DSM-5 Could Be Hazardous to Your Mental Health

By Elayne Clift
OpEdNews.com
Originally published on December 22, 2012

Here are some excerpts:

Feminist therapists are concerned for women in particular. Diagnoses such as Borderline Personality Disorder (BPD) and Sexual Dysfunction have disparaged women and compromised them in troubling ways. For example, one expert says that BPD is almost exclusively applied to women because its symptoms relate to emotion and anger.   Some women with the diagnosis have histories of abuse and may have difficulty expressing anger "appropriately."   Such vulnerable women need to have their coping styles better understood before assumptions are made about their behavior.

Similarly, "sexual dysfunction" among women is often based on assumptions about what constitutes normal sexual behavior.   "If only performance failures or lack of desire count, the entire context of sexual activity becomes invisible and of secondary importance," says one member of the Association of Women in Psychology (AWP).

Another AWP member focuses on classism in psychiatric diagnosis.   "Poor women and women of color are particularly likely to be misdiagnosed or encounter bias in treatment," she says. "Therapists may interpret chronic lateness or missed appointments as hostility or resistance to treatment rather than the outcomes of unreliable transportation, irregular shift work, and unpredictable child care arrangements."

The entire article is here.

DSM-5 Wins APA Board Approval

By John Gever, Senior Editor
MedPage Today
Originally published December 1, 2012

The American Psychiatric Association's board of trustees has approved the fifth edition of its influential diagnostic manual, dubbed DSM-5, the group announced Saturday.

The board vote is the last step before the manual is formally released at the APA's annual meeting next May. The association's Diagnostic and Statistical Manual of Mental Disorders was last revised in 1994; that edition is known colloquially as DSM-IV.

According to an APA statement, changes include an end to the system of "axes" used to class diagnoses into broad groups, and an associated restructuring of diagnostic groups to bring disorders thought to be biologically related under the same headings.

Also, many of the diagnostic criteria will now include so-called dimensional assessments to indicate severity of symptoms.

Specific language in DSM-5 was not immediately released, and probably won't be until the formal unveiling in May. Detailed criteria that had been published on the APA's DSM5.org website for public review and comment have now been removed.

However, the statement released Saturday indicated that the manual will include many of the most controversial of the proposed changes from DSM-IV.

The entire article is here.

DSM-5 Field Trials Discredit the American Psychiatric Association

By Allen Frances, M.D.
The Huffington Post
Originally posted October 31, 2012

The $3 million DSM-5 Field Trials have been a pure disaster from start to finish. First, there was the poor choice of design. The study restricted itself to reliability -- the measurement of diagnostic agreement among different raters. Unaccountably, it failed to address two much more crucial questions -- DSM-5's potential impact on who would be diagnosed and on how much its dramatic lowering of diagnostic thresholds would increase the rates of mental disorder in the general population. There was no possible excuse for not asking these simple-to-answer and vitally important questions. We have a right to know how much DSM-5 will contribute to the already rampant diagnostic inflation in psychiatry, especially since this risks even greater overuse of psychotropic drugs.

The entire story is here.

Rates of Nonsuicidal Self-Injury in Youth: Age, Sex, and Behavioral Methods in a Community Sample

AUTHORS:

Andrea L. Barrocas, MA, Benjamin L. Hankin, PhD, Jami F. Young, PhD, and John R. Z. Abela, PhD

OBJECTIVE:

The goal was to assess the rate and behavioral methods of nonsuicidal self-injury (NSSI) in a community sample of youth and examine effects of age and sex.

METHODS:  

Youth in the third, sixth, and ninth grades (ages 7–16) at schools in the community were invited to participate in a laboratory study. A total of 665 youth (of 1108 contacted; 60% participation rate) were interviewed about NSSI over their lifetime via the Self-Injurious Thoughts and Behaviors Interview.

