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Archive 1 |
[This discussion might be interesting to anybody interested in,or knowledgable about, DSM-IV-TR:
http://en.wikipedia.org/wiki/Wikipedia:Administrators%27_noticeboard/Incidents#DSM-IV-TR_Copyright_question -- 82.195.137.125 19:13, 20 December 2005 (UTC)]
Link Update: http://en.wikipedia.org/wiki/Wikipedia:Administrators%27_noticeboard/IncidentArchive57#DSM-IV-TR_Copyright_question
is the diagnostic and scinetific manual a science or pseudo science?
It is a terrible shame to waste much energy whining about disclaimers. I would prefer a more critical approach consisting of the implications of using such a diagnostic i.e the overlap between disorders. Also links to relevent advocates and challegeners of the DSM would be ideal.
I made some changes, what do you think? I would like make more. What speically would people like? Some of the article appears to be POV, I tried to make it more objective Expo512 08:43, 6 March 2006 (UTC)
Isn't it like IVr or some upgrade of the original IV?
I think something needs to be said about the changes between III-R and IV, like the introduction of five different axes to differentiate mental, social and physical functioning. That whole system could be put in the introduction, since it's the current standard. -- Kimiko 19:03, 17 Mar 2004 (UTC)
I have added a link to a list of DSM Codes to the See Also section of this page. I'm new here, so I hope that I have remained within the proper codes of conduct or etiquette. Cool? Erikpatt 06:15, 11 Jan 2005 (UTC)
I have added some criticism of DSM IV, this may be a personal opinion but I think it's justified. See what you think.
Can anyone explain the purpose of the "cautionary statement" section? The first sentence sort of makes it sound like it is about a "DSM cautionary statement" that is part of the DSM, or is something related to it, but as I read the section it sounds more like the caution is being advised by an author of the article itself. If this is the case, something needs to be done -- no matter how well-intentioned a warning to the reader may be, it is not NPOV to say, "You should know that X is a bad idea" instead of providing facts. (It kind of runs afoul of the "avoid self-references" guideline as well.) This is why Wikipedia has a medical disclaimer. It would certainly be appropriate to have some text in the article describing how and why the DSM is not intended to be used by amateurs, but an entire section that positions itself as a caution from the article to the reader needs to be rewritten so that it only describes the subject from a neutral stance.
If anyone else understands whether the "DSM cautionary statement" is supposed to describe some external statement in the world, or whether it is meant to itself be a caution to the reader, please edit the article as needed. Thank you. – Sommers (Talk) 17:29, 24 January 2006 (UTC)
Upon further examination of which pages link to what used to be the dedicated "DSM cautionary statement" page, it appears that a lot of psychology-related articles were formerly referring to a page which contained a much larger and widespread description of problems perceived with the DSM. This is a problem, since most of those links now refer to a statement that has not properly existed since it was merged into this article. (A lot of it was moved into the "Development" section even before I did the most recent revision of what remained of the "cautionary statement" section.)
I think the best thing to do would be to remove (or at least rewrite) all direct references in other articles to the former cautionary statement. It was an explicitly POV (although well-intentioned) piece that, by its own title, existed only to make a statement about the weaknesses of the DSM (presumably to warn the reader against trusting it too much). It would be much better to describe these possible weaknesses, carefully in line with the NPOV policy, in a section of this article ("Criticisms" or something similar; it seems weird to have this under "Development" anyway) like we would with any controversial subject, and the other articles can point to the relevant issues with the DSM if and when they apply instead of to a blanket statement.
However, because the use of this "cautionary statement" page and the links to it predate my involvement, I'd like to get some feedback on all of this before I take it upon myself to start making changes across a lot of different articles. If no one objects, I'll get started on working my way down this list. Of course I shouldn't be the only one doing this: beside the fact that it's a big task, there are probably plenty of instances where an article says "(See the DSM cautionary statement)" where it really needs something more specific to be added, and I'll likely lack the necessary expertise in most of those cases. So if you want to make the edits yourself, please do. Otherwise, any feedback or information would be appreciated (including explanations about the former use of the cautionary page). Thanks.
– Sommers (Talk) 05:00, 25 January 2006 (UTC)
(I've taken the liberty of moving several posts from here to the bottom of the page, so that they will be in chronological order. If Zeraeph or anyone else objects, please feel free to revert. Thanks. – Sommers (Talk) 22:13, 27 March 2006 (UTC) )
After having set this task aside for some time, I saw that there were no objections and proceeded. All mention of the former DSM cautionary statement has now been excised from the main namespace. The articles that formerly linked to the statement are no longer visible at the "What links here" link above, so in case anyone would like to review the changes, here is the list of the articles:
I hope this helps to improve the neutrality of Wikipedia's overall treatment of the DSM. Any remaining comments or questions about this matter are still, as always, welcome. Thanks again to Limegreen for the attention to my concerns. Happy editing! – Sommers (Talk) 04:10, 23 March 2006 (UTC)
While I agree that the cautionary statement presented a point of view and I understand the reasons for the merge (I merged them myself), I remain concerned that this particular point of view (a pov incorporated into and shared by the publishers of the DSM, the American Psychiatric Association) is rather significant. I perceive this particular information less as an opinion or editorial about the DSM and more like a " Mr. Yuk" for psychiatric diagnoses. I believe that sites such as this one, which draw individuals from outside of the mental health profession in search of clarification for diagnoses that they may have formally (or otherwise) received should have quick access to the pertinent and important information provided in a cuationary statement. So many of my clients are willing to blindly pursue treatment options that they believe are in accordance with a diagnosis that they may have arbitrarily received years and years ago. For this reason, I think a prominent sign saying "Stop and read this first!" that explains the limitations and purposes of diagnostic practices is important. I believe that it is the responsibility of the wiki community to acknowledge that the information available here is integrally linked with the treatment opportunities of those who access it. It seems that offering the reader easy access to a cautionary statement is part of this responsibility. I am a bit concerned that access to this information has been lost during the merge and revisions. There is a reason William Glasser refers to the DSM as "perhaps the most dangerous and harmful book ever created for mental health" and the cautionary statement is an industry accepted step toward recognizing the limitations and potential dangers of the DSM. It is naive to think that a layperson accessing basic encyclopedic information from this site will either acknowledge the limitations of this diagnostic toolbox or dig far enough as is currently necessary to access the warnings previously provided on the cautionary statement page. I was personally responsible for the merge as the community pointed out the limitations of the cautionary statement. However, I am concerned that the removal of this section from this entry removes the metaphoric Mr. Yuk and leaves readers less prepared to access objective information that may have significant impact on their lives. I hope that the wiki community can help with figuring out a way to prominently display this information in a wiki-appropriate format for readers. Erik 04:15, 22 March 2006 (UTC)
For now, I have restored the last, brief, basic version of a "Cautionary Statement" that existed on this article as DSM cautionary statement. This seems to be some kind of legal requirement and, as a whole we are skating on such thin ice we are swimming, already with DSM and the APA, doesn't do to poke THAT particular tiger with too many sticks. I'm restoring the links as fast as I can. My only POV on this is FEAR OF THE APA ;o) -- Zeraeph 13:17, 23 March 2006 (UTC)
The DSM contains it's own cautionary statement see [2]. HOWEVER the APA specifically refuses permission to use ANY content from the DSM IV TR including criteria. Strictly speaking all criteria should exist only as links to sites for which permission has been given.
All DSM criteria and transcriptions of same should be deleted. Now I am certainly not going to DO that deleting, but that is their position. When articles link to criteria on behavenet, the criteria already contain links the warning statement, as they are required to do. It's all a very dodgey area, but where the criteria still appear as part of an article it is simply wise to link the cautionary statement as would be required by the APA to avoid stirring them up. It would probably be best to just link their own disclaimer on behavenet.
And, I am afraid, if they take a mind to it, the APA most certainly CAN sue the bejaysus out of Wikipedia for copyright violation at any time, not least because permission fort use of criteria has been sought and refused...what on earth makes you think they can't? -- Zeraeph 17:28, 25 March 2006 (UTC)
Reprinting entire sections of the DSM (or perhaps even individual criteria, word-for-word) would of course be copyright infringement, but if an article discusses a particular disorder and we want to give the fact, "The DSM lists X as a diagnostic criterion for this disorder", I don't believe the APA can legally prohibit us from doing so (because facts aren't copyrightable). Now, when Wikipedia articles do go beyond this point and infringe on the DSM, we should treat it like any other copyvio problem. (I agree that the problem does indeed exist for some articles.) But as you seem to be aware, there are two problems with using the cautionary statement to address the copyright matter: (1) Wikipedia hasn't been given the same permission as, for example, BehaveNet, so linking to a cautionary statement is a requirement that doesn't apply to us; and (2) as I've pointed out, Wikipedia's DSM cautionary statement is not the same thing as the DSM's own, so there is no point in linking to it anyway, except for a blind guess that it will somehow appease the APA.
If the purpose of the DSM cautionary statement is what you tell me, then what we're doing is bending the NPOV policy to meet an arbitrarily made-up standard in order to mimic a condition of a permission that we haven't been given. There's no legitimate reason to violate the NPOV policy and this isn't even a particularly good one. The cautionary statement is a POV fork, the links to it imply a critical opinion of the DSM, and they need to go now. That said, I understand your opinion and I'm glad you're paying attention to these matters. Thanks again for continuing to discuss this civilly. I look forward to your response. – Sommers (Talk) 15:31, 27 March 2006 (UTC)
What about the claims that DSM was designed to (or is used to) promote cognitive behavior therapy (rather than, for instance, psychoanalysis) and the use of psychoactive drugs (e.g. methylphenidate)? Apokrif 16:54, 2 April 2006 (UTC)
I would prefer not to merge, but to keep that article as a very brief one focused on that subject (like the other axis n articles). "Axis n" are mentioned frequently in other articles, usually without explanation (except of course in the main DSM article). A person who clicks on those references more likely wants a quick explanation, rather than finding themselves in the midst of the large and complex DSM article (if they're that interested in the DSM as a whole, they probably know what the axes are already; and if they become interested in dsm via the axes, it's only one click further). Just my $0.02. —The preceding unsigned comment was added by Sderose ( talk • contribs) 12:56, 8 January 2007 (UTC).
Impotence, premature ejaculation, jet lag, caffeine addiction, and bruxism are examples of surprising inclusions
Who finds them surprising?
and are but only several that non-psychiatrists might not consider to be mental illnesses "non-psychiatrists"? And what do psychiatrists (and psychologists, butchers, bartenders...) consider? Apokrif 16:48, 2 April 2006 (UTC)
Only a group of psychiatrists (and psychologists, too if they'd be invited), apparently drunk on their own power, would hold a vote (and a majority vote of those in the inner sanctum is exactly how entries are made) that would deem the above to be "mental diseases." That is, after all what we are talking about here. It is a valid criticism and more than a few psychiatrists note that the DSM now includes damned near anything that anyone might possibly complain about. Homebuilding 03:05, 12 September 2006 (UTC)
I totally agree, a good amount of criticism of the percieved "medical authority" of DSM-IV is right on it's place on this page. Let's face it, the overwhelming majority of "diagnoses" in the DSM are nothing else but a collection of subjective POV's of a bunch of wealthy and influential psychiatrists, who define behaviors outside the scope of currently socially acceptable limits as "diseases" (a.k.a. "we don't like it, so it must be a disease"). It has about as much objective validity as The Dianetics or the infamous Malleus Maleficarum. The insiders are very much aware of these facts; a considerable amount of psychiatrists, with several decades of practice, have been outspoken against the practical limitations of DSM and it's validity. F. inst. the prominent and influential psychiatrist Loren Mosher stated in his resignation letter to APA that "Finally, why must the APA pretend to know more than it does? DSM IV is the fabrication upon which psychiatry seeks acceptance by medicine in general.", whilst the former APA president Robert Spitzer echoed him in an interivew, admitting "The DSM is not a scientific document.. very few of the categories have an empirical base". Unless the DSM openly states that it's labelings are unscientific/philosophical/religious and to be taken as purely subjective guidelines/alternatives in response to "troubles of daily life", it deserves to be publicly and ruthlessly exposed to the scrutiny of professional criticism. 193.217.56.24 17:29, 3 October 2006 (UTC)
Please note that Robert Spitzer, quoted just above, was and has been the driving force of the DSM--and has "founding father" status. He appointed the entirety of the initial committess and boards of the DSM. He has been the final editor of all DSM versions, up to and including the DSM IV. Once it's off his desk it is ready for the vote, up or down. He has tremendous power over how health insurance money is spent on "mental health" services as this book defines what mental health is. 207.178.98.48 02:17, 12 October 2006 (UTC)
I would like to repeat that there is much more to it then finding a behavior a disease etc. as I have stated within the discrimination section of this talk article. I would like to add that there are many philosophical POVs in various forms that gave birth to the different ideas of what causes mental distress. Also, as I have said before very few disorders do NOT have the tag that it must give the individual trouble in either social, work, or liesure activity. Saying that, caffeinism is the physiological addiction as well as the psychological addiction in which the individual has withdrawal symptoms such as headaches etc that interfere with their normal functioning in which they need to consume more caffeine based products to allieviate and even act normally. Jet lag is defined as repeatedly moving from time zone to time zone in such a way which renders an insomniatic state that interferes with the individuals social, occupation, or leisure activities. Also, the comment about naming everything a disease is not truly the case. A disease has a specific definition as taken from dictionary.com for this debate "a disordered or incorrectly functioning organ, part, structure, or system of the body resulting from the effect of genetic or developmental errors, infection, poisons, nutritional deficiency or imbalance, toxicity, or unfavorable environmental factors; illness; sickness; ailment." There have been links to genetic contributors for many mental disorders including schizophrenia, alcohol abuse, opiate abuse, one particular form of insomnia etc. Though there are what are called disorders as well in which there may be a cognitive impairment that leads to an individual suffering social, occupational, or leisure activities. Finally, there are even psychologists and psychiatrists that reject the medical model and use a phenomenological approach to helping individuals with problems that are not biologically based. —Preceding unsigned comment added by UNache ( talk • contribs)
The DSM-IV doesn't specifically cite its sources, but there are several "sourcebooks" intended to be APA's documentation of the guideline development process, including literature reviews, data analyses and field trials. Funnily enough these key source materials for the major psychiatric "bible" of our time seem to be rarely referred to, or stocked even in major libraries, let alone read. I thought I'd post a mixture of available sources about them here before just trying to edit, since there's so much detail and perspective that somehow needs to be summarised in a balanced way.
Widiger TA, Frances AJ, Pincus Haet al. DSM-IV sourcebook. Vols 1–4. Washington, DC: American Psychiatric Association, 1997.
Volume 1 Volume 2 Volume 3 Volume 4 (possibly not even in print any longer)
The DSM-IV Classification and Psychopharmacology by authors including the guy who directed the process [3]
A Participant's Observations: Preparing DSM-IV
Critical reviews of vol 1 (appears twice) and Vol 2 by mental health professional author on reputable site.
Other articles covering the sourcebooks and DSM development:
PSYCHOPATHOLOGY: Description and Classification
EverSince 13:48, 24 January 2007 (UTC)
I would suggest that if references and citations cannot be provided for the lines marked, then those statements are POV and also do not meet the Wikipedia standard of being verifiable and should be deleted. DPeterson talk 14:38, 14 January 2007 (UTC)
I addded the information that I removed from the History section. I am not sure if I have put this new section in the best place, but I think the information is important as it demonstrates how the community interpretation of a "condition" can effect how the mental health community thinks about a condition. LCP 22:15, 24 May 2007 (UTC)
It's worth noting, as an illustration of just how potentially subjective and socially constructed the various diagnoses in the DSM-IV are, that Homosexuality was listed as a disorder until 1973.
It's also VERY MUCH worth noting that the authors have been shown to have links to the Pharmaceutical Industry: http://www.washingtonpost.com/wp-dyn/content/article/2006/04/19/AR2006041902560.html — Preceding unsigned comment added by 24.49.244.243 ( talk) 23:41, 11 June 2006
Will someone please provide a page on Wikipedia detailing the destructiveness of this DSM document, and the many lives it has destroyed? there are websites devoted to anti-psychiatry you might want to link to. I beg of someone! please help people who have been destroyed by this process of labelling and those in the future who will be. This document is nothing more than a political and cultural means of control. It dehumanizes the wide range of human behavior. For the love of God I wish the DSM would be discredited as the voodoo it is. Psychiatry is a huge business and most lost souls primarily need to be held and loved because of horrible things that have happened, instead are villified and ridiculed and marginalized. If anyone wants to contact me they can, at contesta@comcast.net Its not that I'm against the people who perform these jobs (I think most approach the profession with a certain desire to help), but the whole method of treating people with problems has to change. A new paradigm! 71.206.44.177 01:40, 2 January 2007 (UTC)
We must try to keep in mind that most of the concepts presented in the DSM can be viewed on a continuum and that almost all diagnoses require that there be significant impairment in work, social, or leisure activity that can be documented before the diagnosis is presented. Also, for most diagnosis there is a prevalence rate in which it can help us determine how rare the particular disorder should be within given samples. I do not have the research but if there was an addition of that calibar then it would be based on a rare impairing form of what is being referred to as 'bigotry'. Also, psychological testing uses the idea of clinical as opposed to statistical significance. Clinical significance can be usually seen in which those only scoring 2.5+ standard deviations are usually considered ill which is less than 10% of the population that it was standardized with. That is usually viewed rare enough to warrant further investigation. For this above example, the ideation of bigotry can be very over-simplified and become a belief in trend then what could conceivably be a detremental thought 'disorder' since I lack a better word at this moment. I will try to stress that clinicians use multiple resources besides just the DSM in order to make a diagnostic decision including lab and physician findings and psychological scores etc. UNache 23:26, 5 February 2007 (UTC)
You know, I've been watching this page for a few weeks, and what I can only describe as its slow-motion revert war is getting on my nerves. Some people clearly think that it's appropriate for the DSM page to link to the DSM-IV Codes page. Some people clearly disagree. Not one of these people has bothered to do get a discussion going on the subject. Although I'm generally inclusionist, I don't really care one way or another. But I'd really appreciate it if you'd type a little note here before you make that change again, okay? Something approaching a consensus would be nice. WhatamIdoing 15:32, 23 July 2007 (UTC)
"The APA has entrusted the revision of the DSM to world-renowned scientists who have vast experience in research, clinical care, biology, genetics, statistics, epidemiology, public health and consumer advocacy. They have interests ranging from cross-cultural medicine and genetics to geriatric issues, ethics and addiction. As a group, task force members have authored over 2,500 research reports, books, chapters, white papers and journal articles." This (particularly the first and third sentences) clearly consists of a positive evaluation of the membership of the task force, and not a neutral description of its composition. What is the informational value of the word "vast" here? Is there any reason for an encyclopedia to mention the number of articles published by members of this task force? Presumably someone with an interest in the DSM edited this in.—The preceding unsigned comment was added by 84.189.41.53 ( talk) This clearly consists of a positive evaluation of the membership of the task force, and not a description of its composition. Presumably someone with an interest in the DSM edited this in?
