DSM-5 response

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hettie
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DSM-5 response

Post by hettie » Thu Mar 21, 2013 1:21 pm

As reported by the BPS here http://www.bps.org.uk/news/petition-aga ... 5-launched
a petition has been launched against DSM-5. The BPS webpage (above) gives a link to the BPS's concerns about the new DSM-5 and you can find more information on the website that contains the link to the petition....
http://dsm5response.com/statement-of-concern

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BlueCat
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Re: DSM-5 reposnse

Post by BlueCat » Tue Apr 23, 2013 9:48 pm

Thank you for sharing this! It is an interesting issue, and also, I think, helpful for non-BPS members to see what the BPS is doing.
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moonbeam
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Re: DSM-5 reposnse

Post by moonbeam » Wed Apr 24, 2013 12:59 pm

Thanks for sharing. I wondered whether the publication would be going ahead.

Premenstrual Dysphoric Disorder....

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msrisotto
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Re: DSM-5 reposnse

Post by msrisotto » Fri May 10, 2013 4:18 pm

From a feminist point of view I am horrified at Premenstrual Dysphoric Disorder! How dare they pathologise women in such a way. Not that it is the first time (do they forget 'Hysteria' so easily?). And it's completely unfounded in medical science - there is no testosterone hormone imbalance disorder equivalent for men and hormone treatments do not cure PMS. They're putting themselves at risk of appearing ridiculous. There's a bunch of caffeine related 'disorders' too.

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Re: DSM-5 reposnse

Post by lingua_franca » Sat May 11, 2013 2:53 pm

I've just read the BPS statement on it all. I'm glad that they're taking action on this, as it does seem as though the new DSM is pathologising everyday experience and encouraging people to view normal changes across the lifespan in rigid diagnostic terms. 'Mild Neurocognitive Disorder' as a diagnosis for older adults? How many elderly people don't become more forgetful as they age?

The premenstrual whatever disorder is interesting. As a teenager, when I started to menstruate, I used to get outraged when someone met anger or unhappiness on my part with a soothing 'I expect it's just that time of the month' (often it wasn't). But I couldn't show the indignation, because then that would have been proof of unreasonableness brought about by my uterus. Later I would sometimes catch myself responding to a low mood by wondering where I was in my cycle. Then there are all the jokey magazine articles about PMT and the need for chocolate. I think it's sad that women are taught from a young age to expect bad moods and irritability and unreasonable thinking when they get their period, and that they start to view our experiences in these terms. Gloria Steinem has an interesting essay on the way attitudes to menstruation have developed, If Men Could Menstruate. It's worrying that the new DSM is propagating this kind of unhelpful pathologising and pigeon-holing.
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Gilly
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Re: DSM-5 reposnse

Post by Gilly » Sat May 11, 2013 4:07 pm

Just to play devils avocado on it all (nb - i'm critical of diagnosis, not necessarily opposed to it)
lingua_franca wrote:I've just read the BPS statement on it all. I'm glad that they're taking action on this, as it does seem as though the new DSM is pathologising everyday experience and encouraging people to view normal changes across the lifespan in rigid diagnostic terms. 'Mild Neurocognitive Disorder' as a diagnosis for older adults? How many elderly people don't become more forgetful as they age?
We currently have an ICD diagnostic category of Mild Cognitive Impairment, which is the appearance of cognitive difficulties beyond those expected of the age and ability of the individual, but is not associated with a dementia diagnosis. I'm assuming this that Mild Neurocognitive Disorder is the DSM version of this (someone correct me if not) - MCI is a major risk factor in the development of further neurodegenerative diseases, so its a good way of keeping an eye on people in this situation, and to provide early intervention if they start to deteriorate. Its not going to be as a simple as forgetful > diagnosis and medication, it has to go beyond normal expectations.
msrisotto wrote:From a feminist point of view I am horrified at Premenstrual Dysphoric Disorder! How dare they pathologise women in such a way. Not that it is the first time (do they forget 'Hysteria' so easily?). And it's completely unfounded in medical science - there is no testosterone hormone imbalance disorder equivalent for men and hormone treatments do not cure PMS. They're putting themselves at risk of appearing ridiculous. There's a bunch of caffeine related 'disorders' too.
I don't really see the outrage in this diagnosis, I view it on a similar landscape to the post-partum diagnoses - (almost exclusively) female specific and most likely due to hormonal influences on the person (although obviously not solely). I've quickly read through some of the papers, and again, its about significant mood swings and behaviours which the person is struggling with - as with all DSM diagnoses, it has to cause "clinically significant distress or impairment in social, occupational, or other important areas of functioning". Although I would wonder why this counts as "psychiatric" rather than "medical".