RESULTS: 

Overall, 53 (8.0%) of the 665 youth reported engaging in NSSI; 9.0% of girls and 6.7% of boys reported NSSI engagement; 7.6% of third graders, 4.0% of sixth-graders, and 12.7% of ninth-graders reported NSSI engagement. There was a significant grade by gender interaction; girls in the ninth grade (19%) reported significantly greater rates of NSSI than ninth-grade boys (5%). Behavioral methods of NSSI differed by gender. Girls reported cutting and carving skin most often, whereas boys reported hitting themselves most often. Finally, 1.5% of youth met some criteria for the proposed fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) diagnosis of NSSI.

CONCLUSIONS:  

Children and adolescents engage in NSSI. Ninth-grade girls seem most at risk, as they engage in NSSI at 3 times the rate of boys. Behavioral methods of NSSI also vary by grade and gender. As possible inclusion of an NSSI diagnosis in the fifth edition of the DSM-5 draws near, it is essential to better understand NSSI engagement across development and gender. 

Pediatrics 2012;130:39–45 

The entire article is here.

UConn Researchers Voice Concern Over Proposed Addiction Guideline Changes

By Lisa Catanese
UCONN Today
Originally published June 2, 2012

Two prominent University of Connecticut Health Center researchers are adding their voices to a chorus of other national experts who are questioning proposed changes regarding substance abuse guidelines in a manual used internationally in the diagnosis and treatment of mental illnesses.

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Babor’s reservations about the proposed changes concern the broadening of language defining addiction and the lowering of the threshold of what counts as a substance use disorder. The revisions would expand the number of symptoms of addiction, reduce the number required for a diagnosis, and introduce a “behavioral addiction” category – all of which could lead to millions more people being categorized as addicts when they in fact are simply unhealthy users. This could put a strain on already-limited resources in schools, prisons, and hospitals, he says.

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Kaminer is concerned about the impact of the proposed DSM changes from two perspectives – classifying too many people as having a problem while deterring adolescents from seeking treatment. “There are not enough resources right now,” he says. “This country is collapsing under the burden of health care. Is it necessary to expand diagnosis to include mild cases and yet push away prospective clients by calling them addicts?”

The entire story is here.

The D.S.M. Gets Addiction Right

By Howard Markel
The New York Times - Opinion
Orignally published June 5, 2012

WHEN we say that someone is “addicted” to a behavior like gambling or eating or playing video games, what does that mean? Are such compulsions really akin to dependencies like drug and alcohol addiction — or is that just loose talk?

This question arose recently after the committee writing the latest edition of the Diagnostic and Statistical Manual of Mental Disorders (D.S.M.), the standard reference work for psychiatric illnesses, announced updated definitions of substance abuse and addiction, including a new category of “behavioral addictions.” At the moment, the only disorder featured in this new category is pathological gambling, but the suggestion is that other behavioral disorders will be added in due course. Internet addiction, for instance, was initially considered for inclusion but was relegated to an appendix (as was sex addiction) pending further research.

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Disease definitions change over time because of new scientific evidence. This is what has happened with addiction. We should embrace the new D.S.M. criteria and attack all the substances and behaviors that inspire addiction with effective therapies and support.

The entire opinion is here.

Addiction Diagnoses May Rise Under Guideline Changes

By Ian Urbina
The New York Times
Originally published May 11, 2012

In what could prove to be one of their most far-reaching decisions, psychiatrists and other specialists who are rewriting the manual that serves as the nation’s arbiter of mental illness have agreed to revise the definition of addiction, which could result in millions more people being diagnosed as addicts and pose huge consequences for health insurers and taxpayers.

The revision to the manual, known as the Diagnostic and Statistical Manual of Mental Disorders, or D.S.M., would expand the list of recognized symptoms for drug and alcohol addiction, while also reducing the number of symptoms required for a diagnosis, according to proposed changes posted on the Web site of the American Psychiatric Association, which produces the book.

In addition, the manual for the first time would include gambling as an addiction, and it might introduce a catchall category — “behavioral addiction — not otherwise specified” — that some public health experts warn would be too readily used by doctors, despite a dearth of research, to diagnose addictions to shopping, sex, using the Internet or playing video games.

The entire story is here.

Diagnosing the D.S.M.

