Diagnostic and Statistical Manual (DSM) Tweet

The Diagnostic and Statistical Manual of Mental Disorders, commonly abbreviated as the DSM, is a book published by the American Psychiatric Association providing standardized criteria to the diagnosis of mental health conditions. The DSM is used widely by mental health practitioners in the United States to aid in diagnosing clients. For many decades, there was immense concern that psychiatric diagnoses were based upon the whims of psychiatric professionals and were not scientifically valid. Different practitioners might give the same client completely different diagnoses, which in turn would result in different standards and courses of treatment. The DSM is an attempt to correct for this potential problem.

Revisions to the DSM
Originally published in 1952 based upon data from psychiatric hospitals and practicing mental health clinicians, the DSM has undergone several revisions. For example, it listed homosexuality as a mental disorder until 1974 and was heavily revised in 1980, incorporating many new diagnoses. The current incarnation of the DSM is the DSM-IV, which was published in 1994 and revised in 2000. Revisions to the DSM-V were finalized December 1, 2012, and will be released in May 2013. You can find the latest in DSM news at www.dsm5.org

How is the DSM Organized?
Each diagnosis in the DSM-IV is organized into one of five categories. These include:

Axis I – Clinical disorders such as learning disorders, major mental disorders and substance abuse
Axis II – Personality disorders and intellectual disorders
Axis III – Medical conditions and physical disorders
Axis IV – Disorders with psychosocial and environmental factors that contribute to the development of the disorder
Axis V – Global assessment of functioning

Diagnoses according to the DSM-IV measure each axis and mention whether the client has a diagnosis or symptom within that axis.

The DSM-V combines Axis I, Axis II, and Axis III, with separate distinctions for psychosocial and contextual factors (previously Axis IV) and disability (previously Axis V).

Criticism of the DSM
The DSM has been heavily criticized since its inception for incorporating social norms into diagnoses and turning unusual behavior that may not necessarily indicate mental problems into mental problems. For example, “gender identity disorder” is listed in the DSM-IV. Transgender activists argue that this should not be treated as a stigmatizing disorder, and they appear to have been heard: The term “Gender identity disorder” will be changed to “gender dysphoria,” defined as emotional distress over one’s gender, in the DSM-V. The DSM-V was criticized for the secrecy surrounding its creation and for the American Psychiatric Association’s decision to hire a public relations firm to promote it. Many people feel that the DSM names too many disorders and grants too much power to psychiatrists to stigmatize human behavior. Others argue that the DSM is influenced by pharmaceutical companies to label conditions that can in turn necessitate a need for psychotropic medication.

GoodTherapy.org supported Division 32′s Plea to the DSM-V Task Force, encouraging further review and consideration in the creation of DSM-V.

DSM References