As was foretold, we've added advertisements to the forums! If you have questions, or if you encounter any bugs, please visit this thread: https://forums.penny-arcade.com/discussion/240191/forum-advertisement-faq-and-reports-thread/
Options
[Psychiatry On] big changes coming
nexuscrawler
Registered User regular
Registered User regular
So didn't see a thread on this and thought it might be interesting. In case you didn't know the DSM, the definitive handbook for psychiatric diagnosis is in the process of getting it's first big update in age
http://www.nytimes.com/2010/02/10/health/10psych.html
The big changes seem to be reflecting new research into childhood disorders and autism. Of course there's tons of advocacy and lobbying associated with updates. In the past cultural changes have played a strong role in the diagnosis of mental disorders. For example the removal of homosexuality from the manual reflected it's more widespread acceptance. Likewise transgendered groups have been trying for years to have gender dimorphism removed as a mental illness.
Thoughts or disagreements?
These are a few of the changes proposed on Tuesday by doctors charged with revising psychiatry’s encyclopedia of mental disorders, the guidebook that largely determines where society draws the line between normal and not normal, between eccentricity and illness, between self-indulgence and self-destruction — and, by extension, when and how patients should be treated.
The eagerly awaited revisions — to be published, if adopted, in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders, due in 2013 — would be the first in a decade.
For months they have been the subject of intense speculation and lobbying by advocacy groups, and some proposed changes have already been widely discussed — including folding the diagnosis of Asperger’s syndrome into a broader category, autism spectrum disorder.
But others, including a proposed alternative for bipolar disorder in many children, were unveiled on Tuesday. Experts said the recommendations, posted online at DSM5.org for public comment, could bring rapid change in several areas.
http://www.nytimes.com/2010/02/10/health/10psych.html
The big changes seem to be reflecting new research into childhood disorders and autism. Of course there's tons of advocacy and lobbying associated with updates. In the past cultural changes have played a strong role in the diagnosis of mental disorders. For example the removal of homosexuality from the manual reflected it's more widespread acceptance. Likewise transgendered groups have been trying for years to have gender dimorphism removed as a mental illness.
Thoughts or disagreements?
nexuscrawler on
0
Posts
Sorry.
I think that changes to the DSM do very little to change the common perception of these disorders in the populace. It's no secret that many people use terms like "ADD" and "depression" without much or any knowledge of the actual criteria for the disorders.
As for gender dimorphism (ironic, given your signature, nexus) I tend to think of it in a general sense of distress=disorder. That is, if the person believes himself to be a her (or the other way) and it does not affect his life negatively (that is, his ability to maintain relationships, health, work, education, etc. in a coherent and healthful way) then it's not a disorder. If the dimorphism causes significant distress, or repeated negative consequences without change, it moves into the realm of disorder.
Of course, it's been a decade since I studied psychology.
IOS Game Center ID: Isotope-X
Good for families because some insurance companies and school systems never recognized it in the first place. Bad for kids because Autism is a hugely loaded word.
The other big one for kids is changing the diagnosis for childhood bipolar disorder. By not making it a mental illness but a behavioral problem medicating kids won't be the only option.
As I said in chat a week ago: sex addiction feels like the modern-day version of Victorian female hysteria.
And speaking as someone with an actual autistic diagnose, I welcome the change. "Asperger's" is a very specific name for a very broad range - hence why it's otherwise called "the autistic spectrum" and "autistic spectrum disorder".
I'd say they are still pretty relevant, in the sense that the DSM does affect many people on a daily basis. Whether or not they should be relevant is another story.
Yeah, changes in the DSM do eventually trickle down into the public consciousness, though it does take time. The change from "manic depression" to "bipolar" being one example.
Though it seems there is some controversy about creating a spectrum of autistic disorders. From the AP:
http://chealth.canoe.ca/channel_health_news_details.asp?news_id=30071&rss=67&rid=999999&news_channel_id=39&channel_id=39&rot=3
Personally, I don't think the change is really detrimental to Asperger's... it's reasonably well known that it's a mild form of autism anyway, and putting everything under one umbrella might eventually assist the public's understanding of autism as a whole.
But am I a bad person for giggling a little at the last paragraphs?
I don't understand.
Are you saying most insurance companies and medical practioners don't go to the dsm for mental disorders but instead attempt to keep up with the hundreds of new journals published every day in every psychological and psychiatric sub field?
Because if you are saying that then I'm afraid that's a really unrealistic and untenable position you have established for yourself.
Transsexuality may deserve to be in there, unlike homosexuality. Transsexuals often need to seek medical treatment (surgery and hormone therapy). Having an entry in the DSM makes it easier for them to be covered for those treatments under insurance.
o_O
I guess fewer people will be as willing to (incorrectly) self-diagnose Asperger's, eh?
This. Who cares what the DSM does for public perception of a diagnosis. The people that are actually affected by the DSM are the people being treated.
What the new DSM says will determine your diagnosis and the terms of your treatment. Which can be both beneficial and harmful to a lot of people.
The problem is that it hasn't lead to insurance coverage and overall has hurt the legitimacy of trans people. Currently, the diagnosis is psychological but the treatment is physical, so it really doesn't make sense to have it in there as a psychological disorder. Also you are still be considered to have a disorder under the DSM even after you transition and are living your life all fine and well. Looks like the DSM V fixes some of this by changing 'gender identity disorder' to 'gender incongruence'.
