Thursday, September 13, 2007

Tell me about your manual

This is an excellent op-ed article about the DSM (the "Bible" of mental disorders): Mind Over Manual

EARLIER this summer, the American Psychiatric Association announced that a 27-member panel will update its official diagnostic handbook, the Diagnostic and Statistical Manual of Mental Disorders. The fifth edition, which is scheduled to come out in 2012, is likely to add new mental illnesses and refine some existing ones.

The author does, I think, a good job with both the strengths and the weaknesses of the DSM, and offers a nice recent history. She also notes the inherent problems with all diagnoses of mental disorders:

(T)here is a deeper problem: despite the great progress being made in neuroscience, we still don’t have a clear picture of the brain mechanisms underlying bipolar illness — or most other mental illnesses...Why aren’t we closer to understanding the relationship between manifest illness and its underlying causes? One obstacle is the staggering complexity of the brain.

Included, too, is some legitimate criticism of the checklist-approach to the DSM, ending with:

An updated manual, however, is unlikely to transform treatment substantially — after all, revising diagnoses is still just another way to describe mental conditions we don’t fully understand.

Granted there are few conditions that result in diagnoses that we fully understand, and thus in most cases diagnoses is "just another way to describe...conditions" of all sorts. Still, a nicely done article.
Disclaimer: I am a big fan of the the author's last book, One Nation Under Therapy: How the Helping Culture is Eroding Self-Reliance - as well as the co-author of that book, Christina Hoff Sommers.

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