DSM 5 Flashcards
Neurodevelopmental Disorders
Includes: Intellectual Disabilities, Communication Disorders, ASD, ADHD, SLD, Motor Disorders, Tic Disorders, Other Neurodevelopmental Disorders
Schizophrenia Spectrum and Other Psychotic Disorders
Includes: Schizotypal Personality Disorder, Delusional Disorder, Brief Psychotic Disorder, Schizophreniform Disorder, Schizophrenia, Schizoaffective Disorder, Substance/Medication-Induced Psychotic Disorder, Catatonia
Delusional Disorder
- enduring delusions, may be accompanied by non-promiment hallucinations
- functioning not significantly affected
- behavior generally not odd or peculiar
- delusions can be: erotomania, grandiose, persecutory, jealous, somatic, mixed, or unspecified
Brief Psychotic Disorder
- hallucinations, dellusions, disorganized or incoherent speech, or grossly disorganized or catatonic behavior
- duration: between 1 day and 1 month
Schizophreniform Disorder
- hallucinations, dellusions, disorganized or incoherent speech, or grossly disorganized or catatonic behavior, or negative symptoms (reduced emotional expressiveness or avolition)
- duration: between 1-6 months
Schizophrenia
- At least two symptoms: hallucinations, dellusions, disorganized or incoherent speech, grossly disorganized or catatonic behavior, negative symptoms (reduced emotional expressiveness or avolition)
- significant negative impact on occupational, academic, interpersonal, or self-care functioning
- duration: at least 6 months
Schizoaffective Disorder
-continuous period where major symptoms of schizophrenia are present AND for the majority of the duration of the condition major mood (depressive or manic) episodes are present
Substance/Medication-Induced Psychotic Disorder
symptoms of psychotic disorder during or soon after exposure to a substance/medication or withdrawal from
Catatnonia
Presence of 3 or more: stupor, catalepsy, waxy flexibility, mutism, negativism, posturing, mannerism, stereotypy, agitation, grimacing, echolalia, echopraxia
Bipolar and Related Disorders
Includes:
- Bipolar I Disorder
- Bipolar II Disorder
- Cyclothymic Disorder
Bipolar I Disorder
Characterized by the following episodes:
- Manic episode- lasting at least a week
- Hypomanic episode - lasting 4 consecutive days
- Major depressive episode
Manic episode
- lasting at least a week
- 3 or more: grandiosity, insomnia, garrulousness, incoherent disconnected rapid successions of thought, difficulty paying attention/focusing, agitation, restlessness, increase in goal-directed activity, excessive engagement in unrestrained behaviors with high likelihood of negative outcomes (ex: compulsive shopping, gambling, high-risk business ventures).
Major depressive episode
- sustained during a 2 week period
- 5 or more: persistent negative mood, diminished satisfaction or pleasure from engaging in nearly all activities, significant weight loss, chronic insomnia or hypersomnia, agitation, fatigue, feelings of worthlessness, difficulty concentrating and focusing, suicidal ideation
Bipolar II Disorder
includes hypomanic episode and major depressive episode; no manic episode
Cyclothymic Disorder
- symptoms of hypomania and depression have appeared numerous times, but correct criteria for episodes have not been met
- duration: at least 2 years
- hypomanic and depressive intervals have occurred at least half the time and patient not symptom-free for more than 2 months at a time
Depressive Disorders
Includes:
- Disruptive Mood Dysregulation Disorder
- Major Depressive Disorder
- Persistent Depressive Disorder (previously Dysthymia)
Disruptive Mood Dysregulation Disorder
- frequent outbursts of temper (avg is 3+ times weekly)
- chronic mood of irritability and anger
- duration at least 1 year with no more than a 3-month period without outbursts
- diagnosed between ages 6-18
Major Depressive Disorder
-characterized by symptoms of major depressive episode
Persistent Depressive Disorder (previously Dysthymia)
- amalgamation of symptoms of chronic major depressive disorder and dysthymic disorder
- chronic depressed mood
- while depressed at least 2 conditions present: lac of appetite or overeating, insomnia or hypersomnia, fatigue, low self-esteem, difficulty concentrating and indecisiveness, hopelessness
- duration: at least 2 years
Premenstrual Dysphoric Disorder
Must meet 3 conditions:
- symptoms present during majority of menstrual cycles, at least 5 of symptoms must manifest during final week BEFORE onset of period, improvement noticeable within a few days after beginning period, symptoms minimal or gone week after period
- 1+ symptoms: severe mood swings and emotional sensitivity, irritability and interpersonal friction, significantly depressed mood, considerable anxiety ad emotional agitation
