What is ‘mental retardation’ now called according to the American Psychiatric Association in its revision of DSM-5?

Correct Answer: A. Intellectual disability

The DSM-5 (Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition) published by the American Psychiatric Association in 2013 replaced the outdated term "mental retardation" with Intellectual Disability (ID). This terminology shift reflects a move away from stigmatizing language toward person-first, clinically precise nomenclature. Intellectual Disability is now the standard diagnostic term used globally, including in Indian psychiatric practice and guidelines. The DSM-5 defines ID as a neurodevelopmental disorder characterized by deficits in both intellectual functioning (IQ typically ≤70) and adaptive functioning across multiple domains (communication, self-care, social skills, academic learning, work), with onset during the developmental period (before age 18). This change aligns with the WHO's ICD-11, which also uses "Intellectual Disability" rather than older pejorative terms. In Indian clinical settings, this terminology is now mandated in medical records, psychiatric assessments, and educational planning under the Rights of Persons with Disabilities Act, 2016. The shift emphasizes that individuals with ID have strengths and capabilities, not merely deficits, making it ethically and clinically appropriate.

Why the other options are wrong

B. Mental subnormality — This is an outdated, non-standard term that was occasionally used in older Indian and British psychiatric literature but was never formally adopted by the APA or DSM. It carries stigmatizing connotations and is not the official DSM-5 terminology. NBE includes this to trap students who confuse historical terminology with current diagnostic standards. C. Feeble mindedness — This is a highly archaic, pejorative term from early 20th-century classification systems (pre-1960s). It is explicitly rejected by modern psychiatry and has no place in DSM-5 or contemporary Indian clinical practice. NBE uses this as a distractor to test whether students know the evolution of psychiatric nomenclature and can distinguish obsolete from current terminology. D. Intellectually challenged — While this is person-first, non-stigmatizing language sometimes used colloquially, it is NOT the official DSM-5 diagnostic term. The DSM-5 specifically uses 'Intellectual Disability' as the formal diagnosis. This option traps students who assume any modern, polite term is correct without checking the actual APA standard.

High-Yield Facts

Mnemonics

DSM-5 ID Criteria (IAFAD) IQ deficit (≤70) + Adaptive functioning deficits + Functional domains (communication, self-care, social, academic, work) + Age onset <18 + Diagnosis = Intellectual Disability. Use this when recalling the full diagnostic criteria. Terminology Evolution: MR → ID Mental Retardation (pre-2013, stigmatizing) → Intellectual Disability (DSM-5 2013+, person-first, non-stigmatizing). Remember: newer = better language, APA standard = DSM-5.

NBE Trap

NBE pairs outdated terms like "mental subnormality" and "feeble mindedness" with modern-sounding but non-standard options like "intellectually challenged" to test whether students know the specific APA/DSM-5 terminology versus merely recognizing "non-stigmatizing language." The trap is assuming any polite term = correct answer.

Clinical Pearl

In Indian pediatric and psychiatric practice, using "Intellectual Disability" instead of older terms is now legally and ethically mandated. When counseling parents of a child with developmental delay, using ID terminology demonstrates current knowledge and respects the dignity of the child, aligning with India's disability rights framework and reducing family stigma.

_Reference: DSM-5 (American Psychiatric Association, 2013), Neurodevelopmental Disorders section; Harrison's Principles of Internal Medicine Ch. 387 (Child and Adolescent Psychiatry); Kaplan & Sadock's Synopsis of Psychiatry (11th ed.), Ch. 34 (Intellectual Disability)_