Gotta’ love the DSM-5 — NOT?


dsm5-apaRead it and Weep or
Work Around It?

by Madelyn Griffith-Haynie, CTP, CMC, ACT, MCC, SCAC

“Too many people don’t care what happens
so long as it doesn’t happen to them.”
~ William Howard Taft

I have written this article for ADD Coaches, ADD Professionals, and ADDults who are struggling to find a knowledgeable doctor.

I have none of those highly revered statistics to cite, but I believe it is safe to say that the fifth full revision of the DSM (the first significant update in almost twenty years) . . .

  • is the least popular
  • with the greatest number of advocates
  • for the greatest number of disorders and conditions
  • in the history of the DSM!

There is actually a BOYCOTT afoot – urging everyone to vote with his or her wallet by NOT purchasing or using this DSM in favor of the ICD-9, the current version of the World Health Organization‘s International Classification of Diseases.

This becomes important for professionals or agencies seeking third party reimbursement for services rendered, who must use current diagnostic codes.

Many professionals are unaware that, by U.S. law and international treaty, official diagnostic documents employ ICD codes, but there is NO such requirement for the DSM.

The effective implementation date for ICD-10-CM and ICD-10-PCS is currently October 1, 2014. The ICD-10 codes are not valid for any purpose until that time

NOT that the ICD-9 has been any better received (or is, essentially, that much different).

However, the prospect of not reaching their break-even figure of 12.5 million buyers world-wide to recoup the $25 million it takes to bring the DSM to press would -ahem!- encourage the APA to take widespread objections seriously – AND still allow the brave professionals who join the boycott to get paid, and those of you who have an insurance plan with decent mental health coverage to be able to use it.

You heard it here – strongly and clearly:

I refuse to pull my punches on this issue.  Regardless of how you eventually fall on the DSM do or die line:

  1. ANY ADD or mental health “professional who does not take the time to make SURE he or she understands what all the shoutin’ is about is not worthy of the NAME.
  2. ANY ADDCoach who does not take the time to make SURE he or she understands what all the shoutin’ is about where ADD and all comorbids are concerned is not worth HIRING.
  3. ANY patient (or parent of same) who who does not take the time to make SURE he or she understands what all the shoutin’ is about concerning his or her own diagnosis is contributing to the lousy standards of mental health care overall and dooming themselves and others to substandard care they won’t even recognize as such!

NEVER has advocacy been more important than in the aftermath of what went on during this DSM Caucus!
(unless, of course, it was getting involved WHILE it was happening)

NO excuses accepted. Read the rest of this article, then click the links I have taken the minutes of MY life to provide for you absolutely free of charge, read the words of those who care enough to share strong opinions in print, and GET YOURSELVES EDUCATED.

Until the next DSM is published, it’s likely to be a bumpy ride!

Remember – links on this site are dark grey to reduce distraction potential
while you’re reading. They turn
red on mouseover.

What’s the Buzz? Tell me what’s a-happening

For new readers, the Diagnostic and Statistical Manual [DSM] is published by the American Psychiatric Association [APA]. It is updated every once in a while, following APA review and approval, after a protracted debate by those invited to become part of the DSM Caucus (committee).

The big deal here, on top of the fact that Insurance Companies use the codes contained in this publication to decide whether to cover your medications and office visits, is the potential for misinterpretation, misunderstanding and misapplication by non-specialist doctors.

See ADD – What’s in a Name and The Top Ten Stupid Comments by [supposed] ADD Professionals for how this has played out in the ADD population alone.

Really!  Go read those posts. You need to KNOW about this stuff if you expect to get decent care.

‘Sup with DSM-5?

, the Founder & Editor-in-Chief of PsychCentral, has posted an excellent general overview of the major changes to this revision of the Diagnostic and Statistical Manual of Mental Disorders [DSM-5].

His December post, Final DSM 5 Approved by American Psychiatric Association
can be found HERE
.
Be SURE to read the comments — and take the time to ring in with your opinion.

I will add to it with a few elements relevant to the Attentional Dysregulation population, and David Rabiner, author of the always excellent Attention Research Update, has written a comprehensive review of the changes relative to ADD (link in Related content below).


