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More on the DSM-5

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Following the links in Steve's post on the DSM-5 led me to this post by Allen Frances.  Neuroskeptic refers to Frances as "the creator of the more reliable DSM-IV."  Frances begins with a process criticism of the way the DSM-5 was created and approved (emphasis added):

This is no way to prepare or to approve a diagnostic system. Psychiatric diagnosis has become too important in selecting treatments, determining eligibility for benefits and services, allocating resources, guiding legal judgments, creating stigma, and influencing personal expectations to be left in the hands of an APA that has proven itself incapable of producing a safe, sound, and widely accepted manual.

New diagnoses in psychiatry are more dangerous than new drugs because they influence whether or not millions of people are placed on drugs -- often by primary care doctors after brief visits. Before their introduction, new diagnoses deserve the same level of attention to safety that we devote to new drugs. APA is not competent to do this.
Diagnoses are also dangerous because of their potential to convince gullible jurors, and sometimes even judges, to let criminals off with less than they actually deserve. 
Six years ago, Connecticut Federal District Judge Robert Chatigny tried to spare Michael Ross from execution, despite Ross's own choice to "volunteer," because Ross had the "disease" of sadism.  See Robert Blecker's article.  Fortunately, justice prevailed.  Ross was executed, and Chatigny's atrocious decision cost him a promotion to the Court of Appeals.

Back to the DSM.  Frances lists what he considers to be the DSM-5's 10 worst changes, and he suggests that mental health professionals simply ignore them.

1) Disruptive Mood Dysregulation Disorder: DSM-5 will turn temper tantrums into a mental disorder -- a puzzling decision based on the work of only one research group. We have no idea how this untested new diagnosis will play out in real life practice settings....
Forensically, we can expect to see it asserted in approximately 98% of juvenile delinquency cases.

4) DSM-5 will likely trigger a fad of Adult Attention Deficit Disorder leading to widespread misuse of stimulant drugs for performance enhancement and recreation and contributing to the already large illegal secondary market in diverted prescription drugs.
Just what society needs.  Even more widespread misuse of prescription drugs.

7) First time substance abusers will be lumped in definitionally in with hard-core addicts despite their very different treatment needs and prognosis and the stigma this will cause.
So just use drugs once and you qualify for drug court and "treatment, not jail" laws?  Terrific.

8) DSM-5 has created a slippery slope by introducing the concept of Behavioral Addictions that eventually can spread to make a mental disorder of everything we like to do a lot. Watch out for careless overdiagnosis of Internet and sex addiction and the development of lucrative treatment programs to exploit these new markets.
You see, I'm addicted to bling, so I just had to knock over the jewelry store.

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