GoodTherapy.org Supports Division 32's Plea to the DSM-5 Task Force
GoodTherapy.org publicly declares its support of Division 32's plea to the DSM-5 Task Force for further review and vetting of the proposed changes to the DSM. The Society for Humanistic Psychology submitted an open letter to the American Psychiatric Association on January 9th outlining the concerns their members and others in the mental health community have expressed regarding the anticipated changes. David N. Elkins, President of Division 32 of the American Psychological Association, serves as the main contact person for the open letter project, which was designed to voice the reservations held by many mental health professionals while demonstrating a willingness to discuss this issue further in a transparent and cooperative fashion. Below is a summary of the points addressed in the letter:
- Lack of Representation by Practicing Psychologists on the DSM-5 Task Force. Psychologists represent a large percentage of clinicians who rely on and research the diagnostic information provided in the DSM. As such, Division 32 believes that excluding any contribution from this vast body of practicing clinicians will result in insufficient data required to make medically accurate and clinically beneficial revisions.
- Lowering the Threshold for Clinical Diagnoses of Mood Disorders. Specifically, adjusting the symptom threshold for Attention-Deficit Hyperactivity Disorder, Attenuated Psychosis Syndrome, and Generalized Anxiety Disorder could result in false-positive diagnoses and unnecessary, potentially harmful antipsychotic medication usage for individuals who do not meet the current clinical standards for diagnosis. Also of concern is the pathologizing of grief as a symptom of Major Depressive Disorder.
- New Disorder Categories. Division 32 is particularly concerned with the introduction of several new disorders that are not adequately supported by clinical research, including Mild Neurocognitive Disorder, Attenuated Psychosis Syndrome, and Disruptive Mood Dysregulation Disorder.
- Proposed Change to Definition of Mental Disorder. The new language suggests that an individual may have a mental disorder as a result of social conflict, political opposition, or societal deviance if those conditions were not the primary cause of the disorder. This ambiguous definition requires that clinicians speculate as to what extent external factors influence the development of symptoms and then render diagnostic judgment based on these varying elements.
- Revision of Personality Disorders Category. This is most troubling to Division 32, as the fractured and perplexing recommendations are virtually unsupported by any research. Others, including previous DSM Task Force members and current members of the Personality Disorders Workgroup, view this category as a significant problem as well.
- Physiological and Medical Additions. The DSM-5 proposes that all Mental Disorders are biological in nature and introduces new categories, such as Internet Addiction Disorder, Apathy Syndrome, and Parental Alienation Syndrome, with little to no evidentiary support. Additionally, revising the Somatic Symptoms Disorders category to focus less on somatic symptoms with no medical foundation contradicts the core of somatoform phenomenon.
GoodTherapy.org joins with this committee of the Society for Humanistic Psychology and others, including the American Counseling Association and the British Psychological Society, in urging the DSM-5 Task Force and APA to reconsider its revisions that place emphasis on biological and neurological etiology with disregard to the long-term negative effects this could pose, via psychotropic medication, misdiagnoses, and counterproductive treatment protocols.
We encourage any and all who embrace the vision of a comprehensive and scientifically supported manual designed to help clinicians more accurately diagnose and effectively treat all degrees of mental health impairment to lend their support to this effort. GoodTherapy.org is listed on the petition requesting a full review of the proposed changes to the DSM-5. We urge you, the clinician and the client, to take a stand with us to help preserve, protect, and promote scientifically accurate and nonpathologizing psychological diagnoses and mental health care for all.
Noah Rubinstein, LMFT, CEO