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Dan J Stein - One of the best experts on this subject based on the ideXlab platform.
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dsm 5 field survey hair pulling disorder trichotillomania
Depression and Anxiety, 2012Co-Authors: Christine Lochner, Dan J Stein, Jon E Grant, Brian L Odlaug, Douglas W Woods, Nancy J KeuthenAbstract:Background The aim of this multisite field survey was to examine the DSM-IV-TR criteria, proposed DSM-5 diagnostic criteria, as well as a number of possible additional diagnostic criteria, in patients with hair-pulling disorder (HPD, or trichotillomania). Methods Four sites were involved. Participants older than 10 years of age, male or female, with hair-pulling symptoms in the last 4 weeks were included. Participants were assessed with two modules based on the Structured Clinical Interview for DSM (SCID-I/P), which addressed the DSM-IV-TR criteria set as well as proposed DSM-5 diagnostic criteria for HPD, respectively. Additional questions were established to test other possible diagnostic criteria. Results Eighty-four (79 female, 5 male, 83 adult) participants with current hair-pulling symptoms were included. All of these participants had recurrent hair-pulling and most (n = 82 [98%]) reported repeated attempts to decrease or stop hair-pulling, and 70 (n = 70 [83%]) met the clinical significance criterion. Diagnostic criteria focused on “urge,” “tension,” “need,” “drive,” or “impulse” to pull, or pleasure, gratification or relief during or after pulling, were endorsed by many, but not all. Individuals who did endorse such criteria had significantly more severe hair-pulling symptoms. Conclusions These data support the proposed diagnostic criteria for HPD in adults. Although most adult patients have urges to pull or experience a sense of relief on pulling, as in the case of skin-picking disorder, such phenomena are not universal and so should not be included in the diagnostic criteria. An additional criterion focused on repeated attempts to decrease or stop hair-pulling seems warranted.
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the validity of dsm iv tr criteria b and c of hair pulling disorder trichotillomania evidence from a clinical study
Psychiatry Research-neuroimaging, 2011Co-Authors: Christine Lochner, Dan J Stein, Douglas W Woods, David L Pauls, Martin E Franklin, Elizabeth H Loerke, Nancy J KeuthenAbstract:Abstract In both DSM-IV-TR and the ICD-10, hair-pulling disorder (trichotillomania, or TTM) is described as hair-pulling, with a rising urge or tension prior to pulling or when attempting to resist, and pleasure, relief or gratification during or after pulling. However, it has been questioned whether all patients with hair-pulling experience these other phenomena, and whether they occur with all pulling episodes. The objective of this study was to examine the DSM-IV-TR requirement of criteria B and C for a diagnosis of TTM in a sample of people with hair-pulling. A multi-site sample of adults with hair-pulling who met both DSM-IV-TR diagnostic criteria B and C ( n =82, 89.13%) were compared to those who failed to satisfy both B and C ( n =10, 10.87%) on a number of clinical variables. There were no differences in hair-pulling severity, levels of comorbid depressive and anxiety symptoms, number of comorbid body-focused repetitive behaviors, or impairment between those patients who did and did not meet criteria B and C. Our study does not provide convincing support for the inclusion of the current diagnostic criteria B and C for TTM in DSM-5.
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culture and the anxiety disorders recommendations for dsm v
FOCUS, 2011Co-Authors: Roberto Lewisfernandez, Dan J Stein, Devon E Hinton, Amaro J Laria, Elissa H Patterson, Stefan G Hofmann, Michelle G Craske, Anu Asnaani, Betty LiaoAbstract:Background: The anxiety disorders specified in the fourth edition, text revision, of The Diagnostic and Statistical Manual (DSM-IV-TR) are identified universally in human societies, and also show substantial cultural particularities in prevalence and symptomatology. Possible explanations for the observed epidemiological variability include lack of measurement equivalence, true differences in prevalence, and limited validity or precision of diagnostic criteria. One central question is whether, through inadvertent “over-specification” of disorders, the post-DSM-III nosology has missed related but somewhat different presentations of the same disorder because they do not exactly fit specified criteria sets. This review canvases the mental health literature for evidence of cross-cultural limitations in DSM-IV-TR anxiety disorder criteria. Methods: Searches were conducted of the mental health literature, particularly since 1994, regarding cultural or race/ethnicity-related factors that might limit the universal...
