaviors are considered a "varient" as opposed to part of the disorder itself.

It says "specify if with psychopathic features." This is big. This is a shift away from perceiving aspd people as criminals and inmates only. It's interesting.

#aspd #psychopathic #dsm-5-tr #dimentional

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rodrickonfire · 10 months

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DSM-V TR - Gender Dysphoria.PDF 2022

If anyone wants a PDF here it is

#transgender #trans #trans rights #dsm v tr #dsm #gender dysphoria #Diagnostic and Statistical Manual of Mental Disorders (DSM-5-TR)#Diagnostic and Statistical Manual of Mental Disorders

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mkboys · 2 years

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What the DSM-5-TR 2022 Says about Factitious disorder and malingering

“Individuals who feign dissociative identity disorder usually do not report the subtle symptoms of intrusion characteristic of the disorder; instead they tend to overreport media-based symptoms of the disorder, such as dramatic dissociative amnesia and melodramatic switching behaviors, while underreporting less-publicized comorbid symptoms, such as depression. Individuals who feign dissociative identity disorder tend to be relatively undisturbed by or may even seem to enjoy “having” the disorder, or may ask clinicians to “find” traumatic memories. In contrast, most individuals with genuine dissociative identity disorder are ashamed of and overwhelmed by their symptoms, deny the diagnosis, underreport their symptoms, and display minimization and avoidance of their trauma history.

Individuals who feign the symptoms of dissociative identity disorder usually create limited, stereotyped alternate identities, with feigned amnesia related only to the events for which gain is sought, with apparent switching behaviors and amnesia only displayed while being observed. They may present an “all-good” identity and an “all-bad” identity in hopes of gaining exculpation for a crime.”

Now that’s a whole lot. Take what you want from the DSM-5, and leave what is not helpful. I honestly don’t know how people studying psychology and living with this disorder feel about the current version of the DSM-5 in the description of DID, which is not here, this is taken as a small section following comparisons of DID to other disorders it gets misdiagnosed for. I have to explain my own feelings and experience here, and then I’ll talk about the other things I have picked up on from the community. When I had first begun noticing my symptoms, they were pointed out to me. I assumed someone was joking, or bullying me as they usually did, and disregarded all they had said. I don’t even remember what they pointed out, only that I felt exposed and like they were teasing, conflicting emotions at the same time. As I aged, my stories I would tell family were often inconsistent. I would act loving to one sibling, then talk shit to the other, then I would completely forget about them being there in the house. Gaps of memory loss repeated, and they were extremely minor things to major areas of my life where I hadn’t acted out in any way, but I still was not present for any of it. An example was when I went to Disney in Florida with my dad and brother. I have evidence I was there, but the only memory I had was wondering how long my dad would be out tonight. Drinking. Not knowing was always scary to me. When I talked about it (memory loss) with professionals, it was common to experience some childhood memory loss as you get closer to your twenties. I knew I had some awful shit happen to me, as pain had continued all the way until I was about 17, but I didn’t know the extent of any of it. I still do not know. I do not want to know, I never asked to know, and anything that comes close to reminding me of it, I run. I did not know I had DID. I did not know I had anything at all, except that I was depressed. My family treated mental health as an inconvenience, as I was the only one vocal about it. My ‘identities’ I had at the time, I assumed to be just artistic expression of characters I enjoyed. I only know of 2. First was visual hallucinations of Castiel, only appearing when I was in danger of being hurt. He was briefly in my life, a matter of 7 months, but Sherlock Holmes (now well, well integrated) I often laughed at the idea of being him. For nearly 2 years! It wasn’t simply, ah yes Mr. Holmes. But-- the attitudes, the small grains of details, the pleasant sensations of dopamine, dull driven towards isolation, and the heavy weight of depression when I hadn’t had my own personal version of a ‘high.’ How does a high schooler experience any of that? I didn’t question it, and I didn’t look anything up as to what was going on. I didn’t have control over it, and I had begun missing classes for reasons unknown. Friends retreated as my behavior got more closed-off, I engaged mostly in communities where RP was extraordinarily popular, and my home life was so unstable, I am glad I don’t know how many times I was injured by loved ones. But when I had another tragic event happen, and he had split, I was in danger, and I had put myself in danger, but had never told a soul.

