10-14-2008 National:
Overhaul of diagnostic bible shrouded in secrecy
It's a tried-and-true formula:
1. Do a quick-and-dirty study or two.
2. Find a huge, perhaps escalating, problem that has heretofore been overlooked.
3. Create a product label (aka diagnosis).
And, voila! The drug companies will take it from there. A diagnosis that was once just a twinkle in the eye of a creative researcher becomes reified as a concrete entity.
Over the past couple of decades, the DSM has risen from its humble origin to an object of worship, regarded as the absolute scientific truth. Privately, however, many mental health professionals refer to it as a "joke." That's partly because we are aware of studies showing the poor validity of many of its constructs. It's also because we know about some of the forces (in addition to scientific progress) that influence each new edition. These include internal turf wars (the DSM-III was developed in large part to decrease the power of the psychoanalytic wing of psychiatry), cultural fads, group-think, and outside lobbying. And leading the outside lobbying, of course, is the pharmaceutical industry.
For the remainder of this excellent commentary on the DMS-V please visit "In the News" by Karen Franklin.
1 comment:
Interesting. Take note of what she says is a future planned diagnosis, and which is already being used for civil commitments:
"Hebephilia: All psychodiagnoses, even those of psychotic disorders, have serious conceptual validity problems, but none are weaker than some of those being used to justify the civil commitment of sexually violent predators. The latest, and most farcical, is "hebephilia," or the sexual attraction to teens, which is being aggressively marketed by a small advocacy group. (I'll have more to say about this newly proposed diagnosis very soon; for now, you can check out my Halloween 2007 post, "Invasion of the hebephile hunters.")
In her 2007 Halloween post she describes how one Dennis Doren is pushing this farce:
"Perhaps the most avid proponent of this creative new use is Dennis Doren, a psychologist who evaluates sex offenders for civil commitment and has authored a popular how-to manual for government experts, aptly named Evaluating Sex Offenders: A Manual for Civil Commitments and Beyond.
In his manual, Doren defines hebephilia as a "paraphilia." Another esoteric Greek word, paraphilia is a sexual deviancy characterized by sexual fantasies, urges, or activities involving nonhuman objects, suffering or humiliation of oneself or one's partner, or nonconsenting partners such as children. The paraphilias listed in the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR) include exhibitionism, fetishism, frotteurism, voyeurism, sexual masochism, sexual sadism, and pedophilia. Poor little hebephilia is absent."
Rubber stamped civil commitments.
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