The Diagnostic and Statistical Manual (DSM) of mental disorders is a widely used and popular text that lists and describes the various mental disorders and the criteria that resembles each one specifically. These series of manuals have had several major problems since their introduction and the latest edition which has yet to release still faces problems in terms of validity with the scientific community. By use of a diagnostic criterion they fail to incorporate many factors such as social influences, a scientific base, and distinction between the criteria for the different disorders. These are only a few of the problems facing the DSM but they may also be the most significant. The largest problem with the diagnostic model of the DSM I believe is the complete neglect of social context in relation to behavior. The DSM provides criteria for which clinicians and psychiatrists can make diagnoses but fails to incorporate how a social factor, like the loss of a family member, can lead to behaviors characteristic of a mental disorder such as General Anxiety Disorder. This can lead to many instances of misdiagnosis in either a false negative or false positive manner. There could also be misinterpretation due to social differences where something that is natural to someone in one culture is seen as problematic to another in a different culture. The largest problem that arises from this lack of recognition for social factors is the fundamental attribution bias, which is the misinterpretation of a behavior as due to a person’s personality rather than a result of environmental forces. If people do not have the time or energy to consider these implications that society has on behavior, many misdiagnoses and misinterpretations will continue ... ... middle of paper ... ...making a positive contribution. With more criteria, there should be a stricter process of diagnosing people and better accuracy in doing so. This is not the case as repetitive criteria increase the supposed prevalence rate of different disorders and work to create confusion throughout the scientific community. These problems will continue to hinder the validity of the DSM and with the popularity of these manuals, there may also continue to be negative influences such over-diagnoses. There will also be continued influence from both the government and the pharmaceutical companies that can sway the production of the manuals which may not be in the best interest of science. The authors explain it best I believe when they describe the DSM as a fictitious guide searching to solve every human problem. There may well not be a solution to all the problems that people face.
Diagnostic and Statistical Manual of Mental Disorders: DSM-IV. Arlington, VA.: American Psychiatric Association, 2007. Print.
...s that the DSM can also falsely determine ones specific mental health, showing the struggle between diagnosing someone with genuine disorders and excessively diagnosing individuals.
The DSM has been found to be somewhat bias. There are some pros and cons to the DSM as well. Some have found that it leads to uniform and improved diagnosis, improves informed professional communication through uniformity, and provides the basis for a comprehensive educational tool. While others believe it can lead to diagnostic labels, by providing limited information on the relationship between environmental considerations and aspects of the mental health condition. Lastly, it does not describe intervention strategies (Wakefield,
Frances, A., & Ross, R. (1996). DSM-IV case studies a clinical guide to differential diagnosis. Washington, DC: American Psychiatric Press, Inc.
Identification of any psychosocial or contextual factors to be considered, as outlined in the DSM-5
Originally published in 1952, the DSM has been through a number of revisions in its history. The original manual was the culmination of an extended journey of its own. According to Tartokovsky (2011), the DSM was born out of the need to minimize the confusion that had developed in the world of mental health care with regard to classifying disorders. Prior to this, there had been an initial attempt to create a system of classification that had emerged in 1917 known as the Statistical Manual for the Use of Institutions for the Insane. The manual was written by the early predecessor to the APA and wa...
I think the video featuring Dr. Frances highlights some of the controversy surrounding the publishing of DSM-5. It was interesting to see how changes regarding diagnoses of mental disorders in the DSM-5 could have such overarching effects. Dr. Frances mentioned the specific example of the change regarding a possible diagnosis of major depressive disorder after just two weeks of symptoms, even in times of grief/mourning. In his opinion this was overreach and people experiencing normal grief could be classified with a disorder. According to Regier,Kuhl, & Kupfer (2013) the original two month guideline in DSM-4 was not thought to be specific enough. “Unfortunately, this [two week guideline] also prevented bereaved individuals who were experiencing
Kahn, Ada P., and Jan Fawcett. The Encyclopedia of Mental Health. 2nd ed. New York: Facts On File, 2001.
Saving Normal by Allen Frances is an exploration of the major diagnostic inflation currently occurring in the field of psychiatry. Frances, a prominent and accomplished psychiatrist, is best known for being chair on the task force in the production of the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM), often considered the “bible of psychiatry”. Being an insider, Frances has extensive knowledge of the causes of diagnostic inflation and exactly how the psychiatry field has faced difficulties. In Saving Normal, Frances delves into the history of diagnosis, presents the negative effects of its increase, and considers solutions to this rapid rise. Asserting that the the increase in diagnosis is out of control,
McGrath, E. C., McGonagle, K.A., Zhao, S., Nelson, C.B., Hughes, M., Eshleman, S., Wittchen, H-U., & Kendler, K.S.(2007).Lifetime and 12-month prevalence of DSM-III-R psychiatric disorders in the United States: Results from the National Comorbidity Survey. Archives of General Psychiatry, 51, 3-14.
Diagnostic and statistical manual of mental disorders: DSM-IV-TR. (4th ed.). (2000). Washington, DC: American Psychiatric Association.
This not only affects the lives of the patients, but also the lives of therapists. A simple mistake can ruin an individual’s life, as well as the therapist, doctor, or any health practitioners, and depending on the severity of the misdiagnosis, it may last a lifetime. With so many negative impacts of misdiagnosis, many might ask what are University and professionals doing to put an end to it. There’s so many ways Universities can help prevent misdiagnosis “Teaching medical students in a way that doesn’t always center on looking for the quickest, easiest diagnosis could mean better diagnoses for millions of people every year. Medical students are trained that ‘when you hear hoof beats, think horses, not zebras.’ This cognitive shortcut generally works well, but combined with the pressured reality of modern medical practice, it impacts a doctor’s capacity for critical thinking” as reported by Seattle times from an article named Millions of Patients are Being Treated for the Wrong Condition. First, Universities should teach future therapists and other health practitioners how to appropriately use the Diagnostic and Statistical Manual of Mental Disorders before diagnosing a client. Additionally, universities need to make sure studies are ready to work with a patient before trusting them to diagnose a client. Universities are not the only ones to blame when it comes to
American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders (4th ed.). Washington, DC: Author.
Kendell, R. and Jablensky, A. (2003), Distinguishing between the validity and utility of psychiatric diagnoses, American Journal of Psychiatry, Vol. 160, No. 1, pp. 4-12.
Mental illness is the condition that significantly impede with an individual’s emotional, cognitive or social abilities (Savy and Sawyer, 2009). According to (Savy and Sawyer, 2009) neurological, metabolic, genetic and psychological causes are contributing factors for various types of mental illness like depression, schizophrenia, substance abuse and progression of condition. An elaborate system known as DSM-IV-TR gives a classification system that acts to separate mental illness into diagnostic categories based on the description of symptoms of illness (Savy and Sawyer, 2009). The exact primarily causes of mental illness are complicated, however, it seems to occur in a psychologically and biologically prone individual, in the trigger of environmental and social stress (Elder, Evans and Nizette, 2007).