- 1+ symptom for cumulative total of 5 (from above): decreased interest in daily activities, difficulty with focus and concentration, significant lethargy, marked changes in eating habits (overeating or fixating on certain foods), insomnia or hypersomnia, feelins of being overwhelmed, noticeable physical changes such as bloating, weight gain, swelling of joints, or muscle pain
Obsessive-Compulsive and Related Disorders
Includes:
- Obsessive-Compulsive Disorder
- Body Dysmorphic Disorder
- Hoarding Disorder
- Trichotillomania (hair pulling) Disorder
- Excoriation (skin picking) Disorder
- Substance/Medication-Induced Obsessive-Compulsive and Related Disorder
Obsessive-Compulsive Disorder
- presence of obsessions (unwanted, intrusive thoughts or images that are experienced repeatedly and bring about distress; person tries to alleviate with other thoughts and actions) and/or compulsions (repetitive, ritualized actions that the individual feels compelled to perform in order to alleviate distress from obsessions
- obsessions and/or compulsions last at least 1 hour per day
Body Dysmorphic Disorder
- inordinate attention to at least one perceived flaw in physical appearance that is unnoticeable or appears slight to observers
- engaging in repetitive behaviors as a means of obtaining reassurance about appearance concerns
Hoarding Disorder
- Chronic difficulty in getting rid of possessions regardless of value
- distress when without items
- habit so excessive and hard to maintain habitable living areas
Trichotillomania
- repetitive hair pulling; results in hair loss
- unsuccessful repeated attempts to stop behavior
Excoriation Disorder
- repetitive skin picking resulting in skin lesions
- unsuccessful repeated attempts to stop behavior
Substance/Medication-Induced Obsessive-Compulsive and Related Disorder
- symptoms of OCD transpire concurrently with or following substance intoxication, withdrawal, or exposure to med
- substance/medication capable of bringing about severe anxiety
Anxiety Disorders
Last at least 6 months, involve disproportionate fear response, involve maladaptive behaviors by individual to avoid anxiety-provoking situation Includes: -Separation Anxiety Disorder -Selective Mutism -Specific Phobia -Social Anxiety Disorder -Panic Disorder -Agoraphobia -Generalized Anxiety Disorder -Substance/Medication-Induced Anxiety Disorder
Separation Anxiety Disorder
- anxiety from separation
- 3 or more conditions: repeated anxiety when anticipating/experiencing separation from home/others, incessant rumination over prospect of harm toward significant attachments, chronic refusal or unwillingness to venture way from home, chronic and significant anxiety about being left alone/separated from attachment figures, refusal/unwillingness to sleep away from home, recurring nightmares about separation, recurring physical problems (headaches, nausea, GI distress) when anticipating separation
Selective Mutism
- lasts at least 1 month
- reticence when speaking expected
- affects social, educational, vocational aspects of life
Social Anxiety Disorder
- inordinate fear of situations where individual may be subject to evaluation by others (ex: meetings, conversations with unfamiliar people, being observed, giving speeches/presentations)
- fear of rejection, embarrassment, ridicule, being offended
- avoidance of social situations
Panic Disorder
- repeated panic attacks and at least 4 symptoms: rapid heartbeat, sweating, shaking, shortness of breath, choking sensation, chest pain/discomfort, nausea or GI distress, vertigo or sensation of loss of balance or feeling faint and lightheaded, sensations of heat or cold, paresthesias, derealization, fear of losing emotional control, fear of dying
- at least 1 panic attach followed by one month of 1 or both of following: chronic worry about panic attacks or a marked effort to engage in behaviors to avoid panic attacks
Agoraphobia
- includes significant anxiety about 2 of following: using public transportation, being in open spaces, being in enclosed spaces, being in a crowd, being alone outside one’s home
- scenarios avoided due to fear of being trapped or experiencing panic attacks
- fear responses typically last 6+ months
Generalized Anxiety Disorder
- inordinate worry about a variety of scenarios
- occurs more days than not and lasting at least 6 months
- at least 3 symptoms present (with at least one lasting 6+ months): agitation, loss of energy, difficulty focusing, irritability, muscular tension, difficulty sleeping
Substance/Medication-Induced Anxiety
- panic attacks that transpire concurrently with or following substance intoxication, withdrawal, exposure to med
- substance under consideration capable of bringing about severe anxiety
Trauma and Stressor-Related Disorders
Includes:
- Reactive Attachment Disorder
