TPC-Journal-V4-Issue3

The Professional Counselor \Volume 4, Issue 3 219 measures). In addition, some measures do not adequately parallel the DSM-5 diagnoses that one might expect. The following sections include detailed comparisons of emerging measures and their corresponding DSM-5 diagnoses. The overall purpose of this manuscript is to identify the measures’ level of congruency with DSM- 5 criteria. Thus, counselors need to be aware that certain measures may provide different information about a disorder, and therefore, counselors should make informed choices regarding whether to follow the DSM-5’s criteria. The DSM-5 criteria are a major source for providing diagnoses; and counselors should be cautious when interpreting measures, particularly when the measures are inconsistent with DSM-5 criteria. Emotional Measures. When comparing the symptoms on the PROMIS Emotional Distress—Depression— Short Form (PROMIS Health Organization [PHO] and PROMIS Cooperative Group, 2012g) for adults to symptoms in the DSM-5 on depressive disorders, the former seems to lack many crucial symptoms for depression (APA, 2013g). Containing eight statements—each asking how often the individual has been bothered by the symptom with a time period of 7 days—the measure lacks clarity as to what depression actually looks like. Common symptoms of depression such as lack of pleasure in activities, lack of appetite, weight loss, sleep loss, fatigue and thoughts of death are not addressed. The APA (2013g) noted that irritability can be a mood shown in children with the diagnoses. The parent and pediatric measures (PHO and PROMIS Cooperative Group, 2012h; 2012i) fail to include the aforementioned mood symptom, nor do they mention thoughts of death. Therefore, the DSM-5 criteria for depression appear to be more inclusive than the PROMIS Short Form criteria. The PROMIS Emotional Distress—Anger—Short Form, the PROMIS Emotional Distress—Calibrated Anger Measure—Pediatric, and the PROMIS Emotional Distress—Calibrated Anger Measure—Parent (PHO and PROMIS Cooperative Group, 2012a, 2012b, 2012c) are comprised of five to six short statements (e.g. “I felt angry”) completed on a 1 ( never ) to 5 ( always ) scale. Anger is included in many diagnoses, but the closest example in the DSM-5 is the chapter titled “Disruptive, Impulse-Control, and Conduct Disorders,” whose disorders can include angry moods (APA, 2013g, p. 461). Although this chapter of the DSM-5 is most likely intended for children and adolescents, all the criteria listed in the DSM-5 for angry/irritable mood from the diagnosis of oppositional defiant disorder (ODD) are included in the PROMIS measures for anger. Furthermore, because anger is present in many diagnoses in DSM-5 , all measures can be helpful in providing information on anger depiction with individuals. The PROMIS Emotional Distress—Anxiety—Short Form (PHO and PROMIS Cooperative Group, 2012d) for adults includes seven items that measure symptoms observed in an individual experiencing anxiety (e.g., “I felt anxious,” “I felt fearful”). The adult measure examines both the feelings of anxiety and fear but, unlike the child measure, omits specific places or situations where fear or anxiety is experienced. The pediatric and parent measures (PHO and PROMIS Cooperative Group, 2012e, 2012f) are more detailed, examining a few situations and places (e.g., home and school) while the adult measure (PHO and PROMIS Cooperative Group, 2012d) examines only feelings associated with anxiety (e.g., fearful, anxious, worried). When comparing anxiety measures to DSM-5 criteria, the measures lack many important criteria, particularly the adult measure which focuses on specific feelings only. Mania is a symptom most often seen in bipolar and related disorders in the DSM-5 (APA, 2013g). The Altman Self-Rating Mania Scale (ASRM; Altman et al., 1997) is utilized for mania depiction. The five clusters focus on happiness, self-confidence, sleep, talk and activeness. When compared to the DSM-5 criteria for mania, the ASRM is lacking in certain areas such as distractibility, racing thoughts and high-risk activity involvement (APA, 2013g). Also, the ASRM does not address the importance of an irregular mood disturbance (i.e. elevated, expansive or irritable) . The measure does not encompass all symptoms needed for mania, whereas the DSM-5 criteria are more expansive.