TIME: DSM Challenge

[Ex-User (5841)]

The brief article: http://healthland.time.com/2012/12/03/redefining-crazy-the-bible-of-psychiatry-changes/

I'm glad to see autism finally recognized as a spectrum in the "bible" of psychiatric diagnoses. However my smile disappears quickly upon the discovery that even more culturally biased *mularkey is being incorporated and considered to be a "disorder".

*edited a la Joe Biden.

Case in point:

""Continuing the expansion of diagnostic criteria, the new DSM will also include a controversial new diagnosis called “disruptive mood dysregulation disorder (DMDD),” a label that can be attached to “children who exhibit persistent irritability and frequent episodes of behavior outbursts three or more times a week for more than a year.” Earlier this year, the Huffington Post called DMDD the “tantrum diagnosis,” and a blogger for Wired warned that the new disorder “could be anything, like the meltdown when the shoes can’t be found, the homework got lost, or the braids aren’t quite right.” But the APA says the new diagnosis “is intended to address concerns about potential over-diagnosis and over-treatment of bipolar disorder in children."

Classic. Let's load the kiddies up with more dope and stuff a few more screens in their faces, amirite? NURSE RATCHED! I WANT MY CIGARETTES!!!!

"Other mental-health professionals note that the DSM is subject to political influence. “This is a huge money-maker for the American Psychiatric Association,” says Marsha Linehan, a University of Washington professor and a leading expert on personality disorders. The decisions reflect the votes of the APA’s board of trustees; the entire membership will vote on the revisions later in the spring, but experts don’t expect additional alterations. Which means that the approval this weekend of DSM-5 ends years of editing but begins years of debate."

So let's have this debate.


Your mission, should you choose to accept it, is to choose a diagnosis from either the DSM-IV or what's been published on the pending DSM-V, and make your case for why it should either be validated or obliterated. Given the nature of this forum, I imagine many here have been impacted by some version of the DSM in one form or another. What do you make of it?

Spoiler

Many of you can surmise my position from this thread: http://www.intpforum.com/showthread.php?t=14678 but to provide additional clarification, I hold the position that the ENTIRE DSM can be reduced to 3 spectra: autistic (cognition), schizophrenic (perception), and bipolar (mood); using culturally unbiased criteria to produce appropriately scaled responses that can be positioned on a standard X, Y, Z 3-D graph and treated accordingly. I deem many "disorders" nothing more than coping mechanisms for these spectra that just so happen to be vulnerable to cultural bias and/or pill-pushing corporatism

 

[Ex-User (5841)]

Another article of interest:

http://www.time.com/time/magazine/article/0,9171,2108584,00.html

 

[snafupants]

More bullshit. Anyway, there's an interesting book about the interplay between prescription drugs and (paradoxically) more psychic complications, especially since the late nineteen eighties. The book's called Anatomy of an Epidemic. The finding that drugs make you weaker long-term is basically replicated in other areas outside the United States. It's troubling that so many folks are on Prozac but, yeah, the amount of tots on uppers worries me as well. These things are overprescribed, overdosed, and understudied - not the best cocktail.

But yeah, since the nineteen fifties with drugs like miltown or maybe some time before the fifties there's been an attempt by psychologists to convince medical professionals that psychology as a profession is on equal footing with medicine; psychologists will bleat that psychic distress is not only a disease but physiologically-based and treatable - hence the commodification and reverse engineering of lucrative psychiatric medication. Again, more bullshit. I guess AA does the same thing as the APA but at least the former ostensibly tries to help people get better.

 

[Jennywocky]

well, I was happy they rephrased Gender Identity Disorder as Gender Dysphoria -- because the issue isn't really gender identity, it's the emotional distress that leaves an individual with trauma that has to be coped with, exacerbated with social stigma.

I'm also not bothered by the merging of Asperger's into one end of the autism spectrum, since that seems to just be the regular house-cleaning that occurs once you can see patterns and gradiations of behavior over the long haul. I think Asperger's is generally accepted as a mild form of autism.

But the Tantrum thing and some other items I've seen included? Yeeesh. Seems a stretch to me.

It's a shame also that our medical coverage is so tightly tied to the DSM, as you need to provide a DSM code for billing purposes to get insurance companies to cover psychiatric care. So it's not a purely content-focused book; there're ulterior motives to either include and/or cut things from it.

 

[Ex-User (5841)]

Spoiler

Many of you can surmise my position from this thread: http://www.intpforum.com/showthread.php?t=14678 but to provide additional clarification, I hold the position that the ENTIRE DSM can be reduced to 3 spectra: autistic (cognition), schizophrenic (perception), and bipolar (mood); using culturally unbiased criteria to produce appropriately scaled responses that can be positioned on a standard X, Y, Z 3-D graph and treated accordingly. I deem many "disorders" nothing more than coping mechanisms for these spectra that just so happen to be vulnerable to cultural bias and/or pill-pushing corporatism

I'm surprised no one's taken issue with this^

 

[Jennywocky]

I'm surprised no one's taken issue with this^

maybe you shouldn't have spoilered it.

