Everything I have read in the last months about the proposed DSMV has made me feel even more dubious about the diagnostic enterprise than I have been for years. As I wrote recently the broadening of the notion of disorder so much that even ordinary behavior becomes pathologized is enough for me to be very concerned. I certainly haven't been alone in my concern -- Allen Frances, who was a lead in developing the DSM IV has written about his concerns also. And one of my favorite psychiatrist-bloggers, 1boringoldman, has also written extensively about the problems he sees in the direction indicated by these proposals. I was heartened to see that now my own profession, through the American Psychological Association, is taking a stand and expressing reservations. And even more, has created a petition for those of us who fear the consequences of of what is proposed. In the Open Letter to the DSM V, they cite these concerns:
...we are concerned about the lowering of diagnostic thresholds for multiple disorder categories, about the introduction of disorders that may lead to inappropriate medical treatment of vulnerable populations, and about specific proposals that appear to lack empirical grounding. In addition, we question proposed changes to the definition(s) of mental disorder that deemphasize sociocultural variation while placing more emphasis on biological theory. In light of the growing empirical evidence that neurobiology does not fully account for the emergence of mental distress, as well as new longitudinal studies revealing long-term hazards of standard neurobiological (psychotropic) treatment, we believe that these changes pose substantial risks to patients/clients, practitioners, and the mental health professions in general.
In recent years I have not known the AP to be particularly courageous in taking stands, so this action makes me feel much better about colleagues.
Do read the open letter and if you agree, sign the petition, especially if you are a mental health professional.