By Allen Frances
The New York Times - Opinion
Originally published May 11, 2012

At its annual meeting this week, the American Psychiatric Association did two wonderful things: it rejected one reckless proposal that would have exposed nonpsychotic children to unnecessary and dangerous antipsychotic medication and another that would have turned the existential worries and sadness of everyday life into an alleged mental disorder.

But the association is still proceeding with other suggestions that could potentially expand the boundaries of psychiatry to define as mentally ill tens of millions of people now considered normal. The proposals are part of a major undertaking: revisions to what is often called the “bible of psychiatry” — the Diagnostic and Statistical Manual of Mental Disorders, or D.S.M. The fifth edition of the manual is scheduled for publication next May.

I was heavily involved in the third and fourth editions of the manual but have reluctantly concluded that the association should lose its nearly century-old monopoly on defining mental illness. Times have changed, the role of psychiatric diagnosis has changed, and the association has changed. It is no longer capable of being sole fiduciary of a task that has become so consequential to public health and public policy.

The entire story is here.

Psychiatry Manual Drafters Back Down on Diagnoses

By Benedict Carey
The New York Times - Health
Originally published May 8, 2012

In a rare step, doctors on a panel revising psychiatry’s influential diagnostic manual have backed away from two controversial proposals that would have expanded the number of people identified as having psychotic or depressive disorders.

The doctors dropped two diagnoses that they ultimately concluded were not supported by the evidence: “attenuated psychosis syndrome,” proposed to identify people at risk of developing psychosis, and “mixed anxiety depressive disorder,” a hybrid of the two mood problems.

They also tweaked their proposed definition of depression to allay fears that the normal sadness people experience after the loss of a loved one, a job or a marriage would not be mistaken for a mental disorder.

But the panel, appointed by the American Psychiatric Association to complete the fifth edition of its Diagnostic and Statistical Manual of Mental Disorders, or D.S.M., did not retreat from another widely criticized proposal, to streamline the definition of autism.

The entire story is here.

Autism Criteria Critics Blasted by DSM-5 Leader

By John Gever, Senior Editor
MedPage Today
Origianlly Published May 8, 2012

The head of the American Psychiatric Association committee rewriting the diagnostic criteria for autism spectrum disorders took on the panel's critics here, accusing them of bad science.

Susan Swedo, MD, of the National Institute of Mental Health, said a review released earlier this year by Yale University researchers was seriously flawed. That review triggered a wave of headlines indicating that large numbers of autism spectrum patients could lose their diagnoses and hence access to services.

Swedo spoke at the American Psychiatric Association's (APA) annual meeting, in her role as chairperson of the work group developing new diagnostic criteria for neurodevelopmental disorders in DSM-5, the forthcoming fifth edition of the APA's Diagnostic and Statistical Manual of Mental Disorders.

She was especially incensed by reports in consumer media about the Yale group's study, led by a New York Times article with a "blaring" headline that read, "New Definition of Autism May Exclude Many, Study Suggests." The Yale study, according to the Times article, found that most patients with Asperger's syndrome and about 25% of those with overt autism would not qualify for those diagnoses under DSM-5.

The entire story is here.

A Comparison of DSM-IV and DSM-5 Panel Members' Financial Associations with Industry: A Pernicious Problem Persists

By Krimsky Cosgronve

PLoS Medicine

All medical subspecialties have been subject to increased scrutiny about the ways by which their financial associations with industry, such as pharmaceutical companies, may influence, or give the appearance of influencing, recommendations in review articles, and clinical practice guidelines. Psychiatry has been at the epicenter of these concerns, in part because of high-profile cases involving ghostwriting, and failure to report industry-related income, and studies highlighting conflicts of interest in promoting psychotropic drugs. The revised Diagnostic and Statistical Manual of Mental Disorders (DSM), scheduled for publication in May 2013 by the American Psychiatric Association (APA), has created a firestorm of controversy because of questions about undue industry influence. Some have questioned whether the inclusion of new disorders (e.g., Attenuated Psychotic Risk Syndrome) and widening of the boundaries of current disorders (e.g., Adjustment Disorder Related to Bereavement) reflects corporate interests. These concerns have been raised because the nomenclature, criteria, and standardization of psychiatric disorders codified in the DSM have a large public impact in a diverse set of areas ranging from insurance claims to jurisprudence. Moreover, through its relationship to the International Classification of Diseases, the system used for classification by many countries around the world, the DSM has a global reach.

