Substance-Related and Addictive Disorders

An important departure from past diagnostic manuals is that in DSM-5, the substance-related and addictive disorders chapter has been expanded to include gambling disorder. This reflects the increasing and consistent evidence that some behaviors, such as gambling, also activate the same reward system with effects similar to those of drugs of abuse.

DSM-5 does not include the diagnoses of substance abuse and dependence as utilized in DSM-IV. Rather, criteria are provided for substance use disorder, accompanied by criteria for intoxication, withdrawal, substance induced-disorders, and unspecified substance-related disorders, where relevant.

These questions are from DSM-5 Self-Exam Questions: Test Questions for the Diagnostic Criteria, which may be preordered at http://www.appi.org/SearchCenter/Pages/SearchDetail.aspx?ItemId=62467 from American Psychiatric Publishing. The answers are posted at http://www.psychnews.org/pdfs/DSM-5_Self_Examination_QandA_3.pdf. The questions were developed under the leadership of Philip Muskin, M.D., a professor of clinical psychiatry at Columbia University College of Physicians and Surgeons. The book, available in August, contains 500 questions for all the categories of psychiatric disorders and includes Section III.

1. Which one of these is not a recognized alcohol-related disorder in DSM-5?

a) Alcohol dependence b) Alcohol use disorder c) Alcohol intoxication d) Alcohol withdrawal e) Alcohol-induced sexual disorder

2. The criteria for hallucinogen use disorder are the same as for other substance use disorders, with one exception. Which of the following is not a recognized symptom or consequenceof hallucinogen use?

a) Withdrawal b) Tolerance c) Desire or efforts to cut down or stop use d) Use in situations in which it is physically hazardous e) Craving or a strong desire or urge to use the drug

3. Which of the following is the only non-substance-related addictive disorder to be included in the DSM-5 chapter on addictive disorders?

a) Gambling disorder b) Internet gaming disorder c) Electronic communication addiction disorder d) Compulsive computer gaming e) Compulsive shopping

4. All of the substances listed in DSM-5 are associated with a substance use disorder with the exception of one class. Which substance or class of substances is not associated with a substance use disorder diagnosis in the “Substance Related and Addictive Disorders” section of DSM-5?

a) Caffeine b) Hallucinogens c) Inhalants d) Stimulants e) Tobacco ■