The Making of DSM-III


Book Description

This book chronicles how American psychiatry went from its psychoanalytic heyday in the 1940s and '50s, through the virulent anti-psychiatry of the 1960s and '70s, into the late 20th-century descriptive, criteria-grounded model of mental disorders.




The Making of DSM-III®


Book Description

In 1973, the American Psychiatric Association decided to publish a revised edition of their Diagnostic and Statistical Manual (DSM). There was great hope that a new manual would display psychiatry as a scientific field and aid in combating the attacks of an aggressive anti-psychiatry movement that had persisted for more than a decade. The Making of DSM-III® is a book about the manual that resulted in 1980-DSM-III-a far-reaching revisionist work that created a revolution in American psychiatry. Its development precipitated a historic clash between the DSM-III Task Force--a group of descriptive, empirically oriented psychiatrists and psychologists--and the psychoanalysts the Task Force was determined to dethrone from their dominance in American psychiatry. DSM-III also inaugurated an era in which it and the diagnostic manuals that followed played enormous roles in the daily lives of persons and organizations all over the world, for the DSMs have been translated into many languages. The radical revision process was led by the psychiatrist Robert L. Spitzer, a many-talented man of great determination, energy, and tactical skills, arguably the most influential psychiatrist of the second half of the 20th Century. Spitzer created as major a change in descriptive psychiatry and classification as had the renowned German psychiatrist Emil Kraepelin, almost a century earlier. Kraepelin had been the epochal delineator of dementia praecox from manic-depressive illness, the forerunners of modern schizophrenia and bipolar disorder. In her book, Hannah Decker portrays the many internal and external battles that roiled the creation of DSM-III and analyzes both its positive achievements and significant drawbacks. She also astutely explores the deleterious effects of the violent swings in scientific orientation that have dominated psychiatry over the past 200 years and are still alive today. Decker has written a revealing and exciting book that is based on archival sources never before used as well as extensive interviews with the psychiatrists and psychologists who have brought into being the psychiatry we know today.




DSM


Book Description

The first comprehensive history of "psychiatry's bible"—the Diagnostic and Statistical Manual of Mental Disorders. Over the past seventy years, the Diagnostic and Statistical Manual of Mental Disorders, or DSM, has evolved from a virtually unknown and little-used pamphlet to an imposing and comprehensive compendium of mental disorder. Its nearly 300 conditions have become the touchstones for the diagnoses that patients receive, students are taught, researchers study, insurers reimburse, and drug companies promote. Although the manual is portrayed as an authoritative corpus of psychiatric knowledge, it is a product of intense political conflicts, dissension, and factionalism. The manual results from struggles among psychiatric researchers and clinicians, different mental health professions, and a variety of patient, familial, feminist, gay, and veterans' interest groups. The DSM is fundamentally a social document that both reflects and shapes the professional, economic, and cultural forces associated with its use. In DSM, Allan V. Horwitz examines how the manual, known colloquially as "psychiatry's bible," has been at the center of thinking about mental health in the United States since its original publication in 1952. The first book to examine its entire history, this volume draws on both archival sources and the literature on modern psychiatry to show how the history of the DSM is more a story of the growing social importance of psychiatric diagnoses than of increasing knowledge about the nature of mental disorder. Despite attempts to replace it, Horwitz argues that the DSM persists because its diagnostic entities are closely intertwined with too many interests that benefit from them. This comprehensive treatment should appeal to not only specialists but also anyone who is interested in how diagnoses of mental illness have evolved over the past seven decades—from unwanted and often imposed labels to resources that lead to valued mental health treatments and social services.




Making the DSM-5


Book Description

In 2013, the American Psychiatric Association published the 5th edition of its Diagnostic and Statistical Manual of Mental Disorders (DSM-5). Often referred to as the “bible” of psychiatry, the manual only classifies mental disorders and does not explain them or guide their treatment. While science should be the basis of any diagnostic system, to date, there is no knowledge on whether most conditions listed in the manual are true diseases. Moreover, in DSM-5 the overall definition of mental disorder is weak, failing to distinguish psychopathology from normality. In spite of all the progress that has been made in neuroscience over the last few decades, the psychiatric community is no closer to understanding the etiology and pathogenesis of mental disorders than it was fifty years ago. In Making the DSM-5, prominent experts delve into the debate about psychiatric nosology and examine the conceptual and pragmatic issues underlying the new manual. While retracing the historic controversy over DSM, considering the political context and economic impact of the manual, and focusing on what was revised or left unchanged in the new edition, this timely volume addresses the main concerns of the future of psychiatry and questions whether the DSM legacy can truly improve the specialty and advance its goals.




The Selling of DSM


Book Description

When it was first published in 1980, the Diagnostic and Statistical Manual of Mental Disorders, Third Edition—univer-sally known as DSM-III—embodied a radical new method for identifying psychiatric illness. Kirk and Kutchins challenge the general understanding about the research data and the pro-cess that led to the peer acceptance of DSM-III. Their original and controversial reconstruction of that moment concen-trates on how a small group of researchers interpreted their findings about a specific problem—psychiatric reliability—to promote their beliefs about mental illness and to challenge the then-dominant Freudian paradigm.