After receiving criticism that DSM-IV had no financial disclosure of panel members, to its credit the APA instituted a mandatory disclosure policy. The DSM-5 panel members are required to file financial disclosure statements, which are expected to be listed in the publication, and the APA has made a commitment to improve its management of financial conflicts of interest (FCOIs).

The entire story is here.

My Third Letter to the APA Trustees

A Poor Quality DSM-5 in Unacceptable

By Allen Frances, MD

DSM-5 press coverage has suddenly exploded—more than 100 stories from all around the world were published in just the last three weeks (see title and links below). The press is uniformly negative and extremely damaging to DSM-5, to APA, and to the credibility of psychiatry.

The APA responses have been few, unconvincing, and lacking in substance. Also troubling, 47 mental health organizations have expressed their opposition to DSM-5 by endorsing a petition requesting it to have a scientific review independent of APA. And many users are planning to boycott DSM-5 altogether by substituting ICD-10-CM (which will be freely available on the internet). It is fair to say that DSM-5 has become an object of general public and professional scorn.

What would Mel Sabshin be doing in this time of crisis? Of course, Mel never would have allowed APA to get into this mess—but once in any crisis he was an expert in damage control. Were he here today, Mel would certainly recommend that you immediately cut the DSM-5 losses to prevent its inflicting further damage on APA, on psychiatry, and most importantly on our patients.

The entire blog entry is here.

DSM-5 Critics Pump Up the Volume

By John Gever, Senior Editor, MedPage Today

Published: February 29, 2012

With crunch time looming for the ongoing revision of the psychiatry profession's diagnostic manual, critics hoping to stop what they see as destructive changes are taking their campaign to the consumer media.

In early February, British psychologists and psychiatrists unhappy with proposed changes in the fifth edition of the American Psychiatric Association's (APA) Diagnostic and Statistical Manual of Mental Disorders -- the DSM-5, in its forthcoming incarnation -- staged a successful press conference in London, which generated news coverage around the world.

Meanwhile, the most prominent U.S.-based critic of DSM-5, Allen Frances, MD -- chairman of the task force that developed the fourth DSM edition in 1994 -- has become a regular contributor to the popular Huffington Post website. Last week, he suggested there that the government should force the APA to abandon some of the proposed changes.

And the explosion in social media has allowed other, less well-connected mental health professionals and interested laypeople to create their own platforms for airing concerns about DSM-5 -- starting websites and writing comments on others.

At least in part, the rising furor is driven by the DSM-5 revision schedule. The APA has committed to releasing the final version at its May 2013 meeting. Its internal process for ratifying it requires that it be in essentially final form this winter.

Thus, only a few months remain for critics to sway the DSM-5 leadership.

The entire story is here.

Diagnosis of a DSM 5 News Cycle

By John Grohol

World of Psychology

As I was sitting around catching up on some mental health news on Saturday, I inadvertently stumbled upon another manufactured news cycle about the DSM 5. Considering no new significant research findings were released in the past week on the DSM-5 revision efforts, I was a little surprised.

This latest fake news cycle started on Thursday, apparently with the release of a Reuters news story from Kate Kelland. Kelland notes the newest concern comes from “Liverpool University’s Institute of Psychology at a briefing in London about widespread concerns over the manual.” There’s no link to the briefing. And I’m not sure what a “briefing” is — a press conference? (And since when is a press conference a news item? It’s not really equivalent to a new research study, is it?)

Kelland fails to note that Europe and the U.K. don’t actually use the DSM to diagnose mental disorders — it’s a U.S. reference manual for mental disorders diagnosis. So while it’s nice that some Europeans are expressing concern about this reference text, their concern isn’t exactly much relevant. Context is everything, and Reuters failed to provide any useful context in that article.