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If we EVER expect to see things change for the better
around physician education and the standard of care extended to every single one of us who would like to be able to count on being able to find a knowledgeable professional with a current and comprehensive information base, significantly more of us need to – as they say in the theatre – Sing Out Louise! 
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free-clipart.net

free-clipart.net

ADD still under the bus

While I’m not displeased overall with the DSM-5’s treatment of ADD, as usual, there has been little attention paid, either in the article above or among the DSM politicos themselves, to:

  • the continued inclusion of the “H” in the name of Attention Deficit Disorder,
  • the lack of criteria that reference the differences where women and girls are concerned (although they DID raise the required age of onset to one more consistent with what we see in females) and
  • the probable damage to the undiagnosed in the next generation as a result.

Most of the internet comments I have read — even by individuals I usually agree with and cite — are too concerned with remembering the words to the tired and fallacious Overdiagnosed and Overmedicated tune – bemoaning the fact that it is likely to increase with the publication of DSM-5.

Seemingly more out of touch than ivory tower educators, the “politicians with medical licenses” that staffed the DSM-5 review committees have no IDEA how the non-specialist doctors around the country have [mis]interpreted their perceived “diagnostic Bible,” and what’s likely to occur in response to this particular revision — at least I hope they don’t.

We have a MUCH bigger problem if they ARE aware and are
content to wait for the next caucus to grapple with the issues.

In upcoming articles on this topic I will review some specifics that will matter to the readers of ADDandSoMuchMore, both those with ADD and overlapping diagnoses, but let’s begin here with a trip down memory lane with a brief review of the history of the DSM through The  ADD Lens™.

The Diagnostic and Statistical Manual of Mental Disorders

The first edition of the DSM was published in 1952, with periodic revisions and occasional updates since that time.

For history buffs, Wikipedia gives a fairly comprehensive DSM history across a great many domains, and a version that is slightly easier to read can be found at the beginning of Dr. Allen Frances’ more recently written Psychology Today article, How Psychologists Can Help Correct DSM5: A review of Problems in DSM 5.

A Brief ADD stroll through the DSM

  • DSM-I   – 1952 – no inclusion of ADD by name, despite identification in medical journals since 1902
  • DSM-II  – 1968 – Hyperkinetic Reaction of Childhood [HRC] placed in the childhood section
  • DSM-III – 1980 – ADD with or without hyperactivity – redefined the disorder as mainly a problem of inattention, rather than centered around hyperactivity.
  • DSM-IIIR (revised) – 1987 – essentially relegates ADD as a subtype of ADHD
  • DSM-IV – 1994 – ADHD officially returns hyperactivity as central to the diagnosis in the minds of all non-expert doctors (most of the doctors in the mental health field, by the way, have little ADD expertise and most of those lack factual knowledge, guided solely by an “impression” of  popular beliefs)
  • DSM-IV TR (text revision) 2000 – criteria finally adapted to address a diagnosis of ADHD in an adult — which, in the trenches, was more relevent to males than females.
  • DSM-5 – 2013 – the current catfight

Click HERE to read The Historical Controversy over the Diagnostic Criteria
of ADD from 1902 to 2010

A few words for balance

To be fair, keeping the DSM current is a daunting task, and it is an unrealistic expectation that any DSM caucus will be able to nail the diagnostic criteria and most effective treatment protocols for every single disorder to everyone’s satisfaction.

AND, as they say, all things take time.

Time is relative

clockeyes_smallTo a researcher or doctor, whose life moves ahead relatively smoothly during the process (and who continues to get paid regardless), even a decade does not seem an unreasonable amount of time to wait for better standards of care.

To someone who is struggling with major life activities and looking for help, ten years is an extremely long time.

By the end of that same decade where professionals urge patience with the system . . .

Kids will grow up, move through the educational system, and set the expectations that will shape the rest of their lives.

  • An eight year old who needs professional help to be able to link and learn successfully will experience his or her EIGHTEENTH birthday — out of the mainstream educational system altogether with enough “evidence of failure” that self-esteem can’t help but be negatively affected.
  • Meanwhile, the child who does NOT need help will probably be on his or her way to college, with every expectation of success as long as he or she expends a reasonable amount of effort.

Twenty-somethings will turn into thirty-somethings.  During that particular decade:

Kozzi

Kozzi

  • A neurotypical young adult might be able to complete college, obtain a Masters Degree and a Doctorate, successfully navigate a post-doctoral assignment, and be on his or her way as an established professional.
  • In that same period of time, even a high-IQ young adult who struggles with a psychiatric or neurological disorder without adequate help may well have dropped out – or flunked out – of college, been fired from several relatively low-paying jobs, and been through one or more divorces.
  • For hereditary diagnoses (like ADD, for example), they may well have produced one or more children with similar diagnoses — children who, without the help they need, are tough enough to parent for those without diagnoses of their own.
  • And so it goes, as things continue to worsen until and unless they get help.

