Moderate Alcohol Abuse as DSM–IV–TR Diagnosis

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Signs and Symptoms

Billy displays feelings of denial despite his poor driving record. His drink-driving habit has seen him in court twice over DUI. Moreover, despite being a respected executive (boss) with a family (wife), Billy has a drinking problem. The symptoms apparent in this case include; denial, alcohol abuse and lose of self-control.

DSM-IV-TR Diagnosis

Billy exhibits symptoms of anxiety disorder, which, as specified in DSM-IV-TR criteria include the intake of alcohol “in larger amounts or over a longer period, which results in “recurrent social or interpersonal problems caused or exacerbated by the effects of alcohol” (APA, 2000, p. 234). The DSM-IV-TR diagnosis in this case is a moderate alcohol abuse (code 303.90 (F10.20)), which requires a minimum of four symptoms as specified in the DSM.

Explanation

Billy has a drinking problem. He risks losing his trucking license, but this does not deter him from alcohol use. Moreover, he is in denial and sees no reason to change his drinking habit. This aptly describes an alcohol abuse disorder, which, in Billy’s case manifests as drinking heavily over a long period and “recurrent alcohol use in situations in which it is physically hazardous” (APA, 2000, p. 216). The identified DSM-IV-TR diagnosis indicates a moderate alcohol abuse disorder (303.90), which is characterized by denial of one’s drinking problem.

Conclusion

Billy exhibits no withdrawal or tolerance symptoms, nor does he take benzodiazepine to suppress withdrawal. This implies that his alcohol abuse disorder is not severe (requires more than six symptoms). Moreover, since Billy exhibits no craving for alcohol, an alcohol dependence diagnosis (DSM-IV 303.90) can be ruled out. However, though Billy denies having a drinking problem, he manifests three symptoms, which include affected “roles/obligations at work, school, or home”, denial and “continued alcohol use despite its harmful effects” (APA, 2000, p. 233). Thus, his condition can only be described as a moderate alcohol abuse disorder.

Reference

American Psychiatric Association [APA]. (2000). Diagnostic and statistical manual of mental disorders, (DSM-IV). Washington, DC: APA.

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