Transforming Normality into Pathology: The DSM and the Outcomes of Stressful Social Arrangements

2007 ◽  
Vol 48 (3) ◽  
pp. 211-222 ◽  
Author(s):  
Allan V. Horwitz
Keyword(s):  
Mental Disorders ◽  
Mental Disorder ◽  
Social Space ◽  
Social Groups ◽  
Unmet Need ◽  
Statistical Manual ◽  
Need For Treatment ◽  
Diagnostic And Statistical Manual ◽  
Psychological Mechanisms ◽  
The Social

The sociology of stress shows how nondisordered people often become distressed in contexts such as chronic subordination; the losses of status, resources, and attachments; or the inability to achieve valued goals. Evolutionary psychology indicates that distress arising in these contexts stems from psychological mechanisms that are responding appropriately to stressful circumstances. A diagnosis of mental disorder, in contrast, indicates that these mechanisms are not functioning as they are designed to function. The American Psychiatric Association's Diagnostic and Statistical Manual, however, has come to treat both the natural results of the stress process and individual pathology as mental disorders. A number of social groups benefit from and promote the conflation of normal emotions with dysfunctions. The result has been to overestimate the number of people who are considered to be disordered, to focus social policy on the supposedly unmet need for treatment, and to enlarge the social space of pathology in the general culture.

scholarly journals Mental disorders in Australian 4- to 17- year olds: Parent-reported need for help

2017 ◽  
Vol 52 (2) ◽  
pp. 149-162 ◽  
Author(s):  
Sarah E Johnson ◽  
David Lawrence ◽  
Michael Sawyer ◽  
Stephen R Zubrick
Keyword(s):  
Major Depressive Disorder ◽  
Mental Disorders ◽  
Depressive Disorder ◽  
Conduct Disorder ◽  
Unmet Need ◽  
Household Survey ◽  
Conduct Disorders ◽  
Major Depressive ◽  
Statistical Manual ◽  
Diagnostic And Statistical Manual

Objective: To describe the extent to which parents report that 4- to 17-year-olds with symptoms meeting Diagnostic and Statistical Manual of Mental Disorders, 4th edition criteria for mental disorders need help, the types of help needed, the extent to which this need is being met and factors associated with a need for help. Method: During 2013–2014, a national household survey of the mental health of Australia’s young people (Young Minds Matter) was conducted, involving 6310 parents (and carers) of 4- to 17-year-olds. The survey identified 12-month mental disorders using the Diagnostic Interview Schedule for Children – Version IV ( n = 870) and asked parents about the need for four types of help – information, medication, counselling and life skills. Results: Parents of 79% of 4- to 17-year-olds with mental disorders reported that their child needed help, and of these, only 35% had their needs fully met. The greatest need for help was for those with major depressive disorder (95%) and conduct disorder (93%). Among these, 39% of those with major depressive disorder but only 19% of those with conduct disorder had their needs fully met. Counselling was the type of help most commonly identified as being needed (68%). In multivariate models, need for counselling was higher when children had autism or an intellectual disability, in blended families, when parents were distressed, and in the most advantaged socioeconomic areas. Conclusions: Many children and adolescents meeting Diagnostic and Statistical Manual of Mental Disorders, 4th edition criteria for mental disorders have a completely unmet need for help, especially those with conduct disorders. Even with mild disorders, lack of clinical assessment represents an important missed opportunity for early intervention and treatment.

scholarly journals Lifetime and 12-month prevalence, severity and unmet need for treatment of common mental disorders in Japan: results from the final dataset of World Mental Health Japan Survey

2015 ◽  
Vol 25 (3) ◽  
pp. 217-229 ◽  
Author(s):  
H. Ishikawa ◽  
N. Kawakami ◽  
R. C. Kessler ◽  
Keyword(s):  
Mental Health ◽  
Mental Disorders ◽  
Mental Disorder ◽  
Common Mental Disorders ◽  
Unmet Need ◽  
Diagnostic Interview ◽  
Need For Treatment ◽  
World Mental Health ◽  
The World ◽  
Dsm Iv