Sadly, Reuters is a brand name. And once you write an article under that brand name, it cascades down an entire news cycle. Let’s follow it for fun!

Grohol's critique is here.

New Mental Health Manual is "dangerous" say Experts

By Kate Kelland

Health and Science Correspondence

Reuters

Millions of healthy people - including shy or defiant children, grieving relatives and people with fetishes - may be wrongly labeled mentally ill by a new international diagnostic manual, specialists said on Thursday.

In a damning analysis of an upcoming revision of the influential Diagnostic and Statistical Manual of Mental Disorders (DSM), psychologists, psychiatrists and other experts said new categories of mental illness identified in the book were at best "silly" and at worst "worrying and dangerous."

"Many people who are shy, bereaved, eccentric, or have unconventional romantic lives will suddenly find themselves labeled as mentally ill," said Peter Kinderman, head of Liverpool University's Institute of Psychology at a briefing in London about widespread concerns over the manual.

"It's not humane, it's not scientific, and it won't help decide what help a person needs."

The DSM is published by the American Psychiatric Association (APA) and has symptoms and other criteria for diagnosing mental disorders. It is used internationally and seen as the diagnostic "bible" for mental health medicine.

No one from the APA was immediately available for comment.

More than 11,000 health professionals have already signed a petition (at dsm5-reform.com) calling for the development of the fifth edition of the manual to be halted and re-thought.

Some diagnoses - for conditions like "oppositional defiant disorder" and "apathy syndrome" - risk devaluing the seriousness of mental illness and medical zing behaviors most people would consider normal or just mildly eccentric, the experts said.

At the other end of the spectrum, the new DSM, due out next year, could give medical diagnoses for serial rapists and sex abusers - under labels like "paraphilic coercive disorder" - and may allow offenders to escape prison by providing what could be seen as an excuse for their behavior, they added.

The entire story is here.

Critics attack DSM-5 for overmedicalising normal human behaviour

By Geoff Watts
British Journal of Medicine
Originally published on February 10, 2012

Although not due to be published until May 2013, the fifth edition of the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders (DSM-5) is already provoking dissent among psychiatrists and psychologists in Britain.

Critics claim it will make an already problematic diagnostic system worse and result in more people being labelled mentally ill.

<snip>

"The new categories are based on lists of symptoms that don't necessarily map well on to the underlying biological and psychological processes involved in emotion, behaviour, and cognition," said Nick Craddock, professor of psychiatry at Cardiff University.

Speaking at a critical briefing on the current plans for the DSM-5 he claimed that more aspects of emotion, behaviour, and cognition are going to be labelled as diagnoses.

This will medicalise more of what most people view as normal human behaviour.

He offered the example of someone having an episode of severe low mood that met the accepted diagnostic criteria of depression.

"Currently, if this follows bereavement, it would be excluded. It would be regarded as normal. But in DSM-5 the plan is to remove the bereavement exclusion. What most would view as a normal reaction to the death of a loved one would be labelled as a depressive illness," said Professor Craddock.

Peter Kinderman, professor of clinical psychology at the University of Liverpool and also speaking at the briefing said, "DSM-5 is making the process of describing and explaining situations worse."

 He gave as an example the diagnosis of gambling disorder.

"For individuals and for society gambling is a problem.  I think it's unhelpful to regard it as an illness," he said.

"The proposed revision will include a vast number of social, psychological, and behaviour problems in the category of mental disorder, so pathologising mild eccentricity, loneliness, shyness, sadness, and much else.  One worries about what this will mean for the person who receives the label."

To be categorised as mentally ill has all sorts of consequences, he added.

Professor Kinderman suggested that "the American Psychiatric Association call a halt and convene a representative international expert panel to discuss the proposals."

--------------------------
The article can be found here.
Thanks to Ken Pope for this information.