Now, the trans community is very split on this whole issue. Many would love it to be de-listed as a psychological issue and to become a physical medical issue in the sort of birth defect vein. Some don't want to be listed as a medical issue in any way.
On a personal leve, having it in the DSM has caused many more day to day problems than it has solved.
In the land of the retards, the aspie man is king!
Anyway, the only problem I can see is that it might hamper detection because now there's no specific set of criteria for the mildest end of the spectrum.
Oh, Robman, do you ever know what you're talking about.
And yes I'm highly critical of the DSM, especially how the DSM is used by GPs that really have as much business giving out psychiatric medicine as they do chemo bags. The history of the DSM itself is also a fascinating study in discrimination - it's been shown time and again in countless ways that having that much control over "normal" is dangerous.
And yet it is exponentially more relevant than online journal publications and meta-studies, no matter how much you believe it shouldn't be.
I don't recall my reaction (which means it was probably a shrug of the shoulders) but here's the link if anyone is interested:
Women Who Want to Want
This is a person who insisted that there is no difference between HFCS and everything else after being told by several people they could detect it in a blind taste test on the basis of HFCS and other stuff being made of carbon.
Which is the classic appeal to authority.
No, that's an appeal to not letting you change the subject:
Oh, I remember. I am one of those folks who prefers Coke made with sugar to HFCS, and did comment in that discussion.
And no, Rob, there was no appeal to authority made. Perhaps if I were to make the argument that the DSM is a better resource than those you listed because it is more relevant, but I'm not doing so. I am responding to your asinine statement re: relevance, and stating a simple fact: the DSM is more relevant to day-to-day psychiatry than psych. journals and recent studies.
Should this be the case? Probably not. But it is, if for no other reason than the importance placed upon it by insurance companies when it comes to getting treatments and medications authorized and paid for.
Do you not understand the distinction between relevance and quality? You made a statement regarding one, and now address responses as though they are discussing the other. Not the case. You might want to go read up on logical fallacies a bit more and get back to us.
Do you actually know what the DSM is?
Let's look at the name:
Hell, if that isn't enough, let's look at wikipedia:
It is, quite literally, a dictionary of psychological conditions, including their definition and identification. That is not what primary literature is for.
In fact I'm pretty sure this is the case and your primary hate of the dsm is blaming the tool for being misused.
I'm not sure how source publications would effectively change this.
For Asperger's, I'm pretty sure it's a list of twenty things, and you have it if you have seven. My memory's kind of fuzzy, so I might be wrong.
There's a big section at the start of the book warning about checking for other disorders with similar symptoms and also a great big "use your bloody head this isn't meant to be gospel" warning as well.
Paraphrasing of course, it was actually rather more genteel.
The bigger problem with psychiatry is the elimination of inpatient units without the establishment of community supports, leaving many who are unable to care for themselves without help or care.
I'm not against the idea of a central repository of information, a well-tended volume for practitioners to draw upon. In that sense, the DSM is valuable.
I'm against the DSM because they have a demonstrable track record of marginalizing fringe groups and labeling behavior they view as abnormal as mental illness. Homosexuality to Transsexuality and now Hyper- and Hypo-sexuality. I can't help but wonder if BDSM will go into the volume? But that's more a systemic problem, and I do not know the solution for it.
The DSM has a hard time because when it comes down to it, we use the medical model, but the medical model doesn't actually cover all the bases when it comes to psychiatry. We necessarily lack exact definitions of many mental illnesses and only have a subjective understanding of all but a very few. There just aren't really broken legs in psychiatry.
So then, you tend to just look for what's abnormal and hey, gay people/trans people/nymphos/notphos are weird so...
Also, we don't need more focus on Autism. Autism is pretty bad, but it's nowhere near as important to address, treat, and educate people about than dozens of other mental disorders. It just happens to be in that sweet spot where it hits kids young enough that they're still cute instead of scary.
Our culture likes to embarrass those with mental illnesses, as well, which is part of why the industry is separate and exploitable.
They removed it from the DSM long before it became socially acceptable. What do you want them to do? They're human, they're as impartial as possible.
Let's go over the definition of a mental illness.
1) causes stress or disability
2) not culturally accepted (otherwise religion would count)
3) beyond the individual's control
4) not due to an underlying physical condition
At the time, homosexuality fit those definitions. It caused a great number of people stress and despair, was not culturally acceptable, was beyond their control and wasn't due to a physical condition. Can you blame them for putting it in? I can't. It was since recognized that the stress and despair was due to social exclusion, not the homosexuality itself, but there's still a case for having it in there just so psychiatrists can help people deal with it emotionally. Just 'cause it's in there doesn't mean they try to make it go away. Transgenderism is in the DSM so mental health professionals can a) understand it better and recognise it as the root cause of many other mental disorders and b) help the person become more comfortable with who they are, NOT so that they can "fix" it.
We're going to need a lot more psychiatrists if we stop GPs prescribing that stuff. GPs deal with the frontline, "minor" problems for which an antidepressant is basically a placebo and is highly effective. More serious stuff gets referred, as it should.
Um, no.
Autism can be managed and the quality of life for these children can be vastly improved if caught early. Autism is staggeringly misdiagnosed. Doctors need to be trained on the very early warning signs of autism. What better way to do that than to improve the handbook for diagnosing psychological disorders?