More DSM Outrage


I had a really hard time coming up with a title for this post.  I was torn between, “I Hate the APA”, “The DSM Sucks”, and “Why Won’t These Experts Pull Their Heads Out of Their Asses and Actually Help People?”

According to this article in Medscape by Caroline Cassels, the American Psychiatric Association (APA) will be releasing a consumer guide to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) on April 28th.  This consumer guide will be titled, Understanding Mental Disorders: Your Guide to the DSM-5 and might be the very worst idea in public health.  Ever.

I’m not sure why this surprises me – the APA and the relevant DSM subcommittee have been failing the millions of traumatized children and adults in this country with their bad ideas for years. More recently, in 2009, it failed to include the diagnosis of Developmental Trauma Disorder into the DSM-5, and had the audacity to explain such an action with this: “The notion that early childhood adverse experiences lead to substantial developmental disruptions is more clinical intuition than a research-based fact.  This statement is commonly made but cannot be backed up by prospective studies.”  This statement is so completely false, when I consider how any competent scientist could issue it, I start looking around for the Punk’d cameras.

To add insult to injury, revisions 4 and 5 are chock full of new diagnoses – Disruptive Mood Regulation Disorder, Non-suicidal Self Injury, Intermittent Explosive Disorder, Dysregulated Social Engagement Disorder, Disruptive Impulsive Control Disorder, to name a few – that were included for that revision, yet many of these diagnoses lack validity, per the American Journal of Psychiatry.

Over one million children are abused and neglected every year, and an appropriate trauma diagnosis is crucial for funding and focused research & treatment…but a diagnosis with sound scientific research gets the ax, while invalid bunk makes the cut. Unbelievable.

So the American Journal of Psychiatry exposes issues concerning the validity of DSM diagnoses, and shortly before the DSM-5 was released, the National Institutes of Mental Health announced that it was going to move away from funding based on DSM categories – and this is the organization which funds most psychiatric research in this country.  I doubt it’s likely this has made too much of an impact on the APA or the DSM in the 2 years since this announcement, it does send a pretty clear message that something is amiss with the current system.  And instead of stepping back and considering the grave implications of the direction the DSM has taken over its lifespan, the APA is going to take their broken system, dumb it down, and when the spin doctors finish with it, schlep it to the general public.

And I’m guessing first in line to buy a copy will be the most ardent Fifty Shades protesters.