Treatment Planning Strategies

Diagnostic Considerations Certainly, the main source of information for the proper diagnosis of DMDD is the explicit diagnostic criteria and decision rules in the DSM-5. To document these diagnostic criteria, counselors might consider using one or more of the cross-cutting measures included in Section III of the DSM-5. Outside the DSM-5, there are currently few diagnostic tools for counselors to use in confirming a diagnosis of DMDD. The assessment tools most often used in the research literature measure general irritability, such as the Affective Reactivity Index (Stringaris et al., 2012) or the Clinician Affective Reactivity Index. Specific to the diagnosis of DMDD, Wiggins et al. developed a DMDD module that was used in conjunction with the Kiddie Schedule for Affective Disorders and Schizophrenia for School-Age Children–Present and Lifetime Version. However, this is a new module that has not undergone extensive psychometric evaluation.

In addition to confirming a diagnosis of DMDD, counselors should also assess for common comorbid mental disorders (Mayes et al., 2016). Youth who meet the diagnostic criteria for DMDD almost always have comorbid disorders, most often attention-deficit/hyperactivity disorder (ADHD), conduct disorder, and specific learning disorders. Though one cannot technically diagnose DMDD and ODD concurrently under DSM-5 rules, counselors should also carefully assess and document symptoms of ODD, which will likely be appropriate targets in the treatment planning process

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