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culture and the anxiety disorders recommendations for dsm v
Depression and Anxiety, 2010Co-Authors: Roberto Lewisfernandez, Dan J Stein, Devon E Hinton, Amaro J Laria, Elissa H Patterson, Stefan G Hofmann, Michelle G Craske, Anu Asnaani, Betty LiaoAbstract:Background: The anxiety disorders specified in the fourth edition, text revision, of The Diagnostic and Statistical Manual (DSM-IV-TR) are identified universally in human societies, and also show substantial cultural particularities in prevalence and symptomatology. Possible explanations for the observed epidemiological variability include lack of measurement equivalence, true differences in prevalence, and limited validity or precision of diagnostic criteria. One central question is whether, through inadvertent “over-specification” of disorders, the post-DSM-III nosology has missed related but somewhat different presentations of the same disorder because they do not exactly fit specified criteria sets. This review canvases the mental health literature for evidence of cross-cultural limitations in DSM-IV-TR anxiety disorder criteria. Methods: Searches were conducted of the mental health literature, particularly since 1994, regarding cultural or race/ethnicity-related factors that might limit the universal applicability of the diagnostic criteria for six anxiety disorders. Results: Possible mismatches between the DSM criteria and the local phenomenology of the disorder in specific cultural contexts were found for three anxiety disorders in particular. These involve the unexpectedness and 10-minute crescendo criteria in Panic Disorder; the definition of social anxiety and social reference group in Social Anxiety Disorder; and the priority given to psychological symptoms of worry in Generalized Anxiety Disorder. Limited evidence was found throughout, particularly in terms of neurobiological markers, genetic risk factors, treatment response, and other DSM-V validators that could help clarify the cross-cultural applicability of criteria. Conclusions :O n the basis of the available data, options and preliminary recommendations for DSM-V are put forth that should be further evaluated and tested. (This Article is being co-published by Depression & Anxiety and the American Psychiatric Association. This Article first appeared in
Dave H Schweitzer - One of the best experts on this subject based on the ideXlab platform.
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original research ejaculatory disorders changing paradigms from a historical dsm iii and dsm iv view toward an evidence based definition of premature ejaculation part i validity of dsm iv tr
The Journal of Sexual Medicine, 2006Co-Authors: Marcel D Waldinger, Dave H SchweitzerAbstract:ABSTRACT Background In former days, information obtained from randomized well‐controlled clinical trials and epidemiological studies on premature ejaculation (PE) was not available, thereby hampering the efforts of the consecutive DSM Work Groups on Sexual Disorders to formulate an evidence‐based definition of PE. The current DSM‐IV‐TR definition of PE is still nonevidence based. In addition, the requirement that persistent self‐perceived PE, distress, and interpersonal difficulties, in absence of a quantified ejaculation time, are necessary to establish the diagnosis remains disputable. Aim To investigate the validity and reliability of DSM and ICD diagnosis of premature ejaculation. Methods The historical development of DSM and ICD classification of mental disorders is critically reviewed, and two studies using the DSM‐IV‐TR definition of PE is critically reanalyzed. Results Reanalysis of two studies using the DSM‐IV‐TR definition of PE has shown that DSM‐diagnosed PE can be accompanied by long intravaginal ejaculation latency time (IELT) values. The reanalysis revealed a low positive predictive value for the DSM‐IV‐TR definition when used as a diagnostic test. A similar situation pertains to the American Urological Association (AUA) definition of PE, which is practically a copy of the DSM‐IV‐TR definition. Conclusion It should be emphasized that any evidence‐based definition of PE needs objectively collected patient‐reported outcome (PRO) data from epidemiological studies, as well as reproducible quantifications of the IELT. Waldinger MD, and Schweitzer DH. Changing paradigms from a historical DSM‐III and DSM‐IV view toward an evidence‐based definition of premature ejaculation. Part I—Validity of DSM‐IV‐TR. J Sex Med 2006;3:682–692.
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original research ejaculatory disordersoriginal research ejaculatory disorders changing paradigms from a historical dsm iii and dsm iv view toward an evidence based definition of premature ejaculation part i validity of dsm iv tr
The Journal of Sexual Medicine, 2006Co-Authors: Marcel D Waldinger, Dave H SchweitzerAbstract:Background In former days, information obtained from randomized well‐controlled clinical trials and epidemiological studies on premature ejaculation (PE) was not available, thereby hampering the efforts of the consecutive DSM Work Groups on Sexual Disorders to formulate an evidence‐based definition of PE. The current DSM‐IV‐TR definition of PE is still nonevidence based. In addition, the requirement that persistent self‐perceived PE, distress, and interpersonal difficulties, in absence of a quantified ejaculation time, are necessary to establish the diagnosis remains disputable.
