DSM-5 Update: Annotated List of TS-Si.org Articles

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DSM-5 Update: Annotated List of TS-Si.org Articles

Resources - DSM

Sharon Gaughan

Wednesday, 10 February 2010 08:00

DSM-V

Fairfax, VA, USA. The Manual for Diagnosis of Mental Disorders (DSM-IV) is the principal desktop diagnostic reference for psychiatric diagnosis. Used by physicians and other caregivers in the United States and around the world, the American Psychiatric Association (APA) published the current edition, DSM-IV, in 1994. While influential, there is considerable variation in its acceptance and practical application.

The APA named the Work Groups and membership for the next DSM-5 revision, scheduled an early draft for comment (pub. 2010), and plans on completion of the final version in May 2013. The APA stresses there will be a greater emphasis on evidence-based medicine.

The APA announcement stimulated wide interest in the professional, patient, and activist communities. TS-Si.org expanded its coverage of this important development with a variety of articles that touch on the DSM-V deliberations. Reactions and suggestions from our readers are always welcome. You can see current comments from our readers in the TS-Si.org Comments Section.

This article carries the date of its most recent revision.

TS-Si Resources

TS-Si.org features an extensive collection of research abstracts, technical articles and opinion pieces on the DSM. All TS-Si content is searchable.

Research Abstracts. Citations and abstracts from the professional literature are available in full text, with additional access via the title index.
Technical Articles. Numerous TS-Si articles touch on DSM and related issues. The articles typically include full citations and references. Selected articles provide full text downloads of the source journal articles.
Opinion Pieces. Comment on the DSM take two major forms: independent commentary by our columnists and guest authors, as well as comments left on specific articles by visitors to the site.
Search Engine. Visitors can perform a simple search by entering a search term in the box at the upper right of each page. More complex queries are available via the TS-Si Advanced Search facility.

Related APA / DSM ArticlesTS-Si.org has published a variety of articles on the APA, DSM, and upcoming handbook revisions that will result in the DSM Fifth Edition (DSM-V). Supplementing the scientific/medical reports and other materials available in the TS-Si Article Archive, this annotated list includes announcements, general news articles, analyses, and opinion pieces. We continuously update this list upon publication of relevant articles.

News

APA Working Groups Named For Upcoming DSM-V Edition. TS-Si News Service. The APA named the Work Groups and membership for its coming fifth revision to the Manual for Diagnosis of Mental Disorders (DSM-V).

OII States Position On GID in the DSM-V Revision. OII Australia and OII Aotearoa New Zealand. It has become common place to subsume biological diversity in sex formation under the umbrella terms 'gender diversity' and/or 'transgender'. The purpose of this submission is to explain the reasons why this practice is not appropriate when applied to intersexed and true (HBS) transsexualism.

Psychiatrists Revise the Book of Human Troubles. Benedict Carey. The book is at least three years away from publication, but it is already stirring bitter debates over a new set of possible psychiatric disorders.

Sexual and Gender Identity Disorders in DSM-5. TS-Si News Service. If what you might think you have is not in the DSM, chances are health insurance won’t pay for it (even if it is, coverage may not be guaranteed).

Research Reports

Is The DSM-IV (SCID) Misapplied? What About Bipolar Disorder? TS-Si News Service. Researchers have identified problems with applying the Structured Clinical Interview for DSM-IV (SCID). "… fewer than half the patients previously diagnosed with bipolar disorder received a diagnosis based on a comprehensive, psychiatric diagnostic interview.

Medicalized: Shaping Our Perceptions Of Illness. TS-Si News Service. Do prescription drug ads make people think they're sick when they're not, or create "disease" out of thin air? Does the "empowered patient" movement mean that doctors have lost some of their professional clout when it comes to making diagnoses and prescribing treatment?

Psychiatrists Shifting Away From Psychotherapy Role. TS-Si News Service. Despite the central role of psychotherapy in the practice of psychiatry throughout its history, a declining number of office-based psychiatrists appear provide psychotherapy to their patients.

The DSM: How And Why Did It Categorize Human Traits As Sickness? TS-Si News Service. Regarding social anxiety: By 1987 … "Impairment became something largely in the eye of the beholder, and anticipated embarrassment was enough to meet the diagnostic threshold."

Analysis

Does WPATH Really Have a Mandate to Speak on Behalf of HBS Transsexuals? Joanne Proctor. … the reason why HBS activists treat WPATH with contempt will become apparent. … how can any organization claim to be a legitimate voice on behalf of a minority, having first accused the minority of lying about its lived experience?

