Normal behaviour, or mental illness? (more concern about the new DSM) [View all]

http://www2.macleans.ca/2013/03/19/is-she-a-brat-or-is-she-sick/

Temper tantrum, or ‘disruptive mood dysregulation disorder’? A look at the new psychiatric guidelines that are pitting doctors against doctors
by Anne Kingston on Tuesday, March 19, 2013


Every parent of a preteen has been there: on the receiving end of sullen responses, bursts of frustration or anger, even public tantrums that summon the fear that Children’s Aid is on its way. Come late May, with the publication of the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), however, such sustained cranky behaviour could put your child at risk of a diagnosis of “disruptive mood dysregulation disorder.” This newly minted condition will afflict children between 6 and 12 who exhibit persistent irritability and “frequent” outbursts, defined as three or more times a week for more than a year. Its original name, “temper dysregulation disorder with dysphoria,” was nixed after it garnered criticism it pathologized “temper tantrums,” a normal childhood occurrence. Others argue that even with the name change the new definition and diagnosis could do just that.

“Disruptive mood dysregulation disorder” isn’t the only new condition under scrutiny in the reference manual owned and produced by the American Psychiatric Association (APA)—and lauded as psychiatry’s bible. Even though the final version of DSM-5 remains under embargo, its message is being decried in some quarters as blasphemous. Its various public drafts, the third published last year, have stoked international outrage—and a flurry of op-ed columns, studies, blogs and petitions. In October 2011, for instance, the Society for Humanistic Psychology drafted an open letter to the DSM task force that morphed into an online petition signed by more than 14,000 mental health professionals and 50 organizations, including the American Counseling Association and the British Psychology Society.

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Other updates to DSM-5, the first full revision in nearly two decades, have raised red flags. Forgetting where you put your keys or other memory lapses, a fact of aging formerly shrugged off as “a senior moment,” could portend “minor neurocognitive disorder,” a shift destined to also stoke anxiety. Anyone who overeats once a week for three weeks could have a “binge-eating disorder.” Women not turned on sexually by their partners or particularly interested in sex are candidates for “female sexual interest/arousal disorder.” Nail-biters join the ranks of the obsessive-compulsive, alongside those with other “pathological grooming habits” such as “hair-pulling” and “skin-picking.”

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DSM-5 represents a step back in mental health care, says psychologist Peter Kinderman, head of the Institute of Psychology, Health and Society at the University of Liverpool. Kinderman, who is organizing an international letter of objection to DSM-5 to be posted on dsm5response.org, which launches March 20, believes many new DSM classifications, among them “female orgasmic disorder,” defy common sense. “If you’re not enjoying sex, it’s a problem, but it’s crazy to say it’s a mental illness,” he says. He also questions the new criteria for alcohol and drug “substance-use disorders.” “According to it, 40 to 50 per cent of college students should be considered mentally ill.” Such diagnoses interfere with the human helping response, says Kinderman. “When women get raped, it’s traumatic; when soldiers go to war, they come back emotionally affected. We don’t need the new label, ‘post-traumatic stress disorder,’ ” he says. “We should identify risk, identify problems, identify the threats people have and then we need to help them.”

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Maybe in Liverpool you can look at PTSD as "a new label" that isn't needed. In the US I think, not so.