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the use of old and recent dsm definitions of premature ejaculation in observational studies a contribution to the present debate for a new classification of pe in the dsm v
The Journal of Sexual Medicine, 2005Co-Authors: Marcel D Waldinger, Dave H SchweitzerAbstract:ABSTRACT Introduction The DSM-III definition of premature ejaculation (PE) contains the criterion “control” but not that of “ejaculation time.” In contrast, the Diagnostic and Statistical Manual of Mental Disorders (4th edition, Text Revision) (DSM-IV-TR) contains the criterion “short ejaculation time,” while it lacks “control.” Aim To review the adequacy and consequent use of all criteria of the DSM-IV-TR definition in previously published PE Internet surveys. Methods Reviewing all published cohort studies on PE from 2004 to 2007. MEDLINE and EMBASE computer bibliographies were used. Main Outcome Measure Definitions of DSM-III, DSM-IV-TR, and International Classification of Diseases. Results Five papers, of which three are original studies, reported inclusion of men with PE according to DSM-IV-TR definition but omitted to apply the required “short ejaculation time” criterion. These studies, which have defined PE according to subjective criteria such as control, actually referred to the DSM-III definition. Using DSM-III-like definitions in three different studies revealed a highly variable prevalence of PE (32.5%, 27.6%, and 13.0%). In contrast, based on studies using a 1-minute cutoff point, being the time that is required to call ejaculation time “short” or using the criterion “persistent occurrence,” PE revealed to be far less prevalent (5–6%). Conclusions Unacceptable discrepancies of PE definitions according to DSM-III (abandoned but still used) and DSM-IV-TR argue strongly in favor of a multidimensional new classification of PE for the DSM-V. Waldinger MD, and Schweitzer DH. The use of old and recent DSM definitions of premature ejaculation in observational studies: A contribution to the present debate for a new classification of PE in the DSM-V.
Marcel D Waldinger - One of the best experts on this subject based on the ideXlab platform.
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original research ejaculatory disorders changing paradigms from a historical dsm iii and dsm iv view toward an evidence based definition of premature ejaculation part i validity of dsm iv tr
The Journal of Sexual Medicine, 2006Co-Authors: Marcel D Waldinger, Dave H SchweitzerAbstract:ABSTRACT Background In former days, information obtained from randomized well‐controlled clinical trials and epidemiological studies on premature ejaculation (PE) was not available, thereby hampering the efforts of the consecutive DSM Work Groups on Sexual Disorders to formulate an evidence‐based definition of PE. The current DSM‐IV‐TR definition of PE is still nonevidence based. In addition, the requirement that persistent self‐perceived PE, distress, and interpersonal difficulties, in absence of a quantified ejaculation time, are necessary to establish the diagnosis remains disputable. Aim To investigate the validity and reliability of DSM and ICD diagnosis of premature ejaculation. Methods The historical development of DSM and ICD classification of mental disorders is critically reviewed, and two studies using the DSM‐IV‐TR definition of PE is critically reanalyzed. Results Reanalysis of two studies using the DSM‐IV‐TR definition of PE has shown that DSM‐diagnosed PE can be accompanied by long intravaginal ejaculation latency time (IELT) values. The reanalysis revealed a low positive predictive value for the DSM‐IV‐TR definition when used as a diagnostic test. A similar situation pertains to the American Urological Association (AUA) definition of PE, which is practically a copy of the DSM‐IV‐TR definition. Conclusion It should be emphasized that any evidence‐based definition of PE needs objectively collected patient‐reported outcome (PRO) data from epidemiological studies, as well as reproducible quantifications of the IELT. Waldinger MD, and Schweitzer DH. Changing paradigms from a historical DSM‐III and DSM‐IV view toward an evidence‐based definition of premature ejaculation. Part I—Validity of DSM‐IV‐TR. J Sex Med 2006;3:682–692.
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original research ejaculatory disordersoriginal research ejaculatory disorders changing paradigms from a historical dsm iii and dsm iv view toward an evidence based definition of premature ejaculation part i validity of dsm iv tr
The Journal of Sexual Medicine, 2006Co-Authors: Marcel D Waldinger, Dave H SchweitzerAbstract:Background In former days, information obtained from randomized well‐controlled clinical trials and epidemiological studies on premature ejaculation (PE) was not available, thereby hampering the efforts of the consecutive DSM Work Groups on Sexual Disorders to formulate an evidence‐based definition of PE. The current DSM‐IV‐TR definition of PE is still nonevidence based. In addition, the requirement that persistent self‐perceived PE, distress, and interpersonal difficulties, in absence of a quantified ejaculation time, are necessary to establish the diagnosis remains disputable.
