Project Reason is a 501(c)(3) nonprofit foundation devoted to spreading scientific knowledge and secular values in society. The foundation draws on the talents of prominent and creative thinkers in a wide range of disciplines to encourage critical thinking and erode the influence of dogmatism, superstition, and bigotry in our world.

 
   
 
DSM as a “Bible” for mental health diagnosis
Posted: 09 February 2012 08:06 PM   [ Ignore ]
Sr. Member
Avatar
RankRankRankRank
Total Posts:  14456
Joined  2007-07-20

http://www.msnbc.msn.com/id/46329572/ns/health/#.TzSWpWMk6dA

Agree with the authors.  The DSM as become so extended as to include every damned problematic behavior we can imagine. The root issue is the medical model, which implies a normal behavior.  That’s not established for behavior, as opposed to physiological functioning.

 Signature 

Religion is good for one thing: making you feel better while someone else rules you.  Religion is more a reflection than a cause of conflicts. The causes lie in conflicting cultural mores and traits.

Profile
 
 
Posted: 09 February 2012 08:47 PM   [ Ignore ]   [ # 1 ]
Sr. Member
RankRankRankRank
Total Posts:  4369
Joined  2005-04-29

At least the proposed DSM-5 does a good job with autism diagnosis:
http://www.dsm5.org/ProposedRevisions/Pages/proposedrevision.aspx?rid=94

Dennis, years ago I had a 14-year-old resident whose mental condition would have made an oppositional defiance disorder diagnosis a pathetic understatement. Tourettes, though it was inaccurate, did the trick in getting him into the appropriate school. Within two years, he was well enough to be reunited with his mother, and he continues to do well to this day.

He was in desperate need of an accurate word to be applied to his condition. Autism had managed to do much more harm than good. Without accurate diagnostic terms, teachers end up leaving certain students to fend for themselves, and the above-mentioned child had spent all of his school time prior to arrival in my home either “facing the corner” or literally outside the door of his classrooms.

 Signature 

. . . for it is God who I speak about, even when I speak about myself. For, to know God is to know myself.
Brother Mario

Profile
 
 
Posted: 10 February 2012 07:26 AM   [ Ignore ]   [ # 2 ]
Sr. Member
Avatar
RankRankRankRank
Total Posts:  14456
Joined  2007-07-20
nv - 09 February 2012 08:47 PM

At least the proposed DSM-5 does a good job with autism diagnosis:
http://www.dsm5.org/ProposedRevisions/Pages/proposedrevision.aspx?rid=94

Dennis, years ago I had a 14-year-old resident whose mental condition would have made an oppositional defiance disorder diagnosis a pathetic understatement. Tourettes, though it was inaccurate, did the trick in getting him into the appropriate school. Within two years, he was well enough to be reunited with his mother, and he continues to do well to this day.

He was in desperate need of an accurate word to be applied to his condition. Autism had managed to do much more harm than good. Without accurate diagnostic terms, teachers end up leaving certain students to fend for themselves, and the above-mentioned child had spent all of his school time prior to arrival in my home either “facing the corner” or literally outside the door of his classrooms.

Agree with need for discriminative accuracy, too many one size fits all terms.  “Attention Deficit…..” good example.  Used more to justify drugs for insurance than any examination of individual and evoking conditions.  In any prison, “Antisocial personality disorder” the most common, something like 40% of population there.  Defined as someone defied laws and got caught, basically.  Duhhh.

I was in charge of a small tax-based community mental health center, in fact two different places, and the DSM was used exclusively for insurance reimbursement purposes; no “V” codes in the DSM were used because to do so prevented insurance reimbursement.  That’s a common practice.

[ Edited: 10 February 2012 08:15 AM by Dennis Campbell ]
 Signature 

Religion is good for one thing: making you feel better while someone else rules you.  Religion is more a reflection than a cause of conflicts. The causes lie in conflicting cultural mores and traits.

Profile
 
 
Posted: 10 February 2012 08:36 PM   [ Ignore ]   [ # 3 ]
Sr. Member
RankRankRankRank
Total Posts:  4369
Joined  2005-04-29
Dennis Campbell - 10 February 2012 07:26 AM

Agree with need for discriminative accuracy, too many one size fits all terms.  “Attention Deficit…..” good example.  Used more to justify drugs for insurance than any examination of individual and evoking conditions.  In any prison, “Antisocial personality disorder” the most common, something like 40% of population there.  Defined as someone defied laws and got caught, basically.  Duhhh.

I was in charge of a small tax-based community mental health center, in fact two different places, and the DSM was used exclusively for insurance reimbursement purposes; no “V” codes in the DSM were used because to do so prevented insurance reimbursement.  That’s a common practice.

Looking back on my reply, I see that I may not have presented my intended point.

Defiance-oppositional disorder might sound like some sort of insurance scam, but it does have an important place in the world of psychiatric/psychological diagnosis for those instances when it actually does apply to a particular person. Without going into all sorts of detail about the ins and outs of how I assume the child I mentioned became the way he became, I’ll just say that he was so defiant and oppositional that no teacher he’d ever had in his life had been able to include him in the classroom activities. Once he got diagnosed with something resembling a description of a part of his personality, he transformed over the course of two years into a child his teachers and his mother could handle. He’s no longer even in a special ed class, and the roots of this outcome can be found in a diagnosis that made some modicum of sense.

