Toward DSM-V and the classification of psychopathology. (original) (raw)
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The provision of explicit and specific diagnostic criteria in the Diagnostic and Statistical Manual of Mental Disorders (DSM; American Psychiatric Association, 1980,1987) was instrumental in the production of a substantial amount of informative research. The major emphasis in the preparation of the DSM-IV has been to maximize the impact of this accumulating research on the revision and to document the rationale and empirical support for any changes that are made. In this article we discuss the empirical basis for the DSM-IV. The historical context provided by the previous editions is briefly presented and followed by a description of the process by which the DSM-IV is being constructed. The input of empirical data through literature reviews, data reanalyses, and field trials is described, and an illustration with the antisocial personality disorder diagnosis is given. Work began on the fourth edition of the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) in 1988. The DSM-1V is scheduled to be
Psychiatric Diagnosis: Lessons from the DSM-IV Past and Cautions for the DSM-5 Future
Annual Review of Clinical Psychology, 2012
The American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders provides the authoritative list of what are considered to be mental disorders. This list has a tremendous impact on research, funding, and treatment, as well as a variety of civil and forensic decisions. The development of this diagnostic manual is an enormous responsibility. Provided herein are lessons learned during the course of the development of the fourth edition. Noted in particular is the importance of obtaining and publishing critical reviews, restraining the unbridled creativity of experts, conducting field trials that address key issues and concerns, and conducting forthright risk-benefit analyses. It is suggested that future editions of the diagnostic manual be developed under the auspices of the Institute of Medicine. The goal would be broad representation, an evidence-based approach, disinterested recommendations, and a careful attention to the risks and benefits of each su...
Beyond the DSM-IV: Assumptions, Alternatives, and Alterations
Journal of Counseling & Development, 2006
Current diagnostic processes reflect the limitations and utility of the framework of the Diagnostic and Statistical Manual of Mental Disorders (4th ed.; DSM-IV; American Psychiatric Association, 1994). Clinical information in the DSM-IV's 5-axis system almost exclusively focuses on weaknesses and pathology and is summarized in a flawed categorical system. Hence, the authors describe 3 adjunctive, or alternative, means of conceptualizing behavior; several means of altering the current DSM-IV system; and 2 future directions in the diagnosis of strengths.
Psychoanalytic Psychology, 2015
This article reviews the development of the second edition of the Psychodynamic Diagnostic Manual, the PDM-2. We begin by placing the PDM in historical context, describing the structure and goals of the first edition of the manual, and reviewing some initial responses to the PDM within the professional community. We then outline five guiding principles intended to maximize the clinical utility and heuristic value of PDM-2, and we delineate strategies for implementing these principles throughout the revision process. Following a discussion of two PDM-derived clinical tools -The Psychodiagnostic Chart (PDC) and Psychodynamic Diagnostic Prototypes (PDP)-we review initial research findings documenting the reliability, validity, and clinical value of these two measures.
Journal of Abnormal Psychology, 1991
A survey of the uses and attitudes of 146 mental health professionals, primarily psychiatrists and psychologists, in 42 countries (not including the United States) toward the 3rd edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-III) and its revision (DSM-III-R; American Psychiatric Association, 1980,1987) is reported. The results revealed widespread endorsement of the multiaxial system, theoretical neutrality, descriptive symptom criteria forming discrete categories, and the placement of personality disorders on a separate axis. We report that the DSM-III and DSM-III-R are more widely used around the world than the International Classification of Diseases for teaching, research, and clinical practice. Opinions about various dimensions of the DSM's usefulness and shortcomings are presented. An orderly presentation of the facts alone is a real diagnosis. Whenever groups of facts occur often enough they naturally lead to the formulation of a terminology.-Adolph Meyer The third edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-III; American Psychiatric Association, 1980) and its revision (DSM-III-R; American Psychiatric Association, 1987) will soon be history. By this time the field trials for DSM-IVa.K ongoing, and increasingly, attention is focused on the tentative diagnostic criteria of the new edition. There are many reports in the literature from the United States that discuss the relative merits of the DSM-III and the DSM-III-R. There have been many fewer publications from foreign countries. We assess the foreign impact of the DSM-III and DSM-III-R, so that the designers of the DSM-IV may be aided in their complex task (see Frances et al., 1991; Widiger, Frances, Pincus, Davis, & First, 1991). The DSM-III broke with the format of previous editions by attempting to be theoretically neutral, using descriptive symptom criteria, placing the diagnostic classification system in a multiaxial format (see Williams, 1985a, 1985b), and separating the personality and specific developmental disorders (Axis II) from other mental disorders (Axis I). Moreover, the classification system was often polythetic: Not all of the diagnostic criteria for a given syndrome were necessary to define a patient as having that syndrome. Thus, for example, two patients might have markedly different symptoms on Criterion B and on the fifth-digit subclassification yet still be diagnosed as having an episode of major depression. Along with variability of symptoms within many of the disorders, each disorder was itself a rather fuzzy set. No assumption was made that each menial disorder was a discrete entity, The opinions expressed in this article are those of the authors only and do not necessarily reflect those of the National Institute of Mental Health.
Psychological science in the public interest : a journal of the American Psychological Society, 2017
The diagnosis of mental disorder initially appears relatively straightforward: Patients present with symptoms or visible signs of illness; health professionals make diagnoses based primarily on these symptoms and signs; and they prescribe medication, psychotherapy, or both, accordingly. However, despite a dramatic expansion of knowledge about mental disorders during the past half century, understanding of their components and processes remains rudimentary. We provide histories and descriptions of three systems with different purposes relevant to understanding and classifying mental disorder. Two major diagnostic manuals-the International Classification of Diseases and the Diagnostic and Statistical Manual of Mental Disorders-provide classification systems relevant to public health, clinical diagnosis, service provision, and specific research applications, the former internationally and the latter primarily for the United States. In contrast, the National Institute of Mental Health&#...
Diagnostic and Statistical Manual of Mental Disorders (DSM):To Be or Not to Be
Különleges Bánásmód - Interdiszciplináris folyóirat
Although the Diagnostic and Statistical Manual of Mental Disorders (DSM) is considered to be one of the best diagnostic guides of all times, there are some voices that question its practicality, functionality, and flexibility as well. Even if it has never claimed it to be perfect, it is only stated/portrayed as an organized guide or guidance for information. The Diagnostic and Statistical Manual of Mental Disorders (DSM) is the most widely used and acknowledged, and as well as time honoured (with successive editions over 70 years) system for diagnosing mental disorders in the United States and all over the world. Since 1952, the first edition (DSM-I) and its successive time honoured editions over 70 years. This study is focussing on debates, issues and concerns related to DSM-5, which has had in effect since 2013.
Deconstructing the DSM-IV-TR: A critical perspective
2011
ABSTRACT: This paper examines and offers a critique of the , underlying principles and assumptions, and the nature and consequences of its nosological framework. The reason for this critique is to look at the rationale for some of the diagnostic categories and also why some categories are retained, including some of the long-standing diagnostic groups, such as schizophrenia. It is not the intention here to rehearse the problems of biological psychiatric thinking, nor argue the strengths and weaknesses of the DSM-IV-TR in its definitions and descriptions of particular syndromes and illnesses. The ideas presented here derive from a range of previous research that argued that the DSM-IV-TR colludes in a system of psychiatric care in which all people, by virtue of characteristically human foibles and idiosyncrasies, are potentially classifiable into a variety of diagnostic mental health categories. In the present study, it was argued that because of resource constraints, professional di...