I've pulled this change:
primarily because it's unsourced, but also because it contains a logical error. The number of newly described subtypes of mental illness doesn't say anything about the number of people who have mental illnesses. This is like saying that the world produces a billion pounds of apples each year, and if you replace the "red apples" category with the names of twenty specific kinds of red apples, that somehow the world suddenly produces twenty billion pounds of apples.
This mental error has come up before on this page. The DSM describes kinds of mental illnesses (and a few not-really-illnesses). It does not make anyone be sick or change the number of people who are sick. WhatamIdoing 21:39, 13 October 2007 (UTC)
Needs:
Currently, a critique is buried in the "brief history" section. Here's some more criticism:
Others have criticized DSM for permitting pressure groups to put in or take out things - instead of disorders being added strictly on the basis of scientific evidence. The exclusion of homosexuality was heralded by gay rights groups as proof that homosexuality is normal - yet it was only their political pressure on the APA that made it remove homosexuality. Uncle Ed 17:27, 9 November 2005 (UTC)
Added statement about how professional use it, by request above Expo512 ( talk) 05:37, 30 November 2007 (UTC)
The main article does not make it clear that the postwar DSM grew out of a clash between psychiatric practice and the requirements of the armed forces and Veterans Administration during the second world war. Previously the American Medico-Psychological Association (later the American Psychiatric association) had produced, in conjunction with other bodies, a Statistical Manual which attempted to replace the diagnostic schemes used in the different state hospital systems and academic centres. This went through at least eight editions. However, it was common for a psychiatric consultation, especially with an office patient, not to lead to any clear and explicit diagnosis. Often the standard diagnoses, when applied to abnormal behaviour appearing in the extra-ordinary circumstances of the war, appeared to be wrong, in that the course of symptoms and the long-term outlook was not as expected. Many conditions that would not receive medical intervention in civilian life had to be labelled and managed, whether as diseases, crimes or breaches of discipline. The military and its hospitals found it necessary to label and tabulate many such encounters, and a couple of schemes were developed in the course of the war which returning medical officers found to be of use in civilian practice also. The introduction to the first edition of the DSM gives a brief account of that situation. The DSM-I was devised to reconcile these schemes in the days before the insurance companies acquired hegemony over American medical practice. NRPanikker ( talk) 16:36, 2 January 2008 (UTC)
Why do we have this section on "Referencing the DSM in APA Format"? Is this normal for book pages? If you look up Catch-22 or Green Eggs and Ham, is there a section on how to cite it in a bibliograph? I understand that it might be useful, but is it encyclopedic? WhatamIdoing 23:01, 18 October 2007 (UTC)
This section, I agree, is silly. I moved it to the bottom for now. I would be happy to just delete it. Perhaps it is the APA (that is american psychiatric assoc..) 'party line' on how they want their book referred to. Maybe not. However, it probably should be up to the author to choose. Expo512 ( talk) 05:42, 30 November 2007 (UTC)
The "APA Format" refers to the " APA style," from the Publication Manual of the American Psychological Association, not the American Psychiatric Association. This style guide is used by a wide range of scientific publications. There are other schemes, e.g. that of the MLA (Modern Languages Association), used in other academic fields. As students are increasingly using Wikipedia as a source for essays and academic presentations, it would be a kindness to provide them with references in the form appropriate to their subject. NRPanikker ( talk) 02:41, 5 February 2008 (UTC)
I have removed the globalization tag because it is unexplained. I had a conversation a while ago with the editor who added the tag; as I recall, the editor seemed to think that:
If you think that a globalization tag will result in the improvement of this article, then please restore it and explain your concerns, in detail, right here on this talk page. This will help other editors figure out how to address your concerns. Thanks, WhatamIdoing ( talk) 20:47, 4 March 2008 (UTC)
Beginning with the 1987 Diagnostic and Statistical Manual (DSM-III-R), mental retardation is classified as an Axis II disorder. See [6] [7] [8] and about a half a million other webpages. Interestingly, this change was apparently (ultimately) the result of a lawsuit, City of Cleburne v. Cleburne Living Center. [9] WhatamIdoing ( talk) 19:10, 2 April 2008 (UTC)
http://www.motherjones.com/news/feature/2002/07/disorders.html later —Preceding unsigned comment added by Ben Meijer ( talk • contribs) 22:33, 18 May 2008 (UTC)
WP policy requires that the person putting the text on the page carries the burden of proof that the claim is verifiable by a reliable source. On-line petitions do not meet that standard. I can recommend only that you employ some of the available venues, such as the RS noticeboard, to ascertain whether your source has a reputation for accuracy and fact-checking. Until then, reverting this page to reinstate text that has no RS behind it violates WP:V. I am amenable to this discussion being moved to our mediation discussion.
—
MarionTheLibrarian (
talk) 23:50, 13 June 2008 (UTC)
— MarionTheLibrarian ( talk) 13:52, 15 June 2008 (UTC)
This paragraph keeps getting removed by MarionTheLibrarian:
The appointment, in May 2008, of two of the taskforce members, Kenneth Zucker (editor of the Archives of Sexual Behavior) and Ray Blanchard, has led to an internet petition [1] to remove them. [2] Accoring to Brian Alexander of MSNBC, "The petition accuses Zucker of having engaged in 'junk science' and promoting 'hurtful theories' during his career. [3] According to Duncan Osborne of The Gay City News, "Dr. Ray Blanchard, a psychiatry professor at the University of Toronto, is deemed offensive for his theories that some types of transsexuality are paraphilias, or sexual urges. In this model, transsexuality is not an essential aspect of the individual, but a misdirected sexual impulse.". [4]
Please, if there's a problem with it, tag the relevant statement with citation needed, or take out any part that you believe is not sufficiently referenced. Don't take out the whole thing with no explanation. Dicklyon ( talk) 05:57, 16 June 2008 (UTC)
{{
cite news}}
: line feed character in |title=
at position 28 (
help)
After this edit where it added "According to the Gay City News", TheLibrarian is now complaining about the places where I have added similar attribution. I think it's clear that what's being reported is not opinion, as in the edit above, so I have no problem leaving it out. But that's no reason to blank the whole paragraph as it has done recently. So I've put it back again; where I had attributed authors, I just have the works now; as I said, I don't mind those being removed if anyone cares. It also asserts "BLP violation"; not clear to me how reporting what a newsworthy online petition says is a BLP violation; perhaps someone could add a link to yet another POV on it? Or say more from the cited sources if what is reported now is not balanced? Dicklyon ( talk) 03:34, 18 June 2008 (UTC)
— MarionTheLibrarian ( talk) 03:36, 18 June 2008 (UTC)
WP is not a newspaper, and I do not believe the item belongs in WP at all. The onus is on you to demonstrate that it does belong; for as long as there is no consensus for inclusion, I need add no further comment. I suggest you try an RfC.
—
MarionTheLibrarian (
talk) 03:45, 18 June 2008 (UTC)
You also have an onus to write with NPOV. When a source provides two sides of an issue, it is a violation of NPOV to add to a page only one of those sides. For example, you omit the indications in the very same article of Blanchard himself saying that he is alleged to have views that are exactly opposite to his actual views. That also violates BLP.
—
MarionTheLibrarian (
talk) 03:59, 18 June 2008 (UTC)
Obviously this is pretty lengthy now...maybe it should move down the page, maybe to the end. Maybe it needs thinning out. EverSince ( talk) 18:13, 5 July 2008 (UTC)
The introduction paragraph says:
Is it necessary to have that statement in the introduction? It is probably not an important fact for most people reading about the DSM Jenever Spirit ( talk) 13:26, 10 September 2008 (UTC)
I think that The Encyclopedia of Insanity should be removed from the external links section because it does not seem to be in keeping with the other links in that section. It reads like a highly opinionated piece rather than a considered criticism and it makes gross exaggeration to make a point. For example, where he claims to be paraphrasing the DSM-IV, "You were out of your mind the last time you have a nightmare (307.47)" is factually incorrect (307.47 quite clearly states that one nightmare does not make a disorder). He also hammers home his opinion that therapists will merely use the DSM to make money by repeatedly calling the diagnostic codes "billing codes". Basically it is written as an attack piece rather than as a considered rebuke. I'm not complaining about all the specific criticisms that Davis makes but I am complaining about the tone and style of writing being completely at odds with the other links in the section. Is a literary review of (what at least purports to be) a scientific work really so important that it should be the only review in the external links section?
In short, I think we should instead link to a more thoughtful article exploring the many criticisms of the DSM. "The Encyclopedia of Insanity" could possibly be used as a reference for the criticisms section, but I'm not sure it should have pride of place in the external links section. I fail to see what it adds to the article. Konomios ( talk) 00:10, 26 January 2009 (UTC)
I find the changes and subsections added there generally an improvement, but I wonder if reliability should be discussed together with construct validity under the (newly added) epistemological subheading; I'm not an expert on epistemology, but I think that only construct validity is an epistemological argument while reliability is more of a practical argument. I could be wrong though. Xasodfuih ( talk) 19:22, 8 March 2009 (UTC)
That 1974 decision, however, is still challenged by many conservative and religious groups who maintain that homosexuality is in fact a mental disorder.[49]
The source given there says nothing about religious groups considering homosexuality a mental disorder. In fact, it explicitly says "Research on whether homosexuality is a pathological condition is not formally relevant to the moral debate in the church. Psychological abnormality and immorality are two different things, although sometimes they overlap." It mentions morality in the article, but does not classify either way in saying it is a mental disorder. Neither does it say that such a position is held by Christians. This sentence should be changed or eliminated if no reputable source can be given. Kristamaranatha ( talk) 22:45, 7 August 2009 (UTC)
Action potential discuss contribs 10:43, 30 August 2009 (UTC)
I would start with SCID but diberris tool is not working. Compr Psychiatry. 1994 Jul-Aug;35(4):316-27. Reliability of the Structured Clinical Interview for DSM-III-R: an evaluative review. Segal DL, Hersen M, Van Hasselt VB. PMID 7956189 Earlypsychosis ( talk) 00:07, 1 September 2009 (UTC)
It seems bizarre that this is here. Homosexuality is just one of many conditions. Why is it mentioned specifically here? Its inclusion looks agenda driven. I move to remove it. LCP 21:16, 24 May 2007 (UTC)
It belongs there, in detail, just like "bleeding" is part of the history of medical treatments. Truly it is no longer central to the practice of medicine and there is documenation of progress with Joseph Lister through germ infestation theory. The point is that psychiatry continues to make their decisions regarding inclusion by plebesite (just as they have done since the initial conception of te DSM. Yes, that was in 1973--and the key players, such as Robert Spitzer, are still at the helm. It remains at the core of how the APA conducts the fundamental and essential task of defining mental illness. Homebuilding ( talk) 22:46, 19 March 2010 (UTC)
It would be amusing, if it were not so sad, that leadership on psychiatry appears to promote tolerance, while every revision of the DSM defines and describes ever more aspects of the human condition as deviant and worthy of a diagnostic name and number. And surely, in every case, somewhere, someplace someone will dream up some therapy that they can bill for. In all of these situations, questionable definitions are followed by "treatments" of ever more dubious value. —Preceding unsigned comment added by Homebuilding ( talk • contribs) 22:42, 6 February 2010 (UTC)
The criticism section generally brings up controversial viewpoints which are neither the majority viewpoint or the minority viewpoint. The whole section needs to be pruned. -- scuro 02:35, 4 April 2007 (UTC)
I don't think that addresses the issues sufficiently. Here's my first cut at a version that includes more detail but tries to stay on topic:
--Criticism-- The DSM was criticised soon after its inception. Detractors of the DSM commonly argue:
A Columbia University team headed by Robert Spitzer, an editor of the DSM, acknowledges a concern about the DSM in their annual report of 2001: “Problems with the current DSM-IV categorical (present vs. absent) approach to the classification of personality disorders have long been recognized by clinicians and researchers.” Among the problems, they list “arbitrary distinction between normal personality, personality traits and personality disorder” and point out the fact that the most commonly diagnosed personality disorder is 301.9, Personality Disorder not Otherwise Specified. [1]
Deconstructive critics assert that DSM actually invents illnesses and behaviors through the ostensible process of describing them.
The DSM has also been criticized for wrongly pathologizing behaviors that are simply uncommon or not approved in the society of that time such as homosexuality, which was described as a mental illness until 1974. [2] Based on this successful political action, some people diagnosed with gender identity disorder, various forms of paraphilia, and other "diverse states of being" hope to have these labels removed from future manuals as well. [3]
The potential for conflict of interest has also been raised. Roughly 50% of the authors who previously defined psychiatric disorders have had or have financial relationships with drug companies. [4] This criticism is normally leveled by people who oppose the use of pharmaceutical drugs to treat mental illness.
I thought that the "Eew! We're not like those people" remarks by members of one paraphilic group against members of another paraphilic group detracted from the overall point, which has nothing to do with the wide range of paraphilic behaviors or their potential for social acceptance.
The bit about half the authors having been paid to work for a drug company at some point irritates me, mostly because no one is pointing out that 100% of the editors have a "financial relationship" with an institution (the APA itself) that promotes very expensive talk therapy treatments as its bread and butter, even though talk therapy in isolation may be completely useless for some conditions. The activist charge here may be true enough, but the focus on (inherently tainted?) pharmaceutical money seems selective in a very slimy way.