The Human Genome And HBS: An Opportunity For Further Study. Lisa Thompson & Sharon Gaughan. … study of the HBS population can illuminate the origin of HBS and its treatment, while offering a useful baseline when assessing other medical variations potentially detectable via genomic studies.

What Does The DSM Really Say? Lisa Thompson & Sharon Gaughan. There is an inordinate amount of confusion, some of it undoubtedly self-serving, over distinctions made in the [DSM] …

Opinion

Do Not Link HBS With Gender Identity Disphoria. Diane Lynn Kearny. … We therefore strongly suggest that those who are diagnosed as born with Harry Benjamin Syndrome (HBS) not be linked in any way with those who suffer from Gender Identity Disphoria. The two conditions being diverse are not at all similar in treatment or understanding. Dr. Benjamin would have and did understand just that.

Good-Bye to Transgender and All That. Suzanne Cooke. … Prior to 1979 when the American Psychiatric Association (APA) pathologized transsexualism with the classification of Gender Identity Disorder (GID) it tended to be treated as innate, something similar as to how homosexuality is currently treated. … Many, including Dr. Benjamin, saw it as being more of an intersex condition than a psychiatric one. Indeed the surgery that changes our sex from male to female is similar to other surgeries performed on intersex people with one major exception. It is performed on us after we have reached an age where we have the agency to give fully informed consent.

Grey Lady Down: The Wreck Of The DSM. Sharon Gaughan. … the same people who got us into trouble were now entrusted with getting us out of trouble. Oh, DSM, it is time to let you slip beneath the waves and sleep in peace. The rest of us can return to our drawing boards and try to get it right next time.

Jumping The Shark With the American Psychiatric Association. Lisa Jain Thompson. … they project their male needs and anxieties, deciding without evidence or valid scientific research that HBS women must be crazy, needing a careful male lead in therapy that returns the penis to its true place as lord and master of the world.

Protocols, Shrinks, & Therapists: Answering The Question Game. Lisa Jain Thompson. … you should have already asked yourself the questions and answered them to the best of your knowledge (it’s the therapist’s job to help you fill in the gaps).

Psychiatric Politics: Body Integrity Identity Disorder (BIID). Joanne Proctor. … Russel Reid has as much difficulty as Lawrence, Blanchard and the BIID community, in understanding that male to female genital reconstruction actually involves the fashioning of one living, functional, highly sensitive and sexually responsive organ from the tissue of another. … Genetic and neurobiological variation is never mentioned. The life-long commitment to hormones, to maintain the secondary sex characteristics is ignored. Like the others he sees only those few aspects of anatomical sex normalization that support his beliefs.

Questions Without Answers, Theories Without Clothes. Lisa Jain Thompson. … question with boldness even our gods, even our most revered theories and deeply personal self-rationalizations: gender theory, transgender, crossdressing, fetish transvestism, gender identity disorder, Harry Benjamin Syndrome (HBS), and neurobiological research.

Soft Science and the APA: The Legacy of Freud. Lisa Jain Thompson. … psychology has grown into a soft science … the [APA] relies almost exclusively on isolated case studies, personal observations, and conjectures rather than undertaking the hard scientific research required to determine the underlying physical causes for behavior within the human brain itself.

The DSM and The Bible: Approaching the DSM as Sacred Scripture. Lisa Jain Thompson. … the DSM is not science. It never has been. The DSM is philosophical conjecture and secular religious dogma masquerading as empirical evidence and diagnosis. … It’s time to put the DSM out and clear the air for some actual science.

The Know-it-all Men Of The APA: Kenneth Zucker. Lisa Jain Thompson. … no scientifically rigorous outcome studies to determine either the actual effectiveness of “reparative” treatments or the harm to the patient that may come from them. The emperor has no clothes.

The Know-it-all Men Of The APA: Ray Blanchard. Lisa Jain Thompson. … no scientifically rigorous outcome studies that support Blanchard’s theory of autogynephilia, only soft science exploitations using purposefully culled samples chosen specifically to further a repressive sociosexual agenda.

What About Non-op Transsexuals? A No-op Notion. Sharon Gaughan. … Asserting that SRS is an option for a person born transsexual, even when all other factors are favorable, promotes pseudoscientific approaches to public policy. Denying the underlying medical reality of transsexuals has the consequent effect of characterizing SRS as elective surgery that is minimally cosmetic and not reconstructive. … This unscientific denial stymies initiatives to obtain research attention for transsexuals, improve medical practices, secure legal protection, and provide a variety of needed social services.

