Misplaced Pages

DSM-5

Article snapshot taken from Wikipedia with creative commons attribution-sharealike license. Give it a read and then ask your questions in the chat. We can research this topic together.

This is an old revision of this page, as edited by Penbat (talk | contribs) at 19:58, 22 November 2009 (→Proposed new DSM-V diagnoses). The present address (URL) is a permanent link to this revision, which may differ significantly from the current revision.

Revision as of 19:58, 22 November 2009 by Penbat (talk | contribs) (→Proposed new DSM-V diagnoses)(diff) ← Previous revision | Latest revision (diff) | Newer revision → (diff)

The next (fifth) edition of the American Psychiatric Association's (APA) Diagnostic and Statistical Manual of Mental Disorders (DSM), DSM-V, is currently in consultation, planning and preparation. It is due for publication in May 2012.

Development of DSM-V

In 1999, a DSM–V Research Planning Conference, sponsored jointly by APA and the National Institute of Mental Health (NIMH), was held to set the research priorities. Research Planning Work Groups produced "white papers" on the research needed to inform and shape the DSM-IV, and the resulting work and recommendations were reported in an APA monograph and peer-reviewed literature. There were six workgroups, each focusing on a broad topic: Nomenclature, Neuroscience and Genetics, Developmental Issues and Diagnosis, Personality and Relational Disorders, Mental Disorders and Disability, and Cross-Cultural Issues. Three additional white papers were also due by 2004 concerning gender issues, diagnostic issues in the geriatric population, and mental disorders in infants and young children. The white papers have been followed by a series of conferences to produce recommendations relating to specific disorders and issues, with attendance limited to 25 invited researchers.

On July 23 2007, the APA announced the task force that will oversee the development of DSM-V. The DSM-V Task Force consists of 27 members, including a chair and vice chair, who collectively represent research scientists from psychiatry and other disciplines, clinical care providers, and consumer and family advocates. Scientists working on the revision of the DSM have experience in research, clinical care, biology, genetics, statistics, epidemiology, public health and consumer advocacy. They have interests ranging from cross-cultural medicine and genetics to geriatric issues, ethics and addiction. The APA Board of Trustees required that all task force nominees disclose any competing interests or potentially conflicting relationships with entities that have an interest in psychiatric diagnoses and treatments as a precondition to appointment to the task force. The APA made all task force members' disclosures available during the announcement of the task force. Several individuals were ruled ineligible for task force appointments due to their competing interests. Future announcements will include naming the workgroups on specific categories of disorders and their research-based recommendations on updating various disorders and definitions.

Owing to criticism over the perceived proliferation of diagnoses in the current edition of the DSM, David Kupfer, who is shepherding the DSM's revision, said in an interview: "One of the raps against psychiatry is that you and I are the only two people in the U.S. without a psychiatric diagnosis."

Proposed new DSM-V diagnoses

The proposed new DSM-V diagnoses include the following:

Criticism of DSM-V

Robert Spitzer, the head of the DSM-III task force, has publicly criticized the APA for mandating that DSM-V task force members sign a nondisclosure agreement, effectively conducting the whole process in secret: “When I first heard about this agreement, I just went bonkers. Transparency is necessary if the document is to have credibility, and, in time, you’re going to have people complaining all over the place that they didn’t have the opportunity to challenge anything.”

Although the APA has since instituted a disclosure policy for DSM-V task force members, many still believe the Association has not gone far enough in its efforts to be transparent and to protect against industry influence . In a recent Point/Counterpoint article, Lisa Cosgrove, PhD and Harold J. Bursztajn, MD noted that "the fact that 70% of the task force members have reported direct industry ties---an increase of almost 14% over the percentage of DSM-IV task force members who had industry ties---shows that disclosure policies alone, especially those that rely on an honor system, are not enough and that more specific safeguards are needed." David Kupfer, MD, chair of the DSM-V task force, and Darrel A. Regier, MD, MPH, Vice Chair of the task force, countered that "collaborative relationships among government, academia, and industry are vital to the current and future development of pharmacological treatments for mental disorders." They asserted that the development of DSM-V is the "most inclusive and transparent developmental process in the 60-year history of DSM." The developments to this new version can be viewed on . In June 2009 Allen Frances, head of the DSM-IV task force, issued strongly-worded criticisms of the processes leading to DSM-V and the risk of "serious, subtle, (…) ubiquitous" and "dangerous" unintended consequences such as new "false 'epidemics'". He writes that "the work on DSM-V has displayed the most unhappy combination of soaring ambition and weak methodology" and is concerned about the task force's "inexplicably closed and secretive process."