Background.The aim of this study is to estimate the lifetime and 12-month prevalence, severity and treatment of Diagnostic and Statistical Manual of Mental Disorders fourth edition (DSM-IV) mental disorders in Japan based on the final data set of the World Mental Health Japan Survey conducted in 2002–2006.Methods.Face-to-face household interviews of 4130 respondents who were randomly selected from Japanese-speaking residents aged 20 years or older were conducted from 2002 to 2006 in 11 community populations in Japan (overall response rate, 56%). The World Mental Health version of the World Health Organization Composite International Diagnostic Interview (WMH-CIDI), a fully structured, lay administered psychiatric diagnostic interview, was used for diagnostic assessment.Results.Lifetime/12-month prevalence of any DSM-IV common mental disorders in Japan was estimated to be 20.3/7.6%. Rank-order of four classes of mental disorders was anxiety disorders (8.1/4.9%), substance disorders (7.4/1.0%), mood disorders (6.5/2.3%) and impulse control disorders (2.0/0.7%). The most common individual disorders were alcohol abuse/dependence (7.3/0.9%), major depressive disorder (6.1/2.2%), specific phobia (3.4/2.3%) and generalized anxiety disorder (2.6/1.3%). While the lifetime prevalence of any mental disorder was greater for males and the middle-aged, the persistence (proportion of 12-month cases among lifetime cases) of any mental disorder was greater for females and younger respondents. Among those with any 12-month disorder, 15.3% were classified as severe, 44.1% moderate and 40.6% mild. Although a strong association between severity and service use was found, only 21.9% of respondents with any 12-month disorder sought treatment within the last 12 months; only 37.0% of severe cases received medical care. The mental health specialty sector was the most common resource used in Japan. Although the prevalence of mental disorders were quite low, mental disorders were the second most prevalent cause of severe role impairment among chronic physical and mental disorders.Conclusions.These results suggest lower prevalence of mental disorders in Japan than that in Western countries, although the general pattern of disorders, risk factors and unmet need for treatment were similar to those in other countries. Greater lifetime prevalence for males and greater persistence for females seems a unique feature of Japan, suggesting a cultural difference in gender-related etiology and course of disorders. The treatment rate in Japan was lower than that in most other high-income countries in WMH surveys.

The DSM-V Project: Bad Science Produces Bad Psychiatry

2010 ◽  
Vol 12 (3) ◽  
pp. 189-199 ◽  
Author(s):  
Niall McLaren
Keyword(s):  
Mental Disorders ◽  
Mental Disorder ◽  
Statistical Model ◽  
Field Trials ◽  
Fourth Edition ◽  
Statistical Manual ◽  
Diagnostic And Statistical Manual ◽  
Dsm V

The project to develop the successor to fourth edition of the Diagnostic and Statistical Manual of Mental Disorders has been under way for 10 years, yet it is still several years from completion, and the field trials, the most difficult and expensive part, have not even started. This article explores the reasons why the project is struggling, arguing that the defects the Diagnostic and Statistical Model-V (DSM-V) Committee has found are not chance or random problems that can be overcome by more money but rather represent serious conceptual errors in the very basis of the ideas underlying the project. As a result of these errors, it is predicted that the entire notion of valid categories of mental disorder will collapse in self-contradiction. One of the most recent suggestions for a new disorder, psychotic risk syndrome (now APSS), is used to demonstrate how the principles of science cannot accommodate the unstated ideological demands driving the DSM-V project.

Do We Need Another Eating Disorder?

2020 ◽  
pp. 3-20
Author(s):  
Pamela K. Keel
Keyword(s):  
Eating Disorders ◽  
Eating Disorder ◽  
Mental Disorders ◽  
Mental Disorder ◽  
Statistical Manual ◽  
Diagnostic And Statistical Manual ◽  
Purging Disorder

Most people know about anorexia and some know about bulimia, but very few have ever heard of purging disorder. Purging disorder is an eating disorder characterized by self-induced vomiting or misuse of laxatives, diuretics, or other medications to influence weight or shape in individuals who are not underweight and who do not have large binges. This chapter describes how and when purging disorder was first identified, placing it in the context of the identification of other eating disorders and the factors that determine whether a condition should be considered a new mental disorder. It describes how purging disorder came to be included as an “other specified feeding or eating disorder” in the fifth edition of the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders.

The Present and Future of Psychiatric Diagnosis

2017 ◽  
Author(s):  
Steven E. Hyman
Keyword(s):  
Mental Disorders ◽  
Mental Disorder ◽  
Signs And Symptoms ◽  
International Classification Of Diseases ◽  
Diagnostic Classification ◽  
Statistical Manual ◽  
Classification Schemes ◽  
Diagnostic And Statistical Manual ◽  
Classification Of Diseases

Psychiatric disorders are currently diagnosed according to the Diagnostic and Statistical Manual of Mental Disorders and the closely related International Classification of Diseases. Both diagnostic classification schemes are descriptive and based on a collection of signs and symptoms associated with a given disorder. The fundamental weakness of the schemes is that they are not based on the underlying genetic or neurobiological etiology or pathophysiology of a disorder which of course remain unknown for all common psychiatric syndromes. As more is learned about the biological basis of a mental disorder it will be possibly increasingly to build more accurate diagnostic schemes with greater prognostic and treatment validity.

scholarly journals Social Exclusion of People Who Suffer from Mental Disorders: A Proposal for an Explanatory Model

