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How Good is the Forthcoming DSM?

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The Diagnostic and Statistical Manual of Mental Disorders is the gold standard for diagnosing mental disorders in the United States.  It's had rocky days before, but the new edition which is forthcoming this spring looks particularly bad.  And that's not just some arm-chair speculating by yours truly, but from Allen Frances, M.D. who was the chairman of the previous iteration of the manual:

The $3 million DSM-5 Field Trials have been a pure disaster from start to finish. First, there was the poor choice of design. The study restricted itself to reliability -- the measurement of diagnostic agreement among different raters. Unaccountably, it failed to address two much more crucial questions -- DSM-5's potential impact on who would be diagnosed and on how much its dramatic lowering of diagnostic thresholds would increase the rates of mental disorder in the general population. There was no possible excuse for not asking these simple-to-answer and vitally important questions. We have a right to know how much DSM-5 will contribute to the already rampant diagnostic inflation in psychiatry, especially since this risks even greater overuse of psychotropic drugs.

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I would change the last sentence to read, "We have a right to know how much DSM-5 will contribute to the already rampant diagnostic inflation in psychiatry, especially since this risks even more phony, shake-and-jive defenses."

I can't wait, I guess, for the expanded pile of defense mumbo-jumbo. At least it's an entertaining show.

It is the very goal of the mental health establishment to expand diagnostic inflation in psychiatry. It feathers their own nest and promotes the advanced welfare state most progressives are so fond of.

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