DSM-V

[Shikima]

Hello Fry Guys,

So here I sit at the crossroads trying to understand the overt and covert meanings why DSM-IV-tr was 'updated' to V. There is a lot of historical drama between the previous versions which has created some measure of evolution (which I won't bring up because it would be far too distracting from this posting) in identifying what would be considered normal vs abnormal.

I'm starting to see public postings about it and it is carrying a high degree of paranoia. So with that said, what is the historical context behind this change?

---

Members don't see this ad.

 

[nitemagi]

Q seems broad. Do you mean why do we update nomenclature at all, or why these specific changes? And if the latter, better to focus on specific diagnoses or specific changes, as each has a long political and research battle/history.

 

[OldPsychDoc]

Actually, if you have access to the new APA Textbook*, there is a pretty good chapter in there on the history of diagnostic criteria, and the rationale and process (and controvery) that went into each change.

*available online via a lot of med school libraries, too, if you still have access.

 

[PikminOC]

I'm a fry guy!

 

[nitemagi]

I'm a fry guy!

 

[Shikima]

Actually, if you have access to the new APA Textbook*, there is a pretty good chapter in there on the history of diagnostic criteria, and the rationale and process (and controvery) that went into each change.

*available online via a lot of med school libraries, too, if you still have access.

Thanks. I don't where I work, but I'll look for one. Maybe from the drug reps... haha

 

[splik]

Thanks. I don't where I work, but I'll look for one. Maybe from the drug reps... haha

do you not have a VA athens account - this should give you access to it. though the new APA textbook is awful

 

[Shikima]

do you not have a VA athens account - this should give you access to it. though the new APA textbook is awful

No, I don't have one.

 

[MacDonaldTriad]

Hello Fry Guys,

So here I sit at the crossroads trying to understand the overt and covert meanings why DSM-IV-tr was 'updated' to V.

It was 1994 when DSM-IV replaced DSM-III, so this "update" was 20 years in the making. One more very minor picky point. There was a vote and for now on, the DSM will be using arabic numbers so technically it is now DSM-5. I hate myself for knowing that. DSM-6 should land around 2035 and I don't plan on reading it.

 

[nitemagi]

It was 1994 when DSM-IV replaced DSM-III, so this "update" was 20 years in the making. One more very minor picky point. There was a vote and for now on, the DSM will be using arabic numbers so technically it is now DSM-5. I hate myself for knowing that. DSM-6 should land around 2035 and I don't plan on reading it.

Supposedly they're leaving the door open for online updates, with the plan to release 5.1, 5.2, 5.3 over shorter periods.

 

[erg923]

Supposedly they're leaving the door open for online updates, with the plan to release 5.1, 5.2, 5.3 over shorter periods.

This sounds extremely unpragmatic for clinicians (especially forensic practitioners), not to mention coders, billers, etc.

 

[OldPsychDoc]

It was 1994 when DSM-IV replaced DSM-III, so this "update" was 20 years in the making. One more very minor picky point. There was a vote and for now on, the DSM will be using arabic numbers so technically it is now DSM-5. I hate myself for knowing that. DSM-6 should land around 2035 and I don't plan on reading it.

Envisioning a nursing home for aged psychiatrists where the only reading material for us is the DSM...

 

[nitemagi]

This sounds extremely unpragmatic for clinicians (especially forensic practitioners), not to mention coders, billers, etc.

Tell the APA.

 

[splik]

yes, they are working on DSM 5.1 already...

 

[smalltownpsych]

Envisioning a nursing home for aged psychiatrists where the only reading material for us is the DSM...

That could be one of Dante's Circles of Hell, just when you think you have it down, they change it again and again and again and again......

 

[MacDonaldTriad]

Envisioning a nursing home for aged psychiatrists where the only reading material for us is the DSM...

Old Psychiatrists don’t die, they don’t fade away; they just become geriatric psychiatrists.

 

[MacDonaldTriad]

I have one for DSM-5.2 Autisophobia by proxy.


Hay Boys and Girls, let’s all be like Mickey and avoid autism.

 

[whopper]

I've perused DSM-1, 2, extensively read III, IV and V. With each DSM edition there appeared to be significant improvements. I'd say DSM-V is not much of an improvement at all, possibly in some ways worse.

I do think gender dysphoric disorder is an improvement because it shouldn't be called a disorder unless one has a problem with their gender identity. Aside from some other changes, (e.g. changing MR to intellectual disability), IMHO it really didn't advance our field. And despite the improvements they're more so in words, not really in a fundamental understanding.

An older mentor of mine told me that while the newer DSMs were better, some of the stuff they tossed out was valuable. E.g. passive-aggressive PD was in III but no longer in IV or V. It does exist. When it's out of the lexicon, people tend to not think of it as a possibility (kinda like how in 1984 the gov got rid of words in the dictionary to reduce free thought). The newer docs stopped considering it a possible dx for people they evaluated cause it wasn't in the IV.

 

[vistaril]

A family member once read an article about the dsm(when 5 was coming out) and asked me if I wanted one as a present. They were somewhat surprised when I told them that if they got it for me I would never open it.

I think, unfortunately, this is a book that does more harm to our field than good. just my opinion.

 

[erg923]

A family member once read an article about the dsm(when 5 was coming out) and asked me if I wanted one as a present. They were somewhat surprised when I told them that if they got it for me I would never open it.

I think, unfortunately, this is a book that does more harm to our field than good. just my opinion.

Tell me more...

 

[whopper]

Henry Nasrallah and I forgot his name (he was a head editor of DSM-V) had a friendly debate at one of Nasrallah's psychopharm conferences. They were intentionally being a little over-the-top, with them yelling at each other, being a bit grandiose with their complaints, while in the background there were pics of sumo wrestlers presented.

Despite the intentional sarcasm, they did bring up several good points. Nasrallah brought up how the new DSM-V really isn't such as huge leap forward like the previous DSMs were, and that despite several advances in the understanding of the psychiatric pathologies, none of those advances are really in DSM-V.

In the DSM-Vs defense the editor did bring up that yes there are advances but few if any of them are compatible with clinical practice (he did not bring up this example but an example I can think of is the so many new lab procedures that could possibly better dx dementia but none of them are commercially mass produced, hence we can't clinically use them), and that working on this thing has been an humbling undertaking.

 

[st2205]

Tell me more...

I'd venture to guess it's because you have approximately 297 fancy names for a cluster B personality disorder where people can feel justified and vindicated in proudly proclaiming "it ain't my fault!"

A little hyperbole, but you get the idea.

 

[Shikima]

Can I just go ahead and be hooked up like the matrix movie and have information "uploaded" to my brain....