The Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) was released to the public, May 17, 2013. After years of frequent debates, arguments, and disagreements, the DSM-V is now ready to be further critiqued. Unfortunately, the DSM-5 has already caused a storm of debates, many of which you have already heard. For therapists and many other mental health professionals, the DSM-V is nothing more than a caricature of the field. In an attempt to progress the field, we have taken 70 steps back. Despite this unsettling revision, the way to stay ahead of this manual is to become knowledgeable about it. Below are 3 changes that will cause great controversy in clinical and hospital settings.
Every parent, family, and caregiver should know about:
1.) Asperger’s Syndrome: This category has been changed to reflect modern day thinking on autism spectrum disorders (ASDs). Parents of children with Asperger’s Syndrome are quite upset with this change. Asperger’s Syndrome will now be listed under ASDs as opposed to being a separate category. Many parents appreciated the fact that kids with Asperger’s Syndrome were differentiated from kids with more severe social, behavioral, and emotional problems such as lower functioning autism. With this change, kids with Asperger’s Syndrome will now be classified with kids who have autism.
2.) Social Communication Disorder: This “diagnosis” is supposed to reflect a middle ground for kids who do not meet the diagnostic criteria for an ASD, yet still has extreme issues with social issues and communication. This category is separate from social anxiety disorder.
3.) Disruptive Mood Dysregulation Disorder: The purpose for this category, according to the American Psychiatric Association, is to prevent over-diagnosis and over-treatment of bipolar disorder in youngsters. The problem with this category is that children will be labeled “mentally ill” if they have temper tantrums for more than 3-4 times per week. What child doesn’t have a temper tantrum during the week? Some kids are simply moody, while others are of a rough temperament. This category is likely to lead to over-diagnosis, over-treatment, and misdiagnosis.
Despite the addition of “mild neuro-cognitive disorder” (normal forgetfulness turned psychiatric disorder) and the removal of narcissistic personality disorder (it will no longer be a clinical diagnosis of concern), the DSM continues to receive universal attention and respect from forerunners in the field such as the American Psychological Association, American Psychiatric Association, and various other associations. It’s obvious that it is difficult to remove support of a manual that has developed itself to be “powerful” over time.
There is no doubt that families will encounter more psychiatric diagnoses than ever before and will more than likely experience greater labeling than in past years.
Many people are unsure about the manual’s multiple revisions. In fact, according to Dr. Frances, the author of “Saving Normal” :
…”It is impossible to define “normal”…, let alone “mental disorder.” …Mental disorders should be diagnosed only when a person’s symptoms are obvious, severe and haven’t gone away on their own. Watchful waiting should be the first step in treatment, and medication a last resort. A wise, and increasingly rare, approach.”
I encourage you to stay connected and educate yourself about the DSM as much as you can. When you enter a clinical setting, you will be in a better position to understand how it’s being used.
All the best
Wall Street Journal. (2013). How psychiatry went crazy: The “bible” of psychiatric diagnosis shapes-and-deforms-both treatment and policy. Retrieved May 21, 2013 from, http://online.wsj.com/article/SB10001424127887323716304578481222760113886.html
- DSM-5 Released: The Big Changes (psychcentral.com)
- You Do Not Have Asperger’s (slate.com)
- The DSM-5 is here: What the controversial new changes mean for mental health care (foxnews.com)