Ok, I have taken some time to actually read through DSM 5. While DSM has often been scrutinized--both for what it includes, as well as what it doesn't--the back-lash against the newest edition has been particularly pronounced these past few months. Part of this stems from the micro-analysis that happens with many things in our modern world, though we have to admit that ego, resentment, and a misunderstanding of the process also plays a part. In addition, historical debate over DSM typically took place in-house; that is, by clinicians. With DSM 5, this has broadened to people who have little- to no understanding of the diagnostic process, its purpose, and its strengths/limitations. Thus, there has been a lot of negative press about DSM 5 in Huffington Post, NY Times, and other sources, often by people with practically no understanding of mental health.
Why 5 stars, you might ask? Because my review is based on DSM 5 as a book, not anything else having to do with DSM as a concept or tool. This particular edition 'reads' well, in that the text and lay-out is clear. In contrast to previous editions, the reader will be given more orientation to the book and how to use it. The diagnostic criteria is familiar and through the Table of Contents, Index, and quick-view pages, it is easy to find the diagnosis or category you're looking for. Yes, it's bulky and expensive, but you should have the large edition in your library for now; later, when you're more familiar with the changes, you can buy the quick-reference guide.
As a child psychologist who conducts psychological and neuropsychological evaluations--for social service agencies, schools, the courts, and for families--DSM plays a prominent role in my work. In addition, I have taught a course on DSM to masters-level graduate students for the past 10 years. In my role as a psychologist, I have witnessed first-hand how a DSM diagnosis is formulated, applied, and interpreted. I have also seen the benefits and limitations of assigning a DSM diagnosis to a client. In the end, however, most people are less concerned about the diagnosis, per se, and more about how to facilitate services, treatment or quality of life/education for the individual to whom it is assigned. This will still be the case now that DSM 5 is published.
Through the years, DSM has attempted to reflect our understanding of mental health symptomatology and how it impacts people across the lifespan. This continues to be the case with DSM 5, though admittedly, mental health is a `young' science, and there is much about the human condition we don't fully understand (neither DSM nor any other classification system can help us account for the Sandy Hook shootings; the Cleveland kidnapping case; the Boston bombing; or many other actions our fellow human beings engage in).
With DSM 5, there are some noteworthy modifications to how we code a mental health diagnosis. Thus, users will need to read the introductory chapter in order to make sure their work reflects these changes. In contrast to what has been hyped in the popular media, DSM 5 does not pathologize grief or childhood tantrums. It doesn't randomly lower thresholds, to make it such that more people will now be diagnosed with ADHD, depression, or Bipolar Disorder. And it doesn't eliminate most of the diagnoses that were previously applicable. Rather, DSM 5 reframes some criteria, clarifies various symptom presentations, and tries to shape our perspective on clinical diagnosis. In particular, DSM 5--in contrast to earlier editions--helps to reinforce that we should view most diagnoses from a lifespan perspective, while staying mindful of the fact that its presentation can vary in severity or magnitude. As with previous editions, DSM 5 provides a classification of mental health disorders, but it doesn't make inference about how these should be treated.
In my opinion, DSM is simply one tool we as clinicians use to formulate an understanding of what is happening with a client at any given time. It also serves to provide us with a `common' language, since a diagnosis will be assigned to most of the clients with whom we work. Much of this language, as used in DSM 5, will be familiar, and those of you who have used DSM thus far won't find that the content has changed that much. When you skim the Table of Contents, for example, you won't see a lot of new diagnoses, but you will see a re-working of where some of them are placed (PTSD and OCD, for example, are no longer in the Anxiety Disorders classification).
In particular, I like the expansion we see portrayed in DSM 5 of neurodevelopmental disorders; better clarification for avoiding a mis-diagnosis of Bipolar Disorder with children; the placement of Autism on a spectrum; and distinctions of how PTSD manifests in young children versus adults. What we've previously known as Reactive Attachment Disorder is now split into two separate classifications (to reflect discriminate and indiscriminate manifestations, accordingly). DSM 5 no longer has the classification, `Disorders First Evidenced in Infancy and Early Childhood.' Instead, the classifications are supposedly arranged by manner in which they appear in the lifespan. This rationale doesn't really fit, however, as many of the kids I see in my practice have substance use and/or neurocognitive disorders, which--using this rationale--the authors put later on in the book.
Overall, DSM 5 reflects the evolution we are all involved in, as we try to understand and account for the mental health symptoms
which impact large numbers of the population. People are much more complex than the diagnoses we assign to them, but DSM at least provides us with a place to start. What happens after that depends upon the skill of the clinician; ultimately, isn't that what most of our clients are concerned with?
Product Details :
- Series: Diagnostic and Statistical Manual of Mental Disorders
- Paperback: 991 pages
- Publisher: American Psychiatric Publishing; 5 edition (May 27, 2013)
- Language: English
- ISBN-10: 0890425558
- ISBN-13: 978-0890425558
- Product Dimensions: 7 x 10 inches
More Details about Diagnostic and Statistical Manual of Mental Disorders, 5th Edition
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