- Disinhibited Social Engagement Disorder
- PTSD
Reactive Attachment Disorder
- chronic pattern of emotionally withdrawn behavior with adult caretakers
- diagnosed between 9 months and 5 years
- presence of both: child rarely seeks comfort when distressed, child minimally responsive to comfort when distressed
- at least 2 of following: minimal social responsiveness, minimal positive affect, periods of inexplicable irritability, fear, or sadness during periods of nonthreatening interaction with adult caretakers
- child has received insufficient care due to severe neglect due to lack of emotional care by adult caretakers, instability of frequent changes of caretakers, being raised in settings that limit attachments to adult caretakers
Disinhibited Social Engagement Disorder
- manifested by child’s pattern of seeking out and interacting with unfamiliar adults
- 2 of following must be present: lack of reticence when interacting with unfamiliar adults, overly familiar physical or verbal behavior with unfamiliar adults, little regard for reconnecting with adult caretakers even in unfamiliar environments, unhesitatingly accompanying unfamiliar adults
PTSD
- diagnosis 6 months after traumatic event
- duration at least 1 month - resulting from experiencing actual or threatened death, serious injury, or sexual violence
- includes at least one of the following: directly experiencing or witnessing a traumatic event
- becoming aware of close friends or family members suffering a traumatic event
- repeated exposure to aversive aspects of traumatic events
- at least one intrusion symptom, one avoidance symptom, and 2 symptoms of negative mood, 2 arousal symptoms
- can include dissociative symptoms
intrusion symptoms
- symptoms of PTSD
- include: recurring distressing memories of event, frequent nightmares about event, flashbacks that can include dissociative reactions as if re-living event, intense reactive distress when in presence of cues/reminders about event
- severe physiological reactions upon exposure to cues resembling aspects of the event
avoidance symptoms
- symptoms of PTSD
- chronic avoidance behaviors
- include: attempts to avoid distressing thoughts, feelings, or memories reminiscent of traumatic event; avoidance of external stimuli that may serve as reminders of the traumatic event
negative mood
- symptom of PTSD
- negative transformation of mood or thought related to traumatic event
- includes: dissociative amnesia, chronic and exceedingly negative attitudes and expectations about oneself, others or surroundings, self-blame, chronic negative affect, loss of interest in significant activities, alienation from others, chronic inability to experience positive affect
arousal symptoms
- symptom of PTSD
- significant changes in sensitivity to traumatic events starting or worsening after event
- includes 2 of following: unprovoked irritability and temper tantrums, irresponsible self-destructive activities, hypervigilance, heightened startle reaction, difficulty in focusing and concentrating, disrupted sleep patterns
Acute Stress Disorder
- diagnosed 3 days to 1 month after trauma
- need at least 9 symptoms similar to PTSD
Adjustment Disorder
-appearance of emotional or behavioral symptoms as reaction to definitive stress-inducing events
-symptoms appear within 3 months of event
include one or both: severe distress that is disproportionate to intensity of event, significant deterioration in key areas of functioning
-symptoms endure for no more than 6 months
Dissociative Disorders
- disruption in integration of consciousness as it relates to memory, identity, and perception of environment.
- can be gradual, transient, or chronic
- Includes: dissociative identity disorder, dissociative amnesia, depersonalization/derealization
Dissociative Identity Disorder
-include 2 or more distinct personality states or identities that recurrently assume control of individual’s behavior, accompanied with inability to recall important personal info that is too extensive to be accounted for by forgetfulness
Dissociative Amnesia
-inability to recall important personal info, usually of a traumatic or stressful nature, cannot be explained with ordinary forgetfulness
Depersonalization/Derealization
-persistent and recurring feeling of being estranged from oneself, of being a spectator of one’s own life, and of being detached from one’s mental processes or body that is accompanied by intact reality testing (ex: indiv. aware that it is only a feeling of self-alienation and not reality)
Somatic Symptoms and Related Disorders
- category includes disorders characterized by presence of observable physical symptoms that are indicative of a general medical condition yet are not explained as such, direct effects of a substance, or another mental disorder.