In regards to your second point about there not being a male equivalent - no, but i don't see why there needs to be an equivalent for males for this to be valid? In regards to testosterone though, there is some interesting research showing that it is possibly a factor in antisocial personality disorder (*too high*) and depression in males (*too low) - so it may have an influence.

Although, Disruptive Mood Dysregulation Disorder - THAT doesn't need to be a whole new diagnosis... :)

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matt.berlin
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Re: DSM-5 reposnse

Post by matt.berlin » Sat May 11, 2013 9:12 pm

Gilly wrote:
msrisotto wrote:From a feminist point of view I am horrified at Premenstrual Dysphoric Disorder! How dare they pathologise women in such a way. Not that it is the first time (do they forget 'Hysteria' so easily?). And it's completely unfounded in medical science - there is no testosterone hormone imbalance disorder equivalent for men and hormone treatments do not cure PMS. They're putting themselves at risk of appearing ridiculous. There's a bunch of caffeine related 'disorders' too.
I don't really see the outrage in this diagnosis, I view it on a similar landscape to the post-partum diagnoses - (almost exclusively) female specific and most likely due to hormonal influences on the person (although obviously not solely). I've quickly read through some of the papers, and again, its about significant mood swings and behaviours which the person is struggling with - as with all DSM diagnoses, it has to cause "clinically significant distress or impairment in social, occupational, or other important areas of functioning". Although I would wonder why this counts as "psychiatric" rather than "medical".
Because post-partum diagnoses and diagnostic criteria generally don't pathologise women at all do they?
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Gilly
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Re: DSM-5 reposnse

Post by Gilly » Sat May 11, 2013 9:23 pm

I didn't say they didn't pathologise, but the very definition of pathologise is "to view or characterise as medically or psychologically abnormal" - post partum depression/puerperal psychosis are by this definition a differentiation from what could be thought of as normal, are they not?

why is it wrong to acknowledge that what is happening to someone perhaps isn't normal, and whilst its often understandable from their context/biology etc, that it means they may need additional help and support?
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BlueCat
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Re: DSM-5 reposnse

Post by BlueCat » Sat May 11, 2013 9:45 pm

I guess it depends, Gilly, on how broad-minded society is willing to be about what is a "normal" response to something. I would actually suggest that low mood is a pretty "normal", albeit undesirable and not generally experienced as pleasant response to what could be described as major physical trauma, enforced lifestyle changes, enforced sleep deprivation, reduction in household income, increase in household expenses, major relationship strain....blah blah. I could even suggest that from an evolutionary perspective, a touch of what we today call depression could have had a positive survival influence when our lives were more dangerous than today.

On an entirely different note, might it be a large factor in this that DSM is mainly US, where you absolutely categorically and without exclusion, require a diagnosis in order to get your healthcare provider to pay for any medical input?
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Gilly
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Re: DSM-5 reposnse

Post by Gilly » Sat May 11, 2013 9:59 pm

indeed BC, I read some teaching notes the other day on depression, in which the opening slide was that depression is a normal mood state that humans experience, whereas clinical depression is not.

definitely RE: DSM and America, but obviously it has implications for us in regards to research in the future.
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BlueCat
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Re: DSM-5 reposnse

Post by BlueCat » Sat May 11, 2013 10:04 pm

But we as a society/professional elite decide when something is "clinically" significant, it is all open to interpretation and socially constructed. "Clinical" depression only exists because we say it does.
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Gilly
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Re: DSM-5 reposnse

Post by Gilly » Sat May 11, 2013 10:14 pm

I disagree that its all socially constructed, whilst I agree that we as professionals can assign a "point" at which something becomes a "clinical" issue, perhaps that it is something that we have identified rather than constructed completely?
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Re: DSM-5 reposnse

Post by BlueCat » Sat May 11, 2013 10:18 pm

If we are assigning the point then we are constructing it, surely?
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Gilly
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Re: DSM-5 reposnse

Post by Gilly » Sat May 11, 2013 10:34 pm

hmm, so let me try and explain myself more articulately.

I'm thinking that there is actually something akin to clinical depression, a state in which mood is so low as to impair functioning, that would occur regardless of it we acknowledged or named it, its naturally occurring. Then we come along, discover it, and set a name and some parameters on it (they may not necessarily be correct) - so i regard "construction" as a way of building upon, developing and understanding naturally occurring phenomenon - I don't agree that things necessarily exist solely because we deem they do. This isnt fully formed as my understanding is currently ongoing, but its my current thoughts :)

does that make sense?
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matt.berlin
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Re: DSM-5 reposnse

Post by matt.berlin » Sat May 11, 2013 11:23 pm

I think my point was more along the lines of we don't have a "New dad who works too much to avoid going home and looking after the baby" syndrome. And that's just for starters in how psychology and psychiatry define women's experiences and ways of coping as abnormal and pathological...
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