DSM-5 Changes in Diagnostic Criteria of Sexual Dysfunctions - Article

There were some problems with the validity of the different phases of arousal and the linear model of sexual response in women in the DSM IV. That’s why some gender specific sexual dysfunctions have been added to the DSM V. Female disorders concerning arousal and desire have been merged to female sexual interest/arousal disorder. There are also two more criteria in the DSM V: the symptoms have to be present for at least 6 months and they have to de present 75-100% of the occasions.

Female disorders

Female hypoactive desire dysfunction and female arousal dysfunction have merged into female sexual interest/arousal disorder. This happened because of the high comorbidity between arousal and desire. Dyspareunia and vaginismus are now included in genito-pelvic pain/penetration disorder, because of the similarities between the two. Female orgasm disorder stays the same.

Male disorders

Male hypoactive sexual desire dysfunction has become a separate disorder. Male orgasmic disorder has become delayed ejaculation and male erectile disorder is now called erectile disorder. Premature ejaculation stays the same.

Other disorders

Male dyspareunia, not otherwise specified and sexual dysfunction due to medical condition are left out of the DSM V. Substance- or medication-induced sexual dysfunction stays the same.

Criteria, subtypes and associative traits

The disorder has to cause a significant amount of distress, to get a diagnoses. a new criterion is that a disorder can’t be better explained by a non-sexual disorder, a consequence of severe stress in the relationship or by other significant stressors.

The subtypes are now: lifelong verses acquired, generalized verses situational and severity ranging from mild to moderate to severe. Etiology was left out.

Association traits are now: partners factors, relationship factors, individual vulnerability factors, cultural or religious factors and relevant medical factors.

New criteria for sexual interest/arousal disorder are: initiating sexual activity or response to partner initiating sexual activity, arousal and pleasure, response to sexual cues and sensations during sexual activity. Three of these are needed to get a diagnoses.

For the diagnoses of orgasm disorder, one has to experience a delayed, absent or infrequent orgasm or less intense orgasms.

For the diagnoses of genito-pelvic pain/penetration disorder, one has to experience one of the following: trouble with penetration, pain during penetration or attempt to penetrate, anticipating fear of pain and tense muscles.

The essence of the criteria for men stay the same, except for the fact that a premature ejaculation has to happen within an minute of penetration.

Sexual aversion disorder has been left out of the DSM V, because there was little empirical evidence and this is highly associated with other non-sexual disorders.