- can cause clinically significant distress/impairment in social, vocational, or other areas of functioning
- unintentional symptoms
- includes: Illness Anxiety Disorder, Conversion Disorder, Factitious Disorders
Illness Anxiety Disorder
-fear of having or idea that one is afflicted with a serious disease based on individual misinterpretation of bodily symptoms or functions
Conversion Disorder
(AKA Functional Neurological Symptoms Disorder)
-unexplained symptoms or deficits affecting voluntary motor or sensory functions that suggest a neurological or other general medical condition
Factitious Disorders
-physical or psychological symptoms that are intentionally produced or feigned in order to pretend to be ill.
Feeding and Eating Disorders
-presence of persistent feeding and eating disturbances: pica, rumination disorder, and feeding disorders of infancy or early childhood, avoidant/restrictive food intake disorder, anorexia nervosa, bulimia nervosa, binge-eating disorder
Rumination Disorder
-repeated regurgitation of food for at least 1 month
Avoidant/Restrictive Food Intake Disorder
- chronic avoidance of or lack of interest in eating (due to sensory attributes of food) leading to significant weight loss or nutritional deficiency
- can lead to enteral feeding
Anorexia Nervosa
-individual’s refusal to maintain a minimally normal body weight, intense fear of gaining weight, significantly distorted perception of body size and shape
Bulimia Nervosa
- binge-eating and inappropriate ways to prevent weight gain (ex: vomiting, misuse of laxatives/diuretics)
- self-evaluation excessively influenced by body shape and size
Binge-eating Disorder
- periods of binge eating averaging once a week for at least 3 months
- binges include a rapid consumption of abnormally large quantities of food while apparently unable to control this behavior
Elimination Disorders
Includes: encopresis and enuresis
Encopresis
defecation in inappropriate places or occasions
Enuresis
urination in inappropriate places or occasions
Sleep-Wake Disorders
Includes: -Primary Sleep Disorders -Insomnia Disorder -Hypersomnolence Disorder Narcolepsy -Breathing Related Disorders -Parasomnias -Nightmare Disorder -Rapid Eye Movement (REM) Sleep Behavior Disorder -Restless Leg Syndrome -Substance/Medication-Induced Sleep Disorder
Primary Sleep Disorders
-sleep disorders where mental disorder, medical condition, or substance has been ruled out
Insomnia Disorder
- inability to fall or stay asleep at least 3 nights a week
- duration: lasting at least 3 months
Hypersomnolence Disorder
- excessive sleep of 9+ hours that is unsatisfying with episodes of lapsing into sleep during the day and difficulty staying awake after awakening fully - at least 3 times per week
- duration: lasting at least 3 months
Narcolepsy
episodes of irresistible need to sleep during the day occurring at least 3 times per week
- duration: at least 3 months
- includes one of following: episodes of cataplexy, hypocretin deficiency, REM latency during sleep
Breathing-Related Sleep Disorders
-includes: sleep apnea hypopnea, central sleep apnea, sleep-related hyperventilation, and circadian rhythm sleep-wake disorder
Parasomnias
abnormal behavioral or physiological events occurring in association with sleep
-includes: nightmares, sleep terror, sleepwalking
Non-Rapid Eye Movement Sleep Arousal Disorders
- periods of inability to become fully awake
- includes one of the following: sleepwalking, sleep terror
Nightmare Disorder
repeated instances of enduring extremely threatening dreams that are accurately recalled, accompanied by the ability of the individual to wake up completely
Rapid-Eye Movement (REM) Sleep Behavior Disorder
- repeated instances of sudden awakening accompanied by vocalizations and/or complex movements during REM stages
- individual has no problem waking up and being alert
Restless Legs Syndrome
- seemingly irresistible need to shift position of the legs due to discomfort when remaining still.