These aren’t qualities you want. When I got to college, I didn’t understand who the hell I was supposed to be. Literally. I know people say that a lot, but it was beyond looking in the mirror, confused, it was ‘I’m going to be fucking sick.’ I didn’t understand why I would own so many feminine things, why did I like white frilly bedding? Since when? None of it made any sense, a few months later I cut my hair, stopped wearing more feminine clothes, used different pronouns because I’ll be damned to be forced to be a woman. Gender dysphoria was not enough of a description for what was happening. When I heard things, I saw things, all so unexplainable, it would happen when I was on the verge of not recovering from attempts. They had distracted me long enough to get me out of the situation, and after the self hatred I had would be all consuming. These kinds of things are what it’s like for someone w/ DID. We do not have strict rules, no real answers as to what is and isn’t possible, people with DID are trying to survive reality. I am not trying to make this long post as a way of saying, you have to had have a miserable life to really have DID. No, because I have known people that were so successful, but so fucking depressed, and happened to have people among them internally. More so, if you are trying to research DID, and come across accounts like ours, where we are open about who we are and what we look like, what we enjoy...... etc..... Please be cautious. I say I have it, it does not mean I was proud of it, or currently want it. It’s not cruel to them to say I wish I did not, because they know if I did not then the severity of trauma wouldn’t exist. We’re comfortable in acceptance as we have gone beyond denial. If you look at my archive, this blog is new. It was made 2022. I do not have any other social accounts where I came out as a system because of how afraid I was of myself, even though I’ve known for so long now, there was no pride in it. Only fear. Never confessing to anyone. Only confusion, rage, and amnesia. Reasons why people on here engage in discourse is because they feel the need to protect others from getting them involved in a space where it’s actually not safe at all. We’re traumatised people that have come together to try live, and unless someone in the group has some form of therapy to offer, it’s often a mess of voices and vents. The smaller communities don’t have this happen too often, because even three accounts could be 20 different people with 20 different opinions. Some far more. People fight every day over what DID is and what has to happen for it, but don’t dare try to address how we need to be trying to get ourselves in a safer place over finding someone else who maybe had the Same Kind of Trauma. I also love to be told why I am wrong, and if you’re comfortable with it, I’d love to have a discussion where I won’t talk over you or fight you on any of it. I enjoy learning deeply, but only these types of topics... Sometimes personal knowledge is more valuable to me.

#long post #isaac #system discourse #did system #system stuff #dsm-5-tr #quen #I think why I am so scared now is because i'm getting a new psy evaluation and im scared somehow I have done this to myself when the years #of evidence exist #so yes not a good idea to read the DSM-5 to prepare #but i look at the whole picture of it this time #this post is not a good example....

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mischiefmanifold · 2 years

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note to everyone who’s interested in the DSM-V-TR:

you can get a free PDF copy at z-lib via the following link or you can visit z-lib(dot)org, click on books, and type in the title you’re looking for

#dsm 5 tr #resources #z library

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hauntedselves · 1 year

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Core schizoid traits and criteria

From the Psychodynamic Diagnostic Manual (2006):

From the DSM-IV-TR (2000) and the ICD-10 (2019):

Guntrip's core traits (1969):

In the SWAP-200 personality assessment:

From the DSM-5-TR (2022):

The ICD-11 (2022) doesn't have a specific schizoid diagnosis, but it's detachment trait domain in its personality disorder traits section is similar to SzPD:

From Zachary Wheeler, Treatment of Schizoid Personality [dissertation] (2013); the DSM-5-TR (2022), & the ICD-11 (2022).

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snakeskinass · 12 days

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Random psychology disorder (somewhat) explained #1 (Trichotillomania/Hair-Pulling Disorder)

Diagnostic Criteria

A. Recurrent pulling out of one’s hair, resulting in hair loss.

B. Repeated attempts to decrease or stop hair pulling.

C. The hair pulling causes clinically significant distress or impairment in social, occupational, or other important areas of functioning.

D. The hair pulling or hair loss is not attributable to another medical condition (e.g., a dermatological condition).

E. The hair pulling is not better explained by the symptoms of another mental disorder (e.g., attempts to improve a perceived defect or flaw in appearance in body dysmorphic disorder).

Diagnostic Features

The essential feature of trichotillomania (hair-pulling disorder) is the recurrent pulling out of one’s own hair (Criterion A).

Hair pulling may occur from any region of the body in which hair grows; the most common sites are the scalp, eyebrows, and eyelids, while less common sites are axillary, facial, pubic, and perirectal regions.

Hair-pulling sites may vary over time.

Hair pulling may occur in brief episodes scattered throughout the day or during less frequent but more sustained periods that can continue for hours, and such hair pulling may endure for months or years.

Criterion A requires that hair pulling lead to hair loss, although individuals with this disorder may pull hair in a widely distributed pattern (i.e., pulling single hairs from all over a site) such that hair loss may not be clearly visible.

In addition, individuals may attempt to conceal or camouflage hair loss (e.g., by using makeup, scarves, or wigs).

Individuals with trichotillmania have made repeated attempts to decrease or stop hair pulling (Criterion B).

Criterion C indicates that hair pulling causes clinically significant distress or impairment in social, occupational, or other important areas of functioning.

The term distress includes negative affects that may be experienced by individuals with hair pulling, such as feelings a loss of control, embarrassment, and shame.

Significant impairment may occur in several different areas of functioning (e.g., social, occupational, academic, and leisure), in part because of avoidance of work, school, or other public situations.

Associated Features

Hair pulling may be accompanied by a range of behaviors or rituals involving hair.

