March 16, 2012
By Mike Barrett
“The Diagnostic and Statistical Manual of Mental Disorders is a joke. The new edition is said to have multiple ties with big pharma. Isn’t that nice?” –KTRN
The psychiatric bible, known as the Diagnostic and Statistical Manual of Mental Disorders, is hailed by psychiatrists and psychiatry supporters alike. The 5th edition of the manual, scheduled for publication in May of 2013, is stirring up massive controversy.
Being the go-to text for diagnosing every mental disorder known to (and created by) man while ultimately leading to widespread medicating of the population, the 900-page bible is now being pegged for financial conflicts of interest.
In 1994, DSM-4, the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders, was published. Shortly following the publication, the American Psychiatric Association implemented a new policy which would force expert advisors to divulge any ties with drug industries in order to cut down on potential conflicts of interests. Despite the newly instituted policy, an astonishing 70 percent of the panel members of the newest edition, DSM-5, reported having financial relationships with pharmaceutical companies. About 57 percent reported ties in the previous edition.
‘Organizations like the APA have embraced transparency too quickly as the solution…Our data show that transparency has not changed the dynamic.’ said Lisa Cosgrove, associate professor of clinical psychology at the University of Massachusetts-Boston and lead author of the study.
Ultimately leading to millions of people being labeled as ‘mentally ill’, the DSM-5 is also criticized greatly for the addition of new, quite startling diagnoses. With the new criteria, the following situations would cause someone to have a mental or psychiatric disorder.
Grief following the loss of a loved one
Mild memory loss in the elderly
Frequent temper tantrums in kids
February 17, 2012
By Jonathan Benson
With every new revision of the American Psychiatric Association’s (APA) controversial Diagnostic and Statistical Manual of Mental Disorders (DSM) comes the addition of new so-called “mental disorders” that are really just variances in human behavior. And the manual’s proposed fifth edition is no exception, as it proposes reclassifying normal behaviors like bereaving the death of a loved one, for instance, or spending “too much” time surfing the internet, as mental disabilities that necessitate taking psychiatric medications.
The successor to DSM-4, which was originally published in 1994, DSM-5 is set to be released in May 2013 following various preliminary draft revisions, several public comment periods, and general review by the psychiatric and medical communities. But so far, thousands of health professionals have already come out in opposition to the new manual in its current form, as it basically redefines a number of otherwise normal human behaviors as supposed mental illnesses.
According to David Pilgrim from the University of Central Lancashire in the U.K., it is obvious that DSM-5 “will help the interests of the drug companies” by widening the scope of what is considered to be mental illness. He told Reuters Health in a recent interview that the new guidelines “risk treating the experience and conduct of people as if they are botanical specimens waiting to be identified and categorized in rigid boxes.” He added that it is a “form of collective madness,” and referred to the proposed revisions as a “pseudo-scientific exercise.”
May 17, 2010
By Ethan A. Huff
Psychiatrists have been working on the fourth revision of the Diagnostic and Statistical Manual of Mental Disorders (DSM) and, in it, they hope to add a whole slew of new psychiatric disorders. Unfortunately, many of these disorders are merely differences in personality and behavior among people.
The new edition may include “disorders” like “oppositional defiant disorder”, which includes people who have a pattern of “negativistic, defiant, disobedient and hostile behavior toward authority figures.” Some of the “symptoms” of this disorder including losing one’s temper, annoying people and being “touchy”.
Other “disorders” being considered include personality flaws like antisocial behavior, arrogance, cynicism or narcissism. There are even categories for people who binge eat and children who have temper tantrums.
Children are already over-diagnosed for allegedly being bipolar or having attention-deficit disorder (ADD), which results in their being prescribed dangerous antipsychotic drugs. To categorize even more childhood behaviors as psychiatric disorders will only further increase the number of children who will be needlessly prescribed antipsychotic drugs.
Each new revision of DSM has included controversial new additions, and this newest version is no exception. In fact, the manual has increased considerably in size over the years. What is most disturbing about the current proposed revisions is the blatantly brave, new way in which so-called medical professionals are viewing individual characteristics.
Children who exhibit unique eccentricities in accordance with their unique personalities, in general, would be categorized as having a mental illness. If this criteria had been used in past centuries to diagnose illness, there may have never been people like Mozart or Einstein who ventured outside the norm and came up with new or unique ideas.
A Washington Post article captured the essence of this concept perfectly in the following quote:
“If seven-year-old Mozart tried composing his concertos today, he might be diagnosed with attention-deficit hyperactivity disorder and medicated into barren normality.”
The perception that character differences are somehow a psychic illnesses not only absolves individuals of personal responsibility, but it takes away their unique personhood. It reduces people into subjects that cannot think for themselves, but rather have to be controlled through drugs.
