DSM-S is also used as a reference for the courts and attorneys in assessing the forensic con- sequences of mental disorders. As a result, it is important to note that the definition of mental disorder included in DSM-S was developed to meet the needs of clinicians, public health professionals, and research investigators rather than all of the technical needs of the courts and legal professionals. It is also important to note that DSM-S does not provide treatment guidelines for any given disorder.
When used appropriately, diagnoses and diagnostic information can assist legal deci- sion makers in their determinations. For example, when the presence of a mental disorder is the predicate for a subsequent legal determination (e.g., involuntary civil commitment), the use of an established system of diagnosis enhances the value and reliability of the de- termination. By providing a compendium based on a review of the pertinent clinical and research literature, DSM-S may facilitate legal decision makers’ understanding of the rel- evant characteristics of mental disorders. The literature related to diagnoses also serves as a check on ungrounded speculation about mental disorders and about the functioning of a particular individual. Finally, diagnostic information about longitudinal course may im- prove decision making when the legal issue concerns an individual’s mental functioning at a past or future point in time.
However, the use of DSM—S should be informed by an awareness of the risks and lim- itations of its use in forensic settings. When DSM-5 categories, criteria, and textual descrip- tions are employed for forensic purposes, there is a risk that diagnostic information will be misused or misunderstood. These dangers arise because of the imperfect fit between the questions of ultimate concern to the law and the information contained in a clinical diagno- sis. In most situations, the clinical diagnosis of a DSM-5 mental disorder such as intellec- tual disability (intellectual developmental disorder), schizophrenia, major neurocognitive disorder, gambling disorder, or pedophilic disorder does not imply that an individual with such a condition meets legal criteria for the presence of a mental disorder or a speci- fied legal standard (e.g., for competence, criminal responsibility, or disability). For the latter, additional information is usually required beyond that contained in the DSM-5 diagnosis, which might include information about the individual’s functional impairments and how these impairments affect the particular abilities in question. It is precisely because impair- ments, abilities, and disabilities vary widely within each diagnostic category that assign- ment of a particular diagnosis does not imply a specific level of impairment or disability.
Use of DSM—S to assess for the presence of a mental disorder by nonclinical, nonmed— ical, or otherwise insufficiently trained individuals is not advised. Nonclinical decision tions regarding the etiology or causes of the individual’s mental disorder or the individ- ual’s degree of control over behaviors that may be associated with the disorder. Even when diminished control over one’s behavior is a feature of the disorder, having the diag- nosis in itself does not demonstrate that a particular individual is (or was) unable to con- trol his or her behavior at a particular time.
Neurodevelopmental Disorders ................................. 31
Schizophrenia Spectrum and Other Psychotic Disorders ............ 87
Bipolar and Related Disorders ................................. 1 23
Depressive Disorders ........................................ 155
Anxiety Disorders ........................................... 189
Obsessive-Compulsive and Related Disorders .................... 235
Trauma- and Stressor-Related Disorders ........................ 265
Dissociative Disorders ....................................... 291
Somatic Symptom and Related Disorders ....................... 309
Feeding and Eating Disorders ................................. 329
Elimination Disorders ........................................ 355
Sleep-Wake Disorders ....................................... 361
Sexual Dysfunctions ......................................... 423
Gender Dysphoria ........................................... 451
Disruptive, Impulse-Control, and Conduct Disorders ............... 461