Thus, individuals may search for a particular kind of hair to pull (e.g., hairs with specific texture or color), may try to pull out hair in a specific way (e.g., so that the root comes out intact), or may visually examine or tactilely or orally manipulate the hair after it has been pulled (e.g., rolling the hair between the fingers, pulling the strand between the teeth, biting the hair into pieces, or swallowing the hair).

Hair pulling may also be preceded or accompanied by various emotional states; it may be triggered by feelings of anxiety or boredom, may be preceded by an increasing sense of tension (either immediately before pulling out the hair or when attempting to resist the urge to pull), or may lead to gratification, pleasure, or a sense of relief when the hair is pulled out.

Hair-pulling behavior may involve varying degrees of conscious awareness, with some individuals displaying more focused attention on the hair pulling (with preceding tension and subsequent relief), and other individuals displaying more automatic behavior (in which the hair pulling seems to occur without full awareness).

Many individuals report a mix of both behavioral styles.

Some individuals experience an “itch-like” or tingling sensation in the scalp that is alleviated by the act of hair pulling.

Pain does not usually accompany hair pulling.

Patterns of hair loss are highly variable.

Areas of complete alopecia, as well as areas of thinned hair density, are common.

When the scalp is involved, there may be a predilection for pulling out hair in the crown or parietal regions.

There may be a pattern of nearly complete baldness except for a narrow perimeter around the outer margins of the scalp, particularly at the nape of the neck (“tonsure trichotillmania”).

Eyebrows and eyelashes may be completely absent.

Hair pulling does not usually occur in the presence of other individuals, except immediate family members.

Some individuals have urges to pull hair from other individuals and may sometimes try to find opportunities to do so surreptitiously.

Some individuals may pull hairs from pets, dolls, and other fibrous materials (e.g., sweaters or carpets).

Some individuals may deny their hair pulling to others.

The majority of individuals with trichotillmania also have one or more other body-focused repetitive behaviors, including skin picking, nail biting, and lip chewing.

Differential Diagnosis

Normative hair removal/manipulation. Trichotillmania should not be diagnosed when hair removal is performed solely for cosmetic reasons (i.e., to improve physical appearance).

Many individuals twist and play with their hair, but this behavior does not usually qualify for a diagnosis of trichotillmania.

Some individuals may bite rather than pull hair; again, this does not qualify for a diagnosis of trichotillmania.

Other obsessive-compulsive and related disorders. Individuals with OCD and symmetry concerns may pull out hairs as part of their symmetry rituals, and individuals with body dysmorphic disorder may remove body hair that they perceive as ugly, asymmetrical, or abnormal; in such cases a diagnosis of trichotillmania is not given.

Stereotypic movement disorder. Stereotypic movement disorder can sometimes involve hair-pulling behavior.

For example, a child with intellectual developmental disorder (intellectual disability) or autism spectrum disorder may engage in stereotypic head banging, hand or arm biting, and hair pulling when frustrated or angry, and sometimes when excited.

This behavior, if impairing, would be diagnosed as stereotypic movement disorder (co-occurring with intellectual developmental disorder or autism spectrum disorder) rather than trichotillmania.

Psychotic disorder. Individuals with a psychotic disorder may remove hair in response to a delusion or hallucination.

Trichotillmania is not diagnosed in such cases.

Another medical condition. Trichotillmania is not diagnosed if the hair pulling or hair loss is attributed to another medical condition (e.g., inflammation of the skin or other dermatological conditions).

Other causes of noncicatricial (nonscarring) alopecia (e.g., alopecia areata, androgenic alopecia, telogen effluvium) or cicatricial (scarring) (e.g., chronic discoid lupus erythematosus, lichen planopilaris, central centrifugal cicatricial alopecia, pseudopelade, folliculitis decalvans, dissecting folliculitis, acne keloidalis nuchae) should be considered in individuals with hair loss who deny hair pulling.

Skin biopsy or dermoscopy can be used to differentiate individuals with trichotillmania from those with dermatological disorders.

Substance-related disorders. Hair-pulling symptoms may be exacerbated by certain substances-for example, stimulants-but it is less likely that substances are the primary cause of persistent hair pulling.

Comorbidity

Trichotillmania is often accompanied by other mental disorders, most commonly major depressive disorder and excoriation (skin-picking) disorder.

Repetitive body-focused symptoms other than hair pulling or skin picking (e.g., nail biting) occur in the majority of individuals with trichotillmania and may deserve an additional diagnosis or other specified obsessive-compulsive and related disorder (i.e., other body-focused repetitive behavior disorder).

#taken straight from the DSM-5-TR #trichotillomania #hair-pulling disorder #dsm 5 #psychology #obsessive-compulsive spectrum #kill me #this took way too long #I honestly just want to talk about psychology #obsessive compulsive spectrum #obsessive compulsive behavior #can you tell that my special interest is psychology?#mental illness #mental health #mentalheathawareness #mental heath support #long post #long ramble #special interest

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