Which brings us to perhaps the biggest thrust behind the DSM revisions: the drug companies. Pharmaceutical companies stand to gain a lot for having virtually every person categorized as mentally ill and in need of drugs.
A more accurate approach to the situation is to assess the psychiatrists and drug lords who are contriving such nonsense as being the true possessors of mental illness. Perhaps these people are the ones that need to be institutionalized.
March 2, 2010
By George F. Will
Peter De Vries, America’s wittiest novelist, died 17 years ago, but his discernment of this country’s cultural foibles still amazes. In a 1983 novel, he spotted the tendency of America’s therapeutic culture to medicalize character flaws:
“Once terms like identity doubts and midlife crisis become current,” De Vries wrote, “the reported cases of them increase by leaps and bounds.” And: “Rapid-fire means of communication have brought psychic dilapidation within the reach of the most provincial backwaters, so that large metropolitan centers and educated circles need no longer consider it their exclusive property, nor preen themselves on their special malaises.”
Life is about to imitate De Vries’s literature, again. The fourth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM), psychiatry’s encyclopedia of supposed mental “disorders,” is being revised. The 16 years since the last revision evidently were prolific in producing new afflictions. The revision may aggravate the confusion of moral categories.
Today’s DSM defines “oppositional defiant disorder” as a pattern of “negativistic, defiant, disobedient and hostile behavior toward authority figures.” Symptoms include “often loses temper,” “often deliberately annoys people” or “is often touchy.” DSM omits this symptom: “is a teenager.”
This DSM defines as “personality disorders” attributes that once were considered character flaws. “Antisocial personality disorder” is “a pervasive pattern of disregard for . . . the rights of others . . . callous, cynical . . . an inflated and arrogant self-appraisal.” “Histrionic personality disorder” is “excessive emotionality and attention-seeking.” “Narcissistic personality disorder” involves “grandiosity, need for admiration . . . boastful and pretentious.” And so on.
If every character blemish or emotional turbulence is a “disorder” akin to a physical disability, legal accommodations are mandatory. Under federal law, “disabilities” include any “mental impairment that substantially limits one or more major life activities”; “mental impairments” include “emotional or mental illness.” So there might be a legal entitlement to be a jerk. (See above, “antisocial personality disorder.”)
The revised DSM reportedly may include “binge eating disorder” and “hypersexual disorder” (“a great deal of time” devoted to “sexual fantasies and urges” and “planning for and engaging in sexual behavior”). Concerning children, there might be “temper dysregulation disorder with dysphoria.”
This last categorization illustrates the serious stakes in the categorization of behaviors. Extremely irritable or aggressive children are frequently diagnosed as bipolar and treated with powerful antipsychotic drugs. This can be a damaging mistake if behavioral modification treatment can mitigate the problem.
Another danger is that childhood eccentricities, sometimes inextricable from creativity, might be labeled “disorders” to be “cured.” If 7-year-old Mozart tried composing his concertos today, he might be diagnosed with attention-deficit hyperactivity disorder and medicated into barren normality.
Furthermore, intellectual chaos can result from medicalizing the assessment of character. Today’s therapeutic ethos, which celebrates curing and disparages judging, expresses the liberal disposition to assume that crime and other problematic behaviors reflect social or biological causation. While this absolves the individual of responsibility, it also strips the individual of personhood and moral dignity.
James Q. Wilson, America’s preeminent social scientist, has noted how “abuse excuse” threatens the legal system and society’s moral equilibrium. Writing in National Affairs quarterly (“The Future of Blame”), Wilson notes that genetics and neuroscience seem to suggest that self-control is more attenuated — perhaps to the vanishing point — than our legal and ethical traditions assume.
The part of the brain that stimulates anger and aggression is larger in men than in women, and the part that restrains anger is smaller in men than in women. “Men,” Wilson writes, “by no choice of their own, are far more prone to violence and far less capable of self-restraint than women.” That does not, however, absolve violent men of blame. As Wilson says, biology and environment interact. And the social environment includes moral assumptions, sometimes codified in law, concerning expectations about our duty to desire what we ought to desire.
It is scientifically sensible to say that all behavior is in some sense caused. But a society that thinks scientific determinism renders personal responsibility a chimera must consider it absurd not only to condemn depravity but also to praise nobility. Such moral derangement can flow from exaggerated notions of what science teaches, or can teach, about the biological and environmental roots of behavior.
Or — revisers of the DSM, please note — confusion can flow from the notion that normality is always obvious and normative, meaning preferable. And the notion that deviations from it should be considered “disorders” to be “cured” rather than stigmatized as offenses against valid moral norms.