What do you think? Do we have a consensus to include the details but lose the remarks? WhatamIdoing 05:01, 10 July 2007 (UTC)
It seems to me that we should add a section discussing the benefits of the DSM. (neutral point-of-view)I think this could be done in a different section. ~
(NOTE: I did not contribute the immediately previous unsigned, undated comment.) Do these criticisms also apply to the relevant similar sections of ICD-9/10/11? If so, should that be noted here? Perhaps a whole new article needs to be created, discussing the relative pros and cons of these sorts of categorical diagnosis methodologies (NPOV) and simply referenced here and on the ICD pages? I am not qualified to create such a discussion, should that be the case. Spartan26 ( talk) 16:00, 2 April 2010 (UTC)
Footnotes 20-24 referencing DSM-IV Sourcebook Volume 1, Sourcebook Volume 2, Sourcebook Volume 3, and Sourcebook Volume 4 lead nowhere. Pbh444 ( talk) 16:06, 17 September 2010 (UTC)
Do I remember correctly that there were copyright issues, also here in Wikipedia itslef, about DSM's contents? (Issues that point out that DMS's contents are a authors' creations). -- 151.82.246.203 ( talk) 10:35, 17 December 2010 (UTC)
I believe that use of this source should be evaluated on the basis that the host cite of the paper presented is incredibly biased in consideration of homosexuality as a mental disorder. NARTH, while claiming to be a genuine, unbiased source, seems quite biased to be perfectly frank. NARTH disagrees with the APA on many issues regarding homosexuality including whether homosexuality is actually an illness. I think that source 53 is heavily filled with said differences and should not be included in a discussion of the DSM unless specific consideration is given to the fact that the information comes from NARTH rather than the APA since the DSM is a work of the APA. I'm not saying that the information given in source 53 should be entirely discredited, just that it should either be clearly stated in the article where the information comes from or that the information should be verified by another source. — Preceding unsigned comment added by Saiuu ( talk • contribs) 04:53, 12 April 2011 (UTC)
Wasn't the reason homosexuality was taken out of the DSM guide because of lobbying from gay rights activists? I ask because of the article's inference that homosexuality originally being in the DSM guide was a fault of the book. -- Yodamace1 16:55, 5 January 2006 (UTC)
The objectivity of the article is totally removed with the phrase "those homo fags". This should really be fixed, but I don't feel qualified to just change it to "homosexuals" or something else. --A Visitor 07:20, 8 January 2008 (UTC) —Preceding unsigned comment added by 64.91.106.159 ( talk)
The recent section about the Drs. Zucker, Blanchard and Lawrence being selected for the American Psychiatric Assoc.'s committees should have been corrected rather than entirely removed for reported reason that it is factually incorrect as to Lawrence. Whether Zucker and Blanchard promote so-called reparative therapy on children (they deny they do) it needs to be reported that an overwhelming majority of the Queer community (rightly or wrongly) is protesting their appointment largely on that basis. Oddly, the Queer community and NARTH are in agreement that Zucker and Blanchard are in favor of ex-gay reparative therapy for children (despite Z+B's claims not to be) partly because their actions contradict their words. —Preceding unsigned comment added by 69.226.225.201 ( talk) 20:06, 18 May 2008 (UTC)
I don't think homosexuality should have been taken out as a mental disorder. If there was enough public pressure to remove pedophilia as a mental disorder would that make it right. This is a fallacy of ad populum or in this case listening to a local minority. Politicizing a scientific manual is not good science. —Preceding unsigned comment added by 206.78.255.34 ( talk) 08:49, 25 November 2009 (UTC)
I wonder about the veracity of the following statement: "That 1974 decision [to declassify homosexuality as a disorder] is still challenged by some, mainly conservative and religious, groups..." The citation given doesn't back up that statement. In any case, it seems a little bit biased to me, as if the writer is simply trying to dismiss the objections. Aren't there any knowledgeable people who object to the reclassification who aren't conservative or religious? Is the opposite side labelled liberal or irreligious? Is there only a bias on one side? At what point is it discussed the homosexual groups were instrumental in removing homosexuality from the manual? Isn't the bias of homosexuals toward homosexuality something to be considered?-- 76.118.2.97 ( talk) 01:38, 6 July 2010 (UTC)
I have a minor issue with the final sentence of the first paragraph: "There have been five revisions since it was first published in 1952, gradually including more mental disorders, although some have been removed and are no longer considered to be mental disorders, most notably homosexuality." It doesn't seem to me that the phrase "most notably" is supported, partly because there is not really a standard way to quantify what is "most notable" (i.e., how is notableness measured? There are ways, perhaps, but it seems somewhat subjective which you might choose). This could be most simply solved by removing the word "most," but there may be better rephrasings. That homosexuality's removal from the DSM can be called notable at all (if not the most notable) strikes me as well supported in the Political Controversies section (section 4.6 of the article), so I think keeping the word "notably" is not a problem. Lukescp ( talk) 07:22, 24 January 2012 (UTC)
I was just comparing this article with the one on ICD, and was surprised to find one huge difference. This article is approximately 1/3 criticism of the DSM, including a third of the lede section. The ICD article has no mention of any criticism or controversy until the final sentence. Searches of Google and Pubmed show somewhat higher criticism of DSM versus ICD, but not by a wide margin, and the more sweeping sorts of criticisms made to either, apply to the other. I'm not even going to attempt to evaluate why the articles on very similar publications are so different, but it might be worth pondering. 50.0.101.103 ( talk) 22:37, 2 December 2012 (UTC)
GA toolbox |
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Reviewing |
Reviewer: Zad68 ( talk · contribs) 03:14, 18 January 2013 (UTC)
Zad
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03:14, 18 January 2013 (UTC)I did not complete the review, as once I saw enough problems, I stopped, so there may also be further issues. This article still needs significant work before GA, starting with rooting out the plagiarism issues, and so it is not being listed for GA.
Zad
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04:42, 18 January 2013 (UTC)
Rate | Attribute | Review Comment |
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1. Well-written: | ||
1a. the prose is clear, concise, and understandable to an appropriately broad audience; spelling and grammar are correct. | Some issues as noted below, including some confirmed and some suspected plagiarism | |
1b. it complies with the Manual of Style guidelines for lead sections, layout, words to watch, fiction, and list incorporation. | WP:WTW "current", "upcoming", "claim" | |
2. Verifiable with no original research: | ||
2a. it contains a list of all references (sources of information), presented in accordance with the layout style guideline. | ||
2b. reliable sources are cited inline. All content that could reasonably be challenged, except for plot summaries and that which summarizes cited content elsewhere in the article, must be cited no later than the end of the paragraph (or line if the content is not in prose). | ||
2c. it contains no original research. | ||
3. Broad in its coverage: | ||
3a. it addresses the main aspects of the topic. | ||
3b. it stays focused on the topic without going into unnecessary detail (see summary style). | ||
4. Neutral: it represents viewpoints fairly and without editorial bias, giving due weight to each. | uses of WP:WTW "claim", very large and possibly WP:UNDUE Critcism section may not be in line with emphasis found sources (need explanation). | |
5. Stable: it does not change significantly from day to day because of an ongoing edit war or content dispute. | No recent edit-warring and quiet Talk page | |
6. Illustrated, if possible, by media such as images, video, or audio: | ||
6a. media are tagged with their copyright statuses, and valid non-free use rationales are provided for non-free content. | ||
6b. media are relevant to the topic, and have suitable captions. | ||
7. Overall assessment. | Not passed. |
My first observation is that the Criticism section takes up nearly half the body of the article. Is that in line with what is found in reliable sources? I'm not coming into this article knowing a whole lot about the DSM but it is a bit surprising to me to find such a large Criticism section, can you please comment on this?
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In this table:
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"DSM 5 will accept diagnoses that achieve reliabilities as unbelievably low as 0.2-0.4 (barely beating the level of chance agreement two monkeys could achieve throwing darts at a diagnostic board" [13] - Allen Frances, M.D., was chair of the DSM-IV Task Force ParkSehJik ( talk) 06:54, 29 November 2012 (UTC)
==> Please see 44.2 CONSENSUS, below, for a summary of the consensus reached. Also, please see 44.2.1 Adding Back the "Political Controversies" subsection and its contents, below, if you disagree.[Edit]
I would like to reach We have reached consensus on two issues: [Edit]
1) Is the information currently in Section 5.1- Criticism: Political Controversies important enough to include in this article?
2) If so, should it remain in its own subsection or should it be integrated elsewhere in the article?
What do you think?
Mark D Worthen PsyD 13:46, 22 May 2013 (UTC)
Zad
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01:21, 23 May 2013 (UTC)
Zad
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01:27, 23 May 2013 (UTC)We have reached consensus that reference to homosexuality as a mental disorder should be integrated into the article in a relevant section and, to the extent that such additions refer to contemporary (i.e., in 2013) assertions that homosexuality is a mental disorder, such additions should be made in a manner that does not accord the viewpoint undue emphasis ( WP:UNDUE), i.e., space and prominence in the article that is out of proportion with its:
Mark D Worthen PsyD 05:03, 24 May 2013 (UTC)
If you believe that the "Political Controversies" subsection should be restored with some or all of the material that had been included, please first discuss your proposal here before editing the page.
In your discussion, please explain why restoring that subsection, including all or most of its content, is important in light of:
Mark D Worthen PsyD 04:59, 24 May 2013 (UTC)
It strikes me that there are particular problems with POV, for two reasons: the Criticisms are pushed to the end of the article instead of being integrated in a balanced way throughout the text. Authors such as Prof Stuart A. Kirk (UCLA), who have said a lot about the DSM over many decades, are not mentioned. Kirk wrote The Selling of the DSM in 1992, and his most recent book Mad Science (2013) also extensively reviews DSM history. I don't plan to get involved in editing this article in a major way, but will add a few paragraphs in the first half of the article that might help to balance it and make it a little more comprehensive. Johnfos ( talk) 00:52, 24 May 2013 (UTC)
I'm going to point out some of the problems with the criticism section. It's really bad and needs a lot of work. I would suggest deleting it or cutting it down until it is fixed.
Reliability and Validity Concerns[edit]
The revisions of the DSM from the 3rd Edition forward have been mainly concerned with diagnostic reliability--the degree to which different diagnosticians agree on a diagnosis. (no source)
It was argued that a science of psychiatry can only advance if diagnosis is reliable. (by who?)
If clinicians and researchers frequently disagree about a diagnosis with a patient, then research into the causes and effective treatments of those disorders cannot advance. (no source - who said this? - it doesn't even really make sense because research specifically lists the inclusion criteria. This is true for all medical research.)
Hence, diagnostic reliability was a major concern of DSM-III. (Who was concerned?)
When the diagnostic reliability problem was thought to be solved, subsequent editions of the DSM were concerned mainly with "tweaking" the diagnostic criteria. (source?)
Unfortunately, neither the issue of reliability (accurate measurement) or validity (do these disorders really exist) was settled. (source? Also reliability is and validity are not correctly defined)
However, most psychiatric education post DSM-III focused on issues of treatment--especially drug treatment--and less on diagnostic concerns. (source?)
In fact, Thomas R. Insel, M.D., Director of the NIMH, has recently stated the agency would no longer fund research projects that rely exclusively on DSM criteria due to its lack of validity. (In fact? Is that meant to be proof?)
Superficial symptoms[
By design, the DSM is primarily concerned with the signs and symptoms of mental disorders, rather than the underlying causes. It claims to collect them together based on statistical or clinical patterns. As such, it has been compared to a naturalist’s field guide to birds, with similar advantages and disadvantages.[43] The lack of a causative or explanatory basis, however, is not specific to the DSM, but rather reflects a general lack of pathophysiological understanding of psychiatric disorders. As DSM-III chief architect Robert Spitzer and DSM-IV editor Michael First outlined in 2005, "little progress has been made toward understanding the pathophysiological processes and etiology of mental disorders. If anything, the research has shown the situation is even more complex than initially imagined, and we believe not enough is known to structure the classification of psychiatric disorders according to etiology."[44] (can you use letters to the editor as a source?)
The DSM's focus on superficial symptoms is claimed to be largely a result of necessity (assuming such a manual is nevertheless produced), since there is no agreement on a more explanatory classification system.[citation needed]
Reviewers note, however, that this approach is undermining research, including in genetics, because it results in the grouping of individuals who have very little in common except superficial criteria as per DSM or ICD diagnosis.[3](where does the source say this?)
Despite the lack of consensus on underlying causation, advocates for specific psychopathological paradigms have nonetheless faulted the current diagnostic scheme for not incorporating evidence-based models or findings from other areas of science. (source?)
A recent example is evolutionary psychologists' criticism that the DSM does not differentiate between genuine cognitive malfunctions and those induced by psychological adaptations, a key distinction within evolutionary psychology, but one widely challenged within general psychology.[45][46][47] Another example is a strong operationalist viewpoint, which contends that reliance on operational definitions, as purported by the DSM, necessitates that intuitive concepts such as depression be replaced by specific measurable concepts before they are scientifically meaningful. One critic states of psychologists that "Instead of replacing 'metaphysical' terms such as 'desire' and 'purpose', they used it to legitimize them by giving them operational definitions...the initial, quite radical operationalist ideas eventually came to serve as little more than a 'reassurance fetish' (Koch 1992) for mainstream methodological practice."[48]
Dividing lines
Despite caveats in the introduction to the DSM, it has long been argued (by who?)
that its system of classification makes unjustified categorical distinctions between disorders, and uses arbitrary cut-offs between normal and abnormal. A 2009 psychiatric review noted that attempts to demonstrate natural boundaries between related DSM syndromes, or between a common DSM syndrome and normality, have failed.[3] Some argue that rather than a categorical approach, a fully dimensional, spectrum or complaint-oriented approach would better reflect the evidence.[49][50][51][52]
In addition, it is argued (by who?)
that the current approach based on exceeding a threshold of symptoms does not adequately take into account the context in which a person is living, and to what extent there is internal disorder of an individual versus a psychological response to adverse situations.[53][54] The DSM does include a step ("Axis IV") for outlining "Psychosocial and environmental factors contributing to the disorder" once someone is diagnosed with that particular disorder.
Because an individual's degree of impairment is often not correlated with symptom counts, and can stem from various individual and social factors, the DSM's standard of distress or disability can often produce false positives.[55] On the other hand, individuals who do not meet symptom counts may nevertheless experience comparable distress or disability in their life. (Every test in medicine has false positives and false negatives. What's the point of this section?)
Cultural bias
Some psychiatrists also argue that current diagnostic standards rely on an exaggerated interpretation of neurophysiological findings and so understate the scientific importance of social-psychological variables.[56] Advocating a more culturally sensitive approach to psychology, critics such as Carl Bell and Marcello Maviglia contend that the cultural and ethnic diversity of individuals is often discounted by researchers and service providers.[57] In addition, current diagnostic guidelines have been criticized as having a fundamentally Euro-American outlook. Although these guidelines have been widely implemented, opponents argue that even when a diagnostic criteria set is accepted across different cultures, it does not necessarily indicate that the underlying constructs have any validity within those cultures; even reliable application can only demonstrate consistency, not legitimacy.[56] Cross-cultural psychiatrist Arthur Kleinman contends that the Western bias is ironically illustrated in the introduction of cultural factors to the DSM-IV: the fact that disorders or concepts from non-Western or non-mainstream cultures are described as "culture-bound", whereas standard psychiatric diagnoses are given no cultural qualification whatsoever, is to Kleinman revelatory of an underlying assumption that Western cultural phenomena are universal.[58] Kleinman's negative view towards the culture-bound syndrome is largely shared by other cross-cultural critics, common responses included both disappointment over the large number of documented non-Western mental disorders still left out, and frustration that even those included were often misinterpreted or misrepresented.[59] Many mainstream psychiatrists have also been dissatisfied with these new culture-bound diagnoses, although not for the same reasons. Robert Spitzer, a lead architect of the DSM-III, has held the opinion that the addition of cultural formulations was an attempt to placate cultural critics, and that they lack any scientific motivation or support. Spitzer also posits that the new culture-bound diagnoses are rarely used in practice, maintaining that the standard diagnoses apply regardless of the culture involved. In general, the mainstream psychiatric opinion remains that if a diagnostic category is valid, cross-cultural factors are either irrelevant or are only significant to specific symptom presentations.[56]
Medicalization and financial conflicts of interest
It has also been alleged (by who?) that the way the categories of the DSM are structured, as well as the substantial expansion of the number of categories, are representative of an increasing medicalization of human nature, which may be attributed (by who?) to disease mongering by psychiatrists and pharmaceutical companies, the power and influence of the latter having grown dramatically in recent decades (according to who?).[60]
Of the authors who selected and defined the DSM-IV psychiatric disorders, roughly half had had financial relationships with the pharmaceutical industry at one time, raising the prospect of a direct conflict of interest.[61] The same article concludes that the connections between panel members and the drug companies were particularly strong in those diagnoses where drugs are the first line of treatment, such as schizophrenia and mood disorders, where 100% of the panel members had financial ties with the pharmaceutical industry.[61] In 2005, then American Psychiatric Association President Steven Sharfstein released a statement in which he conceded that psychiatrists had "allowed the biopsychosocial model to become the bio-bio-bio model".[62] (It seems that if we're going to have a section questioning the use of prescription drugs then we should have a discussion about all the research that is preformed to balance out what is really an ad hominem attack)
However, although the number of identified diagnoses has increased by more than 200% (from 106 in DSM-I to 365 in DSM-IV-TR), psychiatrists such as Zimmerman and Spitzer argue it almost entirely represents greater specification of the forms of pathology, thereby allowing better grouping of more similar patients.[3] William Glasser, however, refers to the DSM as "phony diagnostic categories", arguing that "it was developed to help psychiatrists – to help them make money".[63]
In addition, the publishing of the DSM, with tightly guarded copyrights, has in itself earned over $100 million for the American Psychiatric Association.[64] (What is the purpose of this line? It appears to be to question the motives of the APA. If that's going to be done, then do it, and back it up with something. Instead this line makes it seem like it's somehow immoral to publish books.)
Consumers and survivors
A consumer is a person who accesses psychiatric services and may have been given a diagnosis from the Diagnostic and Statistical Manual of Mental Disorders, while a survivor self-identifies as having survived psychiatric intervention and the mental health system (which may have involved involuntary commitment and involuntary treatment). (According to who - these are not commonly used descriptions in psychiatry - seems 100% POV)
Some are relieved to find that they have a recognized condition to which they can give a name. Indeed, many people self-diagnose. Others, however, feel they have been given a "label" that invites social stigma and discrimination (i.e. mentalism), or one that they simply do not feel is accurate. Diagnoses can become internalized and affect an individual's self-identity, and some psychotherapists find that this can worsen symptoms and inhibit the healing process.[65]
Some in the Psychiatric survivors movement (more broadly the consumer/survivor/ex-patient movement) actively campaign against their diagnosis, or its assumed implications, and/or against the DSM system in general.
It has been noted that the DSM often uses definitions and terminology that are inconsistent with a recovery model, and that can erroneously imply excess psychopathology (e.g. multiple "comorbid" diagnoses) or chronicity.[66] (This line makes no sense. It's saying that people who disagree with psychiatry disagree with what psychiatrists do - not really needed)
DSM-5 Critiques
Psychiatrist Allen Frances has been critical of proposed revisions to the DSM-5. In a 2012 article, Frances warned that if this DSM version is issued unamended by the APA, it will "medicalize normality and result in a glut of unnecessary and harmful drug prescription."[67] In a December 2, 2012 blog post in Psychology Today, Frances lists the ten "most potentially harmful changes" to DSM-5:[68]
Disruptive Mood Dysregulation Disorder, for temper tantrums Major Depressive Disorder, includes normal grief Minor Neurocognitive Disorder, for normal forgetting in old age Adult Attention Deficit Disorder, encouraging psychiatric prescriptions of stimulants Binge Eating Disorder, for excessive eating Autism change, reducing the numbers diagnosed First time drug users will be lumped in with addicts Behavioral Addictions, making a "mental disorder of everything we like to do a lot." Generalized Anxiety Disorder, includes everyday worries Post-traumatic stress disorder, changes opening "the gate even further to the already existing problem of misdiagnosis of PTSD in forensic settings."
