User Tag List

Results 1 to 8 of 8

  1. #1
    Glycerine
    Guest

    Default The NIMH Rejects DSM-5

    http://m.dailykos.com/story/2013/05/...-rejects-DSM-V
    The largest scientific organization for mental health research is withdrawing support for the newest edition of the DSM and are creating their own diagnostic system. Thoughts.

  2. #2
    Senior Member Nicodemus's Avatar
    Join Date
    Aug 2010
    Posts
    9,128

    Default

    Good.

  3. #3
    Senior Member
    Join Date
    Dec 2008
    Posts
    4,226

    Default

    In for The Secret of NIMH jokes. <subscribed>

  4. #4
    & Badger, Ratty and Toad Mole's Avatar
    Join Date
    Mar 2008
    Posts
    18,524
    Quote Originally Posted by Glycerine View Post
    http://m.dailykos.com/story/2013/05/...-rejects-DSM-V
    The largest scientific organization for mental health research is withdrawing support for the newest edition of the DSM and are creating their own diagnostic system. Thoughts.
    As we move from a print based society to an electronic based society, we need therapy to help us make the transition. And so we find ourselves living in the Therapeutic Society.

    But as the electronic world changes our sense ratios, we will have less need of therapy, and we will take our new sense ratios for granted.

    So therapy is a passing social phase.

    Therapy helps us adjust to our new electronic conditions.

  5. #5

    Default A lot of fuss over a blog post?

    I think this is the "strongly worded critique" that this Psychology Today article on the same subject was referring to, and I think what a lot of articles that came out at that time referred to. But in it, the author talks about a rejection to come in the (then) future (even though it is clear that his own opinion of the DSM was poor). Granted, this is the director of the NIMH giving his opinon, so it carries weight, but I see nothing particularly official about it.

    This is about the most I can get out of it:
    That is why NIMH will be re-orienting its research away from DSM categories. Going forward, we will be supporting research projects that look across current categories – or sub-divide current categories – to begin to develop a better system. What does this mean for applicants? Clinical trials might study all patients in a mood clinic rather than those meeting strict major depressive disorder criteria. Studies of biomarkers for “depression” might begin by looking across many disorders with anhedonia or emotional appraisal bias or psychomotor retardation to understand the circuitry underlying these symptoms. What does this mean for patients? We are committed to new and better treatments, but we feel this will only happen by developing a more precise diagnostic system. The best reason to develop RDoC is to seek better outcomes.
    ^To me, the above seems like common sense, and not at all surprising.


    It is possible that all the fuss is about Insel's short opinion piece, with some blurbs about how the NIMH will fund research. If so, I think the blogosphere has itself gone nuts--complete with articles titled "NIMH Delivers A Kill Shot To DSM-5"

    Giving the bloggers the benefit of the doubt, I continued on my hunt for primary source...

    Here is an article on NIMH that is bit more friendly, and talks as if a rejection has already occurred. But still, no primary source for an official rejection...

    Here is a draft version of something from NIMH from two years ago that seems to foreshadow this development.
    Currently, diagnosis in mental disorders is based on clinical observation and patients’ phenomenological symptom reports. This system, implemented with the innovative Diagnostic and Statistical Manual-III (DSM-III) in 1980 and refined in the current DSM-IV-TR (Text Revision), has served well to improve diagnostic reliability in both clinical practice and research. The diagnostic categories represented in the DSM-IV and the International Classification of Diseases-10 (ICD-10, containing virtually identical disorder codes) remain the contemporary consensus standard for how mental disorders are diagnosed and treated, and are formally implemented in insurance billing, FDA requirements for drug trials, and many other institutional usages. By default, current diagnoses have also become the predominant standard for reviewing and awarding research grants.
    However, in antedating contemporary neuroscience research, the current diagnostic system is not informed by recent breakthroughs in genetics; and molecular, cellular and systems neuroscience. Indeed, it would have been surprising if the clusters of complex behaviors identified clinically were to map on a one-to-one basis onto specific genes or neurobiological systems. As it turns out, most genetic findings and neural circuit maps appear either to link to many different currently recognized syndromes or to distinct subgroups within syndromes. If we assume that the clinical syndromes based on subjective symptoms are unique and unitary disorders, we undercut the power of biology to identify illnesses linked to pathophysiology and we limit the development of more specific treatments. Imagine treating all chest pain as a single syndrome without the advantage of EKG, imaging, and plasma enzymes. In the diagnosis of mental disorders when all we had were subjective complaints (cf. chest pain), a diagnostic system limited to clinical presentation could confer reliability and consistency but not validity. To date, there has been general consensus that the science is not yet well enough developed to permit neuroscience-based classification. However, at some point, it is necessary to instantiate such approaches if the field is ever to reach the point where advances in genomics, pathophysiology, and behavioral science can inform diagnosis in a meaningful way. RDoC represents the beginning of such a long-term project.
    But this is still a draft document. So my search for the "official rejection" continues...

