We've noticed that you're using an ad blocker

Our content is brought to you free of charge because of the support of our advertisers. To continue enjoying our content, please turn off your ad blocker.

It's off now Dismiss How do I disable my ad blocker?
❌

How to disable your ad blocker for our site:

Adblock / Adblock Plus
  • Click on the AdBlock / AdBlock Plus icon on the top right of your browser.
  • Click “Don’t run on pages on this domain.” OR “Enabled on this site.”
  • Close this help box and click "It's off now".
Firefox Tracking Prevention
  • If you are Private Browsing in Firefox, "Tracking Protection" may casue the adblock notice to show. It can be temporarily disabled by clicking the "shield" icon in the address bar.
  • Close this help box and click "It's off now".
Ghostery
  • Click the Ghostery icon on your browser.
  • In Ghostery versions < 6.0 click “Whitelist site.” in version 6.0 click “Trust site.”
  • Close this help box and click "It's off now".
uBlock / uBlock Origin
  • Click the uBlock / uBlock Origin icon on your browser.
  • Click the “power” button in the menu that appears to whitelist the current website
  • Close this help box and click "It's off now".
  • Topics
  • CME
  • Special Reports
  • Slideshows
  • Quizzes
  • Blogs
  • Conferences
  • Classifieds
  • Archives

Modern Medicine Network
  • Login
  • Register
Skip to main content
Modern Medicine Network
  • Login
  • Register
Menu
User
Home
  • Topics
  • CME
  • Special Reports
  • Slideshows
  • Quizzes
  • Blogs
  • Conferences
  • Classifieds
  • Archives

SUBSCRIBE: eNewsletter

APA Responds Lamely to the Petition to Reform DSM-5

  • Allen Frances, MD
Nov 8, 2011
  • DSM-5, Healthcare Reform
More Like This
DSM-5 Will Not Be Credible Without An Independent Scientific Review

What Would A Useful DSM-5 Look Like? And An Update On The Petition Drive

Psychologists Petition Against DSM-5: Users Revolt Should Capture APA Attention

More >

Last week I challenged the American Psychiatric Association (APA) to end its silence in the face of widespread criticism and finally to mount its belated public defense of DSM-5. These are the 5 questions that cry out for straight answers:

1) Why is APA not willing to have an independent scientific review of questionable DSM-5 proposals—especially since its own internal and confidential review process has been so badly discredited?

2) Since the DSM-5 suggestions will all broaden the definition of mental disorder, why should we not worry about diagnostic inflation and the massive mislabeling of normal people as mentally ill?

3) Won’t this diagnostic inflation exacerbate the already rampant over prescription of psychotropic medications (especially by primary care doctors, especially antipsychotics, especially to kids)?

4) Why should we not worry about the unintended forensic complications of a sloppily written DSM-5 containing suggestions that are obvious targets for forensic misuse?

5) Won’t the many small, needless, and arbitrary changes in DSM-5 complicate future research efforts and make impossible the interpretation of data collected before versus after DSM-5?

The first public APA response to the concerns about DSM-5 is truly astounding in its carelessness and inaccuracy—a sad marker of the failed process that is DSM-5. The APA letter got off to a strange start by getting the date wrong—it was originally dated October 4, not November 4 (this has since been corrected in the current posted version, but the glaring slip confirms doubts about the quality of DSM-5 writing and proof reading for a manual that requires the precision of a legal document). The letter ended with an equally strange sign off—by the “DSM-5 Task Force” (are there no individuals willing to stand up and be counted for DSM-5?). In between this muddled beginning and sheepish ending, the APA Apologia completely ignores all five crucial concerns about DSM-5 safety and credibility and instead provides a compendium of misleading statements and blatant inaccuracies. Here is just a sampling:

1) APA stresses that final decisions await the completion of the field trials that are belatedly being conducted at academic centers—as if the results will in some way be contributory check on bad ideas. But these field trials have been disorganized and misdirected—their data will be terribly late in coming and totally irrelevant to the concerns about diagnostic inflation and misdiagnosis that are raised in the petition. For no apparent reason, the field trials address only on the (really who cares) question of reliability—and will offer nothing at all on the really essential questions of validity and predicting the risks of diagnostic inflation.

2) APA promises that the clinician field trial data will “contribute to the final decision making.” How can this possibly be true when the clinician field trial is (as with everything DSM-5) is so disorganized and far behind schedule that it is just now getting underway?

3) APA makes the truly bizarre (and Orwellian “newspeak”) claim that its “level of both internal and external review and field trial exposure has never before been undertaken by any previous DSM or ICD revision proposals.” The simple fact is that DSM-5 has been shrouded in secrecy from its original confidentiality contracts that gagged DSM-5 work group members to its current confidential scientific review—as if anything claiming the name of science should ever be kept secret. DSM-5 has been unable to self-correct and is remarkably resistant to correction from without. Its current draft suggestions are for the most part essentially the same as the flawed and poorly written drafts first posted in Feb 2010. Vigorous public criticism has obviously had virtually no impact on the hermetically sealed DSM-5 process.

It is clearly incumbent on APA to allay the many outstanding concerns raised by the petition with straightforward and credible answers-—public relations pablum simply will not cut it. If DSM-5 fails to conduct a serious dialog with its users, there will no reason for them to trust or buy it. Clinicians (and their patients) would be better served by their simply downloading the official ICD-10-CM codes which will be freely available on the internet. The Petition to Reform DSM-5 is the only way to force APA to subject DSM-5 to the independent, external, scientific review that is essential for a safe and credible DSM-5.

The petition is available for signing at: http://www.ipetitions.com/petition/dsm5/.

The APA response to the petition is at: http://www.dsm5.org/Newsroom/Documents/DSM5%20TF%20Response_Society%20for%20Humanistic%20Psychology_110411r.pdf.

The Petition’s response back to APA is at:
http://societyforhumanisticpsychology.blogspot.com/2011/11/response-to-letter-from-dsm-5-task.html.

Related Articles

  • EHR Vendors Seek Clarity from CMS
  • Physicians Drifting Towards Single-Payer Support
  • Trump Says Opioid Crisis is National Emergency
  • Could Physician Ownership Save Healthcare?
  • MIPS Virtual Groups Draws Skepticism from Providers

Resource Topics rightRail

  • Resource Topics
  • Partner Content
ADHD
Schizophrenia
Bipolar Disorder
Geriatric Psychiatry
Major Depressive Disorder
Smart IOP – A New Kind of Intensive Outpatient Program
Three Things Mental Health Professionals Need to Know About Telemedicine – TODAY!
How Telemedicine Can Transform Patient Engagement

Current Issue

Psychiatric Times Vol 35 No 3
Mar 12, 2018 Vol 32 No 3
Digital Edition
Subscribe
Connect with Us
  • Twitter
  • Facebook
  • Google+
  • LinkedIn
  • RSS
Modern Medicine Network
  • Home
  • About Us
  • Advertise
  • Advertiser Terms
  • Privacy statement
  • Terms & Conditions
  • Editorial & Advertising Policy
  • Editorial Board
  • Contact Us
Modern Medicine Network
© UBM 2018, All rights reserved.
Reproduction in whole or in part is prohibited.