The second part of my DSM5 article for The 21st Floor.
Part 2: Post-Traumatic Stress… Disorder?
Everyone knows about Post-Traumatic Stress Disorder. Surprisingly for something so widely-known, it’s only been around in the psychiatric manuals since 1980. In a major difference from many other psychiatric disorders, we know precisely its cause – ‘an event or events that involved actual or threatened death or serious injury, or a threat to the physical integrity of self or others’ (as the DSM-IV states). The symptoms include recurrent memories or dreams of the event, the feeling that the event is happening again and again, and ‘intense psychological distress’. The question, however, is this: how valid is PTSD as a distinct disorder, aside from anxiety, depression, phobias, and other problems we already know about?
This article was written for the superb new skeptic’s magazine site The 21st Floor, where a wealth of fascinating and humorous information can be found. Go there!
It’s nice to be able to speak in the same language. The American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders, currently in its 4th Edition (DSM-IV), gives psychiatrists and clinical psychologists the chance to do just that, being as it is a list of every psychiatric disorder currently known, categorised into useful diagnostic criteria. Well, I say ‘useful’.
Each time a new version of the DSM is in production, a tsunami of controversy rolls across the brain sciences, as researchers into particular mental disorders battle to have their particular interpretations included in the ‘official’ text, which clinicians will then use to diagnose their patients. Now is one of those times – the 5th Edition (DSM5) is on its way, drafted here, and a movement to fill it with rigorous, evidence-based disorders which are more than merely psychiatrist’s figments. Past embarrassments, such as the inclusion in previous editions of homosexuality as a disorder (now thankfully expunged from the manual), constantly come back to haunt the DSM’s writers, and as you can see from articles such as this one decrying the new draft, you can’t please all of the psychologists, all of the time.
There is legitimate criticism of some of the DSM criteria, and there is nonsense. In this 3-part post I’ll first sort the scientific wheat from the desperate, bizarre, anti-psychiatrist chaff. In parts 2 and 3, I’ll discuss a couple of pertinent issues for the DSM5 writers – the validity of a syndrome everyone knows about (Post-Traumatic Stress Disorder), and the validity of an entirely new creation (Coercive Paraphilic Disorder).