Will the New DSM-5 Over-Diagnose?
Positive psychology emphasizes individuals’ strengths, and focuses on obtaining optimal mental development (as opposed to just diminishing negative symptoms), which is why I’m drawn to the field. For instance, positive psychologists not only seek to lift depression, but they encourage clients to explore their sense of happiness and resilience as well.
While not a student of abnormal psychology, I’m obviously aware that there are those who suffer from very serious illnesses. The Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5) is published by the American Psychiatric Association to provide a standard classification and common language for mental illness. It’s used by clinicians and researchers of various orientations and backgrounds.
And with the advent of the latest edition, diagnoses run rampant, encouraging us to pose the infamous question: are mental health professionals a bit too ready to diagnose disorders?
As Psych Central founder John Grohol, PsyD, cites in his post on Psych Central’s World of Psychology blog, the DSM-5 features additions and revisions, and a few are sounding that ‘overboard’ alert.
There’s the “bereavement exclusion removal.” In the DSM-4, you weren’t diagnosed with major depressive disorder in the initial two months of grieving for a loved one. The rationale for this change was to eliminate the two-month time period, but what’s the further explanation?
“Bereavement is recognized as a severe psychosocial stressor that can precipitate a major depressive episode in a vulnerable individual, generally beginning soon after the loss. When the major depressive disorder occurs in the context of bereavement, it adds an additional risk for suffering, feelings of worthlessness, suicidal ideation, poorer somatic health, worse interpersonal and work functioning, and an increased risk for persistent complex bereavement disorder.”
The passage goes on to state that bereavement-related depression is most likely to appear in individuals with a personal or family history of major depressive episodes.
The problem? We may now find people wondering if their grieving is ‘normal,’ and there may be those who wish to breeze past the mourning process altogether. Otherwise, they would spiral downward into this newly-stamped ‘disorder.’ It’s human to be situated in a stage of bereavement. We’re all human.
Another alteration is the inclusion of Mild Neurocognitive Disorder — an early detection of Major Neurocognitive Disorder (which incorporates amnestic disorder and dementia). The reasoning? It’s a preemptive diagnostic measure, with the hopes that a more effective treatment plan could be implemented.
Yet, doesn’t old age naturally render hints of memory loss and casual forgetfulness? Stress may contribute to those symptoms, too. So, where do we draw the line?
And then there’s Hoarding Disorder, characterized as “persistent difficulty discarding or parting with possessions regardless of their actual value,” along with “a perceived need to save items” and “distress associated with discarding them.”
One blog post predicts that over-diagnosis is a probable outcome. “For starters, large numbers of Americans will recognize themselves in the phrase ‘persistent difficulty discarding or parting with possessions,’ not least because the latter don’t need to have ‘actual value’ for us to experience distress.”
Will individuals, especially those prone to nostalgia, begin to question if there’s something a bit off when it comes to preserving items? How do we distinguish between mental illness and reminiscence?
In regard to the bigger picture, this is psychology catering to weakness. And once we start seeing increases in diagnoses, we’ll see more prescriptions doled out in order to self-medicate with drugs that carry a host of side effects (but that’s another story for another article).
I understand that additional diagnostic criteria within the DSM-5 attempts to ‘cover the bases’ and prevent illness, but it’s murky territory when symptoms simply correlate with our humanity.
Suval, L. (2014). Will the New DSM-5 Over-Diagnose?. Psych Central. Retrieved on December 8, 2016, from http://psychcentral.com/blog/archives/2014/01/20/will-the-new-dsm-5-over-diagnose/