What's Wrong With DSM-5?
What's Wrong With DSM-5?
Dr. Strakowski: Now that attenuated psychosis syndrome and mixed anxiety depressive disorder are no longer in play, what are your biggest concerns with the remaining DSM-5 proposals?
Dr. Frances: Again, the DSM-5 Task Force responding to criticism is good news. But there is also bad news. First off, DSM-5 reported embarrassingly poor field trial results at this year's meeting, yet it still plans to go ahead with its May 2013 publication. This violates the original DSM-5 plan (and promise) to rewrite the poorly drafted criteria sets and then to retest them to ensure that they were acceptable. As it stands, DSM-5 not only lacks credibility itself but also will tarnish the credibility of our entire field. The only possible motivation for this shortsighted decision is that APA is choosing publishing profits over public trust.
Also discouraging are all the remaining reckless suggestions that now appear fast-tracked to make it into DSM-5. Here is a short list:
The Biggest Problems With DSM-5?
Dr. Strakowski: Now that attenuated psychosis syndrome and mixed anxiety depressive disorder are no longer in play, what are your biggest concerns with the remaining DSM-5 proposals?
Dr. Frances: Again, the DSM-5 Task Force responding to criticism is good news. But there is also bad news. First off, DSM-5 reported embarrassingly poor field trial results at this year's meeting, yet it still plans to go ahead with its May 2013 publication. This violates the original DSM-5 plan (and promise) to rewrite the poorly drafted criteria sets and then to retest them to ensure that they were acceptable. As it stands, DSM-5 not only lacks credibility itself but also will tarnish the credibility of our entire field. The only possible motivation for this shortsighted decision is that APA is choosing publishing profits over public trust.
Also discouraging are all the remaining reckless suggestions that now appear fast-tracked to make it into DSM-5. Here is a short list:
Disruptive mood dysregulation disorder
Minor neurocognitive disorder
Removing the bereavement exclusion for major depressive disorder
Lowered ADHD threshold (by raising the allowed age of onset to 12)
Lowered threshold and poor reliability for generalized anxiety disorder
Combining substance abuse with substance dependence under the rubric of addictive disorders yielding low reliability and unnecessary stigma
A category for "behavioral addictions" that will promote "Internet addiction" as a NOS (not otherwise specified) diagnosis; can "addictions" to sex, shopping, and work, etc, be far behind?
Wording of the pedophilia criteria set that tries to sneak in hebephilia and invites forensic abuse
Making binge-eating a mental disorder
An unusable personality section that the APA Assembly voted unanimously to oppose
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