Maererano neDSM-IV, chirwere chekudhakwa chinodhakwa ndeichi: "kushandiswa kwechinwiwa chinodhakwa chisina kukodzera nekuremara kwakakosha mumakiriniki kunoratidzwa neanenge matatu ezviitiko zvinotevera mukati megore rimwe chete: kushivirira; kurega; kutorwa muhuwandu hukuru kana kwenguva yakareba kupfuura chinangwa; chishuwo kana kuedza kusingabudirire kuderedza kana kudzora kushandiswa; nguva yakawanda inoshandiswa kuwana, kushandisa, kana kupora kubva mukushandisa; zvemagariro, zvebasa, kana zviitiko zvekuvaraidza zvakagadziriswa kana kuderedzwa; kuenderera mberi nekushandisa pasinei neruzivo rwepanyama kana rwepfungwa. " Pasinei nekunzwisisa kwakawanda mushoko, kwakave nekuedza kutsanangura izwi rekuti doro sechinhu chakakosha, sekuratidzwa neanenge matatu ezviitiko zvinotevera mukati megore rimwe chete: kushivirira; kurega; kutorwa; kutorwa; kutorwa; uye kutorwa. " Kubva muna 1992, Dr. William A. Meekell (AA.M.D.) akawana tsananguro yekudhakwa
DSM-IV inorondedzera kupindwa muropa nedoro