Controversy: Revision Of The Dsm Iv To Dsm V

2024 words - 8 pages

Criticisms of the DSM-5 Task Force
This fifth revision of the Diagnostic and Statistical Manual of Mental Disorders or DSM will be the standard classification of mental disorders (Nauert, 2011). Mental health professionals and other health professionals will use this standard in their diagnoses and researches. The American Psychiatric Association released a draft of proposed changes after a decade of review and revision by the Association. Allen Frances, chairman and editor of DSM IV, and Robert Spitzer, editor of DSM III, expressed objections to the task force conducting the revisions and the proposed revisions. Present chairman is David Kupfer and vice chairman is Darrel Regier (Nauert; Collier, 2010).
The DSM-5 Scientific Review Work Group is tasked with providing quality evidence to support the proposed revisions (Spitzer & Frances, 2010). The objections or problems relating to its work are continued secrecy, the intended paradigm shift, and composition of the group, charge, method, and timing. Dr. Allen Frances’ editorials assailed the work group’s lack of transparency in the methods, progress, timelines, and products it uses (Collier, 2010). Dr. Robert Spitzer raised the same objection to the lack of transparency, especially when he was refused the minutes of a meeting in 2008. Dr. Spitzer argued that this lack of openness deters the free flow of information between the work group and outside experts necessary for proper revision (Collier). These were in response to the announcement made by that its deliberations and reports would be confidential and only its existence will remain public.
Composition of Work Group and Charge
Dr. Frances (2010) lamented the group’s claim that it would render an equivalent of an independent NIMH peer review. Two members have been involved with DSM-5 and cannot, therefore, claim independence. The process should be undertaken by experts in evidence-based medicine who are truly and fully independent and capable of applying the standards of scientific proof in all medical specialties. The committee needs to guarantee that it is using a truly unbiased and independent review process (Frances).
This should go beyond a scientific review and tackle a thorough risk-benefit analysis of all recommendations (Spitzer & Frances, 2010; Oldham, 2010). This plan was expressed in the charge. That charge requires the ideal and broader experience in primary care, public policy, health economics, and forensics. The composition of the current work group cannot comply with the requirements of the charge (Spitzer & Frances, Oldham).
Method and Timing

The assessments appear limited to the evidence the group already produced (Spitzer & Frances, 2010). The comprehensiveness and balance of the reviews have not been determined. The lack of a standard operating procedure in the literature process makes the reviews variable in both quality and method (Spitzer & Frances).

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