Not Diseases, but Categories of Suffering

By GARY GREENBERG

The New York Times - Opinion

Published: January 29, 2012

YOU’VE got to feel sorry for the American Psychiatric Association, at least for a moment. Its members proposed a change to the definition of autism in the fifth edition of their Diagnostic and Statistical Manual of Mental Disorders, one that would eliminate the separate category of Asperger syndrome in 2013. And the next thing they knew, a prominent psychiatrist was quoted in a front-page article in this paper saying the result would be fewer diagnoses, which would mean fewer troubled children eligible for services like special education and disability payments.

Then, just a few days later, another front-pager featured a pair of equally prominent experts explaining their smackdown of the A.P.A.’s proposal to eliminate the “bereavement exclusion” — the two months granted the grieving before their mourning can be classified as “major” depression. This time, the problem was that the move would raise the numbers of people with the diagnosis, increasing health care costs and the use of already pervasive mind-altering drugs, as well as pathologizing a normal life experience.

Fewer patients, more patients: the A.P.A. just can’t win. Someone is always mad at it for its diagnostic manual.

It’s not the current A.P.A.’s fault. The fault lies with its predecessors. The D.S.M. is the offspring of odd bedfellows: the medical industry, with its focus on germs and other biochemical causes of disease, and psychoanalysis, the now-largely-discredited discipline that attributes our psychological suffering to our individual and collective history.

The entire story is here.

Dr. Robert Gordon's Comment on DSM

Recently, Dr. Robert Gordon posted a comment on the Pennsylvania Psychological Association's listserv about the upcoming DSM-5 revision.

I have been writing to the DSM 5 committee my suggestions and concerns. However, I do not like the DSM. I use a combination of the ICD and PDM. The DSM is American psychiatry's political motive to put mental health care under their umbrella.

As I commonly state in court, "The DSM is a product of a particular guild and it has no legal or scientific authority. My diagnostic opinion is based on the best available research."

 Yet, in over 100 years, the American Psychological Association has not been able to do better. We argue a lot among ourselves, but we have failed to produce a diagnostic system that is better than the DSM.

The international psychodynamic community produced the excellent Psychodynamic Diagnostic Manual (PDM 2006).

WHY A NEW DIAGNOSTIC MANUAL?

Robert Gordon, PhD ABPP

The Psychodynamic Diagnostic Manual (PDM Task Force, 2006) is the first psychological diagnostic classification system that considers the whole person in various stages of development. A task force of five major psychoanalytic organizations and leading researchers, under the guidance of Stanley I. Greenspan, Nancy McWilliams, and Robert Wallerstein came together to develop the PDM. The resulting nosology goes from the deep structural foundation of personality to the surface symptoms that include the integration of behavioral, emotional, cognitive, and social functioning.

The PDM improves on the existing diagnostic systems by considering the full range of mental functioning. In addition to culling years of psychoanalytic studies of etiology and pathogenesis, the PDM relies on research in neuroscience, treatment outcome, infant and child development, and personality assessment.

The PDM does not look at symptom patterns described in isolation, as do the International Classification of Diseases (ICD) and the Diagnostic and Statistical Manual of the American Psychiatric Association (DSM). Research on brain development and the maturation of mental processes suggests that patterns of behavioral, emotional, cognitive, and social functioning involve many areas working together rather than in isolation. Although it is based on psychodynamic theory and supporting research, the PDM is not doctrinaire in its presentation. It may be used in conjunction with the ICD or DSM. The PDM Task Force made an effort to use language that is accessible to all the schools of psychology. It was developed to be particularly useful in case formulation that could improve the effectiveness of any psychological intervention.

The PDM has received very favorable reviews from mostly the psychoanalytic community (Clemens, 2007; Ekstrom, 2007; Migone, 2006; and Silvio, 2007).  However, even non-psychodynamic psychologists that were introduced to the PDM as part of MMPI-2 and ethics/risk management workshops had a positive reaction to the new diagnostic system.  Ninety percent of 192 psychologists surveyed (65 Psychodynamic, 76 CBT and 51 Family Systems, Humanistic/Existential, Eclectic with no primary preference) rated the PDM as favorable to very favorable (Gordon, 2008).