And THAT’s the trajectory of individuals who are doing their best to “color within the lines.”

According to published statistics, many individuals who need help with neurological or psychological struggles will, in an attempt to self-medicate, turn to alcohol and drugs during that decade.

  • Some will become trapped in addiction.
  • Some of those will end up serving jail time, some will have prison records.
  • Others will have attempted suicide.  Some attempts will have succeeded.

Of those who manage to stay out of serious trouble

  • Most will be trapped in limp-along lives, repeatedly falling into holes and digging themselves out: Ph.D.s driving taxis.

So what happens to those lives if the next DSM update takes another TWENTY years?

  • In addition to the time between these last two major DSM updates, that’s about five years less than the time I have been personally working full-time for change that hasn’t really happened.
  • We really need to rally the troops if we ever expect anything to be significantly different – and that means ALL of us need to step up and sing out.  (Psssst! – you too!)
  • Check out Sis-Boom-Bah! to remind you of what’s really OFF about how the ADD community is treated, that the ASD and TBI communities have managed to impact so much better in the past twenty years, primarily as the result of grass-roots insistence on change.

Diagnosis is the FIRST step on the road to success

Differential Diagnosis is extremely important, but NO treatment professional can reasonably be expected to be an expert in every single mental health issue faced by the entire human population. So, in that sense, they are ALL “non-expert doctors” for some disorders.

The DSM will either help OR HINDER their efforts to provide a diagnosis that is as accurate as possible, leading the way to an effective treatment protocol, hopefully before lives become unnecessarily difficult.

The process of putting together the APA Diagnostic Manual has become unwieldy, but the most recent Caucus seems to have exacerbated the problems rather than addressing them.

In my opinion and those of many others, the process has become politicized and held close to the vest to an extent that practically guarantees problems at the back-end, limiting the possibility of critical review until release (work group members signed confidentiality agreements).

Without external quality control, and the fact that no one working on DSM-5 was experienced in writing diagnostic criteria, it is not surprising that at least some of DSM-5 codes will have damaging consequences.

Ch-ch-ch-CHANGES & Controversies

Disorders that will be newly included in DSM-5 — but only in Section 3, a category of disorders needing further research — include: Attenuated psychosis syndrome, Internet use gaming disorder, Non-suicidal self-injury, and Suicidal behavioral disorder.

Section 3 disorders generally won’t be reimbursed by insurance companies for treatment, since they are still undergoing research and revision to their criteria.

The disorders that merit reimbursement are the focus of the majority of the controversy. 

According to Dr. Allen Frances, professor emeritus at Duke University, chairman of the DSM-IV task force and one of the most visible detractors of the DSM-5:

The American Psychiatric Association has never once addressed the substantive questions raised about DSM-5. Instead, it has always followed the public relations recommendation to endlessly repeat the same meaningless mantra that many experts worked hard on DSM-5, that it reflects the latest in new science, and that it was the most open process ever.

When more than 50 mental health associations requested an independent evidence based review of the controversial new proposals in DSM-5, APA brushed them off.

Whenever the DSM-5 leaders and I have been invited to debate, they always refuse to meet face to face and to discuss the issues point by point. Their ‘talking points’, deaf ear, circle the wagons approach has deprived DSM-5 of a much needed opportunity to self correct before its rushed publication.

The latest in APA’s fluffy public relations has come from the president of the American Psychiatric Association. He has made two astounding claims — that criticism of DSM-5 is somehow equivalent to criticism of psychiatry and that it signifies stigma against mental illness.

For original text CLICK HERE

Critics World-wide

Dr. Patrick Landman of Université de Paris VII, a prominent French psychiatrist who has written an oft-referenced book on the DSM-5 has been quoted as saying,

I will not buy DSM-5. I will not use it. I will not teach it.”

Dr. Landman wrote the following response to the APA PR offensive (formatting mine):

Let’s be clear — to oppose DSM-5 is NOT to oppose psychiatry.