(This is deceptively worded - it makes it sound like the DSM-5 is including temper tantrums under disruptive mood dysregulation disorder [and so on]. This is not an established fact, but one guys opinion of what would happen)
Frances and others have published debates on what they see as the six most essential questions in psychiatric diagnosis:[69]
are they more like theoretical constructs or more like diseases how to reach an agreed definition whether the DSM-5 should take a cautious or conservative approach the role of practical rather than scientific considerations the issue of use by clinicians or researchers whether an entirely different diagnostic system is required. (This would be good in an article about Frances)
In 2011, psychologist Brent Robbins co-authored a national letter for the Society for Humanistic Psychology that has brought thousands into the public debate about the DSM. Approximately 14,000 individuals and mental health professionals have signed a petition in support of the letter. Thirteen other American Psychological Association divisions have endorsed the petition.[70] Robbins has noted that under the new guidelines, certain responses to grief could be labeled as pathological disorders, instead of being recognized as being normal human experiences.[71] (I'm not sure if this is a specific enough criticism to be included. Any diagnostic criteria for anything will have false positives and/or false negatives - also this ignores the role of the physician as any decent physician would get a history)
I think the section should be taken out or pruned until someone has a chance to go through and fix it. Whoever does should ask themselves if this is the right article for each bit of information, if it represents a POV, and if it's properly sourced.
The sections on the first two editions on the DSM seem to pick out homosexuality in particular as a focus. The section of the second edition's seventh printing is written in such a way as to suggest that homosexuality was removed purely due to political pressure. And the section on DSM-III-R also picks out sexual orientation. It seems that the focus on sexuality throughout these sections and the misleading account of homosexuality being removed are driven by a conservative agenda. — Preceding unsigned comment added by 82.20.19.182 ( talk) 14:10, 21 September 2013 (UTC)
I believe that this is a really good topic for discussion, as there is a logic behind it that is not obvious. My view is that Axis II is derived from traits that are life-long, and Axis I is about disorders that are affective (not necessarily, but including depression). I am posing this suggestion as a question, as sources are hard to find concerning this.-- John Bessa ( talk) 17:19, 15 February 2011 (UTC)
This
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Dr. Ofer Zur and Nola Nordmarken (2010) describe how the DSM pathologizes healthy groups, such as autistics, women, the elderly, and people with strong expressed emotions. Full article here.
Azziaz ( talk) 06:57, 18 December 2011 (UTC)
(Note: Just wanted to add a request - I've recently found out that the "belief in supernatural beings, such as ghosts, spirits, angels and demons" was considered a sign of mental illness and incompetency before DSM-IV 1994. Could the experts please confirm this fact and report it in this article?) — Preceding unsigned comment added by Philosopher3000 ( talk • contribs) 23:55, 9 March 2012 (UTC)
Hi. How can I get DSM-IV-TR and get it for free? — Preceding unsigned comment added by Mustafa Bakacak ( talk • contribs) 11:07, 27 September 2012 (UTC)
The section Consumers says: "A Consumer is a person who has accessed psychiatric services and been given a diagnosis from the DSM." Is consumer really the best, most standard term? Isn't client or user more common?? Lova Falk talk 17:26, 18 June 2010 (UTC)
I believe it is necessary to mention that Aspergers was first recognized by the DSM-IV. It is a popular topic amongst society and its origination should be noted. Here is my hopeful addition: The DSM-IV was also the first to recognize Asperger's Syndrome as one of the five disorders listed under the category of pervasive developmental disorder. Here is the citation to the book where I found this information: Grandin, Temple, and Richard Panek. The Autistic Brain: Thinking across the Spectrum. Boston: Houghton Mifflin Harcourt, 2013. Print.
Let me know what you think! -- Rzelmano1221 ( talk) 23:24, 18 April 2014 (UTC)
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is out of body experience is a disorder? — Preceding unsigned comment added by 14.142.41.30 ( talk) 09:56, 20 August 2015 (UTC)
I want to find the number of mental disorders listed in each DSM version.
At present there are some inconsistencies in the way this is described:
I'd like the article to:
-- Grahamstoney ( talk) 03:22, 24 July 2015 (UTC)
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I find this article disappointing. I have only a layman's knowledge of psychiatry and psychology, but have some hopefully constructive criticisms. First, and most obvious is why are all five editions (as well as supplementary publications which are generally included) treated the same? There has been enormous changes in the DSM's content and uses; is it USEFUL or INFORMATIVE to discuss them as being parts of a single thing? Second, it would be useful to discuss the major alternatives to the Euro-centric? DSM (including the ICD, Ch. V) used by mental health practitioners the world over. (Does China use the DSM? India? Indonesia? Brazil? Pakistan? (those countries and the USA comprise ½ of the world population. How about (other) Islamic, Arabic, or African countries?) Third, the section titled "DSM-5 critiques" was written PRIOR to it being published (May 2013) and should be revised. Any claims before that time were speculative predictions; and are of limited relevance, imho. NOWHERE in that section is mention of the petition (Oct 2013) for outside review mentioned, for example. Lastly, the section titled "Reliability and validity concerns" should be rewritten. Here is my suggested revision:"The DSM's diagnostic reliability — the degree to which different diagnosticians agree on a diagnosis - continues to be a major source of concern.[55] If clinicians often differ in their diagnosis of a patient, or of the criteria which they use to categorize mental disorders, then treatment may not be optimum. Misdiagnosis can lead to both sub-optimal treatment as well as limiting insurance reimbursements for (hence access to) care. In 2013, Thomas R. Insel, M.D., Director of the NIMH, stated that the agency would no longer fund research projects that rely exclusively on DSM criteria due to its lack of validity.[56] NIMH has proposed use of the RDoC classification system as an alternative." 216.96.113.99 ( talk) 07:01, 29 June 2016 (UTC)
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Just my 2 cents that the section I've tagged might be giving undue weight to one person's opinion - more citations that comment about the opinions (ideally, not self-written sources) would be required to demonstrate the importance of said opinions. 69.165.196.103 ( talk) 05:23, 12 March 2017 (UTC)
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Is the title of this publication properly italicized or not? There seems to not be a consensus, and I feel as though there should be one. Michipedian ( talk) 10:41, 31 July 2017 (UTC)
Hello,
Very first contribution to WP.
Under History/DSM-I (1952), ref 17[i] cannot be used to support the fact it is supposed to support, i.e. that "The manual was 130 pages long and listed 106 mental disorders". The information about number of pages and entries is nowhere to be found in this paper. I suggest citing this more recent paper[ii] which informs about both facts: "The DSM-I contained 128 categories and was published as a smallish (132 pages) paperback book that cost $3.", 'categories' meaning listed disorders from what I understand. I further suggest making the appropriate changes to the sentence.
[i] Grob, GN. (1991) Origins of DSM-I: a study in appearance and reality Am J Psychiatry. April;148(4):421–31.
[ii] Blashfield, R. K., Keeley, J. W., Flanagan, E. H., & Miles, S. R. (2014). The cycle of classification: DSM-I through DSM-5. Annual Review of Clinical Psychology, 10, 25–51. http://doi.org/10.1146/annurev-clinpsy-032813-153639
Regards,
Richard 176.159.24.144 ( talk) 21:29, 25 October 2018 (UTC)
Hi, I've tried to introduce a gentle historical record of the US Navy and US Army from DSM-1, combined with a UN WHO quote on the viral nature of mental diseases as expanded in numbers from 1952 to 2001 under UN inspection. It is part of the campaign the Israeli Mossad is managing against the phoenomenon of torture, as it is manifested in advanced scientific medical experiments tied to lifelong torture of human beings and animals. I was blocked by an Australian Wikipedia activist named David Gerard from even bringing the subject to the awareness of the community. Here are the sources which i tried to quote, DSM-1 page vii (1948 psychiatry history and forward) https://archive.org/details/dsm-1/page/n7 And here's the United Nation's World Health Organization's statement on the subject of people affected according to psychiatry/DSM https://www.who.int/whr/2001/media_centre/press_release/en/
Please see if you can process the original data into Wikipedia quality info, And ofcourse I'm available for any further info leaks I may be able to provide. War.technology ( talk) 08:37, 15 December 2018 (UTC)
Jump down to Lede discussion part 2 (23 February 2019) | Jump down to Lede discussion part 3 (26 February 2019) |
Yeah, Talk should help, Flyer22 Reborn!
Disclosure (of stance / bias: not of firm opinion): I’m very sympathetic to the aims and achievements of the DSM, in pulling together a reference platform out of the mental-health disaster of last century’s total war. To me, DSM is a worthwhile target for critics because it’s the only target. Its weaknesses are not APA self-indulgence, they’re the big issues in Anglophone culture’s ideas about mental health. And maybe in US healthcare delivery too, but that’s not my thing. (I’m a Brit.)
In particular, I’m impatient with criticism that DSM should be rejected as a mere muddle of symptomatology. So was eighteenth-century physical medicine; and the solution to that was to do the work and make the progress - not to complain tht medicine was unscientific and shouldn’t be attempted!</rant>
What I was originally tackling is the way the lede closes. I experienced it as a POV ambush, a bait-&-switch from encyclopaedic style, to push an undeclared agenda, leaving a nasty aftertaste.
At the close of the lede! I presume that’s the worst possible place in an article to do that - and this is an important article!
Looking again, it still seems clear to me tht there’s a problem tht needs solving.
( There are other minor problems with the sentence: the $100m figure in the source relates to DSM-IV, not to DSM’s whole history; and annualising the figure will mislead if in fact the revenue-stream is lumpy / cyclic. )
Rather than getting into the policy long grass . . Maybe I took the wrong approach to reworking the text in the first place. How about moving the point to the opening paragraph? where it helps convey DSM’s established status?
( The following proposal includes other tweaks. )
Pinging: not sure how the system works: hope this is OK?
POV: great tht we’ve both felt uncomfortable! - it’s not just me! Also tht you’ve already sorted out rather the same issue elsewhere, as you describe.
Lede as summary: I had missed this, tht the point appears only in the lede. Really, that alone is decisive. That is, the first (?only) step is to transfer the point from lede to body.
You? or me? (Hint: I reckon you know the particular article better - and know what you’re doing generally rather better too!)
Other minor problems: I hope you agree with me tht annualising the revenue-stream is potentially misleading (and close to OR)? And of course the stated figure relates to just DSM-IV (presumably inc -TR)?
Policy points: what policy points apply to the new copy will become clear when it’s drafted; but if relevant . . I don’t share your qualms about By whom tags. It would help to locate the citation early in the sentence (as I did in my initial para-split attempt; forgot in my more recent effort moving the point to an earlier para). On that basis, I’d think anyone who adds that tag - while the answer to his/her question, last=, is staring right back from that exact point in the source code! - needs to be sat down in a quiet corner and listen while something is explained! And I doubt tht the suggested lede-limit of four paragraphs has a lot of weight, either, in application to an article of this length and importance.
In the body: *then* back in the lede again? Probably basically leave this until we have it in the body and we can judge how the whole thing looks. Thinking ahead, though, in case it helps with orientation / context . . I don’t fully trust my own ideas on this (because of my suspected bias in favor of DSM, + doubts tht I may be over-correcting); but my hunch is (i) there is an argument tht the APA is getting a little too comfortable with the revenue stream, and cozy with Big Pharma too; and (ii) it’s important enough for eventual mention in the lede.
Neutroboard / Med: I suppose we could? if we begin to feel doubts? But certainly at this stage it seems clear to me :-)
Pinging: mmm. Well, let me know if probs. (I did try looking at WP:Ping!)
I’ve now rewritten the moved copy to suit its new location - and to reflect its cited source(!) I’ve also taken care to avoid claiming to summarise the NYT article as a whole, rather than just this criticism.
As the point it makes is simply that, though - a criticism - should it really be in that section? rather than in History? (I would have said that earlier: but it wasn’t till I revisited the NYT piece, as part of this rewrite, tht I was reminded how fierce the criticism is. The piece ends with the words “laughing all the way to the bank”! - almost intemperate for the NYT?!)
Inexperienced editors: well, yes, and I’m much encouraged to see tht we’re seeing the basic issue in the same way. But shouldn’t we be pushing back? rather than surrendering the article space to contributors who need to attend to an explanation?
In this case, though, I’ve now simply mentioned the NYT in the running copy. I considered mentioning Gary Greenberg, instead of NYT . . it looks like he may be sufficiently notable to warrant mention? - but I’m not in a position to judge.
- SquisherDa ( talk) 04:08, 25 February 2019 (UTC)
Another editor changed "US" to either "U.S." or "United States" (
diff). I searched the article and found two instances of "US", which I changed to "U.S." for one, and "United States" for the other (
diff) for consistency per
MOS:US. Unless there is a compelling reason to change the way we abbreviate "United States" in this article, I am in favor using "U.S.". The article does not frequently mention other countries using abbreviations, e.g., UK, AUS, NZ, which is one reason to prefer "US" in some articles (see
MOS:US).
- Mark D Worthen PsyD
(talk) (I am a man. The traditional male pronouns are fine.) 13:38, 30 September 2019 (UTC)
Following the copyright issue (see top of this talk page), I'm surprised that the article does not state that this manual is a creative work, as even sated and claimed by the authors. Not so far from, for example, a novel or a personal report of a news or so on, differently form stating fact or "actual" definition of real things as "Water in rivers goes downstream ", "The Sun is a star", "The Sun rises in the East zone, set in the West zone", "New York is in Unite States", or for a medical example "Pharyngitis is every inflammation of the pharynx". We can hold to be sure that some other authors have written earlier than me, even word for word, but no one of such authors can claim a copyright stating that this wording are his/her own property and thinking tath he/sehe block anyone else to use the same sentence.
Amazing this book is introduced it this Wikipedia's article not as an authors' invention and imagination (as claimed by themself!) but as a "real thing". (Off course, we need to point out that someone actually use for the classification of mental disorders, but Iliad can not be introduced as a "real treasure map" not even if Heinrich Schliemann used it in that way). -- 95.239.2.134 ( talk) 09:28, 21 October 2019 (UTC)
I added a multiple issues tag (banner) to the article, specifying:
Please discuss here. Thank you - Mark D Worthen PsyD (talk) (I'm a man—traditional male pronouns are fine.) 17:00, 16 May 2020 (UTC)
It would helpful to have in this article a comparison of the DSM with other serious non-US and non-Anglophone systems of diagnosing and describing mental health, if such exist. (I myself know absolutely nothing about this, but would love to read if other experts wrote it.) Acwilson9 ( talk) 20:28, 14 September 2020 (UTC)
The opening paragraph made it sound as though the DSM is the default authority in all countries. As far as I know the DSM is only an authority in the USA. I have attempted to clarify this. Please improve if you think it can be improved. SpectrumDT ( talk) 11:39, 8 April 2021 (UTC)
This article was the subject of a Wiki Education Foundation-supported course assignment, between 28 February 2022 and 27 March 2022. Further details are available on the course page. Student editor(s): Zeboman123 ( article contribs).
Hello Wikipedians! My name is Nicholas, and I am a fourth year medical student at UCSF going into psychiatry. I am going to work on the DSM page as part of an elective course. Hopefully I’ll be able to help!There are a few different parts of the page that look like they could use some work.
First I plan on improving the citations on the “Pre-DSM-1 (1840-1849)” section. I will update all of the citations and add citations wherever needed. I hope to have this accomplished by 3/10/2022.
I will then edit the “superficial symptoms” section as it is tagged for having too many/overly lengthy quotations. I will work to pare down the essential information to make it more readable as well as confirming citations and adding citations if needed. I hope to complete this by 3/15/2022.
Finally I will work on the section “Distinction from ICD” section to try to include more specific comparisons regarding the difference between the DSM and other widely used psychiatric diagnostic manuals. I hope to have this completed by 3/21/2022.
If anyone is interested in this page and wants to talk please reach out! Thanks!
Nicholas — Preceding unsigned comment added by Zeboman123 ( talk • contribs) 07:03, 4 March 2022 (UTC)
Peer review of this article as part of the UCSF Spring 2022 Wikipedia Elective course.
Overall, the edits made to this article are outstanding and I believe they significantly improve upon the previous version of the article.
Two sections in particular that I believe had the most major improvements are the "distinction from ICD" and "superficial symptoms" sections.
The edits improve upon the article's readability, content, and flow and are appropriate for an encyclopedia audience at large.
Comments:
Suggestions:
Really excellent job on improving this article! WikiUser950 ( talk) 21:52, 17 March 2022 (UTC)
On March 16, 2022, at 06:12, a subheading under DSM-II (1968) was changed from "Seventh printing of the DSM-II (1974)" to "Sixth printing. . . ." to indicate the first printing that removed homosexuality as a mental disorder. I own a copy of the DSM-II which first included a note about eliminating "Homosexuality" per se as a mental disorder. The printing is the seventh, not the sixth. The copyright page shows the Sixth printing as issued in October 1973, which is before the APA trustees voted to make the change. They voted in December 1973, and the decision was upheld in May 1974 in a referendum of the voting members of the association. The seventh printing, in July 1974, includes a page with "Special Note — Seventh Printing" and the announcement that since the last printing (6th) of the manual, the trustees voted to make the change. Rawars ( talk) 15:11, 1 May 2022 (UTC)
If you were diagnosed as a hyperactive child when you young and diagnosed with ADHD as an adult could you possibly get addicted to to medication prescribed for high ADHD as an adult? 174.240.50.138 ( talk) 20:57, 12 June 2022 (UTC)
Currently the introduction calls it the "bible" of Psychiatry. There is no source for this, so it comes across like an opinion rather than verifiable information. I think it might qualify as WP:FLOWERY. I imagine people outside the US might consider something else to the "bible" of psychiatry, so it seems somewhat American-centric. I'm not planning to change it but thought I would leave my feedback. Pythagimedes ( talk) 23:48, 21 July 2022 (UTC)
Actually, I looked at the edit history and this seems it was recent addition by an IP, so I'm going to go ahead and just remove it. Pythagimedes ( talk) 23:56, 21 July 2022 (UTC)
This is an archive of past discussions. Do not edit the contents of this page. If you wish to start a new discussion or revive an old one, please do so on the current talk page. |
Archive 1 |
[This discussion might be interesting to anybody interested in,or knowledgable about, DSM-IV-TR:
http://en.wikipedia.org/wiki/Wikipedia:Administrators%27_noticeboard/Incidents#DSM-IV-TR_Copyright_question -- 82.195.137.125 19:13, 20 December 2005 (UTC)]
Link Update: http://en.wikipedia.org/wiki/Wikipedia:Administrators%27_noticeboard/IncidentArchive57#DSM-IV-TR_Copyright_question
is the diagnostic and scinetific manual a science or pseudo science?
