MSNBC just reported via Reuters on the flap over the DSM-5, the next edition of the Diagnostic and Statistical Manual of Mental Disorders that psychiatrists use to diagnose mental illnesses. “More than 11,000 health professionals have already signed a petition (at http://dsm5-reform.com) calling for the development of the fifth edition of the manual to be halted and re-thought,” says the article.
The article then talks about a number of proposed new mental illness diagnoses, some of which are, I agree, tough to swallow. For example, creating diagnoses for sex criminals “may allow offenders to escape prison by providing what could be seen as an excuse for their behavior,” says the article. Such diagnoses could indeed lead to legal nightmares, to be sure. And yet – you gotta admit some sexual predators certainly are sick.
There are two things, though, that bother me about the news report. The first is this statement:
… psychologists, psychiatrists and mental health experts said its new categories and “tick-box” diagnosis systems were at best “silly” and at worst “worrying and dangerous.”
I haven’t ventured into all the new categories and diagnoses, but in fact, the “tick-box” diagnosis system hasn’t changed from the current version, the DSM-IV. And I mean, there’s no difference. The DSM-5 lists the symptoms and the number of symptoms required for a diagnosis the same way the DSM-IV does.
The second is the focus on Oppositional Defiant Disorder. The article makes this sound like a new diagnosis when, in fact, it isn’t. Here’s the pertinent section:
Other examples of diagnoses cited by experts as problematic included … “oppositional defiant disorder” – a condition in which a child “actively refuses to comply with majority’s requests” and “performs deliberate actions to annoy others.”
“That basically means children who say ‘no’ to their parents more than a certain number of times,” [psychologist Dr. Peter] Kinderman said. “On that criteria, many of us would have to say our children are mentally ill.”
Oppositional Defiant Disorder appears in the DSM-IV, which has been around since 1994. The diagnostic criteria have been slightly revised in the DSM-5 proposal, and some portions are still under review, but by and large it remains the same. And both the DSM-IV and the proposed DSM-5 have versions of this critical item: “The disturbance in behavior causes clinically significant impairment in social, educational, or vocational activities.”
A child who says “no” frequently couldn’t be diagnosed with ODD under either the current or the proposed criteria.
I agree there are problems with the DSM-5. For example, the current proposal for the criteria for a hypomanic episode flatly contradicts itself. But it sure would help the public perception if news outlets would get their facts straight before publishing distortions like these.
The study of GEnetics will soon make dsm contaversy a fading factor as it will all areas for disease.even reversal of diseases is happening as we see about alxzheimers in thursdays edition of the journal science. I predict that money spent now on inpatiet care will instead be freed up by genetics and there will be lots of resources savaiable to trhe legal system to sort out the disturbed. Lawmakers however need to be given early notice of this change to meet the needs that generate dsm and other psych debates.
Although you have some valid concerns, the fact is that DSM-IV already illustrated the dangers we are being warned about. Here on our webpage is information on how DSM-IV and its checkbox approach lead to a 4000% increase in diagnoses of bipolar disease in children. This particular example about DSM-IV is probably the most egregious, but not the only. You can find many google hits on this topic, although a couple of prescient ones are included on our page to help you. (Such as from the DSM-IV Chief, himself.)
http://hopefortheviolentlyaggressivechild.com/?page_id=52
Coincidentally My father-in-law is a psychiatrist who coincidentally just published that website and his book to help many of the people (mostly children) who were inadvertently caught up in this false epidemic.
Please look it over, as we need all the help we can get spreading the news of his discoveries to those who need this help.
I do believe this is another soft analysis of DSM-5 changes. Look deeply into this please. If you don’t have time to look deeper and obsess over every detail and go after info regarding this DSM-5 change to autism diagnosis, may I suggest you go to a website with a mom of autistic son who already did quite a bit of research on this and tells us more than we may care to know. It can be found at http://www.autismseizureselfinjuriousbehavior.com/2012/01/has-american-psychiatric-association.html
or type in a search engine the title, “Autistics with Severe Behaviors Exist”. It exposes a very possible reason why Dr. Catherine Lord and others are trying to create a caste system in the autism diagnosis. They seem to want to eliminate the most high functioning among spectrum, along with the most severely afflicted autistics. It’s all about money. Some researchers, usually the principal investigators who are making their way up autism corporate industry, no joke, want autistics with moderate to high (but not too high) to be in the research now. IMany people don’t understand how these people think or what drives them. It’s not about helping autistic individuals. It’s about much more. It’s so much easier to research autistics who can talk. And fits their agendas.