- occurs mostly at night, at least 3 times per week
- duration: at least 3 months
Substance/Medication-Induced Sleep Disorder
- significant interruption to sleep upon exposure to medication/substance, shortly thereafter, or withdrawal
- suspected med/substance can produce significant disruptions to sleep
Sexual Dysfunctions
-includes: delayed ejaculation, erectile disorder, female orgasmic disorder, female sexual interest/arousal disorder, genito-pelvic pain/penetration disorder, male hypoactive sexual desire disorder, premature ejaculation, substance/medication-induced sexual dysfunction
Delayed Ejaculation
- significant undesired delay in ejaculation
- duration: at least 6 months
Erectile Disorder
persistent, recurrent inability to attain or maintain erection
Female Orgasmic Disorder
- persistent or recurrent delay or absence of female orgasm
- diagnosis made considering age, sexual experience, general health, and degree of sexual stimulation
Female Sexual Interest/Arousal Disorder
- greatly diminished or absent sexual interest or arousal with both mental and physical stimulation
- duration: at least 6 months
Genito-Pelvic Pain/Penetration Disorder
- genital pain experienced during sex; pain can be present before and after intercourse
- duration: at least 6 months
Male Hypoactive Sexual Desire Disorder
- chronic lack of interest or desire in sexual stimulation or activity
- duration: at least 6 months
Premature Ejaculation
- repeated instances of ejaculation occurring about one minute after penetration in all instances of sexual activity
- duration: at least 6 months
Substance/Medication-Induced Sexual Dysfunction
- severe disruption in sexual functioning after exposure to med/substance, shortly thereafter, and during withdrawal from
- suspected med has ability to produce sexual dysfunction
Gender Dysphoria
-strong, persistent cross-gender identification along with persistent discomfort with one’s sex
Disruptive, Impulse-Control, and Conduct Disorders
- failure to resist an impulse or drive or temptation to perform an act that is harmful to self or others
- frequent tension or arousal before committing act
- frequent relief, pleasure, gratification after completing act
- ensuing feelings of guilt, regret, or self-recrimination may or may not be present
- includes: ODD, Intermittent Explosive Mood Disorder, Conduct Disorder, Pyromania, Kleptomania
Oppositional Defiant Disorder
- repeated displays of angry, irritable moods and argumentative, defiant, vindictive behaviors toward at least one person that is not a sibling
- duration: at least 6 months
Intermittent Explosive Disorder
- discrete episodes of failure to restrain aggressive impulses, resulting in serious assaults or destruction of property
- degree of aggressiveness is grossly disproportionate to the objective physical or psychological provocation
Conduct Disorder
- repeated instances of activity within a 1 year period
- duration: at least 6 months
- aggression toward people, animals, destruction of property, deceitfulness or theft, and/or serious transgression of rules
Pyromania
- ignition of fires for pleasure, gratification, and relief of tension
- fascination with and curiosity about contexts with fire, witnessing effects, and aftermath
Kleptomania
-repeated failure to resist impulses to steal objects unneeded for personal or monetary value.
Gambling Disorder
-persistent and recurrent maladaptive gambling behavior that disrupts personal, family, or vocational pursuits.
Neurocognitive Disorders
Includes:
- Delirium
- Major Neurocognitive Disorder
- Dementia
- Mild Neurocognitive Disorder
Delirium
- disturbance of consciousness and alteration in cognition that develops over a short interval
- can be due to general medical condition, substance-induced delirium, and delirium due to multiple etiologies
Major Neurocognitive Disorder
- serious cognitive impairments in at least one of following: complex attention, executive function, learning and memory, language, perceptual-motor, or social cognition
- can be due to Alzheimer’s, frontotemporal lobar degeneration, Lewy body disease, vascular disease, TBI, substance/medication use, HIV, prion disease, Parkinson’s, Huntington’s, etc.