It is a terrible shame to waste much energy whining about disclaimers. I would prefer a more critical approach consisting of the implications of using such a diagnostic i.e the overlap between disorders. Also links to relevent advocates and challegeners of the DSM would be ideal.
I made some changes, what do you think? I would like make more. What speically would people like? Some of the article appears to be POV, I tried to make it more objective Expo512 08:43, 6 March 2006 (UTC)
Isn't it like IVr or some upgrade of the original IV?
I think something needs to be said about the changes between III-R and IV, like the introduction of five different axes to differentiate mental, social and physical functioning. That whole system could be put in the introduction, since it's the current standard. -- Kimiko 19:03, 17 Mar 2004 (UTC)
I have added a link to a list of DSM Codes to the See Also section of this page. I'm new here, so I hope that I have remained within the proper codes of conduct or etiquette. Cool? Erikpatt 06:15, 11 Jan 2005 (UTC)
I have added some criticism of DSM IV, this may be a personal opinion but I think it's justified. See what you think.
Can anyone explain the purpose of the "cautionary statement" section? The first sentence sort of makes it sound like it is about a "DSM cautionary statement" that is part of the DSM, or is something related to it, but as I read the section it sounds more like the caution is being advised by an author of the article itself. If this is the case, something needs to be done -- no matter how well-intentioned a warning to the reader may be, it is not NPOV to say, "You should know that X is a bad idea" instead of providing facts. (It kind of runs afoul of the "avoid self-references" guideline as well.) This is why Wikipedia has a medical disclaimer. It would certainly be appropriate to have some text in the article describing how and why the DSM is not intended to be used by amateurs, but an entire section that positions itself as a caution from the article to the reader needs to be rewritten so that it only describes the subject from a neutral stance.
If anyone else understands whether the "DSM cautionary statement" is supposed to describe some external statement in the world, or whether it is meant to itself be a caution to the reader, please edit the article as needed. Thank you. – Sommers (Talk) 17:29, 24 January 2006 (UTC)
Upon further examination of which pages link to what used to be the dedicated "DSM cautionary statement" page, it appears that a lot of psychology-related articles were formerly referring to a page which contained a much larger and widespread description of problems perceived with the DSM. This is a problem, since most of those links now refer to a statement that has not properly existed since it was merged into this article. (A lot of it was moved into the "Development" section even before I did the most recent revision of what remained of the "cautionary statement" section.)
I think the best thing to do would be to remove (or at least rewrite) all direct references in other articles to the former cautionary statement. It was an explicitly POV (although well-intentioned) piece that, by its own title, existed only to make a statement about the weaknesses of the DSM (presumably to warn the reader against trusting it too much). It would be much better to describe these possible weaknesses, carefully in line with the NPOV policy, in a section of this article ("Criticisms" or something similar; it seems weird to have this under "Development" anyway) like we would with any controversial subject, and the other articles can point to the relevant issues with the DSM if and when they apply instead of to a blanket statement.
However, because the use of this "cautionary statement" page and the links to it predate my involvement, I'd like to get some feedback on all of this before I take it upon myself to start making changes across a lot of different articles. If no one objects, I'll get started on working my way down this list. Of course I shouldn't be the only one doing this: beside the fact that it's a big task, there are probably plenty of instances where an article says "(See the DSM cautionary statement)" where it really needs something more specific to be added, and I'll likely lack the necessary expertise in most of those cases. So if you want to make the edits yourself, please do. Otherwise, any feedback or information would be appreciated (including explanations about the former use of the cautionary page). Thanks.
– Sommers (Talk) 05:00, 25 January 2006 (UTC)
(I've taken the liberty of moving several posts from here to the bottom of the page, so that they will be in chronological order. If Zeraeph or anyone else objects, please feel free to revert. Thanks. – Sommers (Talk) 22:13, 27 March 2006 (UTC) )
After having set this task aside for some time, I saw that there were no objections and proceeded. All mention of the former DSM cautionary statement has now been excised from the main namespace. The articles that formerly linked to the statement are no longer visible at the "What links here" link above, so in case anyone would like to review the changes, here is the list of the articles:
I hope this helps to improve the neutrality of Wikipedia's overall treatment of the DSM. Any remaining comments or questions about this matter are still, as always, welcome. Thanks again to Limegreen for the attention to my concerns. Happy editing! – Sommers (Talk) 04:10, 23 March 2006 (UTC)
While I agree that the cautionary statement presented a point of view and I understand the reasons for the merge (I merged them myself), I remain concerned that this particular point of view (a pov incorporated into and shared by the publishers of the DSM, the American Psychiatric Association) is rather significant. I perceive this particular information less as an opinion or editorial about the DSM and more like a " Mr. Yuk" for psychiatric diagnoses. I believe that sites such as this one, which draw individuals from outside of the mental health profession in search of clarification for diagnoses that they may have formally (or otherwise) received should have quick access to the pertinent and important information provided in a cuationary statement. So many of my clients are willing to blindly pursue treatment options that they believe are in accordance with a diagnosis that they may have arbitrarily received years and years ago. For this reason, I think a prominent sign saying "Stop and read this first!" that explains the limitations and purposes of diagnostic practices is important. I believe that it is the responsibility of the wiki community to acknowledge that the information available here is integrally linked with the treatment opportunities of those who access it. It seems that offering the reader easy access to a cautionary statement is part of this responsibility. I am a bit concerned that access to this information has been lost during the merge and revisions. There is a reason William Glasser refers to the DSM as "perhaps the most dangerous and harmful book ever created for mental health" and the cautionary statement is an industry accepted step toward recognizing the limitations and potential dangers of the DSM. It is naive to think that a layperson accessing basic encyclopedic information from this site will either acknowledge the limitations of this diagnostic toolbox or dig far enough as is currently necessary to access the warnings previously provided on the cautionary statement page. I was personally responsible for the merge as the community pointed out the limitations of the cautionary statement. However, I am concerned that the removal of this section from this entry removes the metaphoric Mr. Yuk and leaves readers less prepared to access objective information that may have significant impact on their lives. I hope that the wiki community can help with figuring out a way to prominently display this information in a wiki-appropriate format for readers. Erik 04:15, 22 March 2006 (UTC)
For now, I have restored the last, brief, basic version of a "Cautionary Statement" that existed on this article as DSM cautionary statement. This seems to be some kind of legal requirement and, as a whole we are skating on such thin ice we are swimming, already with DSM and the APA, doesn't do to poke THAT particular tiger with too many sticks. I'm restoring the links as fast as I can. My only POV on this is FEAR OF THE APA ;o) -- Zeraeph 13:17, 23 March 2006 (UTC)
The DSM contains it's own cautionary statement see [2]. HOWEVER the APA specifically refuses permission to use ANY content from the DSM IV TR including criteria. Strictly speaking all criteria should exist only as links to sites for which permission has been given.
All DSM criteria and transcriptions of same should be deleted. Now I am certainly not going to DO that deleting, but that is their position. When articles link to criteria on behavenet, the criteria already contain links the warning statement, as they are required to do. It's all a very dodgey area, but where the criteria still appear as part of an article it is simply wise to link the cautionary statement as would be required by the APA to avoid stirring them up. It would probably be best to just link their own disclaimer on behavenet.
And, I am afraid, if they take a mind to it, the APA most certainly CAN sue the bejaysus out of Wikipedia for copyright violation at any time, not least because permission fort use of criteria has been sought and refused...what on earth makes you think they can't? -- Zeraeph 17:28, 25 March 2006 (UTC)
Reprinting entire sections of the DSM (or perhaps even individual criteria, word-for-word) would of course be copyright infringement, but if an article discusses a particular disorder and we want to give the fact, "The DSM lists X as a diagnostic criterion for this disorder", I don't believe the APA can legally prohibit us from doing so (because facts aren't copyrightable). Now, when Wikipedia articles do go beyond this point and infringe on the DSM, we should treat it like any other copyvio problem. (I agree that the problem does indeed exist for some articles.) But as you seem to be aware, there are two problems with using the cautionary statement to address the copyright matter: (1) Wikipedia hasn't been given the same permission as, for example, BehaveNet, so linking to a cautionary statement is a requirement that doesn't apply to us; and (2) as I've pointed out, Wikipedia's DSM cautionary statement is not the same thing as the DSM's own, so there is no point in linking to it anyway, except for a blind guess that it will somehow appease the APA.
If the purpose of the DSM cautionary statement is what you tell me, then what we're doing is bending the NPOV policy to meet an arbitrarily made-up standard in order to mimic a condition of a permission that we haven't been given. There's no legitimate reason to violate the NPOV policy and this isn't even a particularly good one. The cautionary statement is a POV fork, the links to it imply a critical opinion of the DSM, and they need to go now. That said, I understand your opinion and I'm glad you're paying attention to these matters. Thanks again for continuing to discuss this civilly. I look forward to your response. – Sommers (Talk) 15:31, 27 March 2006 (UTC)
What about the claims that DSM was designed to (or is used to) promote cognitive behavior therapy (rather than, for instance, psychoanalysis) and the use of psychoactive drugs (e.g. methylphenidate)? Apokrif 16:54, 2 April 2006 (UTC)
I would prefer not to merge, but to keep that article as a very brief one focused on that subject (like the other axis n articles). "Axis n" are mentioned frequently in other articles, usually without explanation (except of course in the main DSM article). A person who clicks on those references more likely wants a quick explanation, rather than finding themselves in the midst of the large and complex DSM article (if they're that interested in the DSM as a whole, they probably know what the axes are already; and if they become interested in dsm via the axes, it's only one click further). Just my $0.02. —The preceding unsigned comment was added by Sderose ( talk • contribs) 12:56, 8 January 2007 (UTC).
Impotence, premature ejaculation, jet lag, caffeine addiction, and bruxism are examples of surprising inclusions
Who finds them surprising?
and are but only several that non-psychiatrists might not consider to be mental illnesses "non-psychiatrists"? And what do psychiatrists (and psychologists, butchers, bartenders...) consider? Apokrif 16:48, 2 April 2006 (UTC)
Only a group of psychiatrists (and psychologists, too if they'd be invited), apparently drunk on their own power, would hold a vote (and a majority vote of those in the inner sanctum is exactly how entries are made) that would deem the above to be "mental diseases." That is, after all what we are talking about here. It is a valid criticism and more than a few psychiatrists note that the DSM now includes damned near anything that anyone might possibly complain about. Homebuilding 03:05, 12 September 2006 (UTC)
I totally agree, a good amount of criticism of the percieved "medical authority" of DSM-IV is right on it's place on this page. Let's face it, the overwhelming majority of "diagnoses" in the DSM are nothing else but a collection of subjective POV's of a bunch of wealthy and influential psychiatrists, who define behaviors outside the scope of currently socially acceptable limits as "diseases" (a.k.a. "we don't like it, so it must be a disease"). It has about as much objective validity as The Dianetics or the infamous Malleus Maleficarum. The insiders are very much aware of these facts; a considerable amount of psychiatrists, with several decades of practice, have been outspoken against the practical limitations of DSM and it's validity. F. inst. the prominent and influential psychiatrist Loren Mosher stated in his resignation letter to APA that "Finally, why must the APA pretend to know more than it does? DSM IV is the fabrication upon which psychiatry seeks acceptance by medicine in general.", whilst the former APA president Robert Spitzer echoed him in an interivew, admitting "The DSM is not a scientific document.. very few of the categories have an empirical base". Unless the DSM openly states that it's labelings are unscientific/philosophical/religious and to be taken as purely subjective guidelines/alternatives in response to "troubles of daily life", it deserves to be publicly and ruthlessly exposed to the scrutiny of professional criticism. 193.217.56.24 17:29, 3 October 2006 (UTC)
Please note that Robert Spitzer, quoted just above, was and has been the driving force of the DSM--and has "founding father" status. He appointed the entirety of the initial committess and boards of the DSM. He has been the final editor of all DSM versions, up to and including the DSM IV. Once it's off his desk it is ready for the vote, up or down. He has tremendous power over how health insurance money is spent on "mental health" services as this book defines what mental health is. 207.178.98.48 02:17, 12 October 2006 (UTC)
I would like to repeat that there is much more to it then finding a behavior a disease etc. as I have stated within the discrimination section of this talk article. I would like to add that there are many philosophical POVs in various forms that gave birth to the different ideas of what causes mental distress. Also, as I have said before very few disorders do NOT have the tag that it must give the individual trouble in either social, work, or liesure activity. Saying that, caffeinism is the physiological addiction as well as the psychological addiction in which the individual has withdrawal symptoms such as headaches etc that interfere with their normal functioning in which they need to consume more caffeine based products to allieviate and even act normally. Jet lag is defined as repeatedly moving from time zone to time zone in such a way which renders an insomniatic state that interferes with the individuals social, occupation, or leisure activities. Also, the comment about naming everything a disease is not truly the case. A disease has a specific definition as taken from dictionary.com for this debate "a disordered or incorrectly functioning organ, part, structure, or system of the body resulting from the effect of genetic or developmental errors, infection, poisons, nutritional deficiency or imbalance, toxicity, or unfavorable environmental factors; illness; sickness; ailment." There have been links to genetic contributors for many mental disorders including schizophrenia, alcohol abuse, opiate abuse, one particular form of insomnia etc. Though there are what are called disorders as well in which there may be a cognitive impairment that leads to an individual suffering social, occupational, or leisure activities. Finally, there are even psychologists and psychiatrists that reject the medical model and use a phenomenological approach to helping individuals with problems that are not biologically based. —Preceding unsigned comment added by UNache ( talk • contribs)
The DSM-IV doesn't specifically cite its sources, but there are several "sourcebooks" intended to be APA's documentation of the guideline development process, including literature reviews, data analyses and field trials. Funnily enough these key source materials for the major psychiatric "bible" of our time seem to be rarely referred to, or stocked even in major libraries, let alone read. I thought I'd post a mixture of available sources about them here before just trying to edit, since there's so much detail and perspective that somehow needs to be summarised in a balanced way.
Widiger TA, Frances AJ, Pincus Haet al. DSM-IV sourcebook. Vols 1–4. Washington, DC: American Psychiatric Association, 1997.
Volume 1 Volume 2 Volume 3 Volume 4 (possibly not even in print any longer)
The DSM-IV Classification and Psychopharmacology by authors including the guy who directed the process [3]
A Participant's Observations: Preparing DSM-IV
Critical reviews of vol 1 (appears twice) and Vol 2 by mental health professional author on reputable site.
Other articles covering the sourcebooks and DSM development:
PSYCHOPATHOLOGY: Description and Classification
EverSince 13:48, 24 January 2007 (UTC)
I would suggest that if references and citations cannot be provided for the lines marked, then those statements are POV and also do not meet the Wikipedia standard of being verifiable and should be deleted. DPeterson talk 14:38, 14 January 2007 (UTC)
I addded the information that I removed from the History section. I am not sure if I have put this new section in the best place, but I think the information is important as it demonstrates how the community interpretation of a "condition" can effect how the mental health community thinks about a condition. LCP 22:15, 24 May 2007 (UTC)
It's worth noting, as an illustration of just how potentially subjective and socially constructed the various diagnoses in the DSM-IV are, that Homosexuality was listed as a disorder until 1973.