Making Us Crazy


Book Description

A persuasive and passionate plea from two mental health professionals to ease use of the Diagnostic Statistical Manual of Mental Disorders under their belief that it is leading to an over-diagnosed society. For many health professionals, the Diagnostic Statistical Manual of Mental Disorders (DSM) is an indispensable resource. As the standard reference book for psychiatrists and psychotherapist everywhere, the DSM has had an inestimable influence on the way medical professionals diagnosis mental disorders in their patients. But with a push to label clients with pathological disorders in order to get reimbursed by insurance companies, the purpose of the DSM is no longer serving as a reference book. Instead, it is acting as a list of things that can qualify a patient’s diagnosis. In Making Us Crazy, Stuart Kirk and Herb Kutchins evaluate how the DSM has become the influence behind diagnoses that assassinate character and slander the opposition, often for political or monetary gain. By examining how the reference book serves as a source to label every phobia and quirk that arises in a patient, Kirk and Kutchins question the overuse of the DSM by today’s mental health professionals.




The Book of Woe


Book Description

“Gary Greenberg has become the Dante of our psychiatric age, and the DSM-5 is his Inferno.” —Errol Morris Since its debut in 1952, the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders has set down the “official” view on what constitutes mental illness. Homosexuality, for instance, was a mental illness until 1973. Each revision has created controversy, but the DSM-5 has taken fire for encouraging doctors to diagnose more illnesses—and to prescribe sometimes unnecessary or harmful medications. Respected author and practicing psychotherapist Gary Greenberg embedded himself in the war that broke out over the fifth edition, and returned with an unsettling tale. Exposing the deeply flawed process behind the DSM-5’s compilation, The Book of Woe reveals how the manual turns suffering into a commodity—and made the APA its own biggest beneficiary.




Psychiatric Diagnosis Revisited


Book Description

This book explores the purpose of clinical psychological and psychiatric diagnosis, and provides a persuasive case for moving away from the traditional practice of psychiatric classification. It discusses the validity and reliability of classification-based approaches to clinical diagnosis, and frames them in their broader historical and societal context. The Diagnostic and Statistical Manual of Mental Disorders (DSM) is used across the world in research and a range of mental health settings; here, Stijn Vanheule argues that the diagnostic reliability of the DSM is overrated, built on a limited biomedical approach to mental disorders that neglects context, and ultimately breeds stigma. The book subsequently makes a passionate plea for a more detailed approach to the study of mental suffering by means of case formulation. Starting from literature on qualitative research the author makes clear how to guarantee the quality of clinical case formulations.




Saving Normal


Book Description

From "the most powerful psychiatrist in America" (New York Times) and "the man who wrote the book on mental illness" (Wired), a deeply fascinating and urgently important critique of the widespread medicalization of normality Anyone living a full, rich life experiences ups and downs, stresses, disappointments, sorrows, and setbacks. These challenges are a normal part of being human, and they should not be treated as psychiatric disease. However, today millions of people who are really no more than "worried well" are being diagnosed as having a mental disorder and are receiving unnecessary treatment. In Saving Normal, Allen Frances, one of the world's most influential psychiatrists, warns that mislabeling everyday problems as mental illness has shocking implications for individuals and society: stigmatizing a healthy person as mentally ill leads to unnecessary, harmful medications, the narrowing of horizons, misallocation of medical resources, and draining of the budgets of families and the nation. We also shift responsibility for our mental well-being away from our own naturally resilient and self-healing brains, which have kept us sane for hundreds of thousands of years, and into the hands of "Big Pharma," who are reaping multi-billion-dollar profits. Frances cautions that the new edition of the "bible of psychiatry," the Diagnostic and Statistical Manual of Mental Disorders-5 (DSM-5), will turn our current diagnostic inflation into hyperinflation by converting millions of "normal" people into "mental patients." Alarmingly, in DSM-5, normal grief will become "Major Depressive Disorder"; the forgetting seen in old age is "Mild Neurocognitive Disorder"; temper tantrums are "Disruptive Mood Dysregulation Disorder"; worrying about a medical illness is "Somatic Symptom Disorder"; gluttony is "Binge Eating Disorder"; and most of us will qualify for adult "Attention Deficit Disorder." What's more, all of these newly invented conditions will worsen the cruel paradox of the mental health industry: those who desperately need psychiatric help are left shamefully neglected, while the "worried well" are given the bulk of the treatment, often at their own detriment. Masterfully charting the history of psychiatric fads throughout history, Frances argues that whenever we arbitrarily label another aspect of the human condition a "disease," we further chip away at our human adaptability and diversity, dulling the full palette of what is normal and losing something fundamental of ourselves in the process. Saving Normal is a call to all of us to reclaim the full measure of our humanity.




The DSM-5 in Perspective


Book Description

Since its third edition in 1980, the Diagnostic and Statistical Manual of Mental Disorders (DSM) of the American Psychiatric Association has acquired a hegemonic role in the health care professions and has had a broad impact on the lay public. The publication in May 2013 of its fifth edition, the DSM-5, marked the latest milestone in the history of the DSM and of American psychiatry. In The DSM-5 in Perspective: Philosophical Reflections on the Psychiatric Babel, experts in the philosophy of psychiatry propose original essays that explore the main issues related to the DSM-5, such as the still weak validity and reliability of the classification, the scientific status of its revision process, the several cultural, gender and sexist biases that are apparent in the criteria, the comorbidity issue and the categorical vs. dimensional debate. For several decades the DSM has been nicknamed “The Psychiatric Bible.” This volume would like to suggest another biblical metaphor: the Tower of Babel. Altogether, the essays in this volume describe the DSM as an imperfect and unachievable monument – a monument that was originally built to celebrate the new unity of clinical psychiatric discourse, but that ended up creating, as a result of its hubris, ever more profound practical divisions and theoretical difficulties.