The appointment, in May 2008, of two of the taskforce members, Kenneth Zucker and Ray Blanchard, has led to an internet petition to remove them. According to MSNBC, "The petition accuses Zucker of having engaged in 'junk science' and promoting 'hurtful theories' during his career." According to The Gay City News, "Dr. Ray Blanchard, a psychiatry professor at the University of Toronto, is deemed offensive for his theories that some types of transsexuality are paraphilias, or sexual urges. In this model, transsexuality is not an essential aspect of the individual, but a misdirected sexual impulse." Blanchard responded, "Naturally, it's very disappointing to me there seems to be so much misinformation about me on the Internet. my views, they completely reversed my views." Zucker "rejects the junk-science charge, saying there 'has to be an empirical basis to modify anything' in the DSM. As for hurting people, 'in my own career, my primary motivation in working with children, adolescents and families is to help them with the distress and suffering they are experiencing, whatever the reasons they are having these struggles. I want to help people feel better about themselves, not hurt them.'"

Borderline personality disorder controversy

The Treatment and Research Advancements National Association for Personality Disorders (TARA-APD) campaigns to change the name and designation of borderline personality disorder in DSM-V. The paper How Advocacy is Bringing BPD into the Light reports that "the name BPD is confusing, imparts no relevant or descriptive information, and reinforces existing stigma...".

References

  1. DSM-V: The Future Manual
  2. First, M. (2002) A Research Agenda for DSM-V: Summary of the DSM-V Preplanning White Papers Published in May 2002
  3. Kupfer, First & Regier (2002) A Research Agenda for DSM-V
  4. Regier DA, Narrow WE, First MB, Marshall T (2002). "The APA classification of mental disorders: future perspectives". Psychopathology. 35 (2–3): 166–70. doi:10.1159/000065139. PMID 12145504.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  5. DSM-5 Research Planning
  6. APA DSM-V Research Planning Activities
  7. Regier, MD, MPH, Darrel A. (2007). "Somatic Presentations of Mental Disorders: Refining the Research Agenda for DSM-V" (pdf). Psychosomatic Medicine. 69. Lippincott Williams and Wilkins: 827–828. doi:10.1097/PSY.0b013e31815afbe4. Retrieved 2007-12-21.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  8. Grossman, Ron (December 27, 2008). "Psychiatric manual's update needs openness, not secrecy, critics say". Chicago Tribune.
  9. Carey, Benedict (December 17, 2008). "Psychiatrists Revise the Book of Human Troubles". New York Times.
  10. "Financial Ties between DSM-IV Panel Members and the Pharmaceutical Industry"]Psychother Psychosom 2006;75:154–160 DOI: 10.1159/000091772]
  12. Frances, Allen (26 June 2009). "A Warning Sign on the Road to DSM-V: Beware of Its Unintended Consequences" (Full text). Psychiatric Times. Retrieved 2009-09-06. {{cite journal}}: Cite has empty unknown parameter: |month= (help)
  13. "Objection to DSM-V Committee Members on Gender Identity Disorders," last accessed 22.55GMT 10 May 2008.
  14. Lou Chibbaro Jr. (2008-05-30). "Activists alarmed over APA: Head of psychiatry panel favors 'change' therapy for some trans teens". Washington Blade.
  15. ^ Alexander, Brian (2008-05-22). "What's 'normal' sex? Shrinks seek definition: Controversy erupts over creation of psychiatric rule book's new edition". MSNBC. Retrieved 2008-06-14.
  16. ^ Osborne, Duncan (2008-05-15). "Flap Flares Over Gender Diagnosis". Gay City News. Retrieved 2008-06-14.
  17. [http://www.tara4bpd.org Treatment and Research Advancements National Association for Personality Disorders(TARA-APD)
  18. http://www.tara4bpd.org/dyn/index.php?option=content&task=view&id=32&Itemid=35 How Advocacy is Bringing BPD into the Light

External links

Categories: