For further clinical evaluation and research, the APA is offering a number of “emerging measures” in Section III of DSM-5-TR. These patient assessment measures were developed to be administered at the initial patient interview and to monitor treatment progress, thus serving to advance the use of initial symptomatic status and patient reported outcome (PRO) information, as well as the use of “anchored” severity assessment instruments. Instructions, scoring information, and interpretation guidelines are included. Clinicians and researchers may provide APA with further data on the instruments’ usefulness in characterizing patient status and improving patient care.
Level 1 Cross-Cutting Symptom Measures
- DSM-5 Self-Rated Level 1 Cross-Cutting Symptom Measure—Adult (also available in print book)
- DSM-5 Parent/Guardian-Rated Level 1 Cross-Cutting Symptom Measure—Child Age 6–17 (also available in print book)
- DSM-5 Self-Rated Level 1 Cross-Cutting Symptom Measure—Child Age 11–17
Level 2 Cross-Cutting Symptom Measures
For Adults
- Level 2—Depression—Adult (PROMIS Emotional Distress—Depression—Short Form)
- Level 2—Anger—Adult (PROMIS Emotional Distress—Anger—Short Form)
- Level 2—Mania—Adult (Altman Self-Rating Mania Scale [ASRM])
- Level 2—Anxiety—Adult (PROMIS Emotional Distress—Anxiety—Short Form)
- Level 2—Somatic Symptom—Adult (Patient Health Questionnaire 15 Somatic Symptom Severity Scale [PHQ-15])
- Level 2—Sleep Disturbance—Adult (PROMIS—Sleep Disturbance—Short Form)
- Level 2—Repetitive Thoughts and Behaviors—Adult (Adapted from the Florida Obsessive-Compulsive Inventory [FOCI] Severity Scale [Part B])
- Level 2—Substance Use—Adult (Adapted from the NIDA-Modified ASSIST)
For Parents of Children Ages 6–17
- Level 2—Somatic Symptom—Parent/Guardian of Child Age 6–17 (Patient Health Questionnaire 15 Somatic Symptom Severity Scale [PHQ-15])
- Level 2—Sleep Disturbance—Parent/Guardian of Child Age 6–17 (PROMIS—Sleep Disturbance—Short Form)
- Level 2—Inattention—Parent/Guardian of Child Age 6–17 (Swanson, Nolan, and Pelham, version IV [SNAP-IV])
- Level 2—Depression—Parent/Guardian of Child Age 6–17 (PROMIS Emotional Distress—Depression—Parent Item Bank)
- Level 2—Anger—Parent/Guardian of Child Age 6–17 (PROMIS Emotional Distress—Calibrated Anger Measure—Parent)
- Level 2—Irritability—Parent/Guardian of Child Age 6–17 (Affective Reactivity Index [ARI])
- Level 2—Mania—Parent/Guardian of Child Age 6–17 (Adapted from the Altman Self-Rating Mania Scale [ASRM])
- Level 2—Anxiety—Parent/Guardian of Child Age 6–17 (Adapted from PROMIS Emotional Distress—Anxiety—Parent Item Bank)
- Level 2—Substance Use—Parent/Guardian of Child Age 6–17 (Adapted from the NIDA-Modified ASSIST)
For Children Ages 11–17
- Level 2—Somatic Symptom—Child Age 11–17 (Patient Health Questionnaire 15 Somatic Symptom Severity Scale [PHQ-15])
- Level 2—Sleep Disturbance—Child Age 11–17 (PROMIS—Sleep Disturbance—Short Form)
- Level 2—Depression—Child Age 11–17 (PROMIS Emotional Distress—Depression—Pediatric Item Bank)
- Level 2—Anger—Child Age 11–17 (PROMIS Emotional Distress—Calibrated Anger Measure—Pediatric)
- Level 2—Irritability—Child Age 11–17 (Affective Reactivity Index [ARI])
- Level 2—Mania—Child Age 11–17 (Altman Self-Rating Mania Scale [ASRM])
- Level 2—Anxiety—Child Age 11–17 (PROMIS Emotional Distress—Anxiety—Pediatric Item Bank)
- Level 2—Repetitive Thoughts and Behaviors—Child Age 11–17 (Adapted from the Children’s Florida Obsessive Compulsive Inventory [C-FOCI] Severity Scale)
- Level 2—Substance Use—Child Age 11–17 (Adapted from the NIDA-Modified ASSIST)
Disorder-Specific Severity Measures
For Adults
- Severity Measure for Depression—Adult (Patient Health Questionnaire [PHQ-9])
- Severity Measure for Separation Anxiety Disorder—Adult
- Severity Measure for Specific Phobia—Adult
- Severity Measure for Social Anxiety Disorder (Social Phobia)—Adult
- Severity Measure for Panic Disorder—Adult
- Severity Measure for Agoraphobia—Adult
- Severity Measure for Generalized Anxiety Disorder—Adult
- Severity of Posttraumatic Stress Symptoms—Adult (National Stressful Events Survey PTSD Short Scale [NSESS])
- Severity of Acute Stress Symptoms—Adult (National Stressful Events Survey Acute Stress Disorder Short Scale [NSESS])
- Severity of Dissociative Symptoms—Adult (Brief Dissociative Experiences Scale [DES-B])
For Children Ages 11–17
- Severity Measure for Depression—Child Age 11–17 (PHQ-9 modified for Adolescents [PHQ-A]—Adapted)
- Severity Measure for Separation Anxiety Disorder—Child Age 11–17
- Severity Measure for Specific Phobia—Child Age 11–17
- Severity Measure for Social Anxiety Disorder (Social Phobia)—Child Age 11–17
- Severity Measure for Panic Disorder—Child Age 11–17
- Severity Measure for Agoraphobia—Child Age 11–17
- Severity Measure for Generalized Anxiety Disorder—Child Age 11–17
