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See continuing updates on the APA, DSM, and the upcoming DSM Fifth Edition (DSM-V).
 
See our Annotated List of DSM-related news, research reports, analyses, and opinion pieces.
 
Visit the TS-Si Article Archive for reports on science, medicine, government, society, and other topics.
Chad A. Mirkin, Northwestern University, George B. Rathmann Professor of Chemistry in the Weinberg College of Arts and Sciences. Photo by Bill Arsenault. 

DNA Blueprints Guide The Construction Of Specific Human Structures

Chad Mirkin discusses using DNA to build a three-dimensional structure out of gold, likening the process to building a house. Starting with basic materials such as bricks, wood, siding, stone and shingles, a construction team can build many different types of houses out of the same building blocks.
 
The article includes an audio recording of the full interview. Photo courtesy of the UCSD School of Medicine.
APA Working Groups Named For Upcoming DSM-V Edition Print E-mail
Medicine - Soc & Psych
TS-Si News Service   
Sunday, 18 May 2008 17:00
DSM-V
Embryo: Zygote
 
A Short Primer. Conception occurs at the moment sperm fuses with ova. The resulting zygote, not yet an embryo, has no sexual differentiation.
 
This is how all of us begin, even those of us born in test tubes.
 
The default condition of a human is female. At the moment of conception we have female configured brains and, without an influx of male hormone, we will be born with a female brain and female sexual anatomy. We call this the standard development pattern.
 
Sometimes, however, the genetic plan for the developing embryo misfires. The brain’s neurobiology configures first, the body’s later. For a boy to be born, the male hormone testosterone must wash over the undifferentiated fetus at two distinct points in the development.
 
•  The first is when the human brain locks into gender identity. If the male hormone is not present at this time, the neurobiology of the brain will remain configured in the female state.
 
•  The second crucial point is when the human body develops sexual organs, internal and eternal. If the male hormone is present, for whatever reason, the sexual organs will be male; if the male hormone is not present, the organs will default to female.
 
So, where do HBS people come from?
 
•  In an HBS man (female to male), testosterone washed over the brain, changing the neurobiology to male, but not over the body so that the person was born with male neurobiology within a female anatomy.
 
•  In an HBS woman (male to female), testosterone washed over the body, but not the brain so that the person was born with female neurobiology in a body with male anatomy.
Springfield, VA, USA. The American Psychiatric Association (APA) has named the Work Groups and membership for its coming fifth revision to the Manual for Diagnosis of Mental Disorders (DSM-V).
 
The DSM is a guide to what the APA terms mental disorders. It is the handbook desktop reference used most often for diagnostics in the United States and internationally.
 
The manual contains a listing of psychiatric disorders, diagnostic codes, information on the prevalence of each disorder, and diagnostic criteria. The APA advertises the DSM as a non-theoretical guide that does not offer information on causes or treatments.
 

APA Names DSM-V Work Group Members: Experts to Revise Manual for Diagnosis of Mental Disorders. News Release No. 08-27. American Psychiatric Association (APA). May 1, 2008. [ Download PDF ] The APA release has the names and personnel rosters for all of the working groups named so far (eff. 1 May 2008).

 
The DSM is a publication known as the bible of psychiatry. It is consulted on a regular basis by insurance companies, courts, prisons and schools, as well as by physicians and mental health workers.
 
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 Diagnostic and Statistical Manual of Mental Disorders (DSM) has undergone several revisions. The current edition (DSM-IV, Text Revision) is available on the the DSM-IV-TR web site.The DSM has gone though five major revisions since first publication, 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.
 
The DSM has its share of critics. According to Christopher Lane, a scholar at Northwestern University, the DSM has a history of medicalizing what for many people, appear to be common behavioral attributes. Lane chronicled what he calls the "highly unscientific and often arbitrary way" in which widespread revisions were made to the DSM in his book, Shyness: How Normal Behavior Became a Sickness.
 
Lane notes that by 1987 the DSM removed the key phrase "a compelling desire to avoid," requiring instead only "marked distress". Lane argues that could include concern about saying the wrong thing. "Impairment became something largely in the eye of the beholder, and anticipated embarrassment was enough to meet the diagnostic threshold."
 
Since the last major edition (DSM-IV), most of the changes have been 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.
 
Completion of the DSM-V revisions is planned for 2011/12.
 
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).
 
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).

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.

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.
 
 
TS-Si News ServiceThe TS-Si News Service is a collaborative effort by TS-Si.org editors, contributors, and corresponding institutions. The sources can include the cited individuals and organizations, as well as TS-Si.org staff contributions. Articles and news reports do not necessarily convey official positions of TS-Si, its partners, or affiliates. We welcome your comments. Use the form below to leave a public comment or send private correspondence via the TS-Si Contact Page. We will not divulge any personal details or place you on a mailing list without your permission.
 
 
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Last Updated on Monday, 19 May 2008 03:27