  • Recently, the APA leadership has been portraying all opposition against DSM-5 as a form of anti-psychiatry.
  • This is nonsense.
  • Such rhetoric aims to discredit critics so that DSM-5 does not to have to respond to their serious and well-documented arguments.

Opposition to the DSM-5 methods and changes comes from all over the world and includes tens of thousands of psychiatrists, clinical psychologists, counselors, social workers and other mental health practitioners.

The people who oppose DSM-5 belong to many different schools of thought, but unite in the worry that it is not safe or scientifically sound. We are all deeply invested in psychiatry and cannot by any stretch of the imagination be seen as anti-psychiatry.

Indeed, we are trying to save psychiatry from the errors of DSM-5.

The stigma issue is equally a red herring.

We are deeply concerned with the dignity and rights of all users of psychiatry and committed to the struggle against all forms of discrimination against the mentally ill.

  • Most who oppose DSM-5 do not reject the classification of mental disorders.
  • We consider it essential for epidemiology, research, and clinical work.
  • What we do contest is the specific reliability, validity and usefulness new DSM-5 diagnoses and also the closed and disorganized way in which it was prepared.

Even those critics of DSM-5 who question its reductionistic biomedical model do not question a biological contribution to mental disorder. They are in favor of real scientific breakthroughs, but refuse to accept a purely biological ideology. They do not reject the use of medication when it is useful to bring about a patient’s remission or recovery.

Finally, saying that the DSM-5 will lead to over-diagnosis and over-medicalization of forms of behavior which for the longest time have been perceived as part of normal human variation (such as mourning) and that the DSM-5 will trigger new false epidemics and lead to inappropriate drug prescriptions which may turn out to be dangerous (especially in children) has nothing whatsoever to do with anti-psychiatry but rather accords with common sense and … yes, the defense of psychiatry.

Saving Your Own [quality of] Life

Click at least some of the links below and get yourselves informed.  If you expect to receive adequate care yourself and for your clients and loved-ones until the publication of the next version of the DSM, you really need to arm yourselves with information.
 

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As always, if you want notification of new articles in the ADD Basics Series – or any new posts on this blog – give your email address to the nice form on the top of the skinny column to the right. (You only have to do this once, so if you’ve already asked for notification about a prior series, you’re covered for this one too). STRICT No Spam Policy

IN ANY CASE, stay tuned.
There’s a lot to know, a lot here already, and a lot more to come – in this Series and in others.
Get it here while it’s still free for the taking.

Want to work directly with me? If you’d like some one-on-one (couples or group) coaching help with anything that came up while you were reading this Series, click HERE for Brain-based Coaching with mgh, with a contact form at its end, or click the E-me link on the menubar at the top of every page. Fill out the form, submit, and an email SOS is on its way to me; we’ll schedule a call to talk about what you need. I’ll get back to you ASAP (accent on the “P”ossible!)

Don’t Forget that I am on sabbatical until September 16, 2013.
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Related articles right here on ADDandSoMuchMore.com
(in case you missed them above)

DSM-related Articles ’round the ‘net

BY THE WAY: Since ADDandSoMuchMore.com is an Evergreen site, I revisit all my content periodically to update links — when you link back, like, follow or comment, you STAY on the page. When you do not, you run a high risk of getting replaced by a site with a more generous come-from.

About Madelyn Griffith-Haynie, MCC, SCAC
Award-winning ADD Coach Training Field founder; ADD Coaching field co-founder; [life] Coaching pioneer -- Neurodiversity Advocate, Coach, Mentor & Poster Girl -- Multi-Certified -- 25 years working with EFD [Executive Functioning disorders] and struggles in hundreds of people from all walks of life. I developed and delivered the world's first ADD-specific coach training curriculum: multi-year, brain-based, and ICF Certification tracked. In addition to my expertise in ADD/EF Systems Development Coaching, I am known for training and mentoring globally well-informed ADD Coach LEADERS with the vision to innovate, many of the most visible, knowledgeable and successful ADD Coaches in the field today (several of whom now deliver highly visible ADD coach trainings themselves). For almost a decade, I personally sponsored and facilitated seven monthly, virtual and global, no-charge support and information groups The ADD Hours™ - including The ADD Expert Speakers Series, hosting well-known ADD Professionals who were generous with their information and expertise, joining me in my belief that "It takes a village to educate a world." I am committed to being a thorn in the side of ADD-ignorance in service of changing the way neurodiversity is thought about and treated - seeing "a world that works for everyone" in my lifetime. Get in touch when you're ready to have a life that works BECAUSE of who you are, building on strengths to step off that frustrating treadmill "when 'wanting to' just doesn't get it DONE!"

