Critics of the DSM-5 Revision Process Draft Petition

The farsical DSM 5 revision debacle continues. The situation has grown even more comical than previously as members of the American Psychological Association have drafted a petition expressing alarm about some of the current prospective disease categories and calling for changes.

MedScape Medical News, repeating the need for tempering the blunders of the recent past, published a news piece on the matter bearing the heading, Petition Calls for Critical Changes to Upcoming DSM-5.

The disease making process behind the DSM was always very unscientific. This is what neither the American public nor the American Psychological Association seems to understand.

Allen Frances, one of the drafters of the DSM-IV, has become one of the most vocal critics, not opponents, of the process involved in the drafting of the DSM-5. What position he will take when the DSM-6 is being formulated is anyone’s guess.

Divisions of the American Psychological Association have created an online petition addressing “serious reservations” about the upcoming Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5). Launched October 22, the petition has already garnered more than 3000 signatures from mental health professionals, students, and organizations.

I, having serious reservations about the DSM-I, the DSM-II, the DSM-III, the DSM-IV, and the current revisions under review, am not one of the signatories.

One of the issues, although by no means the only issue, for the petitioners is the matter of attenuated psychosis syndrome, the linguistic loophole by which what was formerly referred to as psychosis risk syndrome gets back off the chopping block.

“There’s this idea that if you identify people early, somehow you’ll be able to prevent a full-blown psychosis or full-blown schizophrenia. But research has shown that only up to 20% to 30% of identified people actually went on to develop psychosis, meaning up to 70% or 80% of these people received treatment for a disorder they never ended up developing,” said [Fordham University doctorial candidate] Ms. [Sarah R.] Kamens.

This is not the only proposal these psychiatrists have made for increasing business, and for pushing pharmaceutical products. They also want to reduce the criteria needed to make a diagnosis of attention deficit disorder, and they want to reduce criteria needed to make a diagnoss of generalized anxiety disorder as well.

“We believe we have tapped into a growing frustration with the DSM-5 process. And the groundswell has been quite overwhelming. It’s important to realize, this is not some fringe group that is anti-DSM-5 or antipsychiatry in any way. It’s a group of all kinds of professionals.”

Minor objections to this document are okay, professionals make them; major objections, on the other hand, are made by members of fringe groups. Maybe we need to ship a few more people off to Guantanamo Bay, huh? Assuming they are amateurs, of course.

Unfortunately, once this DSM-5 becomes psychiatric gospel in 2013, the debate will probably die down until we reach the debate on the revisions for the DSM-6. These dead sea scrolls we leave to some archeologist from the post-psychiatric distant future. “Why post-psychiatric”, you may ask? Well, for starters, our very survival is at stake. As you may have noticed, the creeping medicalization of society is now beginning to creep at a cheetah’s pace.

5 Responses

  1. Whereas there used to be substantial DSM to ICD homologation, it appears this is destined for history as they drift further apart.

    Perhaps it is time to simply obsolete the DSM and use the ICD as the authoritative reference in clinical work. With the DSM used by research scientists.

    • Neither/nor. What is the ICD, but a more global DSM? I think there are better approaches to life crises than that of labeling them, and drugging them into oblivion. Some people have real problems, and the answers to those problems are found neither in psychiatric labels nor in pill bottles. Rather than blaming the victim, we should work on changing the circumstances that make victims.

  2. A person who had no experience of, or interest or stake in psychiatry but who was aware of the existence of the the DSM and it’s revisions might say:

    “Doctors are scientists. Psychiatrists are doctors so psychiatrists are scientists. Scientists know that their knowledge is not and will likely never be complete. They know that what they practice is almost certainly not perfect but are striving to increase their knowledge and improve their practice. So I would expect that manuals, texts, education and policies will change and that changes will be for the best for society in general ”

    If we were talking about engineers, not pseudo doctors, the previous statement would much more likely be true for every engineer. Engineers are way less able to lie about the past successes and failures of their power plants, bridges, roads, satellite launches etc.

    And they are not the kind of people who even as teenagers would have any interest in lying or pretending to have knowledge that they did not possess, was unknowable or was UNFALSIFIABLE.

    You and I know that the general public have no interest in the concept of unfalsifiability and are easily influenced by emotionally charged arguments from people who seem to be members of a group that is generally respected.

    So the shrinks aided by their hand-wringing entourage will continue to perpetrate their garbage..

    • A person might reply, “Framed papers and stuffed shirts.” Unfortunately, some of these framed papers and stuffed shirts have managed to fanangle a lot more power and wealth than the rest of us dummies.

      I know the kind of God or authority or sky titty that some of these people are still sucking on, and that is it’s own best critique. We know better. Reality is another matter.

      I don’t blame shinks in toto. I rather blame the ascendant biological medical model school of head-shrinking. The possibility exists for psychiatrists to do a world of good. It’s just the ones that actually think outside the box, and do that good, are few and far between. This is to say that there is a lot of room for improvement, and ever optimistic I would like to think those improvements are on the way.

      When it comes down to it, I think this has a lot to do with the power of large corporations, and this is all the more reason to become involved in the OCCUPY movement that started in NYC with Wall St, and that is gradually sweeping the globe. We can change the world of human affairs, or we can perish. Frankly, I’d rather change the world.

  3. Sure, it could be said that the shrinks are only giving the people what they want and an individual shrink can say, “If I don’t do it someone else will.” But it’s difficult to find an apology for them when they deliberately lie and misrepresent a person in just the same way that a bratty bullying schoolkid might do. And this is the norm in Victoria, we have the highest rate of psychiatric commitment and forced drugging in the world.

    I’m not sure that it would be possible to be a good shrink anymore even in private practice. If any of your patients screw up and you haven’t drugged them you’ll be in trouble. In Victoria private practitioners are increasingly under scrutiny, even surveillance. I know of one who is suspended while being investigated for alleged Medicare fraud. He’s been in private practice for 30 years. He knows too much and doesn’t prescribe enough. They’ve sent cops around to most of his patients asking them to verify the dates and times of their recent appointments. And he’s been forbidden from seeing his patients even if he doesn’t charge them. Like a restraining order.

    As for the big corps, Pharma, mining etc they all appear to be operating legally. Everyone knows they keep secrets and that’s fine, anybody can have a secret. But of course we can reasonably suspect that many secrets are lies and lies secret.

    So I guess this is what OCCUPY is about. There were a couple of rallies here in Melbourne. A few people were beaten up and arrested by the pigs. Some of those will probably embark on careers as psych patients.

    I didn’t go to the rallies but if I can drag myself away from Minecraft I might see if I can meet up with a few occupiers.

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