DSM 4 28 14 Saturday May 10 2014 8 06 PM Until the 1950s there was no universal standardized method of diagnosis of mental illness 1840 census Idiocy Insanity categories Post WWII PTSD symptoms American Psychological Association categorized a diagnostic system 1952 Diagnostic and Statistical Manual of Mental Disorders DSM All recognized psychiatric disorders and symptoms Had a Freudian psychoanalytic skew No research behind it 1968 DSM II Not very different than DSM I still used Freudian theory 1980 DSM III Shift in psychological world Freudian perspective fading Atheoretical symptom based model Universally poor reception Vague ambiguous unclear Some unhappy Freudians Some disliked atheoretical model 1987 DSM III R revised corrected perceived errors Tried to clear some ambiguities language Incorporated more empirical research not as atheoretical 1994 DSM IV Similar to DSM III R More research incorporated into the model 2000 DSM IV TR text revision changed some language 2013 DSM 5 not very different from DSM IV Pages Disorders DSM I DSM II DSM III 130 134 494 DSM III R 567 DSM IV DSM 5 886 992 106 182 265 292 297 Models for diagnoses 1 2 Social Norm Model Distress Model i Does it cause distress harm to yourself or others 3 Functional impairment i ii The ability to love and work defines normality Sigmund Freud Ability to form maintain relationships and function at work in life etc 4 Medical Model DSM diagnoses Tend to be observable behavioral symptoms Symptom based checklist approach Improve reliability of diagnoses Common criticisms of DSM Never defines what a mental illness is Do we need to define mental illness Over pathologizing Normal variation in human behavior becoming defined as mental illness Does a poor job defining normal abnormal behavior Arbitrary checklists ex 5 9 symptoms disorder What is clinically significant impairment Poor differentiation amongst the disorders Some disorders are very similar to each other difficult to diagnose Diagnoses just label symptoms without explaining anything Atheoretical What does the DSM do well DSM enhances reliability Spurs empirical research Creates operational objective definitions There is no DSM disorder that can be established with a lab test or similar Psychology Page 1 1 Must cause clinically significant impairment in social occupational educational areas of functioning to be considered a DSM disorder i All diagnoses may be a physiological illness with biological causes in the brain etc There is no DSM disorder that can be established with a lab test or similar Diagnosis To guide toward treatment Reduces stigma by explaining behavior Prognosis Predicts what will happen in medicine not in psychology Psychology Page 2