18 Responses to Gotta’ love the DSM-5 — NOT?

  1. Pingback: THANKS to all who read & commented on My Birthday Prayer | ADD . . . and-so-much-more

  2. Gene says:

    Hi, constantly i used to check web site posts here early in the daylight, as i love to find out
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    website: svn.id.ethz.ch/projects/forums/ticket/20596

    Like

  3. Juanita says:

    Hola! I’ve been reading your web site for some time now and finally got the bravery
    to go ahead and give you a shout out from Huffman Texas!
    Just wanted to tell you keep up the excellent work!

    url:tnij.org/consumerelectronics81156

    Like

    • Gracias, Juanita – and Hola! right back atcha’ Bienvenidos. So glad you left me a shout out to let me know you are reading (and that you like the site).

      btw – the url you left me goes to a site with a bunch of lovely firewood pictures with content primarily in Japanese/Chinese? (sorry, USA is lousy about language training, more’s the pity – and my [American] url checker only speaks English — y no soy mucho mejor!)

      Are you sure you entered it correctly?

      xx,
      mgh

      Like

  4. Wonderful post — probably the best of yours that I’ve read — I’ve learned so much! I’ve been aware that there is a lot of controversy about the new DSM — now I have some understanding of why.

    MY area of interest, circadian rhythm disorders, has been improved. A few years ago it was moved from code 307 to code 327, that is from mental to neuro, YAY. And a few “new” subdivisions have just been added. PERHAPS this might lead to a few more physicians having heard of us? (Actually the new one-year Sleep Medicine subspecialty program will help more in the USA, after a while.)

    A friend has been blogging changes to HER area of interest: autism. Diagnostic criteria have been improved.

    I am so sorry to read that AD(H)D has been “thrown under the bus”.

    And re: comments disappearing — I’ve TRIED to train myself to highlight and copy just before posting. Not too effectively.

    (A suggestion: “…can’t help but be negatively effected” — I think you mean affected.)

    Now to click on some of your links and learn even more.

    (Right click, copy.)

    Like

    • ~~~~~~~~~~~~~~~~~~~~~~
      ANYONE ELSE READING: If you have any tincture of sleep timing struggles, click on Delayed’s name (above) to go read a chrono blog that is the best on the web, IMHO!!
      ~~~~~~~~~~~~~~~~~~~~~~
      WHOA – you came back to redo your comment! Thank you SO much.

      I’m thrilled you like this article – and the fact you DO means you READ the whole article. It is so disheartening to note how few really do. Sometimes I think I could insert the winning lottery numbers and no one would WIN!!

      I know my articles are long & take some time and attention to get through, but I spend *much* more time researching and writing — and I put it out there for FREE, dag-nabit!

      I COULD charge my former $4K for a 2.5 year training to share this info (STILL deciding whether to make that choice again).

      So I get t-totally “ticked” off when so many others are content to remain in the dark rather than get themselves educated – ESPECIALLY when all that’s required is taking the time to READ something laid out in front of them, with all the room in the world to ask questions, disagree or add to the info!!!

      (other informed bloggers probably feel the same way, btw – I’m NOT saying I am the ONLY informed source)

      Why do I care? Nothing re: standards of care will change very much very quickly if the affected population lacks knowledge about their OWN disorder — and I want things to change TOTALLY while I’m still young enough to celebrate! (and, in ANOTHER 20-years I’ll be ::gasp:: eighty)

      I alternate between despair, anger and the resolve to give up the objective and find a more proactive community to work with so I don’t continue to waste additional minutes of my own life “tilting at windmills” that SERIOUSLY need the Tin Man’s oilcan!!!

      I want to play with people like YOU — engaged, curious, generous with information and feedback, with a global view that extends beyond areas central to your original interest-base.

      (the above by way of saying thank you SO much for coming back to replace the comment you lost)
      ~~~~~~~~~~~~~~~~~~~~~~
      Yes, I DO mean “affected” – my brain’s spell-checker sleeps in class! Thanks for the catch.
      ~~~~~~~~~~~~~~~~~~~~~~

      RE: “under the bus” – it depends on who you are and where you stand, but I do have to admit that DSM-5 on ADD is not *all* bad. The come-from, however is way off as long as hyperactivity remains central (rather than the attentional foundation to Executive Functioning Dysregulations.

