DSM

A new article suggests counselors and psychotherapists are dissatisfied with current diagnostic systems and outlines some potential alternatives.

The American Journal of Psychiatry (January, 2103) recently published a series of articles that analyzed the outcomes of the field trials that were conducted by the DSM-5 Task Force, to determine the inter-rater reliability of the multiple diagnostic categories that will comprise the DSM-5. A table below tracks the downward progression of inter-rater reliability from DSM-III through DSM-5.

While a great deal of the excitement about advances in psychological treatments comes from the potential for research in neuroscience to unlock the secrets of the brain, many mental health experts would like to temper this enthusiasm. A special issue of the Behavior Therapist released this month calls into question the predominant conception of mental illnesses as brain disorders.

In just two decades, pointing out the pseudoscience of the DSM has gone from being an “extremist slur of radical anti-psychiatrists” to a mainstream proposition from the former chairs of both the DSM-3 and DSM-4 taskforces and the director of NIMH. In addition to the pathologizing of normal behaviors, another explanation for the epidemic — the adverse effects of psychiatric medications — is also evolving from radical to mainstream, thanks primarily to the efforts of Robert Whitaker and his book Anatomy of an Epidemic. While diagnostic expansionism and Big Pharma certainly deserve a large share of the blame for this epidemic, there is another reason.

Derek Summerfield, consultant psychiatrist at South London and Maudsley National Health Service Foundation Trust, challenges the assumption that Western depression is a universal condition.

More than a year on from the release of DSM-5, a Medscape survey found that just under half of clinicians had switched to using the new manual. Most non-users cited practical reasons, typically explaining that the health care system where they work has not yet changed over to the DSM-5. Many, however, said that they had concerns about the reliability of the DSM, which at least partially accounted for their non-use. Throughout the controversies that surrounded the development and launch of the DSM-5 reliability has been a contested issue: the APA has insisted that the DSM-5 is very reliable, others have expressed doubts. Here I reconsider the issues: What is reliability? Does it matter? What did the DSM-5 field trials show?

Robert Whitaker notes on Al Jazeera's "Inside Story" that a helpful diagnostic text must be both reliable and valid, and the DSM is neither...

Dr. Raskin discusses psychotherapists’ dissatisfaction with current psychiatric diagnostic systems and explores alternatives.

In a new report, the United Nations Special Rapporteur on the right to health, Dr. Dainius Pūras, calls for a move away from the biomedical model and “excessive use of psychotropic medicines.”

The latest issue of the journal Behavioral and Brain Sciences features several prominent researchers arguing that mental health concerns are not “brain disorders.”

Neuroscience researchers find no differences in brain connectivity between children with diagnoses of autism, ADHD, and those with no diagnoses.

The team that developed the Power Threat Meaning framework as a diagnostic alternative reflects on the response to the framework after one year.

A new study finds that clinicians’ disregard for mental health patients’ insight into their own condition may be detrimental to treatment.

Amid calls for a retraction, Lancet Psychiatry publishes articles criticizing the original finding and a response from the authors.

A case analysis of an American Indian woman illustrates how the DSM diagnostic criteria misrepresent the lives of indigenous people.

Researchers detect disparity between white and African American patients diagnosed with schizophrenia when symptoms of a mood disorder are present.

What makes the DSM so pernicious is that it is a cultural document whose influence transcends not only psychiatric practice but also the Western civilization from which it originates. Each revision of the DSM rescripts and reimagines how we make sense of our experiences, reinterprets what thoughts, feelings and behaviors are socially sanctioned, and ultimately what it means to be human.

A new study systematically explores critical reactions to the DSM-5 and identifies unifying themes.

There has been a lot of talk lately about neuroscience and the future of the medical model of "mental illness." It was made clear, in NIMH director Thomas Insel’s statement, that the DSM is a system of identification and classification of what are deemed disorders within our human experience. This isn’t exactly news to the vast majority of people who have spent even a little bit of time thinking about whether or not psychiatric diagnosis makes sense.

‘Diagnosing’ someone with a devastating label such as ‘schizophrenia’ or ‘personality disorder’ is one of the most damaging things one human being can do to another. Re-defining someone’s reality for them is the most insidious and the most devastating form of power we can use. It may be done with the best of intentions, but it is wrong - scientifically, professionally, and ethically. The DSM debate presents us with a unique opportunity to put some of this right, by working with service users towards a more helpful understanding of how and why they come to experience extreme forms of emotional distress.

A discussion of the role of epistemic injustice in the experiences of patients diagnosed with psychiatric disorders.

A new article examines the usefulness of the ADHD diagnosis and suggests alternatives

The recent furore surrounding publication of the new DSM has provided a much-needed opportunity to discuss and debate crucial issues about how we make sense of, and respond to, experiences of madness and distress. Many psychiatrists, psychologists and other mental health professionals have expressed their dismay about the dominance and inadequacy of a biomedical model of mental illness. Whilst we share these concerns, welcome these debates and support colleagues that are willing to take a stand, The Hearing Voices Network believes that people with lived experience of diagnosis must be at the heart of any discussions about alternatives to the current system.

Revealing the false information provided about psychiatry should cause any thinking person, patient, thought-leader or politician to wonder: “how many otherwise normal or potentially curable people over the last half century of psych drug propaganda have actually been mis-labeled as mentally ill (and then mis-treated) and sent down the convoluted path of therapeutic misadventures – heading toward oblivion?”

Criticisms of the DSM-5 spark alternative proposals and calls to reform diagnostic systems in the mental health field.