- Severity of Posttraumatic Stress Symptoms—Child Age 11–17 (National Stressful Events Survey PTSD Short Scale [NSESS])
- Severity of Acute Stress Symptoms—Child Age 11–17 (National Stressful Events Survey Acute Stress Disorder Short Scale [NSESS])
- Severity of Dissociative Symptoms—Child Age 11–17 (Brief Dissociative Experiences Scale [DES-B])
Clinician-Rated
- Clinician-Rated Severity of Autism Spectrum and Social Communication Disorders
- Clinician-Rated Dimensions of Psychosis Symptom Severity (also available in print book)
- Clinician-Rated Severity of Somatic Symptom Disorder
- Clinician-Rated Severity of Oppositional Defiant Disorder
- Clinician-Rated Severity of Conduct Disorder
- Clinician-Rated Severity of Nonsuicidal Self-Injury
Disability Measures
- WHODAS 2.0 (World Health Organization Disability Schedule 2.0, 36-item version, self-administered) (also available in print book)
- WHODAS 2.0 (World Health Organization Disability Schedule 2.0, 36-item version, proxy-administered)
Personality Inventories
For Adults
- The Personality Inventory for DSM-5—Brief Form (PID-5-BF)—Adult
- The Personality Inventory for DSM-5 (PID-5)—Adult
- The Personality Inventory for DSM-5—Informant Form (PID-5-IRF)—Adult
For Children Ages 11–17
- The Personality Inventory for DSM-5—Brief Form (PID-5-BF)—Child Age 11–17
- The Personality Inventory for DSM-5 (PID-5)—Child Age 11–17
Early Development and Home Background
For Parents of Children Ages 6–17
Clinician-Rated
Cultural Formulation Interviews
- Cultural Formulation Interview (also available in print book)
- Cultural Formulation Interview—Informant Version (also available in print book)
- Alternative Versions to the Core Cultural Formulation Interview (CFI)
- Supplementary Modules to the Core Cultural Formulation Interview (CFI)
About the Measures
These measures should be used to enhance clinical decision-making and not as the sole basis for making a clinical diagnosis. Further information on these measures can be found in DSM-5-TR. The measures can be broadly classified into four types:
- Cross-cutting symptom measures may aid in a comprehensive mental status assessment by drawing attention to symptoms that are important across diagnoses. They are intended to help identify additional areas of inquiry that may guide treatment and prognosis. The cross-cutting measures have two levels: Level 1 questions are a brief survey of 13 domains for adult patients and 12 domains for child and adolescent patients, and Level 2 questions provide a more in-depth assessment of certain domains.
- Severity measures are disorder-specific, corresponding closely to criteria that constitute the disorder definition. They may be administered to individuals who have received a diagnosis or who have a clinically significant syndrome that falls short of meeting full criteria. Some of the assessments are self-completed, whereas others require a clinician to complete.
- The World Health Organization Disability Assessment Schedule, Version 2.0 (WHODAS 2.0) assesses a patient’s ability to perform activities in six areas: understanding and communicating; getting around; self-care; getting along with people; life activities (e.g., household, work/school); and participation in society. The scale is self- or informant-administered and corresponds to concepts contained in the WHO International Classification of Functioning, Disability and Health.
- The Personality Inventories for DSM-5 measure maladaptive personality traits in five domains: negative affect, detachment, antagonism, disinhibition, and psychoticism. For adults and children ages 11 and older, there are brief forms with 25 items and full versions with 220 items. A full version for informants is also available.
The Early Development and Home Background (EDHB) form may assist in the assessment of the early development and past and current home background experiences of a child receiving care. Two versions are provided: one to be completed by the child’s parent or guardian, and the other to be completed by the clinician.
The Cultural Formulation Interview (CFI) is a set of 16 questions that clinicians may use to obtain information during a mental health assessment about the impact of culture on key aspects of an individual’s clinical presentation and care. The Informant Version collects collateral information on the CFI domains from family members or caregivers. In addition, the Supplementary Modules to the Cultural Formulation Interview can help clinicians conduct a more comprehensive cultural assessment. The first eight supplementary modules explore the domains of the core CFI in greater depth. The next three modules focus on populations with specific needs, such as children and adolescents, older adults, and immigrants and refugees. The last module explores the experiences and views of individuals who perform caregiving functions.