… await the updated DSM-V, with new mental disorders just for us, a voice of caution arises among the psychiatrists:
The first draft [of the DSM-V] is crucial because only the Task Force working as a whole can discipline and reconcile the often inconsistent outputs produced by the different Workgroups. It is a very reliable rule of thumb that Workgroups are always more willing to make changes than is desirable. Experts in any given area tend to have their pet ideas and to worry more about missed cases than about creating potential false positives. By ruthlessly applying the necessary rule of empirical documentation, the Task Force must provide a useful check on Workgroup enthusiasm.
Allow UD to clarify.
The Workgroups include people riding lots of horses very hard: Mr Internet Addiction. Ms Intermittent Explosive Disorder. Their careers and fortunes are riding on these things… False positives, you say? I dare you to falsify any psychiatric diagnosis. Can’t be done, and certainly not by some confused patient sitting in a psychiatrist’s office. What’s the poor fool going to say? I really doubt there’s good research backing up your claim that I need anti-psychotics because I’m shy. No, once the designation’s in the manual, we’re out of the starting gate…
Problems can result even from improvements in the wording of criteria sets. For example, the better written and more easily remembered DSM-IV criteria set for ADHD may have resulted in its overuse—especially by primary care doctors and the general public.
However perilous it is to change existing criteria sets, the risks are much greater still whenever the system adds totally new diagnoses that are at best lightly tested. The potential for false positive epidemics and forensic conundrums are much harder to predict for anything novel. New disorders are best kept in the appendix until they have achieved wide acceptance in the field. The DSM system should always follow, not lead, research and practice. It can never be paradigm shifting on its own weight.
Same crap. So the new ADHD language has netted more clients than the old. Problem?
So we’re creating new epidemics. And?
Publishing profits are the only possible driver of a fixed and implacable 2012 publication deadline, and this is obviously not acceptable.
The man’s paranoid.
August 27th, 2009 at 9:48AM
Excuse me, Margaret. Shy is not a disorder. It’s a civil rights issue.
August 27th, 2009 at 9:57AM
That too.