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the use of old and recent dsm definitions of premature ejaculation in observational studies a contribution to the present debate for a new classification of pe in the dsm v
The Journal of Sexual Medicine, 2005Co-Authors: Marcel D Waldinger, Dave H SchweitzerAbstract:ABSTRACT Introduction The DSM-III definition of premature ejaculation (PE) contains the criterion “control” but not that of “ejaculation time.” In contrast, the Diagnostic and Statistical Manual of Mental Disorders (4th edition, Text Revision) (DSM-IV-TR) contains the criterion “short ejaculation time,” while it lacks “control.” Aim To review the adequacy and consequent use of all criteria of the DSM-IV-TR definition in previously published PE Internet surveys. Methods Reviewing all published cohort studies on PE from 2004 to 2007. MEDLINE and EMBASE computer bibliographies were used. Main Outcome Measure Definitions of DSM-III, DSM-IV-TR, and International Classification of Diseases. Results Five papers, of which three are original studies, reported inclusion of men with PE according to DSM-IV-TR definition but omitted to apply the required “short ejaculation time” criterion. These studies, which have defined PE according to subjective criteria such as control, actually referred to the DSM-III definition. Using DSM-III-like definitions in three different studies revealed a highly variable prevalence of PE (32.5%, 27.6%, and 13.0%). In contrast, based on studies using a 1-minute cutoff point, being the time that is required to call ejaculation time “short” or using the criterion “persistent occurrence,” PE revealed to be far less prevalent (5–6%). Conclusions Unacceptable discrepancies of PE definitions according to DSM-III (abandoned but still used) and DSM-IV-TR argue strongly in favor of a multidimensional new classification of PE for the DSM-V. Waldinger MD, and Schweitzer DH. The use of old and recent DSM definitions of premature ejaculation in observational studies: A contribution to the present debate for a new classification of PE in the DSM-V.
Andrew E Skodol - One of the best experts on this subject based on the ideXlab platform.
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clinician judgments of clinical utility a comparison of dsm iv tr personality disorders and the alternative model for dsm 5 personality disorders
Journal of Abnormal Psychology, 2014Co-Authors: Leslie C. Morey, Andrew E Skodol, John M. OldhamAbstract:This study compared the perceived clinical utility of DSM-IV-TR personality disorder diagnoses (retained in DSM-5) with the alternative model presented in DSM-5 Section III, using a national sample of clinicians applying both systems to their own patients. A sample of 337 mental health clinicians (26% psychiatrists, 63% psychologists, and 11% other professional disciplines) provided a complete assessment of all personality disorder features listed in DSM-IV-TR and DSM-5 Section III. After applying each diagnostic model, clinicians evaluated the clinical utility of that model with respect to communication with patients and with other professionals, comprehensiveness, descriptiveness, ease of use, and utility for treatment planning. These perceptions were compared across DSM-IV-TR and the 3 components of the DSM-5 Section III model, and between psychiatrists and nonpsychiatrists. Although DSM-IV-TR was seen as easy to use and useful for professional communication, in every other respect the DSM-5 Section III model was viewed as being equally or more clinically useful than DSM-IV-TR. In particular, the DSM-5 dimensional trait model was seen as more useful than DSM-IV-TR in 5 of 6 comparisons-by psychiatrists as well as other professionals. Although concerns were expressed about the clinical utility of the DSM-5 personality disorder system during its development, these criticisms were offered without data on the proposed system. The results of this study demonstrate that aside from the current familiarity of the DSM-IV-TR approach, it offers little advantage in perceived clinical utility over the DSM-5 Section III system, whereas the latter is viewed as being more useful in several respects.
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initial construction of a maladaptive personality trait model and inventory for dsm 5
Psychological Medicine, 2012Co-Authors: Robert F Krueger, Jaime Derringer, Kristian E Markon, David Watson, Andrew E SkodolAbstract:Background DSM-IV-TR suggests that clinicians should assess clinically relevant personality traits that do not necessarily constitute a formal personality disorder (PD), and should note these traits on Axis II, but DSM-IV-TR does not provide a trait model to guide the clinician. Our goal was to provide a provisional trait model and a preliminary corresponding assessment instrument, in our roles as members of the DSM-5 Personality and Personality Disorders Workgroup and workgroup advisors. Method An initial list of specific traits and domains (broader groups of traits) was derived from DSM-5 literature reviews and workgroup deliberations, with a focus on capturing maladaptive personality characteristics deemed clinically salient, including those related to the criteria for DSM-IV-TR PDs. The model and instrument were then developed iteratively using data from community samples of treatment-seeking participants. The analytic approach relied on tools of modern psychometrics (e.g. item response theory models). Results A total of 25 reliably measured core elements of personality description emerged that, together, delineate five broad domains of maladaptive personality variation: negative affect, detachment, antagonism, disinhibition, and psychoticism. Conclusions We developed a maladaptive personality trait model and corresponding instrument as a step on the path toward helping users of DSM-5 assess traits that may or may not constitute a formal PD. The inventory we developed is reprinted in its entirety in the Supplementary online material, with the goal of encouraging additional refinement and development by other investigators prior to the finalization of DSM-5. Continuing discussion should focus on various options for integrating personality traits into DSM-5.
