A Clinician’s Guide to the DSM-5-TR _ ___________________________________________________________
Proposed Criteria for CUD A problematic pattern of caffeine use leading to clinically significant impairment or distress, as manifested by at least three of the following criteria occurring within a 12-month period [1]: • A persistent desire or unsuccessful efforts to cut down or control caffeine use. • Continued caffeine use despite knowledge of having a persistent or recurrent physical or psychological problem that is likely to have been caused or exacerbated by caffeine. • Withdrawal, as manifested by either of the following: ‒ The characteristic withdrawal syndrome for caffeine ‒ Caffeine (or a closely related substance) is taken to relieve or avoid withdrawal symptoms • Caffeine is often taken in larger amounts or over a longer period than was intended. • Recurrent caffeine use resulting in a failure to fulfill major role obligations at work, school, or home (e.g., repeated tardiness or absences from work or school related to caffeine use or withdrawal). • Continued caffeine use despite having persistent or recurrent social or interpersonal problems caused or exacerbated by the effects of caffeine (e.g., arguments with spouse about consequences of use, medical problems, cost). • Tolerance, as defined by either of the following: ‒ A need for markedly increased amounts of caffeine to achieve the desired effect ‒ Markedly diminished effect with continued use of the same amount of caffeine • A great deal of time is spent on activities necessary to obtain caffeine, use caffeine, or recover from its effects. • Craving or a strong desire or urge to use caffeine. INTERNET GAMING DISORDER Internet gaming disorder (IGD) is a condition included in the Conditions for Further Study section of the DSM-5-TR, indicating that more research is needed before it can be con- sidered an official diagnosis [1]. The DSM-5 defines IGD as “a pattern of excessive and prolonged Internet gaming that results in a cluster of cognitive and behavioral symptoms, including progressive loss of control over gaming, tolerance, and withdrawal symptoms, analogous to the symptoms of substance use disorders” [1]. To meet the criteria for IGD, an individual must experience five or more of nine specified symptoms within a year, such as preoccupation with gaming, withdrawal symptoms when gaming is taken away, and loss of interest in other activities.
‒ Excessive involvement in activities with a high potential for painful consequences (e.g., the individual engages in unrestrained buying sprees, sexual indiscretions, or foolish business investments) • The episode is associated with an unequivocal change in functioning that is uncharacteristic of the individual when not symptomatic. • The disturbance in mood and the change in functioning are observable by others. • The episode is not severe enough to cause marked impairment in social or occupational functioning or to necessitate hospitalization. If there are psychotic features, the episode is, by definition, manic. • The episode is not attributable to the physiological effects of a substance (e.g., a drug of abuse, a medication, or other treatment). CAFFEINE USE DISORDER Caffeine use disorder (CUD) is a condition included in the DSM-5-TR under the Conditions for Further Study section, indicating that more research is needed before it can be consid- ered an official diagnosis. The proposed criteria for CUD are like other substance use disorders but with a more conservative threshold to prevent overdiagnosis, given the prevalence of nonproblematic caffeine use in the general population. For a potential CUD diagnosis, an individual must endorse at least three criteria [1]: • A persistent desire or unsuccessful effort to control caffeine use • Continued use despite harm • Withdrawal symptoms Research suggests that CUD may affect a significant portion of caffeine consumers, with one study finding that 8% of a sample of U.S. adults met the proposed DSM-5 criteria [2]. Individu- als meeting these criteria tend to consume more caffeine, are often younger, and are more likely to be cigarette smokers. They may experience caffeine-related functional impairment, poorer sleep, and greater levels of depression, anxiety, and stress. Symp- toms of CUD can include anxiety, insomnia, and other issues that interfere with daily life. While caffeine is widely consumed and generally considered safe, CUD highlights that, for some individuals, caffeine use can become problematic and may require clinical attention. However, more research is needed to fully understand this condition’s prevalence, severity, and clinical significance before it can be officially recognized as a disorder in future editions of the DSM.
32
EliteLearning.com/Social-Work
Powered by FlippingBook