The American Psychiatric Association has planned to release the latest edition of the Diagnostic and Statistical Manual of Mental Disorders this coming May. This will be the fifth edition and will include some of the most dramatic changes yet. There are too many for me to fully explore, but I will touch on some of the major edits.
One common criticism is the increased risk of overdiagnosis because the criteria for some existing disorders have become broader, such as the standard for depression. People inside and outside of the APA have also made proposals for new disorders like Negativistic (Passive Aggressive) Personality Disorder, Internet Addiction Disorder, adult forms of ADHD and behavioral disorders specific to gambling. Some critics say these disorders just provide excuses to sell more drugs and should be redefined or dropped entirely.
Others believe it is excessive to diagnose a disorder based on the fact that someone has an undesirable trait, such as passive aggression or hypersexuality. I shared suspicions of overdiagnosis when I discovered that obesity was once on the table for becoming an eating disorder in the DSM-5. Designating obesity as an eating disorder would obviously cause problems with overdiagnosis in the United States, and people would feel pressured to buy drugs to remedy their new disorder. However, obesity does not seem to be up for discussion anymore and, with luck, some of these other so-called disorders may be dropped before May.
There are also massive restructuring changes, including the integration of autism and Asperger’s syndrome into the manual, as well as eliminating the five-axis system. I was satisfied with the five axes and do not fully understand the reason for eliminating them. The five axes organize the analysis of mental illnesses, personality disorders and mental retardation, medical conditions, psychological factors and global assessment of functioning. I found that having these five factors allowed for a rich assessment of patients because it considered contributing factors and their interaction with the disorder in question.
I believe these looming changes to the DSM represent outside influences on the APA and society’s tendency to regard abnormality as something that must be changed if possible. People have often thought, “If only we could diagnose all the people that annoy us with Annoying Personality Disorder and then have psychiatrists prescribe medication that would not make them annoying anymore. Wouldn’t that be nice?” Unfortunately, sometimes overdiagnosis is a watered-down attempt to do just that. As for the changes in restructuring, the only ones that could be problematic are the dimensional approach to personality disorders and the abandonment of the five-axis system, all of which have been fiercely debated.
A version of this article appeared in the Wednesday, March 5 print edition. Joseph Rauch is a contributing writer. Email him at email@example.com.
- Weekend Roam: Little Germany
- WSN Editorial Board reflects on spring semester events
- Strawberry Festival promises delicious, intergalactic fun
- Clive Davis Institute collaborates with DJ Swivel
- Best places to dine on dumplings
- 'Heroes' is not super enough for Xbox Live film program launch
- NYU SLAM sees victory through 'badidas' campaign
- Victoria Ettore elected student council president
- Hester Street Fair hosts diverse vendors, delicious food