Remember when we talked about Paris Hilton and decided that John Belushi shouldn’t diagnosis people with mental disorders? (If not, check it out – you missed the guy from Reading Rainbow!) Well today I want to start a new series on diagnostic labeling – because some serious drama is about to go down. That’s right, you guessed it – the latest edition of the Diagnostic Statistical Manual of Mental Disorders comes out in May! Oh yeah:
What can I say? Ever since I got my tattoo, I’ve been a lil gangsta ;)
For those of you who don’t know
you betta ask somebody!, the DSM is this huge book that classifies mental disorders. It’s really important because it provides clear language for doctors and patients to use when discussing symptom development and (more importantly for those dolla dolla bills y’all): it helps determine what medical expenses your insurance company will or will not cover. (Ok sorry: my gangster phase has officially passed. I think talking about statistical manuals and insurance policies killed it.)
Long story short: this is the book that tells you what’s wrong.
The DSM lists criteria for each disorder and basically serves as a big psychiatric Trapper Keeper. (Do kids still use those anymore?!) What makes it into the binder, and what gets left out, can stir up quite the controversy – as is always the case each time the DSM comes out with a new edition. We’re currently on the fifth round and, between “temper tantrum” disorders and the inclusion of severe PMS as a defined mental illness, this version promises to be no exception.
I’m sorry, wait. Did you just say PMS was a mental illness?
Well, not me so much as the American Psychiatric Association… And not PMS so much as PMDD (premenstrual dysmorphic disorder). But, yes. That definitely just happened.
Previously referenced in the appendix of the DSM-IV, PMDD makes its big league debut with the DSM-V. Experts predict that “far less than 10%” of premenopausal women will experience “premenstrual distress of the type and severity that would meet the proposed DSM-V diagnostic criteria.” But those who do will qualify for a mental disorder diagnosis.
I haven’t spent a lot of time thinking about this one… (I’ve been too busy writing letters to the editor of the New York Times about elimination of the bereavement exclusion in major depressive episodes – which I’m sure someone is on the edge of their seat reading right now…) so I’ll leave this one up to you guys to discuss!
This journal article outlines arguments for including PMDD; this journal article outlines articles against (note: the second article was written in 2004, when PMDD was still just in the appendix – imagine how upset the authors must be now!). My suggestion is to form your own opinion, then read the opposite paper and see how you feel at the end.
So those are the basics
Like I said, there’s always going to be some type of drama surrounding DSM publication – which I think is important to point out, as that claim is the first line of defense used against critics of DSM change. And while we’re clearing the playing field, I think I should also stress: I don’t have a problem with classification systems (I think they’re necessary); I don’t have a problem with diagnostic labels (I think they’re essential). I’m not part of some fanatical, anti-psychiatry revolution (or any anti-psychaitry revolution – you know, just to be clear). I’m just a regular psychology student with some very specific, very legitimate concerns about the DSM-V.
And I think I deserve to have my objections taken seriously.
…But until that happens, I’ll just rant and rave about them here on my blog! haha :)
So get excited, because over the next week we’re going to talk about elimination of the bereavement exclusion (I know all that negation sounds awkward, but the phrasing will make more sense next post!) and disruptive mood dysregulation disorder – or, as it’s known in the streets: a fast way to label your kid with a mental disorder when he annoys you with too many tantrums! (Hey, look at that! My gangsta lean is coming back!)
But in the meantime, remember: if you’re not a doctor…
Can’t wait to hear your thoughts on PMDD and the DSM-V!
I haven’t formed my own opinion yet, so really looking forward to hearing yours!
Epperson, C.N., Steiner, M., Hartlage, S.A., Eriksson, E., Schmidt, P.J., Jones, I. and Yonkers, K. (2012). Premenstrual Dysphoric Disorder: Evidence for a New Category for DSM-5. American Journal of Psychiatry. Retrieved: 20 March 2013.
Offman, A. & Kleinplatz, P.J. (2004). Does PMDD Belong in the DSM? Challenging the Medicalization of Women’s Bodies. The Canadian Journal of Human Sexuality, 13(1). Retrieved: 20 March 2013.