An Open Letter to the DSM-5
As the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders continues to develop, there has been more and more reaction from professional groups with concerns. The most recent of these is an open letter that was sponsored by group of American Psychological Association divisions, and you can read it here: Open Letter to the DSM-5.
The biggest complaint here is that the DSM-5 development committee appears to have departed from the “atheoretical” approach that the past two version of have taken, in favor of a clear biomedical approach. The DSM-5 also seems to be changing the very definition of mental disorder by adding the criterion: ‘[A behavioral or psychological syndrome] that reflects an underlying psychobiological dysfunction.’
The APA divisions, and this author, are most concerned about this because it minimizes the importance of sociocultural variation; and this combined with other moves the DSM-5 is making in lowering the threshold to be diagnosed with some disorders (ADHD, GAD, MDD), means that even more of the normal human condition will be pathologized. In plain words, more stuff that is a normal part of human life is turned into a disorder/disease. The more suspicious can see how this dovetails with the pharmaceutical industry’s efforts to do the same.
The bottom line is that big changes are coming in how we all discuss, treat, and understand what it means to have a mental disorder. Anyone who knows the long history of doing this may see the potential blunders ahead, and this letter could be an interesting historical artifact someday. I’ll stay with the woo-woo side that all of these things are combinations of nature and nurture that don’t always have an underlying biological dysfunction, and will wait for research and history to continue proving us, and that crazy idea, right.
Will Meek PhD is a psychologist in Vancouver, Washington, and writes weekly at his blog: Vancouver Psychology.
Meek, W. (2011). An Open Letter to the DSM-5. Psych Central. Retrieved on April 18, 2015, from http://psychcentral.com/blog/archives/2011/10/30/open-letter-to-the-dsm-5/