It's also VERY MUCH worth noting that the authors have been shown to have links to the Pharmaceutical Industry: http://www.washingtonpost.com/wp-dyn/content/article/2006/04/19/AR2006041902560.html — Preceding unsigned comment added by 24.49.244.243 ( talk) 23:41, 11 June 2006
Will someone please provide a page on Wikipedia detailing the destructiveness of this DSM document, and the many lives it has destroyed? there are websites devoted to anti-psychiatry you might want to link to. I beg of someone! please help people who have been destroyed by this process of labelling and those in the future who will be. This document is nothing more than a political and cultural means of control. It dehumanizes the wide range of human behavior. For the love of God I wish the DSM would be discredited as the voodoo it is. Psychiatry is a huge business and most lost souls primarily need to be held and loved because of horrible things that have happened, instead are villified and ridiculed and marginalized. If anyone wants to contact me they can, at contesta@comcast.net Its not that I'm against the people who perform these jobs (I think most approach the profession with a certain desire to help), but the whole method of treating people with problems has to change. A new paradigm! 71.206.44.177 01:40, 2 January 2007 (UTC)
We must try to keep in mind that most of the concepts presented in the DSM can be viewed on a continuum and that almost all diagnoses require that there be significant impairment in work, social, or leisure activity that can be documented before the diagnosis is presented. Also, for most diagnosis there is a prevalence rate in which it can help us determine how rare the particular disorder should be within given samples. I do not have the research but if there was an addition of that calibar then it would be based on a rare impairing form of what is being referred to as 'bigotry'. Also, psychological testing uses the idea of clinical as opposed to statistical significance. Clinical significance can be usually seen in which those only scoring 2.5+ standard deviations are usually considered ill which is less than 10% of the population that it was standardized with. That is usually viewed rare enough to warrant further investigation. For this above example, the ideation of bigotry can be very over-simplified and become a belief in trend then what could conceivably be a detremental thought 'disorder' since I lack a better word at this moment. I will try to stress that clinicians use multiple resources besides just the DSM in order to make a diagnostic decision including lab and physician findings and psychological scores etc. UNache 23:26, 5 February 2007 (UTC)
You know, I've been watching this page for a few weeks, and what I can only describe as its slow-motion revert war is getting on my nerves. Some people clearly think that it's appropriate for the DSM page to link to the DSM-IV Codes page. Some people clearly disagree. Not one of these people has bothered to do get a discussion going on the subject. Although I'm generally inclusionist, I don't really care one way or another. But I'd really appreciate it if you'd type a little note here before you make that change again, okay? Something approaching a consensus would be nice. WhatamIdoing 15:32, 23 July 2007 (UTC)
"The APA has entrusted the revision of the DSM to world-renowned scientists who have vast experience in research, clinical care, biology, genetics, statistics, epidemiology, public health and consumer advocacy. They have interests ranging from cross-cultural medicine and genetics to geriatric issues, ethics and addiction. As a group, task force members have authored over 2,500 research reports, books, chapters, white papers and journal articles." This (particularly the first and third sentences) clearly consists of a positive evaluation of the membership of the task force, and not a neutral description of its composition. What is the informational value of the word "vast" here? Is there any reason for an encyclopedia to mention the number of articles published by members of this task force? Presumably someone with an interest in the DSM edited this in.—The preceding unsigned comment was added by 84.189.41.53 ( talk) This clearly consists of a positive evaluation of the membership of the task force, and not a description of its composition. Presumably someone with an interest in the DSM edited this in?
I've pulled this change:
primarily because it's unsourced, but also because it contains a logical error. The number of newly described subtypes of mental illness doesn't say anything about the number of people who have mental illnesses. This is like saying that the world produces a billion pounds of apples each year, and if you replace the "red apples" category with the names of twenty specific kinds of red apples, that somehow the world suddenly produces twenty billion pounds of apples.
This mental error has come up before on this page. The DSM describes kinds of mental illnesses (and a few not-really-illnesses). It does not make anyone be sick or change the number of people who are sick. WhatamIdoing 21:39, 13 October 2007 (UTC)
Needs:
Currently, a critique is buried in the "brief history" section. Here's some more criticism:
Others have criticized DSM for permitting pressure groups to put in or take out things - instead of disorders being added strictly on the basis of scientific evidence. The exclusion of homosexuality was heralded by gay rights groups as proof that homosexuality is normal - yet it was only their political pressure on the APA that made it remove homosexuality. Uncle Ed 17:27, 9 November 2005 (UTC)
Added statement about how professional use it, by request above Expo512 ( talk) 05:37, 30 November 2007 (UTC)
The main article does not make it clear that the postwar DSM grew out of a clash between psychiatric practice and the requirements of the armed forces and Veterans Administration during the second world war. Previously the American Medico-Psychological Association (later the American Psychiatric association) had produced, in conjunction with other bodies, a Statistical Manual which attempted to replace the diagnostic schemes used in the different state hospital systems and academic centres. This went through at least eight editions. However, it was common for a psychiatric consultation, especially with an office patient, not to lead to any clear and explicit diagnosis. Often the standard diagnoses, when applied to abnormal behaviour appearing in the extra-ordinary circumstances of the war, appeared to be wrong, in that the course of symptoms and the long-term outlook was not as expected. Many conditions that would not receive medical intervention in civilian life had to be labelled and managed, whether as diseases, crimes or breaches of discipline. The military and its hospitals found it necessary to label and tabulate many such encounters, and a couple of schemes were developed in the course of the war which returning medical officers found to be of use in civilian practice also. The introduction to the first edition of the DSM gives a brief account of that situation. The DSM-I was devised to reconcile these schemes in the days before the insurance companies acquired hegemony over American medical practice. NRPanikker ( talk) 16:36, 2 January 2008 (UTC)
Why do we have this section on "Referencing the DSM in APA Format"? Is this normal for book pages? If you look up Catch-22 or Green Eggs and Ham, is there a section on how to cite it in a bibliograph? I understand that it might be useful, but is it encyclopedic? WhatamIdoing 23:01, 18 October 2007 (UTC)
This section, I agree, is silly. I moved it to the bottom for now. I would be happy to just delete it. Perhaps it is the APA (that is american psychiatric assoc..) 'party line' on how they want their book referred to. Maybe not. However, it probably should be up to the author to choose. Expo512 ( talk) 05:42, 30 November 2007 (UTC)
The "APA Format" refers to the " APA style," from the Publication Manual of the American Psychological Association, not the American Psychiatric Association. This style guide is used by a wide range of scientific publications. There are other schemes, e.g. that of the MLA (Modern Languages Association), used in other academic fields. As students are increasingly using Wikipedia as a source for essays and academic presentations, it would be a kindness to provide them with references in the form appropriate to their subject. NRPanikker ( talk) 02:41, 5 February 2008 (UTC)
I have removed the globalization tag because it is unexplained. I had a conversation a while ago with the editor who added the tag; as I recall, the editor seemed to think that:
If you think that a globalization tag will result in the improvement of this article, then please restore it and explain your concerns, in detail, right here on this talk page. This will help other editors figure out how to address your concerns. Thanks, WhatamIdoing ( talk) 20:47, 4 March 2008 (UTC)
Beginning with the 1987 Diagnostic and Statistical Manual (DSM-III-R), mental retardation is classified as an Axis II disorder. See [6] [7] [8] and about a half a million other webpages. Interestingly, this change was apparently (ultimately) the result of a lawsuit, City of Cleburne v. Cleburne Living Center. [9] WhatamIdoing ( talk) 19:10, 2 April 2008 (UTC)
http://www.motherjones.com/news/feature/2002/07/disorders.html later —Preceding unsigned comment added by Ben Meijer ( talk • contribs) 22:33, 18 May 2008 (UTC)
WP policy requires that the person putting the text on the page carries the burden of proof that the claim is verifiable by a reliable source. On-line petitions do not meet that standard. I can recommend only that you employ some of the available venues, such as the RS noticeboard, to ascertain whether your source has a reputation for accuracy and fact-checking. Until then, reverting this page to reinstate text that has no RS behind it violates WP:V. I am amenable to this discussion being moved to our mediation discussion.
—
MarionTheLibrarian (
talk) 23:50, 13 June 2008 (UTC)
— MarionTheLibrarian ( talk) 13:52, 15 June 2008 (UTC)
This paragraph keeps getting removed by MarionTheLibrarian:
The appointment, in May 2008, of two of the taskforce members, Kenneth Zucker (editor of the Archives of Sexual Behavior) and Ray Blanchard, has led to an internet petition [1] to remove them. [2] Accoring to Brian Alexander of MSNBC, "The petition accuses Zucker of having engaged in 'junk science' and promoting 'hurtful theories' during his career. [3] According to Duncan Osborne of The Gay City News, "Dr. Ray Blanchard, a psychiatry professor at the University of Toronto, is deemed offensive for his theories that some types of transsexuality are paraphilias, or sexual urges. In this model, transsexuality is not an essential aspect of the individual, but a misdirected sexual impulse.". [4]
Please, if there's a problem with it, tag the relevant statement with citation needed, or take out any part that you believe is not sufficiently referenced. Don't take out the whole thing with no explanation. Dicklyon ( talk) 05:57, 16 June 2008 (UTC)
{{
cite news}}
: line feed character in |title=
at position 28 (
help)
After this edit where it added "According to the Gay City News", TheLibrarian is now complaining about the places where I have added similar attribution. I think it's clear that what's being reported is not opinion, as in the edit above, so I have no problem leaving it out. But that's no reason to blank the whole paragraph as it has done recently. So I've put it back again; where I had attributed authors, I just have the works now; as I said, I don't mind those being removed if anyone cares. It also asserts "BLP violation"; not clear to me how reporting what a newsworthy online petition says is a BLP violation; perhaps someone could add a link to yet another POV on it? Or say more from the cited sources if what is reported now is not balanced? Dicklyon ( talk) 03:34, 18 June 2008 (UTC)
— MarionTheLibrarian ( talk) 03:36, 18 June 2008 (UTC)
WP is not a newspaper, and I do not believe the item belongs in WP at all. The onus is on you to demonstrate that it does belong; for as long as there is no consensus for inclusion, I need add no further comment. I suggest you try an RfC.
—
MarionTheLibrarian (
talk) 03:45, 18 June 2008 (UTC)
You also have an onus to write with NPOV. When a source provides two sides of an issue, it is a violation of NPOV to add to a page only one of those sides. For example, you omit the indications in the very same article of Blanchard himself saying that he is alleged to have views that are exactly opposite to his actual views. That also violates BLP.
—
MarionTheLibrarian (
talk) 03:59, 18 June 2008 (UTC)
Obviously this is pretty lengthy now...maybe it should move down the page, maybe to the end. Maybe it needs thinning out. EverSince ( talk) 18:13, 5 July 2008 (UTC)
The introduction paragraph says:
Is it necessary to have that statement in the introduction? It is probably not an important fact for most people reading about the DSM Jenever Spirit ( talk) 13:26, 10 September 2008 (UTC)
I think that The Encyclopedia of Insanity should be removed from the external links section because it does not seem to be in keeping with the other links in that section. It reads like a highly opinionated piece rather than a considered criticism and it makes gross exaggeration to make a point. For example, where he claims to be paraphrasing the DSM-IV, "You were out of your mind the last time you have a nightmare (307.47)" is factually incorrect (307.47 quite clearly states that one nightmare does not make a disorder). He also hammers home his opinion that therapists will merely use the DSM to make money by repeatedly calling the diagnostic codes "billing codes". Basically it is written as an attack piece rather than as a considered rebuke. I'm not complaining about all the specific criticisms that Davis makes but I am complaining about the tone and style of writing being completely at odds with the other links in the section. Is a literary review of (what at least purports to be) a scientific work really so important that it should be the only review in the external links section?
In short, I think we should instead link to a more thoughtful article exploring the many criticisms of the DSM. "The Encyclopedia of Insanity" could possibly be used as a reference for the criticisms section, but I'm not sure it should have pride of place in the external links section. I fail to see what it adds to the article. Konomios ( talk) 00:10, 26 January 2009 (UTC)
I find the changes and subsections added there generally an improvement, but I wonder if reliability should be discussed together with construct validity under the (newly added) epistemological subheading; I'm not an expert on epistemology, but I think that only construct validity is an epistemological argument while reliability is more of a practical argument. I could be wrong though. Xasodfuih ( talk) 19:22, 8 March 2009 (UTC)
That 1974 decision, however, is still challenged by many conservative and religious groups who maintain that homosexuality is in fact a mental disorder.[49]
The source given there says nothing about religious groups considering homosexuality a mental disorder. In fact, it explicitly says "Research on whether homosexuality is a pathological condition is not formally relevant to the moral debate in the church. Psychological abnormality and immorality are two different things, although sometimes they overlap." It mentions morality in the article, but does not classify either way in saying it is a mental disorder. Neither does it say that such a position is held by Christians. This sentence should be changed or eliminated if no reputable source can be given. Kristamaranatha ( talk) 22:45, 7 August 2009 (UTC)
Action potential discuss contribs 10:43, 30 August 2009 (UTC)
I would start with SCID but diberris tool is not working. Compr Psychiatry. 1994 Jul-Aug;35(4):316-27. Reliability of the Structured Clinical Interview for DSM-III-R: an evaluative review. Segal DL, Hersen M, Van Hasselt VB. PMID 7956189 Earlypsychosis ( talk) 00:07, 1 September 2009 (UTC)
It seems bizarre that this is here. Homosexuality is just one of many conditions. Why is it mentioned specifically here? Its inclusion looks agenda driven. I move to remove it. LCP 21:16, 24 May 2007 (UTC)
It belongs there, in detail, just like "bleeding" is part of the history of medical treatments. Truly it is no longer central to the practice of medicine and there is documenation of progress with Joseph Lister through germ infestation theory. The point is that psychiatry continues to make their decisions regarding inclusion by plebesite (just as they have done since the initial conception of te DSM. Yes, that was in 1973--and the key players, such as Robert Spitzer, are still at the helm. It remains at the core of how the APA conducts the fundamental and essential task of defining mental illness. Homebuilding ( talk) 22:46, 19 March 2010 (UTC)
It would be amusing, if it were not so sad, that leadership on psychiatry appears to promote tolerance, while every revision of the DSM defines and describes ever more aspects of the human condition as deviant and worthy of a diagnostic name and number. And surely, in every case, somewhere, someplace someone will dream up some therapy that they can bill for. In all of these situations, questionable definitions are followed by "treatments" of ever more dubious value. —Preceding unsigned comment added by Homebuilding ( talk • contribs) 22:42, 6 February 2010 (UTC)
The criticism section generally brings up controversial viewpoints which are neither the majority viewpoint or the minority viewpoint. The whole section needs to be pruned. -- scuro 02:35, 4 April 2007 (UTC)
I don't think that addresses the issues sufficiently. Here's my first cut at a version that includes more detail but tries to stay on topic:
--Criticism-- The DSM was criticised soon after its inception. Detractors of the DSM commonly argue:
A Columbia University team headed by Robert Spitzer, an editor of the DSM, acknowledges a concern about the DSM in their annual report of 2001: “Problems with the current DSM-IV categorical (present vs. absent) approach to the classification of personality disorders have long been recognized by clinicians and researchers.” Among the problems, they list “arbitrary distinction between normal personality, personality traits and personality disorder” and point out the fact that the most commonly diagnosed personality disorder is 301.9, Personality Disorder not Otherwise Specified. [1]
Deconstructive critics assert that DSM actually invents illnesses and behaviors through the ostensible process of describing them.
The DSM has also been criticized for wrongly pathologizing behaviors that are simply uncommon or not approved in the society of that time such as homosexuality, which was described as a mental illness until 1974. [2] Based on this successful political action, some people diagnosed with gender identity disorder, various forms of paraphilia, and other "diverse states of being" hope to have these labels removed from future manuals as well. [3]
The potential for conflict of interest has also been raised. Roughly 50% of the authors who previously defined psychiatric disorders have had or have financial relationships with drug companies. [4] This criticism is normally leveled by people who oppose the use of pharmaceutical drugs to treat mental illness.
I thought that the "Eew! We're not like those people" remarks by members of one paraphilic group against members of another paraphilic group detracted from the overall point, which has nothing to do with the wide range of paraphilic behaviors or their potential for social acceptance.
The bit about half the authors having been paid to work for a drug company at some point irritates me, mostly because no one is pointing out that 100% of the editors have a "financial relationship" with an institution (the APA itself) that promotes very expensive talk therapy treatments as its bread and butter, even though talk therapy in isolation may be completely useless for some conditions. The activist charge here may be true enough, but the focus on (inherently tainted?) pharmaceutical money seems selective in a very slimy way.
