Should Disabling Premenstrual Symptoms Be A Mental Disorder?
Women's moods can change based on the phases of their menstrual cycle. But does that mean they have a psychiatric disorder? Simmons, 24, will have been doing just fine, working, taking care of her daughter.
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#2 Oct 22, 2013
Psychiatric Diagnosis: Too Little Science, Too Many Conflicts of Interest [i]
Paula J. Caplan, Ph.D.
There is a lot of pain and suffering in the world, and it is tempting to believe that the mental health community knows how to help. It is widely believed, both by mental health professionals and the general population, that if only a person gets the right psychiatric diagnosis, the therapist will know what kind of measures will be the most helpful. Unfortunately, that is not usually the case, and getting a psychiatric diagnosis can often create more problems than it solves, including a lifetime of being labeled, difficulties with obtaining affordable (or any) health insurance (due to now having a pre-existing condition), loss of employment, loss of child custody, the overlooking of physical illnesses and injuries because of everything being attributed to psychological factors, and the loss of the right to make decisions about oneís medical and legal affairs. The creation and use of psychiatric diagnosis, unlike, for instance, psychiatric drugs, is not overseen by any regulatory body, and rarely does anyone raise the question of what role the assignment of a psychiatric label has played in creating problems for individuals.[ii]
The Problematic History
These serious limitations have not prevented the authors of the American Psychiatric Associationís (APA) Diagnostic and Statistical Manual of Mental Disorders (DSM), sometimes known as ďthe therapistís Bible,Ē from making expansive claims about their knowledge and authority and wielding enormous power to decide who will and will not be called mentally ill and what the varieties of alleged mental illness will be. The DSMís current edition is called DSM-IV-TR, and it was preceded by the original DSM (in 1952), then DSM-II (1968), DSM-III (1980), DSM-III-R (Third Edition Revised)(1987), DSM-IV (1994), and DSM-IV-TR (2000). The DSM-V is currently in preparation and slated for 2013 publication. Each time a new edition appears, the media ask whichever psychiatrist is the lead editor why a new edition was necessary, and like clockwork, each editor replies that it was because the previous edition really wasnít scientific (Caplan, 1995). And each time a new edition appears, it contains many more categories than does the previous one. For instance, DSM-III-R contained 297 categories, and DSM-IV contained 374 (Caplan, 1995).
I served as an advisor to two of the DSM-IV committees, before resigning due to serious concerns after witnessing how fast and loose they play with the scientific research related to diagnosis (Caplan, 1995). The DSM is widely used, not only in the mental health system, but also in general medical practice, in schools, and in the courts. I have been involved since 1985 in trying to alert both therapists and the public to the manualís unscientific nature and the dangers that believing in its objectivity poses. Since then, I have watched with interest a national trend toward gradually increasing openness to the idea that psychiatric diagnosis (A)is largely unscientific,(B)is highly subjective and political, and (C)can cause untold harm, ranging from the patientsí lowered self-confidence to loss of custody of children to loss of health insurance (because any psychiatric label can be considered evidence of a pre-existing condition) to loss of the right to make decisions about their medical and legal affairs.
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