Skip to comments.NIMH Delivers A Kill Shot To DSM-5
Posted on 05/04/2013 5:48:42 PM PDT by neverdem
The National Institute of Mental Health (NIMH) is distancing itself from the the American Psychiatric Association and its upcoming Diagnostic and Statistical Manual of Mental Disorders (DSM-5).
While they acknowledge that the goal of DSM "is to provide a common language for describing psychopathology" they are no longer convinced that approach has value if we are going to solve 21st century cognitive science problems. It is, paraphrasing the statement of Thomas R. Insel, M.D., Director of the National Institute of Mental Health, more of a dictionary than a manual. He uses the term "Bible" instead of 'manual' but I would have used 'glossary' rather than 'dictionary'.
Insel pulls no punches in his statement on why they are not going to fund things based on DSM criteria any more.
"The weakness is its lack of validity. Unlike our definitions of ischemic heart disease, lymphoma, or AIDS, the DSM diagnoses are based on a consensus about clusters of clinical symptoms, not any objective laboratory measure."
This is a charge leveled at psychology as well, and the field in general, but psychiatry takes the biggest hits, because they are supposed to be the most evidence-based. Unlike psychology, psychiatrists have to be M.D.s first. Writing in The New Yorker, Gary Greenberg tries to tackle why cognitive science hasn't kept pace with medicine, much less the physical and life and earth sciences, writing rather nicely that "its not entirely clear that psychiatrists want a solution to the problem."
Insel is more blunt. "DSM diagnoses are based on a consensus about clusters of clinical symptoms, not any objective laboratory measure. In the rest of medicine, this would be equivalent to creating diagnostic systems based on the nature of chest pain or the quality of fever."
Basically, he says DSM is stuck in the past.
Indeed, symptom-based diagnosis, once common in other areas of medicine, has been largely replaced in the past half century as we have understood that symptoms alone rarely indicate the best choice of treatment.NIMH is leaving the past behind. In the past, Insel notes, they would reject a biomarker that did not match a DSM category. Now they instead want to collect how all data - genetic, imaging, physiologic and cognitive - cluster, and not just how symptoms do. They call it the Research Domain Criteria (RDoC) project.
Patients with mental disorders deserve better.
No wonder we call it psychobabble
Ah, yes - another chance to admit I’m a shrink and suffer the slings and arrows of outrageous insults from the broad brushes of “fellow” FReepers . . .
But, I’ll sally forth anyway, and try to say something informed about the serial DSM abominations, on the off-chance that someone out there, somehow, gives a flying whatever, or has even the slightest clue what the profession and its practice are really all about, or . . . nah. Forget it. Why bother.
Thomas R. Insel, M.D., Director of the National Institute of Mental Health... pulls no punches in his statement on why they are not going to fund things based on DSM criteria any more. "The weakness is its lack of validity. Unlike our definitions of ischemic heart disease, lymphoma, or AIDS, the DSM diagnoses are based on a consensus about clusters of clinical symptoms, not any objective laboratory measure." This is a charge leveled at psychology as well, and the field in general, but psychiatry takes the biggest hits, because they are supposed to be the most evidence-based.
Serious question: Does anyone know what precisely is going on in a person’s brain that causes depression?
I understand your pain. The unique human being is not a ball to be dropped by the human one year old from their high chair. This world was created for the human who was created in the image of God. Quite a difference.
Taking neuroscience and love it. Wish I could afford to access to all the journals.
Assuming you're in college/university the organization may have access to it: try asking at their library or, if that fails, the dept-head.
I think it has quite a bit to do with visual input. It depresses me when I see a picture of BO.
>>But, Ill sally forth anyway, and try to say something informed about the serial DSM abominations
An informed FReeper would know the psychiatry community redefined homosexuality away from being a mental illness by an edit in DSM-II. This should be enough for anyone to understand that DSM abominations exist. Whether you are a Christian or a serious atheist Darwinist, it is obvious to anyone that homosexuality is an abnormal mental issue.
The medical school affiliated with your university will have some of the more prominent journals. Your neuroscience professor can certainly write you a recommendation so that you’re allowed access. But failing that, a lot of abstracts are available online. The Society for Neuroscience in DC is quite helpful to students, too. PubMed has quite a bit of material you can pick through, some as abstracts and some complete articles.
Bother, please, because some of us are interested and informed and would be grateful for your opinion.
Will be the means of “diagnosis” then forced “treatment”....
Seem to remember it was pretty common for dissidents to be diagnosed as mentally unstable and disappeared into treatment programs.....never to be heard from again.
There are many of us out here who value what you have to say. Please bother. The only reason i click on this type of thread is to get the link and to see if you and a few others have contributed. Otherwise, the ill-informed, stereotyped comments i have to wade through wouldn’t be worth the trip. :-)
shoot...and I was hoping to have someone comment who actually has a valid opinion.
I just always thought that the various DSMs had really loosey goosey criteria that you could apply to almost anyone if the situation was just right
It’s fairly obvious that this redefinition was made for political reasons.
The reply to this would be that the earlier definition of homosexuality as mental illness was also based on non-medical criteria.
To which an unbiased outside observer, perhaps from Vulcan, would note that neither definition is based on scientific or medical criteria. And that politics should have no standing in medicine or science.
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