What do you think? Do we have a consensus to include the details but lose the remarks? WhatamIdoing 05:01, 10 July 2007 (UTC)
It seems to me that we should add a section discussing the benefits of the DSM. (neutral point-of-view)I think this could be done in a different section. ~
(NOTE: I did not contribute the immediately previous unsigned, undated comment.) Do these criticisms also apply to the relevant similar sections of ICD-9/10/11? If so, should that be noted here? Perhaps a whole new article needs to be created, discussing the relative pros and cons of these sorts of categorical diagnosis methodologies (NPOV) and simply referenced here and on the ICD pages? I am not qualified to create such a discussion, should that be the case. Spartan26 ( talk) 16:00, 2 April 2010 (UTC)
Footnotes 20-24 referencing DSM-IV Sourcebook Volume 1, Sourcebook Volume 2, Sourcebook Volume 3, and Sourcebook Volume 4 lead nowhere. Pbh444 ( talk) 16:06, 17 September 2010 (UTC)
Do I remember correctly that there were copyright issues, also here in Wikipedia itslef, about DSM's contents? (Issues that point out that DMS's contents are a authors' creations). -- 151.82.246.203 ( talk) 10:35, 17 December 2010 (UTC)
I believe that use of this source should be evaluated on the basis that the host cite of the paper presented is incredibly biased in consideration of homosexuality as a mental disorder. NARTH, while claiming to be a genuine, unbiased source, seems quite biased to be perfectly frank. NARTH disagrees with the APA on many issues regarding homosexuality including whether homosexuality is actually an illness. I think that source 53 is heavily filled with said differences and should not be included in a discussion of the DSM unless specific consideration is given to the fact that the information comes from NARTH rather than the APA since the DSM is a work of the APA. I'm not saying that the information given in source 53 should be entirely discredited, just that it should either be clearly stated in the article where the information comes from or that the information should be verified by another source. — Preceding unsigned comment added by Saiuu ( talk • contribs) 04:53, 12 April 2011 (UTC)
Wasn't the reason homosexuality was taken out of the DSM guide because of lobbying from gay rights activists? I ask because of the article's inference that homosexuality originally being in the DSM guide was a fault of the book. -- Yodamace1 16:55, 5 January 2006 (UTC)
The objectivity of the article is totally removed with the phrase "those homo fags". This should really be fixed, but I don't feel qualified to just change it to "homosexuals" or something else. --A Visitor 07:20, 8 January 2008 (UTC) —Preceding unsigned comment added by 64.91.106.159 ( talk)
The recent section about the Drs. Zucker, Blanchard and Lawrence being selected for the American Psychiatric Assoc.'s committees should have been corrected rather than entirely removed for reported reason that it is factually incorrect as to Lawrence. Whether Zucker and Blanchard promote so-called reparative therapy on children (they deny they do) it needs to be reported that an overwhelming majority of the Queer community (rightly or wrongly) is protesting their appointment largely on that basis. Oddly, the Queer community and NARTH are in agreement that Zucker and Blanchard are in favor of ex-gay reparative therapy for children (despite Z+B's claims not to be) partly because their actions contradict their words. —Preceding unsigned comment added by 69.226.225.201 ( talk) 20:06, 18 May 2008 (UTC)
I don't think homosexuality should have been taken out as a mental disorder. If there was enough public pressure to remove pedophilia as a mental disorder would that make it right. This is a fallacy of ad populum or in this case listening to a local minority. Politicizing a scientific manual is not good science. —Preceding unsigned comment added by 206.78.255.34 ( talk) 08:49, 25 November 2009 (UTC)
I wonder about the veracity of the following statement: "That 1974 decision [to declassify homosexuality as a disorder] is still challenged by some, mainly conservative and religious, groups..." The citation given doesn't back up that statement. In any case, it seems a little bit biased to me, as if the writer is simply trying to dismiss the objections. Aren't there any knowledgeable people who object to the reclassification who aren't conservative or religious? Is the opposite side labelled liberal or irreligious? Is there only a bias on one side? At what point is it discussed the homosexual groups were instrumental in removing homosexuality from the manual? Isn't the bias of homosexuals toward homosexuality something to be considered?-- 76.118.2.97 ( talk) 01:38, 6 July 2010 (UTC)
I have a minor issue with the final sentence of the first paragraph: "There have been five revisions since it was first published in 1952, gradually including more mental disorders, although some have been removed and are no longer considered to be mental disorders, most notably homosexuality." It doesn't seem to me that the phrase "most notably" is supported, partly because there is not really a standard way to quantify what is "most notable" (i.e., how is notableness measured? There are ways, perhaps, but it seems somewhat subjective which you might choose). This could be most simply solved by removing the word "most," but there may be better rephrasings. That homosexuality's removal from the DSM can be called notable at all (if not the most notable) strikes me as well supported in the Political Controversies section (section 4.6 of the article), so I think keeping the word "notably" is not a problem. Lukescp ( talk) 07:22, 24 January 2012 (UTC)
I was just comparing this article with the one on ICD, and was surprised to find one huge difference. This article is approximately 1/3 criticism of the DSM, including a third of the lede section. The ICD article has no mention of any criticism or controversy until the final sentence. Searches of Google and Pubmed show somewhat higher criticism of DSM versus ICD, but not by a wide margin, and the more sweeping sorts of criticisms made to either, apply to the other. I'm not even going to attempt to evaluate why the articles on very similar publications are so different, but it might be worth pondering. 50.0.101.103 ( talk) 22:37, 2 December 2012 (UTC)
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Reviewer: Zad68 ( talk · contribs) 03:14, 18 January 2013 (UTC)
Zad
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03:14, 18 January 2013 (UTC)I did not complete the review, as once I saw enough problems, I stopped, so there may also be further issues. This article still needs significant work before GA, starting with rooting out the plagiarism issues, and so it is not being listed for GA.
Zad
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Rate | Attribute | Review Comment |
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1. Well-written: | ||
1a. the prose is clear, concise, and understandable to an appropriately broad audience; spelling and grammar are correct. | Some issues as noted below, including some confirmed and some suspected plagiarism | |
1b. it complies with the Manual of Style guidelines for lead sections, layout, words to watch, fiction, and list incorporation. | WP:WTW "current", "upcoming", "claim" | |
2. Verifiable with no original research: | ||
2a. it contains a list of all references (sources of information), presented in accordance with the layout style guideline. | ||
2b. reliable sources are cited inline. All content that could reasonably be challenged, except for plot summaries and that which summarizes cited content elsewhere in the article, must be cited no later than the end of the paragraph (or line if the content is not in prose). | ||
2c. it contains no original research. | ||
3. Broad in its coverage: | ||
3a. it addresses the main aspects of the topic. | ||
3b. it stays focused on the topic without going into unnecessary detail (see summary style). | ||
4. Neutral: it represents viewpoints fairly and without editorial bias, giving due weight to each. | uses of WP:WTW "claim", very large and possibly WP:UNDUE Critcism section may not be in line with emphasis found sources (need explanation). | |
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My first observation is that the Criticism section takes up nearly half the body of the article. Is that in line with what is found in reliable sources? I'm not coming into this article knowing a whole lot about the DSM but it is a bit surprising to me to find such a large Criticism section, can you please comment on this?
Sources table
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In this table:
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"DSM 5 will accept diagnoses that achieve reliabilities as unbelievably low as 0.2-0.4 (barely beating the level of chance agreement two monkeys could achieve throwing darts at a diagnostic board" [13] - Allen Frances, M.D., was chair of the DSM-IV Task Force ParkSehJik ( talk) 06:54, 29 November 2012 (UTC)
==> Please see 44.2 CONSENSUS, below, for a summary of the consensus reached. Also, please see 44.2.1 Adding Back the "Political Controversies" subsection and its contents, below, if you disagree.[Edit]
I would like to reach We have reached consensus on two issues: [Edit]
1) Is the information currently in Section 5.1- Criticism: Political Controversies important enough to include in this article?
2) If so, should it remain in its own subsection or should it be integrated elsewhere in the article?
What do you think?
Mark D Worthen PsyD 13:46, 22 May 2013 (UTC)
Zad
68
01:21, 23 May 2013 (UTC)
Zad
68
01:27, 23 May 2013 (UTC)We have reached consensus that reference to homosexuality as a mental disorder should be integrated into the article in a relevant section and, to the extent that such additions refer to contemporary (i.e., in 2013) assertions that homosexuality is a mental disorder, such additions should be made in a manner that does not accord the viewpoint undue emphasis ( WP:UNDUE), i.e., space and prominence in the article that is out of proportion with its:
Mark D Worthen PsyD 05:03, 24 May 2013 (UTC)
If you believe that the "Political Controversies" subsection should be restored with some or all of the material that had been included, please first discuss your proposal here before editing the page.
In your discussion, please explain why restoring that subsection, including all or most of its content, is important in light of:
Mark D Worthen PsyD 04:59, 24 May 2013 (UTC)
It strikes me that there are particular problems with POV, for two reasons: the Criticisms are pushed to the end of the article instead of being integrated in a balanced way throughout the text. Authors such as Prof Stuart A. Kirk (UCLA), who have said a lot about the DSM over many decades, are not mentioned. Kirk wrote The Selling of the DSM in 1992, and his most recent book Mad Science (2013) also extensively reviews DSM history. I don't plan to get involved in editing this article in a major way, but will add a few paragraphs in the first half of the article that might help to balance it and make it a little more comprehensive. Johnfos ( talk) 00:52, 24 May 2013 (UTC)
I'm going to point out some of the problems with the criticism section. It's really bad and needs a lot of work. I would suggest deleting it or cutting it down until it is fixed.
Reliability and Validity Concerns[edit]
The revisions of the DSM from the 3rd Edition forward have been mainly concerned with diagnostic reliability--the degree to which different diagnosticians agree on a diagnosis. (no source)
It was argued that a science of psychiatry can only advance if diagnosis is reliable. (by who?)
If clinicians and researchers frequently disagree about a diagnosis with a patient, then research into the causes and effective treatments of those disorders cannot advance. (no source - who said this? - it doesn't even really make sense because research specifically lists the inclusion criteria. This is true for all medical research.)
Hence, diagnostic reliability was a major concern of DSM-III. (Who was concerned?)
When the diagnostic reliability problem was thought to be solved, subsequent editions of the DSM were concerned mainly with "tweaking" the diagnostic criteria. (source?)
Unfortunately, neither the issue of reliability (accurate measurement) or validity (do these disorders really exist) was settled. (source? Also reliability is and validity are not correctly defined)
However, most psychiatric education post DSM-III focused on issues of treatment--especially drug treatment--and less on diagnostic concerns. (source?)
In fact, Thomas R. Insel, M.D., Director of the NIMH, has recently stated the agency would no longer fund research projects that rely exclusively on DSM criteria due to its lack of validity. (In fact? Is that meant to be proof?)
Superficial symptoms[
By design, the DSM is primarily concerned with the signs and symptoms of mental disorders, rather than the underlying causes. It claims to collect them together based on statistical or clinical patterns. As such, it has been compared to a naturalist’s field guide to birds, with similar advantages and disadvantages.[43] The lack of a causative or explanatory basis, however, is not specific to the DSM, but rather reflects a general lack of pathophysiological understanding of psychiatric disorders. As DSM-III chief architect Robert Spitzer and DSM-IV editor Michael First outlined in 2005, "little progress has been made toward understanding the pathophysiological processes and etiology of mental disorders. If anything, the research has shown the situation is even more complex than initially imagined, and we believe not enough is known to structure the classification of psychiatric disorders according to etiology."[44] (can you use letters to the editor as a source?)
The DSM's focus on superficial symptoms is claimed to be largely a result of necessity (assuming such a manual is nevertheless produced), since there is no agreement on a more explanatory classification system.[citation needed]
Reviewers note, however, that this approach is undermining research, including in genetics, because it results in the grouping of individuals who have very little in common except superficial criteria as per DSM or ICD diagnosis.[3](where does the source say this?)
Despite the lack of consensus on underlying causation, advocates for specific psychopathological paradigms have nonetheless faulted the current diagnostic scheme for not incorporating evidence-based models or findings from other areas of science. (source?)
A recent example is evolutionary psychologists' criticism that the DSM does not differentiate between genuine cognitive malfunctions and those induced by psychological adaptations, a key distinction within evolutionary psychology, but one widely challenged within general psychology.[45][46][47] Another example is a strong operationalist viewpoint, which contends that reliance on operational definitions, as purported by the DSM, necessitates that intuitive concepts such as depression be replaced by specific measurable concepts before they are scientifically meaningful. One critic states of psychologists that "Instead of replacing 'metaphysical' terms such as 'desire' and 'purpose', they used it to legitimize them by giving them operational definitions...the initial, quite radical operationalist ideas eventually came to serve as little more than a 'reassurance fetish' (Koch 1992) for mainstream methodological practice."[48]
Dividing lines
Despite caveats in the introduction to the DSM, it has long been argued (by who?)
that its system of classification makes unjustified categorical distinctions between disorders, and uses arbitrary cut-offs between normal and abnormal. A 2009 psychiatric review noted that attempts to demonstrate natural boundaries between related DSM syndromes, or between a common DSM syndrome and normality, have failed.[3] Some argue that rather than a categorical approach, a fully dimensional, spectrum or complaint-oriented approach would better reflect the evidence.[49][50][51][52]
In addition, it is argued (by who?)
that the current approach based on exceeding a threshold of symptoms does not adequately take into account the context in which a person is living, and to what extent there is internal disorder of an individual versus a psychological response to adverse situations.[53][54] The DSM does include a step ("Axis IV") for outlining "Psychosocial and environmental factors contributing to the disorder" once someone is diagnosed with that particular disorder.
Because an individual's degree of impairment is often not correlated with symptom counts, and can stem from various individual and social factors, the DSM's standard of distress or disability can often produce false positives.[55] On the other hand, individuals who do not meet symptom counts may nevertheless experience comparable distress or disability in their life. (Every test in medicine has false positives and false negatives. What's the point of this section?)
Cultural bias
Some psychiatrists also argue that current diagnostic standards rely on an exaggerated interpretation of neurophysiological findings and so understate the scientific importance of social-psychological variables.[56] Advocating a more culturally sensitive approach to psychology, critics such as Carl Bell and Marcello Maviglia contend that the cultural and ethnic diversity of individuals is often discounted by researchers and service providers.[57] In addition, current diagnostic guidelines have been criticized as having a fundamentally Euro-American outlook. Although these guidelines have been widely implemented, opponents argue that even when a diagnostic criteria set is accepted across different cultures, it does not necessarily indicate that the underlying constructs have any validity within those cultures; even reliable application can only demonstrate consistency, not legitimacy.[56] Cross-cultural psychiatrist Arthur Kleinman contends that the Western bias is ironically illustrated in the introduction of cultural factors to the DSM-IV: the fact that disorders or concepts from non-Western or non-mainstream cultures are described as "culture-bound", whereas standard psychiatric diagnoses are given no cultural qualification whatsoever, is to Kleinman revelatory of an underlying assumption that Western cultural phenomena are universal.[58] Kleinman's negative view towards the culture-bound syndrome is largely shared by other cross-cultural critics, common responses included both disappointment over the large number of documented non-Western mental disorders still left out, and frustration that even those included were often misinterpreted or misrepresented.[59] Many mainstream psychiatrists have also been dissatisfied with these new culture-bound diagnoses, although not for the same reasons. Robert Spitzer, a lead architect of the DSM-III, has held the opinion that the addition of cultural formulations was an attempt to placate cultural critics, and that they lack any scientific motivation or support. Spitzer also posits that the new culture-bound diagnoses are rarely used in practice, maintaining that the standard diagnoses apply regardless of the culture involved. In general, the mainstream psychiatric opinion remains that if a diagnostic category is valid, cross-cultural factors are either irrelevant or are only significant to specific symptom presentations.[56]
Medicalization and financial conflicts of interest
It has also been alleged (by who?) that the way the categories of the DSM are structured, as well as the substantial expansion of the number of categories, are representative of an increasing medicalization of human nature, which may be attributed (by who?) to disease mongering by psychiatrists and pharmaceutical companies, the power and influence of the latter having grown dramatically in recent decades (according to who?).[60]
Of the authors who selected and defined the DSM-IV psychiatric disorders, roughly half had had financial relationships with the pharmaceutical industry at one time, raising the prospect of a direct conflict of interest.[61] The same article concludes that the connections between panel members and the drug companies were particularly strong in those diagnoses where drugs are the first line of treatment, such as schizophrenia and mood disorders, where 100% of the panel members had financial ties with the pharmaceutical industry.[61] In 2005, then American Psychiatric Association President Steven Sharfstein released a statement in which he conceded that psychiatrists had "allowed the biopsychosocial model to become the bio-bio-bio model".[62] (It seems that if we're going to have a section questioning the use of prescription drugs then we should have a discussion about all the research that is preformed to balance out what is really an ad hominem attack)
However, although the number of identified diagnoses has increased by more than 200% (from 106 in DSM-I to 365 in DSM-IV-TR), psychiatrists such as Zimmerman and Spitzer argue it almost entirely represents greater specification of the forms of pathology, thereby allowing better grouping of more similar patients.[3] William Glasser, however, refers to the DSM as "phony diagnostic categories", arguing that "it was developed to help psychiatrists – to help them make money".[63]
In addition, the publishing of the DSM, with tightly guarded copyrights, has in itself earned over $100 million for the American Psychiatric Association.[64] (What is the purpose of this line? It appears to be to question the motives of the APA. If that's going to be done, then do it, and back it up with something. Instead this line makes it seem like it's somehow immoral to publish books.)
Consumers and survivors
A consumer is a person who accesses psychiatric services and may have been given a diagnosis from the Diagnostic and Statistical Manual of Mental Disorders, while a survivor self-identifies as having survived psychiatric intervention and the mental health system (which may have involved involuntary commitment and involuntary treatment). (According to who - these are not commonly used descriptions in psychiatry - seems 100% POV)
Some are relieved to find that they have a recognized condition to which they can give a name. Indeed, many people self-diagnose. Others, however, feel they have been given a "label" that invites social stigma and discrimination (i.e. mentalism), or one that they simply do not feel is accurate. Diagnoses can become internalized and affect an individual's self-identity, and some psychotherapists find that this can worsen symptoms and inhibit the healing process.[65]
Some in the Psychiatric survivors movement (more broadly the consumer/survivor/ex-patient movement) actively campaign against their diagnosis, or its assumed implications, and/or against the DSM system in general.
It has been noted that the DSM often uses definitions and terminology that are inconsistent with a recovery model, and that can erroneously imply excess psychopathology (e.g. multiple "comorbid" diagnoses) or chronicity.[66] (This line makes no sense. It's saying that people who disagree with psychiatry disagree with what psychiatrists do - not really needed)
DSM-5 Critiques
Psychiatrist Allen Frances has been critical of proposed revisions to the DSM-5. In a 2012 article, Frances warned that if this DSM version is issued unamended by the APA, it will "medicalize normality and result in a glut of unnecessary and harmful drug prescription."[67] In a December 2, 2012 blog post in Psychology Today, Frances lists the ten "most potentially harmful changes" to DSM-5:[68]
Disruptive Mood Dysregulation Disorder, for temper tantrums Major Depressive Disorder, includes normal grief Minor Neurocognitive Disorder, for normal forgetting in old age Adult Attention Deficit Disorder, encouraging psychiatric prescriptions of stimulants Binge Eating Disorder, for excessive eating Autism change, reducing the numbers diagnosed First time drug users will be lumped in with addicts Behavioral Addictions, making a "mental disorder of everything we like to do a lot." Generalized Anxiety Disorder, includes everyday worries Post-traumatic stress disorder, changes opening "the gate even further to the already existing problem of misdiagnosis of PTSD in forensic settings."
