For as long as there has been a Diagnostic and Statistical Manual of Mental Disorders (DSM), it has been treated as if it contained scientific truths. Yet, is that what the DSM really is? Or, is really only a rough draft of diagnoses based on the supposed consensus of experts? This seems to be the question that drives the explanation and critique forwarded by Dr. Joel Paris in The Intelligent Clinician’s Guide to the DSM-5®.
A good place to start is to envision a mental disorder as similar to that of a medical diagnosis; viz., that both require scientific classification. However, the differences arise in that mental disorders lack the more fundamental understanding of disease processes. Mental disorders are based more on signs and symptom…show more content… However, the biggest problem in making the DSM-5®, seem to lie not so much in the process, but the fact that it was driven more by ideology than the other previous editions.
The ideology that seems implicit is the principle that “mental disorders are neurobiological and dimensional and lack a cut-off from normality (Kupfer & Regier, 2011) (Paris p. 26).In using dimensionality accompanied with a spectrum of normality, psychiatric disorders can be seen to lack no exact boundary with normality. As seen in previous editions of DSMs, various diagnoses have failed to separate mental disorders from common experiences of life. If this is the case, there is always the chance that diagnoses can be wrong, and wrong diagnoses do have consequences.
Staying on the subject of separating mental illness from life’s “ups and downs,” what is the definition of normal human unhappiness? Has this ever been clearly defined, measured, or interpreted? And, how does a diagnoses involving unhappiness make that condition disabling? With these two questions, it is probable that many problems that would receive a diagnosis under the DSM-5® are painful but not disabling. As Paris rightly states, “The overdiagnosis of major depression, based on its overly broad definition, is one of the most serious problems in contemporary psychiatry” (p. 82).
Paris then concentrates on the multitude of disorders included in the new DSM V®. From Schizophrenia spectrum and other psychoses, through