Moral and Political Implications of the DSM

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A special issue of Public Affairs Quarterly examines “the moral and political implications” of the Diagnostic and Statistical Manual of Mental Disorders.

Articles include, “The Moral and Political Implications of the DSM-5” and “Psychological Justice: DSM-5, False Positive Diagnosis, and Fair Equality of Opportunity.”

Public Affairs Quarterly. Volume 29, Number 1. January 2015. (Table of contents and introductory sections)

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2 COMMENTS

  1. I was looking for an actual definition for the word hyponarrativity, there is none I could find in any actual dictionary online, all I found was what was written here:

    http://www.academia.edu/9044965/Hyponarrativity_and_Context_Specific_Limitations_of_the_DSM-5

    “This article develops a set of recommendations for the psychiatric and medical community in the treatment of mental disorders in response to the recently published fifth edition of the Diagnostic and Statistical Manual of Mental Disorders, i.e., DSM-5. We focus primarily on the limitations of the DSM-5 in its individuation of complicated grief, which can be diagnosed as Major Depression under its new criteria, and Post-Traumatic Stress Disorder (PTSD). We argue that the hyponarrativity of the descriptions of these disorders in the DSM-5, defined as the abstraction of the illness categories from the particular life contingencies and personal identity of the patient (e.g., age, race, gender, socio-economic status), constrains the DSM-5’s usefulness in the development of psychotherapeutic approaches in the treatment of mental disorders. While the DSM-5 is useful in some scientific and administrative contexts, the DSM’s hyponarrativity is problematic, we argue, given that the DSMs are designed to be useful guides for not only scientific research, but also for the education of medical practitioners and for treatment development. our goal therefore is to offer suggestions for mental health practitioners in using the DSM-5, so that they can avoid or eliminate the problems that may stem from the limitations of hyponarrativity.”

    This seems to be a confession that the DSM is not valid or helpful for all those individuals diagnosed with DSM disorders due to “complicated grief.” And this doesn’t just include stigmatization with merely major depressive disorder and PTSD, as this article implies. I have medical evidence that merely expressing concerns of the possible abuse of one’s child gets one diagnosed with bipolar and paranoid schizophrenia. And John Read points out that the actual symptoms of child abuse, are diagnosed in 77% of abused children as “psychosis,” (thus resulting in either a bipolar or schizophrenia diagnosis) compared with 10% in non-abused children.

    So, “complicated grief,” gets misdiagnosed as all the major mental illnesses. And this political document is advocating the perpetual use of a DSM that the writers acknowledge is not beneficial to patients suffering from “complicated grief,” which is likely most patients who actually end up seeing a psychiatric practitioner.

    What happened to Thomas Insel’s defunding of research into the scientifically “lacking in validity” DSM disorders? And shouldn’t a DSM known to not be helping the majority of patients just RIP at some point?

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