Dementia
multiple cognitive deficits and a more narrow diagnosis
Mild Neurocognitive Disorder
-moderate decrease in cognitive functioning that does not disrupt daily activities
Personality Disorders
Includes: -General Personality Disorder -Paranoid Personality Disorder -Schizoid Personality Disorder -Schizotypal Personality Disorder -Antisocial Personality Disorder -Borderline Personality Disorder -Histrionic Personality Disorder -Narcissistic Personality Disorder -Avoidant Personality Disorder -Dependent Personality Disorder -Obsessive-Compulsive Personality Disorder Personality Change Due to Another Medical Condition
General Personality Disorder
- enduring patterns of behavior that are unexpected in individual culture, pervasive and inflexible,
- originates in adolescence and early adulthood
- leads to clinically significant distress or impairment in one or more areas of functioning (ex: social, academic, occupational)
Paranoid Personality Disorder
- pattern of pervasive distrust and suspiciousness of others, motives interpreted as malevolent
- events and actions of others interpreted in most negative way and convictions of others’ hostility based on little or no objective evidence
Schizoid Personality Disorder
- pattern of pervasive detachment from social relationships and restricted range of emotions in social settings
- avoidance of social interaction and prefers solitary activities/interests
- little or no pleasure derived from sensory, bodily, or interpersonal relationships
- flat and expressionless affect
- preference for abstract intellectual interests (mechanical, mathematical, or computer-related pursuits)
Schizotypal Personality Disorder
- repeated instances of lacking adequate social or interpersonal skills along with an acute uneasiness with and diminished ability to maintain close friendships
- manifests in early adulthood
- perceptual distortions and odd thinking, beliefs, and behavior
Antisocial Personality Disorder
- pervasive pattern of disregard for, and violation of, the rights of others that begins in childhood or early adolescence and continues into adulthood
- deceit, manipulation, and exploitation
- sometimes pattern of impulsivity
Borderline Personality Disorder
- pervasive pattern of instability in personal relationships, of self-image and affects
- marked impulsivity with an onset in early adulthood and present in a variety of contexts
- intense concern with abandonment with perception of impending loss, rejection, separation, abandonment, or loss of external stability and structure can lead to profound alterations in self-image, affect, cognition, and behavior
Histrionic Personality Disorder
- pervasive pattern of excessive emotionality and attention-seeking behavior
- originates in early adulthood
- individual feels uncomfortable and unappreciated if not the center of attention
- very melodramatic, histrionic, and flirtatious
Narcissistic Personality Disorder
- pervasive pattern of grandiosity, need for admiration, lack of empathy
- originating in early adulthood and manifesting in diff contexts
- exaggerated sense of self-importance, displaying a conceited, boastful demeanor while overestimating abilities and accomplishments
Avoidant Personality Disorder
- inordinant preoccupation with being disapproved of, socially rejected, or criticized.
- chronic feelings of inadequacy and hypersensitive to possible negative evaluations of others
- avoidant of interpersonal or social involvement due to fear of being exposed, ridiculed, or embarassed
- constant need for reassurance and certainty for acceptance
Dependent Personality Disorder
- inordinate and chronic need to be taken care of, which leads to submissive clinging behavior and fear of separation, abandonment, and rejection
- self-perception of being unable to function without the help of others
- indecisive about everyday matters
- requires a lot of advice and reassurance due to extremely passive manner
Obsessive-Compulsive Personality Disorder
- pervasive preoccupation with orderliness, perfectionism, and control
- manifests in early adulthood
- maintains painstaking attention to rules
- perfectionism interferes with ability to complete tasks
- overly devoted to work
- overconscientious about matters of morality
- unable to throw objects away, reluctant to delegate tasks, miserly, and inflexible
Personality Change Due to Another Medical Condition
- presence of persistent personality disturbance attributed to direct physiological effects of a general medical condition
- must be significant change from individual’s previous characteristic personality pattern
Paraphillic Disorders
conditions lasting at least 6 months, including:
- Voyeuristic Disorder
- Exhibitionist Disorder
- Frotteuristic Disorder
- Sexual Masochism Disorder
- Sexual Sadism Disorder
- Pedophillic Disorder
- Fetishistic Disorder
- Transvestic Disorder
Voyeuristic Disorder
-secretly watching others without their knowledge while they are changing/naked/engaged in sexual activity
Exhibitionistic Disorder
-deriving sexual pleasure from exposing one’s genitals to a stranger
Frotteuristic Disorder
-repeated instances of sexual arousal by rubbing up against strangers or touching nonconsenting people
Sexual Masochism Disorder
-involves acts where sexual excitement is derived from being humiliated, beaten, bound, or otherwise made to suffer
Sexual Sadism Disorder
-involves acts where sexual excitement is derived from the physical or psychological (including humiliation) suffering of victims
Pedophillic Disorder
- involves sexual activity with a prepubescent child (younger than 13)
- typically pedophile is at least 16 years and 5 years older than child
- sexual maturity of child and age difference are taken into consideration
Fetishistic Disorder
-involves utilization of non-living objects for purposes of deriving sexual pleasure or excitement
Transvestic Disorder
- cross-dressing for the purpose of deriving sexual pleasure or excitement
- only for heterosexual males and no indicated when part of a gender identity disorder
