Benefits managers will want to set aside time at the beach this summer to relax with the newly released edition of the Diagnostic and Statistical Manual of Mental Disorders, or DSM-5.
The clinician's bible for identifying and defining psychiatric disorders, the DSM hasn't been updated since 1994. As a result, the latest iteration, DSM-5, contains a vast array of new material addressing conditions such as binge eating disorder, disruptive mood disregulation disorder or hoarding disorder, many of which could be covered by the Americans with Disabilities Act Amendments Act.
Published by the American Psychiatric Association, some of the updates in DSM-5 have more to do with revised terminology than actual diagnosis.
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For example, the term "mental retardation" is replaced throughout the manual with the more current phrase, "intellectual disability." Not only is the term commonly used today, but federal law dictates that it be used. The APA explains that there is a subtle change in the way this diagnosis is arrived at — it now involves a combination of IQ levels and one's ability to function.
Similarly, the term "autism spectrum" now is used is all cases where the four terms — autistic disorder (autism), Asperger's disorder, childhood disintegrative disorder, and pervasive developmental disorder — were once considered appropriate.
Other revisions found in DSM-5 are certain to require more attention from those who implement benefits plans. There are areas where new and perhaps puzzling accommodations will be sought, and other areas where conditions that once demanded accommodation will disappear.
"Bereavement" has been redefined so that sufferers who were once given two months to recover under DSM-IV are now viewed as enduring major symptoms of grief for up to two years.
A new term — mild neurocognitive disorder — makes its appearance in DSM-5, and is described as the symptoms that accompany the aging process.
Dr. Dan Blazer, a co-chair of the Neurocognitive Disorders Work Group, said that the condition has been identified because people who are aging often take longer to perform routine tasks and therefor are at a disadvantage compared to others.
Meantime, in what should come as a relief to HR professionals, DSM-5 declined to designate caffeine use disorder as a true disorder, but only a subject requiring further study.
Also, accommodations for employees with "atypical sexual interests" must now meet a higher standard. An APA white paper concerning the revisions says:
"Most people with atypical sexual interests do not have a mental disorder. To be diagnosed … DSM-5 requires that people with these interests:
- feel personal distress about their interest, not merely distress resulting from society's disapproval; or
- have a sexual desire or behavior that involves another person's psychological distress, injury, or death, or a desire for sexual behaviors involving unwilling persons or persons unable to give legal consent.
In essence, this new distinction liberates many with "atypical sexual interests" from the stigma of a mental disorder, raising the bar before they might be eligible for a workplace accommodation.
To purchase a copy of DSM-5, go to the APA's website.
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Dan Cook
Dan Cook is a journalist and communications consultant based in Portland, OR. During his journalism career he has been a reporter and editor for a variety of media companies, including American Lawyer Media, BusinessWeek, Newhouse Newspapers, Knight-Ridder, Time Inc., and Reuters. He specializes in health care and insurance related coverage for BenefitsPRO.
