Abstract

Objective: Recently revised DSM-5 diagnostic criteria are widely debated. This survey examined the extent to which Board Certified clinical neuropsychologists have adopted the DSM-5 versus other published diagnostic criteria for the differential diagnoses that are most often encountered in clinical practice with adults. Method: A 10-item survey was designed that presented criteria for the diagnosis of cognitive impairment in Alzheimer's disease (DSM-5, DSM-4, ICD-10, NINCDS-ADRDA), Traumatic Brain Injury (DSM-5, DSM-4, ICD-10), Postconcussion Syndrome (DSM-5, DSM-4, ICD-10), Vascular Dementia (DSM-5, DSM-4, ICD-10, NINDS-AIREN), and Malingering (DSM-5, DSM-4, Slick et al.). An invitation to complete the survey was emailed to members of ABCN. Respondents were asked to indicate which criteria they would primarily consider for each diagnosis. Results: Responses were obtained from 129 neuropsychologists with an average of 19 years experience, and cases involving differential diagnosis of Alzheimer's/Vascular dementia (26%), TBI (33%), or malingering (28%). NINDS-ADRDA criteria were preferred (33%) to DSM-5 (17%) in Alzheimer's disease. Preferences for DSM-5 (42%) and ICD-10 (40%) were similar for TBI. ICD-10 criteria (48%) were preferred to DSM-5 (23%) or DSM-4 (29%) in Postconcussion Syndrome. ICD-10 was also preferred (33%) to DSM-5 (20%) or DSM-4 (19%) for Vascular Dementia. Slick et al. criteria for Malingered Neurocognitive Disorder (75%) were used more often than DSM-5 (12%) or DSM-4 (12 %). Preferences were unrelated to years of experience or the percentage of cases seen with each disorder. Conclusion(s): The criteria viewed as most useful vary by diagnosis. Although DSM-5 is seen as an improvement upon DSM-4 in some cases, neuropsychologists generally have not adopted DSM-5 criteria for most disorders.