    Nope. I found nothing. It seems like all the fuss is indeed about that very short blurb by the director of NIMH about the direction he would like research funding to take: http://www.nimh.nih.gov/about/direct...iagnosis.shtml

    The rest turns out to be blog posts about blog posts about articles about blog posts about that single blog post by the director of the NIMH.

    I think Insel was quite reasonable about his opinions. If the NIMH does indeed take the route outlined, I think it would be a good thing. But I feel like there is a lot of fuss about something due to happen slowly in the future (again, if somehow it comes out in some official document at some point).

    EDIT: If someone does find a primary source regarding the rejection of DSM by NIMH as an organization, please let me know. But it really seems like we are reacting to a single (albeit weighty) blog post at this point.

    EDIT2: All this reminded me of this thread I started a long time ago.

    Accept the past. Live for the present. Look forward to the future.
    Robot Fusion
    "As our island of knowledge grows, so does the shore of our ignorance." John Wheeler
    "[A] scientist looking at nonscientific problems is just as dumb as the next guy." Richard Feynman
    "[P]etabytes of [] data is not the same thing as understanding emergent mechanisms and structures." Jim Crutchfield

  6. #6

    Default

    These are the fresh rejections in the scientific world.

  7. #7
    movin melodies kiddykat's Avatar
    Join Date
    Jul 2008
    MBTI
    ENFP
    Enneagram
    4, 7
    Socionics
    IEE
    Posts
    1,115

    Default

    Let's not forget that the DSM's driving force is to bill insurance companies, not to mention how flawed it's been in the past (i.e., labeling Gays as having a "mental disorder").

    Not only was depression overly misdiagnosed for low-glycemic levels, the DSM-V really is NOT the end all, know-all, be all for diagnosis and treatment.

    Several healthcare professionals in the field ADAMANTLY REJECT DSM for its inherent bias. Within reason, of course.

    DSM V's original premises was to take out narcissistic personality disorder out of the set of personality disorders parallels with the attitude of narcissism being more and more acceptable in American society seems all too convenient of a move.

    It's like saying sociopathy is ok. Really? No wonder a scientific community like the National Institute of Mental Health would reject DSM-V. Hopefully, NIMH won't ever become corrupt, either.

  8. #8

    Default

    Quote Originally Posted by kiddykat View Post
    Let's not forget that the DSM's driving force is to bill insurance companies, not to mention how flawed it's been in the past (i.e., labeling Gays as having a "mental disorder").

    Not only was depression overly misdiagnosed for low-glycemic levels, the DSM-V really is NOT the end all, know-all, be all for diagnosis and treatment.

    Several healthcare professionals in the field ADAMANTLY REJECT DSM for its inherent bias. Within reason, of course.

    DSM V's original premises was to take out narcissistic personality disorder out of the set of personality disorders parallels with the attitude of narcissism being more and more acceptable in American society seems all too convenient of a move.

    It's like saying sociopathy is ok. Really? No wonder a scientific community like the National Institute of Mental Health would reject DSM-V. Hopefully, NIMH won't ever become corrupt, either.
    To be honest some of the things you mention go away beyond DSM and I would suggest are a reflection of context and culture, even evidence based practice, at the time, rather than being produced by DSM itself.

    More and more of the traditional or earlier categories of mental illness have been recategorised as "problems with living" since the success, intellectually, of anti-psychiatry commentators, changes in social conventions and norms and, I would argue, also resource and professional pressures, such as caseload management.

    While the medical model of mental illness is bashed a lot, sometimes I think the bashing surrounding the limiting of access to services is legit, there's some good and interesting conclusions arising from those quarters over the last five years, for instance the misdiagnosis as bipolar depressive disorders of various diabetic disorders is one example I can think of.

    I agree with anyone who would reject the "dropping" of narcissism and sociopathy from diagnostic criteria, although I would say that as crazy and all it would appear to most "modern" readers much of the writing which pathologised homosexuality is worth a read, there is at least some of it which dumping would appear as ill advised as dumping narcissism and sociopathy.

    That whole topic impressed upon me just how responsive to culture and trends even medicine, which I believe most of the public would think is pretty objective, can be.

Similar Threads

  1. Replies: 118
    Last Post: 09-16-2008, 09:50 AM
  2. What underlies the fear of rejection?
    By ThatsWhatHeSaid in forum General Psychology
    Replies: 9
    Last Post: 01-25-2008, 01:08 AM

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts
Single Sign On provided by vBSSO