What Shrinks Don’t Know About Biology Can Kill You. Lisa Jain Thompson. Why then should anyone expect a therapist to be a competent authority to a address a neurobiological intersex condition? The problem is not in the minds of men and women born transsexual, the problem is in the genitals and physical layout of the body. A man or woman born transsexual needs a board certified reconstructive plastic surgeon, an endocrinologist, and, if she is female, a good gynecologist — not weekly sessions with a therapist.

The Diagnostic and Statistical Manual of Mental Disorders (DSM)

The DSM is a guide to what the American Psychiatric Association (APA) terms mental disorders. It is the handbook desktop reference used most often for diagnostics in the US and abroad.

The reference is a listing of psychiatric disorders, diagnostic codes, information on the prevalence of each disorder, and diagnostic criteria. The DSM is non-theoretical and does not offer information on causes or treatments.

The DSM has the force of law in a variety of mental health related activities, such as commitment hearings, and is a principal resource used in the development of legislation.

Mental health professionals use the DSM for a variety of purposes, such as clinical practice, research, and educational purposes. Clinicians also use the DMS-IV to classify patients for billing purposes. The government and many insurance carriers require a specific diagnosis in order to approve payment for treatment.

The DSM has gone though five major revisions, with the most recent major update published in 1994. The current version is a minor variant published in July 2000 that adds clarifying text (DSM-IV, Text Revision). The primary goal was to maintain the currency of the DSM-IV text with the empirical literature up to 1992. Most of the changes were in the descriptive text, with some error correction and changed diagnostic codes to reflect updates to the ICD-9-CM coding system adopted by the U.S. Government. It is available from the the DSM-IV-TR web site.

DSM-V publication is planned for 2010/11. The APA Steering Commitee says it is open to suggestions and maintains a web page, DSM-V: The Future Manual.

The Structured Clinical Interview for DSM-IV (SCID) Axis I Disorders (SCID-I) is a semi-structured interview for making the major DSM-IV Axis I diagnoses. The SCID-II is a semi-structured interview for making DSM-IV Axis II: Personality Disorder diagnoses.

The official SCID site maintains a list of Frequently Asked Questions (FAQs).

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DSM-5 Update: Annotated List of TS-Si.org Articles
Wednesday, 10 February 2010

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The hidden agenda could be much worse than anyone realiz

20 May 2008

One of my dearest friends is a forensic psychiatrist who currently is at the top of the profession and refuses to join the APA due to the politics and control issues. We have discussed the current flap over the DSM V and both conclude there is a hidden agenda at work. By jettisoning the medical model and elevating AG as THE diagnosis the eventual end of most SRS will follow. AG as the official causality removes all medical justification for hormone and surgery as treatments. Zucker and Blanchard both state they approve of SRS for AG patients but the DSM is the diagnostic standard, not a treatment guide.

Why would anyone wish this? First you have to understand that the APA and the DSM are not pure science or medicine, they are the products of politics and drug companies. The same ultra conservative gay male members of the APA who pushed and won exclusion of homosexuality from the DSM have an almost pathological hatred of transsexual women and further many of them blame the TG activist movement for failure of ENDA to become law. If AG becomes the default diagnosis then effectively the official position becomes all GID related conditions are psycho-sexual disorders.....in other words HBS women become psycho-sexually disordered men along with the TGs. No politician is going to work for civil rights legislation for sexual deviant men, it will never happen and the entire TG activist movement becomes moot. These are patient men, they are willing to wait a couple of years for this to play out.

The current over the top reaction by TG activists was not only anticipated, it was counted on. It will cause an immediate "circle the wagons" mentality among those APA members who may totally disagree with Zucker and Blanchard but who's egos will not allow them to stand by without defending peers against outsider loud, obnoxious and at times vicious laypeople.

Currently AG is already in the DSM, expanded in the last revision. Privately most gender professionals will tell you the majority of those presenting for SRS fit a narrowed AG profile perfectly with HBS (classic transsexual) clients being the minority. AG is here to stay, has merit as a counter-indication of classic transsexuality and standards for distinguishing it from classic transsexuality that is now in place among the psychiatric profession, clear markers for both conditions. The best case scenario would be inclusion of AG as an exclusionary class for HBS (classic transsexuality) with recognition of multiple causalities thus preserving the pure medical model. This is a compromise position that preserves surgical treatment as standard.

Cathryn

Very Good, It is very nice to read this article. it is i

20 June 2009

Nimesh, Thank you. We are at work on another of our regu

20 June 2009

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Last Updated on Wednesday, 10 February 2010 15:41

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