2019 ◽  
Vol 29 ◽  
Author(s):  
Silvana Carneiro Maciel ◽  
Cicero Roberto Pereira ◽  
Tiago Jessé Souza de Lima ◽  
Luana Elayne Cunha de Souza ◽  
Leoncio Camino ◽  
...  
Keyword(s):  
Mental Disorders ◽  
Mental Disorder ◽  
Social Exclusion ◽  
Minority Groups ◽  
Social Groups ◽  
Explanatory Model ◽  
Perceived Threat ◽  
Regression Analyses ◽  
Perception Of Threat ◽  
The Social

Abstract Beliefs about the nature of social groups may motivate people to exclude members of minority groups from their conviviality. This process is analyzed in this article by proposing an explanatory model for the social exclusion of people suffering from mental disorders wherein beliefs about the nature of mental disorder, the perception of threat and prejudice contribute to social exclusion. Two studies (Study 1, N = 254; Study 2, N = 236) were conducted with university students who answered the following questions about beliefs and prejudices regarding mental disorders, perceived threat and social exclusion. Regression analyses have shown that exclusion is motivated by prejudice, whose impact is mediated by perceived threat. The results also indicated that prejudice is anchored in participants’ beliefs on the nature of mental disorders, especially those with a religious basis.

Factitious disorder and malingering

2020 ◽  
pp. 1342-1349
Author(s):  
Thomas Merten ◽  
Harald Merckelbach
Keyword(s):  
Mental Disorders ◽  
Sick Leave ◽  
Mental Disorder ◽  
Somatic Symptoms ◽  
International Classification Of Diseases ◽  
Factitious Disorder ◽  
Statistical Manual ◽  
Diagnostic And Statistical Manual ◽  
Classification Of Diseases

Factitious disorder and malingering are two forms of abnormal illness behaviour in which mental or somatic symptoms are deliberately fabricated or grossly exaggerated or otherwise grossly misrepresented. They are forms of other-deceit, with the person in question assumed to be fully aware of this deceit. The central distinguishing feature of both is that factitious disorder is commonly thought to be motivated by internal incentives (primary gain: medical treatment, assuming the sick role), while malingering is directed towards an external goal (secondary gain, for example monetary compensation, sick leave). The utility of distinguishing between the two forms of feigning has long been questioned. Similarly, it must be questioned why factitious disorder is apprehended as a mental disorder in its own right. Neither the Diagnostic and Statistical Manual of Mental Disorders (DSM) nor the International Classification of Diseases (ICD) contains useful diagnostic guidelines for reliably diagnosing feigned illness presentations; in particular, several decades of malingering research and conceptual developments have found no repercussion there.

Angststörungen – von der ICD-10 zur ICD-11

2020 ◽  
pp. 1-5
Author(s):  
Timo D. Vloet ◽  
Marcel Romanos
Keyword(s):  
Mental Disorders ◽  
International Classification Of Diseases ◽  
International Classification ◽  
Statistical Manual ◽  
Diagnostic And Statistical Manual ◽  
Dsm 5 ◽  
Classification Of Diseases ◽  
Icd 10

Zusammenfassung. Hintergrund: Nach 12 Jahren Entwicklung wird die 11. Version der International Classification of Diseases (ICD-11) von der Weltgesundheitsorganisation (WHO) im Januar 2022 in Kraft treten. Methodik: Im Rahmen eines selektiven Übersichtsartikels werden die Veränderungen im Hinblick auf die Klassifikation von Angststörungen von der ICD-10 zur ICD-11 zusammenfassend dargestellt. Ergebnis: Die diagnostischen Kriterien der generalisierten Angststörung, Agoraphobie und spezifischen Phobien werden angepasst. Die ICD-11 wird auf Basis einer Lebenszeitachse neu organisiert, sodass die kindesaltersspezifischen Kategorien der ICD-10 aufgelöst werden. Die Trennungsangststörung und der selektive Mutismus werden damit den „regulären“ Angststörungen zugeordnet und können zukünftig auch im Erwachsenenalter diagnostiziert werden. Neu ist ebenso, dass verschiedene Symptomdimensionen der Angst ohne kategoriale Diagnose verschlüsselt werden können. Diskussion: Die Veränderungen im Bereich der Angsterkrankungen umfassen verschiedene Aspekte und sind in der Gesamtschau nicht unerheblich. Positiv zu bewerten ist die Einführung einer Lebenszeitachse und Parallelisierung mit dem Diagnostic and Statistical Manual of Mental Disorders (DSM-5). Schlussfolgerungen: Die entwicklungsbezogene Neuorganisation in der ICD-11 wird auch eine verstärkte längsschnittliche Betrachtung von Angststörungen in der Klinik sowie Forschung zur Folge haben. Damit rückt insbesondere die Präventionsforschung weiter in den Fokus.

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