      Central to my objection is that the current dx code as written is still unlikely to catch many, many of those deserving of dx (and to continue to promote false ideas that sends non-expert minds in directions that exacerbate the difficulty of obtaining dx and decent treatment) — ALL becasue of a legacy H?

      At the very LEAST, both gross and fine motor, as well as (especially important) cognitive hyperactivity need to be spelled out in print (but it would still miss many too many, IMHO, as long as hyperactivity remains central to the dx).

      AND THEN there’s DOCTOR Charlie Parker’s very valid argument that ignoring BIOLOGY as if the brain lived in a box on a shelf (simply stated in my OWN words) – is beyond STUPID — ie. “under the bus.”

      CONCERNED READERS: check out http://CorePsych.com for CP’s info — WELL worth your time.
      ~~~~~~~~~~~~~~~~~~~~~~

      Ditto the under-the-bus treatment of the Autistic Spectrum, as I see it. My personal belief (backed by MANY who are on that particular spectrum themselves) is that Aspergers DOES deserve it’s own listing, lest it be thrown into the HFA pot (High Functioning Autism).

      It makes no more sense than throwing it in with ADD because of the overlap of some of the ADD population with what I refer to as a “high Aspie piece” to their ADD presentation. Hell, why not lump ALL of the neuro-disorders in the same pot? (Specificity of treatment protocols, THAT’s why!)

      The characteristics, challenges and abilities are different, and “generalizing” NEVER leads to adequate care – ESPECIALLY when physician education can ONLY EVER be inadequate

      There are simply too many items to cover in “class” – and most docs are too busy “practicing” post-graduation to have the time to keep up with the research – EVEN in their own areas of specialization (unless they get by on VERY little sleep or forgo time spent on personal interests — or have NO personal lives).
      ~~~~~~~~~~~~~~~~~~~~~~
      The primary problem, EVEN with your area of interest (as well as another of mine: chronos), is the T-I-M-E thing.

      LIVES are being wasted due to lack of adequate identification and treatment!!

      Too much TIME goes by between each version to accept incremental changes that won’t be updated until we lose ANOTHER generation to NEEDLESS struggle and underfunctioning.

      Dement’s in his EIGHTIES and he’s been waving the sleep medicine flag his ENTIRE life (lucky enough to have an income base at Stamford to allow him to continue his advocacy efforts and keep a roof over his head. I tripped across his chrono-list AGES ago — I’m sure you’ve been there too).

      So I do NOT personally give atta-boys to this DSM team for their teensy neuro-nod to the chrono disorders. “Better” is not the same as adequate!!!!! Way too little, way too late.

      ~~~~~~~~~~~~~~~~~~~~~~
      I don’t understand why they continue to PUBLISH the DSM at all, when it COULD be a Wiki.

      The APA could still charge the same thing for access, their up-front would go DOWN substantially — enough to HIRE a couple of full-time editors to oversee changes “limited” to a MUCH larger pool of resources that COULD be field experts for EACH dx, along with a ton of admin-assists to get it on the web (who make less/hr).

      In my view of this NEW diagnostic “bible,” rather than ONE DSM “version”, each dx would have a dated identifier reflecting the most recent changes, and even non-expert MDs would be FORCED to keep up with changes in the field, because they’d have to include the current identifier to make the dx (dx date would also be on record).

      The entire thing would then be SEARCHABLE (and statistics would be FAR easier to gather if it were part of an automated online process) – *and* EACH dx could have its own “Section 3” — a category of information needing further research, (even a “Section 4” for info that is considered “anecdotal” until vetted).

      That would significantly elevate “standards of care,” if only through the underlying tacit acknowledgment that diagnostic criteria change rapidly with new studies and MD’s are expected to be current!

      I have MUCH more to say about logistics and possibilities for this “NEW” DSM, but this is already it’s own article, so I will stop.

      THANKS so much for your interest and interaction. You’ve kept me on my naive “horse” for another day!

      xx,
      mgh

      Like

  5. Pingback: History of Diagnostic Manuals | Free psychology

  6. Just wrote a comment, hit Post, and was told, “Sorry, this comment could not be posted.” Hrmff.

    Like

    • I HATE it when comments disappear, wasting our time (far too often IMHO!). I sent your comment to WordPress, but don’t hold your breath!