The entire article is here.

    

Statement of the American Psychological Association on the DSM-5 Development Process

There are a variety of posts on this blog highlighting concerns about DSM-5.  APA published this press release on December 2, 2011.

Press Release

WASHINGTON—Diagnostic classification systems of disorders and diseases are an integral part of health care delivery. Any such system, including the upcoming 5th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) of the American Psychiatric Association and the pending revision of the International Classification of Diseases (ICD-11) of the World Health Organization, must be based on the best available science and serve the public interest. 

The American Psychological Association has members with significant expertise in the scientific areas relevant to the DSM, and we have urged them to take part in the DSM revision efforts. We are encouraged that many psychologists are making meaningful contributions to the process as individuals, as members of the DSM-5 Task Force and work groups, and through the divisions of the American Psychological Association. This involvement includes offering comments on draft provisions and participating in field trials. 

We applaud the Society for Humanistic Psychology (Division 32 of our association) for its leadership role in generating dialogue and information-sharing within the broader mental health community concerning the revisions process. The Society also has prepared, disseminated, and garnered wide support for an "open letter" to the DSM-5 Task Force and the American Psychiatric Association, which expresses specific concerns related to the DSM-5 development process. 

We share their belief that the purpose of any diagnostic classification system should be to improve treatment outcomes. Thus it is essential to consider the impact of any new diagnostic system or category on vulnerable individuals, groups and populations, particularly children, older adults, and ethnic minorities. By appropriately identifying individuals in need of treatment, it is possible to both safeguard the welfare of individuals and to direct treatment resources where they are most needed. Concerns also have been raised that over-identification or misidentification of individuals as being in need of treatment could lead to the use of unnecessary and potentially harmful interventions.

The American Psychological Association recognizes that there is a diversity of opinion concerning the ongoing DSM-5 development process. Our association has not adopted an official position on the proposed revision; rather, we have called upon the DSM-5 Task Force to adhere to an open, transparent process based on the best available science and in the best interest of the public. In this regard, we appreciate the Task Force's expressed commitment to seriously consider the issues and concerns raised by experts in the mental health field in their deliberations.

We call upon our members (either as individuals or groups) to continue to add their perspectives to enhance the validity and clinical utility of the DSM-5. The American Psychological Association will continue to monitor the revision process and be a strong voice for its transparency. 

The American Psychological Association, in Washington, D.C., is the largest scientific and professional organization representing psychology in the United States and is the world's largest association of psychologists. APA's membership includes more than 154,000 researchers, educators, clinicians, consultants and students. Through its divisions in 54 subfields of psychology and affiliations with 60 state, territorial and Canadian provincial associations, APA works to advance psychology as a science, as a profession and as a means of promoting health, education and human welfare.

DSM 5 Against Everyone Else

By Allen Frances, M.D.

Psychology Today Blog

Allen Frances, MD

So far, opposition to DSM 5 has been expressed by the following organizations: British Psychological Society; American Counseling Association; Society for Humanistic Psychology (APA Division 32); Society for Community Research and Action: Division of Community Psychology (APA Division 27); Society for Group Psychology & Psychotherapy (APA Division 49); Developmental Psychology (APA Division 7); UK Council for Psychotherapy; Association for Women in Psychology; Constructivist Psychology Network; Society for Descriptive Psychology; and the Society of Indian Psychologists.

An editorial by the Society Of Biological Psychiatry wondered whether DSM 5 was necessary at all. The community of personality disorders researchers is virtually unanimous in its opposition to the DSM 5 personality disorders section. There has also been widespread opposition to the sections on somatic, autistic, gender, paraphilic, and psychotic disorders.

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Strikingly, there seems to be virtually no support for DSM 5 outside the very narrow circle of the several hundred experts who have created it and the leadership of the American Psychiatric Association (APA) which stands to reap large profits from its publication. There is no group and precious few individuals outside of APA who have anything good to say about DSM 5. And even within the DSM 5 work groups and the APA governance structures, there is widespread discontent with the process and considerable disagreement about the product.

The entire blog can be accessed here.