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VCU Researchers Assess Proposed Changes to Diagnostic Manual of Mental Disorders

The proposed changes to the diagnostic criteria for alcohol use problems may not result in significant changes in how alcohol use problems are diagnosed.

However, it remains unclear if these changes represent an improvement in the understanding of the disorder, or just a shift, according to Virginia Commonwealth University researchers.

The upcoming fifth edition of “Diagnostic and Statistical Manual of Mental Disorders” includes proposed changes that affect the criteria used to assess alcohol problems. The manual, which is published by the American Psychiatric Association, has helped standardize criteria and classification of mental disorders.

In a study, published online this month in Alcoholism: Clinical & Experimental Research, VCU researchers evaluated whether the proposed changes to the diagnostic criteria for alcohol use problems would result in a more accurate diagnosis. Using a twin sample, the team was able to determine whether there was consistency in the genetic component of risk for alcohol problems between the current and proposed criteria.  

Their findings were equivocal – while the changes are unlikely to result in a less accurate diagnosis, they also do not represent a clear improvement above the current diagnostic criteria. The results indicate that from both a phenotypic and a genetic perspective things are consistent between the current and proposed criteria. This means that data collected under the current diagnostic criteria should still be considered informative.  

“We found that, for the most part, the proposed criteria do a good job of capturing this aspect of risk, though there are some subtle changes,” said contributing author Alexis Edwards, Ph.D., assistant professor in the Department of Psychiatry in the VCU School of Medicine, and the Virginia Institute for Psychiatric and Behavioral Genetics at VCU.

“Our confirmation that a risk for alcohol use problems has a biological component is also important, under both the current and proposed criteria, because it should raise awareness of the fact that a family history of such problems puts you at higher risk,” she said.  

According to Edwards, the findings also suggest that the gene identification successes observed in the field of alcohol research should largely hold up under the proposed criteria; however, under the proposed criteria, researchers might start to see some “new” genetic influences that they were not picking up on before.

She added that current and prospective patients may benefit from these findings because the new criteria might make it easier to recognize whether they have a problem and then they may be directed to seek help if necessary.

Edwards collaborated with Kenneth Kendler, M.D., professor of psychiatry, and human and molecular genetics, and director of the Virginia Institute for Psychiatric and Behavioral Genetics; and Nathan A. Gillespie, Ph.D., assistant professor, and Steven H. Aggen, Ph.D., research associate, both with the Department of Psychiatry and the Virginia Institute for Psychiatric and Behavioral Genetics.

This study was supported in part by the National Institute on Alcohol Abuse and Alcoholism and the National Institute on Drug Abuse, grant numbers AA019849, DA023549, AA017828 and AA011408.

Editor’s Note: A full copy of the manuscript may be obtained by contacting Mary Newcomb with the ACER Editorial Office at 317.375.0819 or acerjournal@earthlink.net, or Carlton Erickson, Ph.D., at The University of Texas at Austin at 512.471.5198 or carl.erickson@austin.utexas.edu.

Sathya Achia Abraham
University Public Affairs
(804) 827-0890

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