812 Highlights of Changes From DSM-IV to DSM-5
distinction in individuals with body dysmorphic disorder. The delusional variant of body
dysmorphic disorder (which identifies individu als who are completely convinced that their
perceived defects or flaws are truly abnormal ap pearing) is no longer coded as both delu-
sional disorder, somatic type, and body dysmorph ic disorder; in DSM-5, this presentation is
designated only as body dysmorphic disorder with the absent insight/delusional specifier.
Individuals can also be diagnosed with other specified obsessive-compulsive and related
disorder, which can include conditions such as body-focused repetitive behavior disorder
and obsessional jealousy, or unspecified obsessive-compulsive and related disorder.
Trauma- and Stressor-Related Disorders
For a diagnosis of acute stress disorder,  qualifying traumatic events are now explicit as to
whether they were experienced directly, witnessed, or experienced indirectly. Also, the
DSM-IV Criterion A2 regarding the subjective reaction to th e traumatic event (e.g., expe-
riencing “fear, helplessness, or  horror”) has been eliminated. Adjustment disorders  are
reconceptualized as a heterogeneous array of  stress-response syndromes that occur after
exposure to a distressing (traum atic or nontraumatic) event, rather than as a residual cat-
egory for individuals who exhibit clinically  significant distress but whose symptoms do
not meet criteria for a more d iscrete disorder (as in DSM-IV).
DSM-5 criteria for PTSD differ significantly from the DS M-IV criteria. The stressor cri-
terion (Criterion A) is more ex plicit with regard to events that qualify as “traumatic” ex-
periences. Also, DSM-IV Criterion A2 (subje ctive reaction) has been eliminated. Whereas