Abstract
Introduction
The Diagnostic and Statistical Manual of Mental Disorders (5th ed.; DSM-5; American Psychiatric Association [APA], 2013) is generally viewed as a universal authority for psychiatric diagnosis in North America. It is an important classification and diagnostic tool used by mental health professionals in a variety of clinical and rehabilitative settings, including psychiatrists, psychologists, social workers, nurses, occupational and rehabilitation therapists, and counselors. The school system is becoming an important setting wherein significant DSM-5 diagnostic determinations are occurring. Moreover, schools serve as an increasingly important venue for mental health promotion and treatment for students presenting with significant psychological issues, as well as for targeted prevention for those at risk. DSM-5 Diagnosis in the Schools was written as a resource for professionals in educational and school psychology, child and adolescent clinical or counseling psychology, as well as educational administration and policy. The 268-page volume is divided into 21 chapters and provides a solid resource discussing the system and organization of the DSM-5 and how this relates to common presenting problems in children and adolescents. The book includes practical recommendations for diagnostic decision making and coding, highlights links to special education eligibility under the Individuals With Disabilities Education Improvement Act (IDEA), discusses ethical and professional issues in school-based assessment, and emphasizes the use of diagnosis as a foundation for effective intervention.
Content and Structure
The volume is divided into three distinct sections. Part I consists of three chapters in which the authors focus on important diagnostic issues for school psychologists and provide an overview of the DSM-5 diagnostic system. This includes a discussion of the role of psychiatric diagnosis in school settings, as well as practical considerations such as who is able to diagnose using the DSM-5. The authors also outline the structure and organization of the DSM-5, including a discussion of its categorical classification, the use of differential diagnosis, and the recording and coding of diagnoses.
Part II is comprised of 12 chapters that present guidelines for evaluating common presenting problems in children and adolescents. This involves an overview of all DSM-5 diagnoses, including problems with intellectual ability and cognition such as intellectual disability and neurocognitive disorders; learning, communication, and motor problems; conditions with highly atypical symptom patterns such as autism spectrum disorders and psychoses; mood problems; anxiety problems including obsessive-compulsive and related disorders as well as traumatic and stressor-related disorders; other internalizing problems such as somatic symptom and related disorders and dissociative disorders; problems with conduct; problems with impulse control; conditions with highly focused symptoms patterns including feeding and eating disorders, elimination disorders, gender dysphoria, paraphilic disorders, and sleep-wake disorders; substance-related problems and other addictive behaviors; personality disorders; and additional DSM-5 categories such as other conditions that may be the focus of clinical attention.
Finally, Part III includes five chapters in which the authors discuss important issues related to the application of DSM-5 in school settings. These include ethical and professional responsibilities for school psychologists, record keeping and documentation practices, reimbursement procedures for assessment and diagnostic practices, and DSM-5 eligibility under IDEA. In addition, the authors provide a brief discussion regarding general concerns about the DSM-5, such as issues related to the overall conceptualization and structure of this diagnostic system.
The volume also includes six types of commentary interspersed throughout the chapters that address important issues related to DSM-5 diagnostic practices. These include “Coding Notes” related to the classification use of the DSM-5 diagnostic system; “Application Notes” intended to clarify formal conventions of DSM-5 and also common practices in professional communications, such as medical reports; “Professional Notes” which identify best-practice recommendations for diagnostic determinations; “IDEA Notes” related to potential associations between DSM-5 diagnoses and classifications of eligibility for special education services under IDEA; “DSM-IV-TR Notes” that summarize the changes to each set of diagnostic criteria from Diagnostic and Statistical Manual of Mental Disorders (4th ed., text rev.; DSM-IV-TR; APA, 2000) to DSM-5; and “Author Commentary” which presents the authors’ personal opinions about issues of interest and concern relevant to DSM-5 diagnostic practices.
Critique
DSM-5 Diagnosis in the Schools serves as an excellent resource for professionals working with children and adolescents in educational settings and covers many fundamental aspects that need to be considered in assessment and diagnostic practices. From a developmental perspective, the authors highlight important considerations and differences based on clinical experience and empirical research for assessing youth in comparison with adult populations related to presenting symptoms, developmental trends, risk factors and associated features, as well as the stability of psychiatric disorders in youth. Furthermore, the authors offer examples from their own clinical experiences in discussing common presenting problems or describing how particular psychiatric diagnoses have typically manifested in patients they have worked with.
One shortcoming with the book is the minimal presentation of current empirical support and discussion of the presented psychiatric conditions. With the majority of the research included in the text being from the late 1990s, the references cited in this book could be updated. In addition, while the authors advocate for the use of self-report instruments and behavior rating scales as assessment measures for particular diagnoses, specific examples or a reference list of the most diagnostically important measures would have been helpful.
Despite these limitations, this book provides a concise yet comprehensive and user-friendly resource to the complexity of the DSM-5. The specific focus on important child and adolescent concerns and applications in the school settings will be particularly useful to school psychologists, as well as professionals and graduate students in the field of child and adolescent clinical or counseling psychology. Overall, this book thoroughly integrates the diagnostic technicalities of DSM-5 with relevant practice in school settings, and will allow practitioners to further their conceptual understanding of assessing and evaluating DSM-5 diagnoses.