Never mind that the DSM is largely a POLITICAL document. Many disorders are in there that haven't been properly researched, and many are not included that ARE properly researched but just don't jibe with the white male viewpoint of the committee. This is why I hesitate to have anything to do with such a rigged process.
Paula Caplan did a very fine critique of the DSM process in her book, They Say You're Crazy.
I think they mostly want submissions backed up by research. I don't believe it is an opinion poll after having looked through it about two months ago.
My changes to DSM would be to add NLD (though I wouldn't know where in the childhood disorders section-- either in LDs or ASDs-- and I cannot seem to decide since I haven't read enough reliable research about it) and also adding CAPD to the childhood disorders section.
I would also be a proponent on more research of eventually moving OCPD and SPD out of the Personality Disorders section or at least duplicating them in the childhood disorders section.
In addition, I'd like to see the exclusion rule taken off of Autism and Schizophrenia. It doesn't make sense. An Autistic person can still develop Schizophrenia. And the same thing for Autism and ADHD. They can be difficult to separate, true, but people can have both.
According to Pat Howlin, the rates of schizophrenia for autistics is the same for the general population. So therefore, 1% of those on the spectrum would have schizophrenia and autism/aspergers.
It seems that the exclusion rule is for doctors' benefit.
I had read a research article from The Journal of Autism and Developmental Disabilities which took a sampling of high-functioning individuals. They found there was a surprising rate of increase in near-relatives of autistic individuals who had Schizophrenia. In addition, also more who had Schizotypal Personality Disorder. There are also many Aspies who would fit this bill for SzPD and many Aspies, so I understand it, are more prone to Psychotic Episodes.
I think one problem is that Schizophrenia and Psychoses are very loosely defined. And where Psychosis ends and where Schizophrenia picks up is very blurry-- or where Bipolar picks up, or where Delusional Disorder picks up, or where Psychotic Depression picks up, etc. It ends up to be the opinion of the diagnostitician.
And what comprises Schizophrenia is an area of contention. I suspect all these labels are in many cases simply describing the similar behavioral symptoms, but the causes are very different and perhaps even unrelated other than in appearance.
I know that as of now there is no way to diagnose via genetics or other nonbehavioral symptoms which would solve many of these arguments. But basing a label on appearance of the individual opens up many problematic issues and no one seems to keep that in mind very much unless they're already working in genetics to solve all this. To many psychiatrists I have met, Schizophrenia is just Schizophrenia. End of story.
Interesting tidbit: a recent study was done in the United States in attempting to count the number of individuals who would be classified as having a \"mental disorder\". The figure surprised even the researchers:
Approximately 40% of Americans have one or more disorders as listed in the DSM.
The real figure is probably even higher.
increase in near-relatives of autistic individuals who had Schizophrenia. In addition, also more who had Schizotypal Personality Disorder."
We discussed that article some time ago and felt that the relatives that were diagnosed with schizophrenia etc, could have been misdiagnosed aspies and auties, certainly from cases in the past
My grandmother is Schizoprenic, I'm certain she isn't mis diagnosed, her symptoms don't match Autistic criteria. Symptoms in the past having included paranoia and hallucinations.
Amy, I understand your point but I do not believe we are talking about the same article. The article which I was refering to is from the Journal of Autism and Developmental Disorders from April 2005 and as of now they do not offer access to it online. This I had gone and copied from a professional journals library. But this perhaps is an unimportant point and I am being too anal.
However, it is not such a leap to make. ASDs are more common in families with Bipolar and vice versa. Also, Bipolar is more common in families with Schizophrenia.
A --> B --> C => A --> C
Despite the contention that Schizophrenia occurs comorbid with an ASD no more frequently than in the general population, from the information I have so far read in the research articles of recent years, the actual though still small body of evidence suggests otherwise.
Side note: In addition, this article also found that Aspergers Disorder appears to be even more familial than Autistic Disorder (their sampling of Autistic Disorder was strictly from the HFA end and thus probably as likely to reproduce as an Asperger).
the DSM upsets me very much. i do not understand what use it is. Can someone please explain?
it is sad if it is treated like the bible is sometimes treated, - literally. the result is that people die. paying so much attention to Criteria in one book and forgetting the purpose of identification of a problem is to find a solution to that problem, regardless of whatever someone is diagnosed with.
Too often a person gets labelled, but then there is no followup to create a plan to help with specific problems.
A diagnosis should not be required to get help. but it is. Autism should not be identified as the problem, but the individual particular experience of problems should be dealt with.
it is horrible to be medicated for something one does not have a proble, with , just because one meets enough Criteria to be diagnosed with something.
I am sorry i am upset. but i do know people who have died because a book of words was treated as gospel.
becca
(the website asking for submissions will not take any unless you have particular qualifications)
the DSM upsets me very much. i do not understand what use it is. Can someone please explain?
That might be because you are not MEANT to understand it. It is a diagnostic manual written for diagnosticians, not patients or laypeople. Its whole point is that it is aimed at a specific audience (i.e. people who understand and know what is meant by the terms used therein), rather than an easy to read explanation for laypeople.
Personally, if I can at all avoid it, I'll go for the in-depth articles and descriptions every time. DSM = Kauderwelsch (German term for gobbledegook but I know how to spell that).
The DSM is first and foremost the bible of the American private health insurance industry, since without a DSM code there will be no pay-out. It provides the necessary linkage for the insertion of madness into the political-economic process. It reduces madness to the level of a commodity. And it allows psychiatry to play the servile role of rationalizing this process while permitting it to flatter itself for its liberal and scientific values. And above all, it perpetuates the very alienation that psychiatric practice is intended to heal.
Stella
i enjoyed those answers very much! (and i am still enjoying Stellas occasional recipes popping up :smile: )
the sad thing is i can understand it from the point of view of someone who is studying psychology. i guess it just makes me sad that those who have completed far more study than i and have a medical qualification, treat it so seriously. i have observed others and myself and ticked off boxes in the DSM to put us into categories, to try and figure out how valid and reliable the thing is.
i guess my own expectation for a diagnostic tool is that it ultimately is beneficial to the majority of those it analyses. the DSM fails most of the time.
So maybe my own expectations are different from those who have had so much more experience.....
all that experience and no ability to critically analyse their own thinking and behaviours.
i wish we could make a submission
becca