(This is deceptively worded - it makes it sound like the DSM-5 is including temper tantrums under disruptive mood dysregulation disorder [and so on]. This is not an established fact, but one guys opinion of what would happen)
Frances and others have published debates on what they see as the six most essential questions in psychiatric diagnosis:[69]
are they more like theoretical constructs or more like diseases how to reach an agreed definition whether the DSM-5 should take a cautious or conservative approach the role of practical rather than scientific considerations the issue of use by clinicians or researchers whether an entirely different diagnostic system is required. (This would be good in an article about Frances)
In 2011, psychologist Brent Robbins co-authored a national letter for the Society for Humanistic Psychology that has brought thousands into the public debate about the DSM. Approximately 14,000 individuals and mental health professionals have signed a petition in support of the letter. Thirteen other American Psychological Association divisions have endorsed the petition.[70] Robbins has noted that under the new guidelines, certain responses to grief could be labeled as pathological disorders, instead of being recognized as being normal human experiences.[71] (I'm not sure if this is a specific enough criticism to be included. Any diagnostic criteria for anything will have false positives and/or false negatives - also this ignores the role of the physician as any decent physician would get a history)
I think the section should be taken out or pruned until someone has a chance to go through and fix it. Whoever does should ask themselves if this is the right article for each bit of information, if it represents a POV, and if it's properly sourced.
The sections on the first two editions on the DSM seem to pick out homosexuality in particular as a focus. The section of the second edition's seventh printing is written in such a way as to suggest that homosexuality was removed purely due to political pressure. And the section on DSM-III-R also picks out sexual orientation. It seems that the focus on sexuality throughout these sections and the misleading account of homosexuality being removed are driven by a conservative agenda. — Preceding unsigned comment added by 82.20.19.182 ( talk) 14:10, 21 September 2013 (UTC)
I believe that this is a really good topic for discussion, as there is a logic behind it that is not obvious. My view is that Axis II is derived from traits that are life-long, and Axis I is about disorders that are affective (not necessarily, but including depression). I am posing this suggestion as a question, as sources are hard to find concerning this.-- John Bessa ( talk) 17:19, 15 February 2011 (UTC)
This
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Dr. Ofer Zur and Nola Nordmarken (2010) describe how the DSM pathologizes healthy groups, such as autistics, women, the elderly, and people with strong expressed emotions. Full article here.
Azziaz ( talk) 06:57, 18 December 2011 (UTC)
(Note: Just wanted to add a request - I've recently found out that the "belief in supernatural beings, such as ghosts, spirits, angels and demons" was considered a sign of mental illness and incompetency before DSM-IV 1994. Could the experts please confirm this fact and report it in this article?) — Preceding unsigned comment added by Philosopher3000 ( talk • contribs) 23:55, 9 March 2012 (UTC)
Hi. How can I get DSM-IV-TR and get it for free? — Preceding unsigned comment added by Mustafa Bakacak ( talk • contribs) 11:07, 27 September 2012 (UTC)
The section Consumers says: "A Consumer is a person who has accessed psychiatric services and been given a diagnosis from the DSM." Is consumer really the best, most standard term? Isn't client or user more common?? Lova Falk talk 17:26, 18 June 2010 (UTC)
I believe it is necessary to mention that Aspergers was first recognized by the DSM-IV. It is a popular topic amongst society and its origination should be noted. Here is my hopeful addition: The DSM-IV was also the first to recognize Asperger's Syndrome as one of the five disorders listed under the category of pervasive developmental disorder. Here is the citation to the book where I found this information: Grandin, Temple, and Richard Panek. The Autistic Brain: Thinking across the Spectrum. Boston: Houghton Mifflin Harcourt, 2013. Print.
Let me know what you think! -- Rzelmano1221 ( talk) 23:24, 18 April 2014 (UTC)
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is out of body experience is a disorder? — Preceding unsigned comment added by 14.142.41.30 ( talk) 09:56, 20 August 2015 (UTC)
I want to find the number of mental disorders listed in each DSM version.
At present there are some inconsistencies in the way this is described:
I'd like the article to:
-- Grahamstoney ( talk) 03:22, 24 July 2015 (UTC)
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I find this article disappointing. I have only a layman's knowledge of psychiatry and psychology, but have some hopefully constructive criticisms. First, and most obvious is why are all five editions (as well as supplementary publications which are generally included) treated the same? There has been enormous changes in the DSM's content and uses; is it USEFUL or INFORMATIVE to discuss them as being parts of a single thing? Second, it would be useful to discuss the major alternatives to the Euro-centric? DSM (including the ICD, Ch. V) used by mental health practitioners the world over. (Does China use the DSM? India? Indonesia? Brazil? Pakistan? (those countries and the USA comprise ½ of the world population. How about (other) Islamic, Arabic, or African countries?) Third, the section titled "DSM-5 critiques" was written PRIOR to it being published (May 2013) and should be revised. Any claims before that time were speculative predictions; and are of limited relevance, imho. NOWHERE in that section is mention of the petition (Oct 2013) for outside review mentioned, for example. Lastly, the section titled "Reliability and validity concerns" should be rewritten. Here is my suggested revision:"The DSM's diagnostic reliability — the degree to which different diagnosticians agree on a diagnosis - continues to be a major source of concern.[55] If clinicians often differ in their diagnosis of a patient, or of the criteria which they use to categorize mental disorders, then treatment may not be optimum. Misdiagnosis can lead to both sub-optimal treatment as well as limiting insurance reimbursements for (hence access to) care. In 2013, Thomas R. Insel, M.D., Director of the NIMH, stated that the agency would no longer fund research projects that rely exclusively on DSM criteria due to its lack of validity.[56] NIMH has proposed use of the RDoC classification system as an alternative." 216.96.113.99 ( talk) 07:01, 29 June 2016 (UTC)
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Just my 2 cents that the section I've tagged might be giving undue weight to one person's opinion - more citations that comment about the opinions (ideally, not self-written sources) would be required to demonstrate the importance of said opinions. 69.165.196.103 ( talk) 05:23, 12 March 2017 (UTC)
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Is the title of this publication properly italicized or not? There seems to not be a consensus, and I feel as though there should be one. Michipedian ( talk) 10:41, 31 July 2017 (UTC)
Hello,
Very first contribution to WP.
Under History/DSM-I (1952), ref 17[i] cannot be used to support the fact it is supposed to support, i.e. that "The manual was 130 pages long and listed 106 mental disorders". The information about number of pages and entries is nowhere to be found in this paper. I suggest citing this more recent paper[ii] which informs about both facts: "The DSM-I contained 128 categories and was published as a smallish (132 pages) paperback book that cost $3.", 'categories' meaning listed disorders from what I understand. I further suggest making the appropriate changes to the sentence.
[i] Grob, GN. (1991) Origins of DSM-I: a study in appearance and reality Am J Psychiatry. April;148(4):421–31.
[ii] Blashfield, R. K., Keeley, J. W., Flanagan, E. H., & Miles, S. R. (2014). The cycle of classification: DSM-I through DSM-5. Annual Review of Clinical Psychology, 10, 25–51. http://doi.org/10.1146/annurev-clinpsy-032813-153639
Regards,
Richard 176.159.24.144 ( talk) 21:29, 25 October 2018 (UTC)
Hi, I've tried to introduce a gentle historical record of the US Navy and US Army from DSM-1, combined with a UN WHO quote on the viral nature of mental diseases as expanded in numbers from 1952 to 2001 under UN inspection. It is part of the campaign the Israeli Mossad is managing against the phoenomenon of torture, as it is manifested in advanced scientific medical experiments tied to lifelong torture of human beings and animals. I was blocked by an Australian Wikipedia activist named David Gerard from even bringing the subject to the awareness of the community. Here are the sources which i tried to quote, DSM-1 page vii (1948 psychiatry history and forward) https://archive.org/details/dsm-1/page/n7 And here's the United Nation's World Health Organization's statement on the subject of people affected according to psychiatry/DSM https://www.who.int/whr/2001/media_centre/press_release/en/
Please see if you can process the original data into Wikipedia quality info, And ofcourse I'm available for any further info leaks I may be able to provide. War.technology ( talk) 08:37, 15 December 2018 (UTC)
Jump down to Lede discussion part 2 (23 February 2019) | Jump down to Lede discussion part 3 (26 February 2019) |
Yeah, Talk should help, Flyer22 Reborn!
Disclosure (of stance / bias: not of firm opinion): I’m very sympathetic to the aims and achievements of the DSM, in pulling together a reference platform out of the mental-health disaster of last century’s total war. To me, DSM is a worthwhile target for critics because it’s the only target. Its weaknesses are not APA self-indulgence, they’re the big issues in Anglophone culture’s ideas about mental health. And maybe in US healthcare delivery too, but that’s not my thing. (I’m a Brit.)
In particular, I’m impatient with criticism that DSM should be rejected as a mere muddle of symptomatology. So was eighteenth-century physical medicine; and the solution to that was to do the work and make the progress - not to complain tht medicine was unscientific and shouldn’t be attempted!</rant>
What I was originally tackling is the way the lede closes. I experienced it as a POV ambush, a bait-&-switch from encyclopaedic style, to push an undeclared agenda, leaving a nasty aftertaste.
At the close of the lede! I presume that’s the worst possible place in an article to do that - and this is an important article!
Looking again, it still seems clear to me tht there’s a problem tht needs solving.
( There are other minor problems with the sentence: the $100m figure in the source relates to DSM-IV, not to DSM’s whole history; and annualising the figure will mislead if in fact the revenue-stream is lumpy / cyclic. )
Rather than getting into the policy long grass . . Maybe I took the wrong approach to reworking the text in the first place. How about moving the point to the opening paragraph? where it helps convey DSM’s established status?
( The following proposal includes other tweaks. )
Pinging: not sure how the system works: hope this is OK?
POV: great tht we’ve both felt uncomfortable! - it’s not just me! Also tht you’ve already sorted out rather the same issue elsewhere, as you describe.
Lede as summary: I had missed this, tht the point appears only in the lede. Really, that alone is decisive. That is, the first (?only) step is to transfer the point from lede to body.
You? or me? (Hint: I reckon you know the particular article better - and know what you’re doing generally rather better too!)
Other minor problems: I hope you agree with me tht annualising the revenue-stream is potentially misleading (and close to OR)? And of course the stated figure relates to just DSM-IV (presumably inc -TR)?
Policy points: what policy points apply to the new copy will become clear when it’s drafted; but if relevant . . I don’t share your qualms about By whom tags. It would help to locate the citation early in the sentence (as I did in my initial para-split attempt; forgot in my more recent effort moving the point to an earlier para). On that basis, I’d think anyone who adds that tag - while the answer to his/her question, last=, is staring right back from that exact point in the source code! - needs to be sat down in a quiet corner and listen while something is explained! And I doubt tht the suggested lede-limit of four paragraphs has a lot of weight, either, in application to an article of this length and importance.
In the body: *then* back in the lede again? Probably basically leave this until we have it in the body and we can judge how the whole thing looks. Thinking ahead, though, in case it helps with orientation / context . . I don’t fully trust my own ideas on this (because of my suspected bias in favor of DSM, + doubts tht I may be over-correcting); but my hunch is (i) there is an argument tht the APA is getting a little too comfortable with the revenue stream, and cozy with Big Pharma too; and (ii) it’s important enough for eventual mention in the lede.
Neutroboard / Med: I suppose we could? if we begin to feel doubts? But certainly at this stage it seems clear to me :-)
Pinging: mmm. Well, let me know if probs. (I did try looking at WP:Ping!)
I’ve now rewritten the moved copy to suit its new location - and to reflect its cited source(!) I’ve also taken care to avoid claiming to summarise the NYT article as a whole, rather than just this criticism.
As the point it makes is simply that, though - a criticism - should it really be in that section? rather than in History? (I would have said that earlier: but it wasn’t till I revisited the NYT piece, as part of this rewrite, tht I was reminded how fierce the criticism is. The piece ends with the words “laughing all the way to the bank”! - almost intemperate for the NYT?!)
Inexperienced editors: well, yes, and I’m much encouraged to see tht we’re seeing the basic issue in the same way. But shouldn’t we be pushing back? rather than surrendering the article space to contributors who need to attend to an explanation?
In this case, though, I’ve now simply mentioned the NYT in the running copy. I considered mentioning Gary Greenberg, instead of NYT . . it looks like he may be sufficiently notable to warrant mention? - but I’m not in a position to judge.
- SquisherDa ( talk) 04:08, 25 February 2019 (UTC)
Another editor changed "US" to either "U.S." or "United States" (
diff). I searched the article and found two instances of "US", which I changed to "U.S." for one, and "United States" for the other (
diff) for consistency per
MOS:US. Unless there is a compelling reason to change the way we abbreviate "United States" in this article, I am in favor using "U.S.". The article does not frequently mention other countries using abbreviations, e.g., UK, AUS, NZ, which is one reason to prefer "US" in some articles (see
MOS:US).
- Mark D Worthen PsyD
(talk) (I am a man. The traditional male pronouns are fine.) 13:38, 30 September 2019 (UTC)
Following the copyright issue (see top of this talk page), I'm surprised that the article does not state that this manual is a creative work, as even sated and claimed by the authors. Not so far from, for example, a novel or a personal report of a news or so on, differently form stating fact or "actual" definition of real things as "Water in rivers goes downstream ", "The Sun is a star", "The Sun rises in the East zone, set in the West zone", "New York is in Unite States", or for a medical example "Pharyngitis is every inflammation of the pharynx". We can hold to be sure that some other authors have written earlier than me, even word for word, but no one of such authors can claim a copyright stating that this wording are his/her own property and thinking tath he/sehe block anyone else to use the same sentence.
Amazing this book is introduced it this Wikipedia's article not as an authors' invention and imagination (as claimed by themself!) but as a "real thing". (Off course, we need to point out that someone actually use for the classification of mental disorders, but Iliad can not be introduced as a "real treasure map" not even if Heinrich Schliemann used it in that way). -- 95.239.2.134 ( talk) 09:28, 21 October 2019 (UTC)
I added a multiple issues tag (banner) to the article, specifying:
Please discuss here. Thank you - Mark D Worthen PsyD (talk) (I'm a man—traditional male pronouns are fine.) 17:00, 16 May 2020 (UTC)
It would helpful to have in this article a comparison of the DSM with other serious non-US and non-Anglophone systems of diagnosing and describing mental health, if such exist. (I myself know absolutely nothing about this, but would love to read if other experts wrote it.) Acwilson9 ( talk) 20:28, 14 September 2020 (UTC)
The opening paragraph made it sound as though the DSM is the default authority in all countries. As far as I know the DSM is only an authority in the USA. I have attempted to clarify this. Please improve if you think it can be improved. SpectrumDT ( talk) 11:39, 8 April 2021 (UTC)
This article was the subject of a Wiki Education Foundation-supported course assignment, between 28 February 2022 and 27 March 2022. Further details are available on the course page. Student editor(s): Zeboman123 ( article contribs).
Hello Wikipedians! My name is Nicholas, and I am a fourth year medical student at UCSF going into psychiatry. I am going to work on the DSM page as part of an elective course. Hopefully I’ll be able to help!There are a few different parts of the page that look like they could use some work.
First I plan on improving the citations on the “Pre-DSM-1 (1840-1849)” section. I will update all of the citations and add citations wherever needed. I hope to have this accomplished by 3/10/2022.
I will then edit the “superficial symptoms” section as it is tagged for having too many/overly lengthy quotations. I will work to pare down the essential information to make it more readable as well as confirming citations and adding citations if needed. I hope to complete this by 3/15/2022.
Finally I will work on the section “Distinction from ICD” section to try to include more specific comparisons regarding the difference between the DSM and other widely used psychiatric diagnostic manuals. I hope to have this completed by 3/21/2022.
If anyone is interested in this page and wants to talk please reach out! Thanks!
Nicholas — Preceding unsigned comment added by Zeboman123 ( talk • contribs) 07:03, 4 March 2022 (UTC)
Peer review of this article as part of the UCSF Spring 2022 Wikipedia Elective course.
Overall, the edits made to this article are outstanding and I believe they significantly improve upon the previous version of the article.
Two sections in particular that I believe had the most major improvements are the "distinction from ICD" and "superficial symptoms" sections.
The edits improve upon the article's readability, content, and flow and are appropriate for an encyclopedia audience at large.
Comments:
Suggestions:
Really excellent job on improving this article! WikiUser950 ( talk) 21:52, 17 March 2022 (UTC)
On March 16, 2022, at 06:12, a subheading under DSM-II (1968) was changed from "Seventh printing of the DSM-II (1974)" to "Sixth printing. . . ." to indicate the first printing that removed homosexuality as a mental disorder. I own a copy of the DSM-II which first included a note about eliminating "Homosexuality" per se as a mental disorder. The printing is the seventh, not the sixth. The copyright page shows the Sixth printing as issued in October 1973, which is before the APA trustees voted to make the change. They voted in December 1973, and the decision was upheld in May 1974 in a referendum of the voting members of the association. The seventh printing, in July 1974, includes a page with "Special Note — Seventh Printing" and the announcement that since the last printing (6th) of the manual, the trustees voted to make the change. Rawars ( talk) 15:11, 1 May 2022 (UTC)
If you were diagnosed as a hyperactive child when you young and diagnosed with ADHD as an adult could you possibly get addicted to to medication prescribed for high ADHD as an adult? 174.240.50.138 ( talk) 20:57, 12 June 2022 (UTC)
Currently the introduction calls it the "bible" of Psychiatry. There is no source for this, so it comes across like an opinion rather than verifiable information. I think it might qualify as WP:FLOWERY. I imagine people outside the US might consider something else to the "bible" of psychiatry, so it seems somewhat American-centric. I'm not planning to change it but thought I would leave my feedback. Pythagimedes ( talk) 23:48, 21 July 2022 (UTC)
Actually, I looked at the edit history and this seems it was recent addition by an IP, so I'm going to go ahead and just remove it. Pythagimedes ( talk) 23:56, 21 July 2022 (UTC)