      La Ronde! — it surely seems that every time they update anything, some other bubble under plastic is activated.

      I keep trying to remember to draft in a notebook ap and cut and paste when it is DONE – because when my cursor wanders “outside the lines” it seems that everything I spent my time on disappears. It makes me CRAZY.

      This wrinkle’s a NEW way to lose content — seeming to mean that something *somebody* did shut down the site for a moment JUST as you were posting, sans notice AS usual. I’m not sure if they even know themselves what they are likely to do when they work on the site. GRRRRRRR!

      It’s a HUGE staff, and most must be pretty good since much works fairly well (and you can’t beat the price) — but at least ONE of them either doesn’t think things through or doesn’t test things before setting them live.

      ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
      I wish they’d simply do what aol used to do and post advanced notice of when the site was unavailable or likely to be unstable because they were updating or upgrading.
      ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

      Sorry you lost your comment – I always enjoy reading them and am mad at the WordPress.com folks for making me miss this one.

      Thanks for trying!
      xx,
      mgh

      Like

  7. roslederman says:

    Unfortunately, ADD is not the only condition that has been slighted by the DSM 5. A condition I know all too well, Sensory Processing Disorder, did not “make the cut” at all and therefore will remain unrecognized by those whole follow the DSM as the diagnostic bible. Very disappointing. I wonder if the people who worked on this latest version realize how unpopular it is…

    Like

    • The closer one tip-toes the dreaded and often denied Reality of Biology, the more the late blooming Neo-Freudians – who wear blinders only looking for overt conflict – are likely to completely discount it’s significant. Think Biology and Reality, you will find Denial.

      Like

    • ROS — there’s an SPD article in draft ANYWAY – it’s “on the list” (once I play catch up for the 10 weeks I’ve been away).

      And YES, Ros, APA can’t help but know — MOST of the links below the article above are fairly scathing, and the APA folks are circling the wagons like mad things, sound-bites countered by shrink-flames.

      MAYBE all the negative attention (and loss of expected revenue) will “force” a redo before another 20 years go by — and MAYBE they will take some of the complaints to heart and do things differently for DSM-SIX.

      I HATE POLITICS!!!!! (especially in the health-care field)

      Thanks for taking the time to read and comment.

      xx,
      mgh

      Like

  8. Thanks Madelyn,
    As you clearly point out, effective treatment depends upon accurate diagnosis. Inadequate diagnosis encourages inadequate, unpredictable treatment, – and inadequate treatment most often results in failed treatment.

    Most overlooked in DSM Diagnosis: The Reality of Biology. Oddly enough we live in remarkable times of mushrooming neuroscience discoveries, yet too few wish to tackle the challenges of understanding mind function beyond simplistic behavioral appearances.

    Functional assessments provide answers that appearances simply can’t identify, because the Reality of Biology takes a bit more time and understanding.

    For those interested in the evolution of how this easily available new Reality plays into the complexity of ADHD your readers may find this program useful: How Reality Changes ADHD Diagnosis and Treatment > at http://corebrain.org/reality

    Thanks for including CorePsych Articles in your refs! Talk soon,
    Chuck

    Like

    • Wouldn’t you THINK that a glance at the reasons why everything was slowed down in the neuro-discovery field might force a reboot and we WOULD see some overlap between fields like ::gasp:: biology and neurology??????

      MEANWHILE, we are all lucky to have YOU and your site.

      RE: Thanks for including CorePsych Articles in your refs!

      While I DO think you’re a cutie ::vbg:: the reason I include CorePsych refs are because your CONTENT is so important for ADDandSoMuchMore.com readers. You are an AMAZING resource.

      If I had more TIME to search for them (or a staff of worker bees to do it FOR me), you’d see your articles linked even more often — so keep adding them in the comments section if I miss them in the article.

      READERS: DO check out his links (bookmark them, even if you don’t have time to study them — and consider buying his book when you are over there – REAL advice, btw. NOT an affiliate link). His stuff is info you won’t find much about ANYwhere else.

      CP: Thanks for taking time out of your crazy/busy schedule to comment here — ESPECIALLY appreciated during the time when I was on sabbatical and the content was auto-posted! As I work my way through the comments left while I was away, I’m honored to discover how much you’ve been here while I’ve been gone. SINCERE thanks.

      xx,
      mgh

      Like

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