TBH, it's a plausible idea, and I have little interest in defending the DSM enough to go my copy of the DSM-IV and see I can find any exceptions to it.

I mean, it seems a bit too simplistic at first glance for me to be sure you're correct; but you're not getting much pushback because you're on a forum where people already agree with your general idea and are skeptical of the reasons some of these "disorders" are included in the book.

 

[IdeasNotTheProblem]

I don't know enough about DMDD to comment about it. However, it does feel a bit disturbing for it to just now become a "disorder". My cynical side would speculate that more "disorders" translates to more doctor visit$, prescription drug$ and an increased public worry arising from the very word "disorder". I don't have any children, but I imagine that nearly every parent would suspect their child of having an unusual amount of tantrums and have little hesitation when it comes to scheduling an appointment.

Also troublesome, is that the disorders defined by the govt influenced diagnostic criteria, will be covered by the govt influenced health insurance system as well.

 

[EyeSeeCold]

I don't have any children, but I imagine that nearly every parent would suspect their child of having an unusual amount of tantrums and have little hesitation when it comes to scheduling an appointment.

The DSM is popular but it's not like every family is a psychiatry/psychology enthusiast. If such a thing happened it'd be those over-worried perfectionist parents. Since not all parents are quick to get their kids diagnosed by some clinic, some people are hardnosed about such things and would just believe the kid just needs more discipline, or might even just see the behavior as normal(let alone the neglectful/enabling parents).

Many of you can surmise my position from this thread: http://www.intpforum.com/showthread.php?t=14678 but to provide additional clarification, I hold the position that the ENTIRE DSM can be reduced to 3 spectra: autistic (cognition), schizophrenic (perception), and bipolar (mood); using culturally unbiased criteria to produce appropriately scaled responses that can be positioned on a standard X, Y, Z 3-D graph and treated accordingly. I deem many "disorders" nothing more than coping mechanisms for these spectra that just so happen to be vulnerable to cultural bias and/or pill-pushing corporatism

I like your idea but it seems too limited.

Also I agree somewhat on the latter part. "Disorders" or even just personalities in general are like the different hues & shades of color, though some are extreme like the levels of contrast+brightness+saturation.

 

[Ex-User (5841)]

Also troublesome, is that the disorders defined by the govt influenced diagnostic criteria, will be covered by the govt influenced health insurance system as well.

This is among my chief complaints. What I imagine took place at the APA directors meeting: "Consumer debt is dropping. LET'S SUCK UP THEIR CASH WITH A NEW CLUSTER OF DISORDERS!"

 

[Ex-User (5841)]

The DSM is popular but it's not like every family is a psychiatry/psychology enthusiast.

^I'd be more concerned with the teachers.

I like your idea but it seems too limited.

What kind of flaccid criticism is that?

 

[Ex-User (5841)]

Not a bad summary from a Prof. Emeritus at Duke: http://www.huffingtonpost.com/allen-frances/dsm-5_b_2227626.html?utm_hp_ref=science

 

[Jennywocky]

Thanks for providing that link. I read through the same items, and that seems to be a pretty assessment of them. It would be cause for concern.

I thought they had a basic commitee that then fields proposals/info from specialists or small groups of specialists in different categories. (Or something similar.) So it's possible for some parts of the book to be on track and other parts to be way off, depending on the people who handled the piece(s). I suppose I should try to Google the process, to make sure, but I think that's what I've read.

 

[Ex-User (5841)]

Relevant thread from a while back: http://www.intpforum.com/showthread.php?t=6215

 

[Da Blob]

Bah Humbug!

Since the DSM-III, the book has been the target of politics and a prostitute for insurance companies and not a legitimate psychological reference.

Everyone has a mental disorder, that prevents she or he from attaining the perfection of fulfilled potential as a conscious entity. Labeling disorders on the basis of standardized criteria is just a fool's game, for each recovery is unique, not subject to any standardized criteria of healing.

But then, psychology, is little more than a scam, neither Art or Science, so it is not surprising that the Psychologist's Bible is a work of fiction, with 'evidence' determined by a vote of those who have a vested interest in maintaining the charade.

Any psychological diagnosis, not based upon physical evidence of a medical disorder (such as an MRI), has about as much scientific validity as the reading of entrails for diagnosis and prognosis.

That is rather the point, the DSM has little scientific validity, but rather fulfills some nonscientific purpose, by pretending to be scientific...