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proposed changes in personality and personality disorder assessment and diagnosis for dsm 5 part ii clinical application
Personality Disorders: Theory Research and Treatment, 2011Co-Authors: Andrew E Skodol, John M. Oldham, Leslie C. Morey, Lee Anna Clark, Robert F Krueger, Donna S Bender, Roel Verheul, Larry J SieverAbstract:The four-part assessment of personality psychopathology proposed for DSM-5 focuses attention on identifying personality psychopathology with increasing degrees of specificity, based on a clinician's available time, information, and expertise. In Part I of this two-part article, we described the components of the new model and presented brief rationales for them. In Part II, we illustrate the clinical application of the model with vignettes of patients with varying degrees of personality psychopathology, selected from the DSM-IV-TR Casebook, to show how assessments might be conducted and diagnoses reached.
Nancy J Keuthen - One of the best experts on this subject based on the ideXlab platform.
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dsm 5 field survey hair pulling disorder trichotillomania
Depression and Anxiety, 2012Co-Authors: Christine Lochner, Dan J Stein, Jon E Grant, Brian L Odlaug, Douglas W Woods, Nancy J KeuthenAbstract:Background The aim of this multisite field survey was to examine the DSM-IV-TR criteria, proposed DSM-5 diagnostic criteria, as well as a number of possible additional diagnostic criteria, in patients with hair-pulling disorder (HPD, or trichotillomania). Methods Four sites were involved. Participants older than 10 years of age, male or female, with hair-pulling symptoms in the last 4 weeks were included. Participants were assessed with two modules based on the Structured Clinical Interview for DSM (SCID-I/P), which addressed the DSM-IV-TR criteria set as well as proposed DSM-5 diagnostic criteria for HPD, respectively. Additional questions were established to test other possible diagnostic criteria. Results Eighty-four (79 female, 5 male, 83 adult) participants with current hair-pulling symptoms were included. All of these participants had recurrent hair-pulling and most (n = 82 [98%]) reported repeated attempts to decrease or stop hair-pulling, and 70 (n = 70 [83%]) met the clinical significance criterion. Diagnostic criteria focused on “urge,” “tension,” “need,” “drive,” or “impulse” to pull, or pleasure, gratification or relief during or after pulling, were endorsed by many, but not all. Individuals who did endorse such criteria had significantly more severe hair-pulling symptoms. Conclusions These data support the proposed diagnostic criteria for HPD in adults. Although most adult patients have urges to pull or experience a sense of relief on pulling, as in the case of skin-picking disorder, such phenomena are not universal and so should not be included in the diagnostic criteria. An additional criterion focused on repeated attempts to decrease or stop hair-pulling seems warranted.
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the validity of dsm iv tr criteria b and c of hair pulling disorder trichotillomania evidence from a clinical study
Psychiatry Research-neuroimaging, 2011Co-Authors: Christine Lochner, Dan J Stein, Douglas W Woods, David L Pauls, Martin E Franklin, Elizabeth H Loerke, Nancy J KeuthenAbstract:Abstract In both DSM-IV-TR and the ICD-10, hair-pulling disorder (trichotillomania, or TTM) is described as hair-pulling, with a rising urge or tension prior to pulling or when attempting to resist, and pleasure, relief or gratification during or after pulling. However, it has been questioned whether all patients with hair-pulling experience these other phenomena, and whether they occur with all pulling episodes. The objective of this study was to examine the DSM-IV-TR requirement of criteria B and C for a diagnosis of TTM in a sample of people with hair-pulling. A multi-site sample of adults with hair-pulling who met both DSM-IV-TR diagnostic criteria B and C ( n =82, 89.13%) were compared to those who failed to satisfy both B and C ( n =10, 10.87%) on a number of clinical variables. There were no differences in hair-pulling severity, levels of comorbid depressive and anxiety symptoms, number of comorbid body-focused repetitive behaviors, or impairment between those patients who did and did not meet criteria B and C. Our study does not provide convincing support for the inclusion of the current diagnostic criteria B and C for TTM in DSM-5.