In other words, a silly-sounding diagnosis might have been exactly what this child needed. “Tourettes” worked in his favor because it’s a proper-sounding diagnosis, but it was entirely inaccurate. What he in fact had was defiance-oppositional disorder, which no one paid much attention to because such a diagnosis was seen to have bullshit etiology. (It was one of about 5 aberrations listed in his then-current psychological assessment.)

Sorry for the lack of clarity in my previous post.

 Signature 

. . . for it is God who I speak about, even when I speak about myself. For, to know God is to know myself.
Brother Mario

Profile
 
 
Posted: 11 February 2012 07:31 AM   [ Ignore ]   [ # 4 ]
Sr. Member
Avatar
RankRankRankRank
Total Posts:  14456
Joined  2007-07-20

Ideally, a good analysis of person is a 1-2 single spaced pages of description of strengths, dispositions, medical, education, etc., that can be done well.  The DSM Dx is just too indiscriminate, if useful for some purposes.

 Signature 

Religion is good for one thing: making you feel better while someone else rules you.  Religion is more a reflection than a cause of conflicts. The causes lie in conflicting cultural mores and traits.

Profile
 
 
Posted: 11 February 2012 08:01 AM   [ Ignore ]   [ # 5 ]
Sr. Member
RankRankRankRank
Total Posts:  4369
Joined  2005-04-29
Dennis Campbell - 11 February 2012 07:31 AM

Ideally, a good analysis of person is a 1-2 single spaced pages of description of strengths, dispositions, medical, education, etc., that can be done well.  The DSM Dx is just too indiscriminate, if useful for some purposes.

I don’t know about any of that, as most of my kids don’t end up needing psychiatric care, though one of them has just started taking meds for ADD. From my end of things, a one-word diagnosis is often more important than a page or two of written description. The special-ed superintendent will not even get out of his chair without some kind of frightening sounding diagnosis. Full pages never seem to move him at all.

 Signature 

. . . for it is God who I speak about, even when I speak about myself. For, to know God is to know myself.
Brother Mario

Profile
 
 
Posted: 11 February 2012 08:11 AM   [ Ignore ]   [ # 6 ]
Sr. Member
Avatar
RankRankRankRank
Total Posts:  14456
Joined  2007-07-20
nv - 11 February 2012 08:01 AM
Dennis Campbell - 11 February 2012 07:31 AM

Ideally, a good analysis of person is a 1-2 single spaced pages of description of strengths, dispositions, medical, education, etc., that can be done well.  The DSM Dx is just too indiscriminate, if useful for some purposes.

I don’t know about any of that, as most of my kids don’t end up needing psychiatric care, though one of them has just started taking meds for ADD. From my end of things, a one-word diagnosis is often more important than a page or two of written description. The special-ed superintendent will not even get out of his chair without some kind of frightening sounding diagnosis. Full pages never seem to move him at all.

Not necessarily psychiatric care, but how best to manage problematic behaviors in a specific environment.

 Signature 

Religion is good for one thing: making you feel better while someone else rules you.  Religion is more a reflection than a cause of conflicts. The causes lie in conflicting cultural mores and traits.

Profile
 
 
Posted: 11 July 2012 06:53 AM   [ Ignore ]   [ # 7 ]
Newbie
Avatar
Rank
Total Posts:  2
Joined  2012-07-07

The DSM process is like a field manual for birds. With little or no training anyone can look up something and say, this is a warbler or a woodpecker, or a bird we would choose to call by that name. But while increasing the agreement on what to call something, any attempt to have the constructs explored for validity (ie does the bird exist? or is there any usefulness in disntiguishing the red breasted variety) have been thrown under the bus.

 Signature 

Diabetes Complications Diabetic Eye Problems

Profile
 
 
Posted: 11 July 2012 07:05 AM   [ Ignore ]   [ # 8 ]
Sr. Member
Avatar
RankRankRankRank
Total Posts:  14456
Joined  2007-07-20
viryan23 - 11 July 2012 06:53 AM

The DSM process is like a field manual for birds. With little or no training anyone can look up something and say, this is a warbler or a woodpecker, or a bird we would choose to call by that name. But while increasing the agreement on what to call something, any attempt to have the constructs explored for validity (ie does the bird exist? or is there any usefulness in disntiguishing the red breasted variety) have been thrown under the bus.

It’s useful for categorizing syndromes for the purposes of, in good part,, insurance reimbursement to the provider, but agree that apart from that is has limited value.  I’ve seen diagnosis changed or made simply to assure payment. A couple goes to marital counseling, be assured that both will get some reimbursable diagnosis like 309.28 or adjustment reaction with mixed features.

 Signature 

Religion is good for one thing: making you feel better while someone else rules you.  Religion is more a reflection than a cause of conflicts. The causes lie in conflicting cultural mores and traits.

Profile