The fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM) has sparked major controversy, with critics arguing that it’s ridiculous that aspects of your normal behaviour, such as checking Twitter a little too often, will be signs of poor mental wellness, and even a new mental disorder.
According to writer and broadcaster Jon Ronson, whose bestselling book, The Psychopath Test, has helped to bring the DSM to the attention of a UK audience, attitudes to the DSM have changed. He explained, ‘When DSM first came out people were really excited. There was something alluring about it because people loved nothing more than mental health checklists. It was also a change from the pseudoscience that had gone before.’ And now? ‘They feel that there is an ivory tower elite trying to turn normal human behaviour into disorders and they don’t want to be told what they are feeling isn’t normal.’
As a previous member of this elite, former chairman of the work party for DSM-IV, Dr Allen Frances, is not looking forward to the new edition of the DSM, as it threatens to unleash what he has called a ‘diagnosis hyperinflation’ by ‘greatly expanding the number of people considered mentally ill, and reduces the ranks of the normal’. Dr Frances elucidates, ‘Grief becomes Major Depressive Disorder; worrying about being sick is Somatic Symptom Disorder; temper tantrums are Disruptive Mood Dysregulation Disorder; gluttony is Binge Eating Disorder; and soon almost everyone will have Attention Deficit Disorder.’
However, Dr David Kupfer, chair of the DSM-5 taskforce, has unsurprisingly asserted that the DSM-5 is not about redefining what is normal. He argued, ‘DSM has been periodically reviewed and revised since it was first published in 1952. The previous version of DSM was completed nearly two decades ago; since that time, there has been a wealth of new research and knowledge about mental disorders that is not reflected in the current [DSM-IV] text.’ He added that ‘at every step of development, we sought to make the process as open and inclusive as possible and did so to a level unprecedented for any area of medicine.’
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