The N.F.L. team executive said the changes to the manual matched complaints against the Patriots.
Disagreement about the effect of the new definition will almost certainly increase scrutiny of the finer points of the psychiatric association's changes to the manual.
Michael First, a psychiatrist at Columbia and leading D.S.M. researcher, thinks the sharp increase between the D.S.M.-III and the D.S.M.-IIIR results has little to do with changes to the manual.
"What we wanted to do was give some clarification, give some forewarning that we have new technologies, too," said Ray Anderson, the league's executive vice president for football operations, who oversaw the changes to the manual.
But we missed a unique opportunity for progress last August when the president's task force on interrogations recommended no changes to the manual, which was hastily revised in 2006 in the aftermath of the Abu Ghraib torture scandal.
Any changes to the manual must be disclosed publicly, the amendment stipulates.
After years of research, professional infighting and maneuvering from various interest groups, the nation's psychiatrists Tuesday unveiled proposed changes to the manual used to diagnose and treat mental disorders around the world.
It is not known whether these changes to the safety manual were received by the Deepwater Horizon before the disaster.
For example, the first session includes more content about the nature of bipolar disorder, a greater emphasis on the role of family and the carer, changes to the wording of the manual and handouts, and the English context of service provision.
Ms. Cerbelli's lawsuit initially called for substantive changes to the department's policy manual, the Patrol Guide.
