Public Release of the DSM-5 Draft

The draft of the DSM-5, the Diagnostic and Statistical Manual, was released this week. This guide to the diagnosis of mental and behavioral health problems will shape the delivery of psychological, psychiatric, and social care for years to come.

You can access the entire draft here at the American Psychiatric Association DSM-5 Development Website. There the APA writes about the comment policy:

The draft disorders and disorder criteria that have been proposed by the DSM-5 Work Groups can be found on these pages. Use the links below to read about proposed changes to the disorders that interest you. Please note that the proposed criteria listed here are not final. These are initial drafts of the recommendations that have been made to date by the DSM-5 Work Groups. Viewers will be able to submit comments until April 20, 2010. After that time, this site will be available for viewing only.

It is interesting to note that the APA included a press release announcing that the DSM-5 Development Process Includes Emphasis on Gender and Cultural Sensitivity.

Actual proposed changes are set up in an interesting way. The opening tab is the proposed revision, but there is also are rationale, severity, and DSM-IV tabs. So it does provide more information than one might think.

So, as one major example, Major Depressive Disorder, Recurrent, has an extensive draft proposal for the DSM-5. Here the rationale isn’t that great, since it largely focuses on single episodes of depression. On the severity side, it’s clear what the APA group is thinking about in terms of differential ratings. And it’s easy to compare the DSM-5 with the DSM-IV criteria.

Vaughan Bell at Mind Hacks includes some extensive commentary, and a wealth of links, on the DSM-5 Draft in the piece The Draft of the New ‘Psychiatric Bible’ Is Published. He opens by saying:

It’s a masterpiece of compromise – intended to be largely backwardly compatible, so most psychiatrists could just get on diagnosing the few major mental illnesses that all clinicians recognise in the same way they always did, with some extra features if you’re an advanced user.

One of the most striking extra features is the addition of dimensions. These are essentially mini questionnaire-like ratings that allow the extent of a condition to be numerically rated, rather than just relying on a ‘you have it or you do not’ categorical diagnosis.

John Grohol, writing over at Psych Central, also provides an initial overview of the main changes in the DSM-V and then provides a review that features the good, the bad and the ugly.

If you’re looking for just the critical, the Psychiatric Times has a piece Opening Pandora’s Box: The 19 Worst Suggestions For DSM-5. Dr. Allen Frances, who chaired the DSM-IV Task Force, identifies two areas that are quite worrisome (and predictable) for a critical medical anthropologist:

(1) Dramatically higher rates of mental disorder, including “millions of newly misidentified false positive ‘patients’ [and] massive overtreatment with medications that are unnecessary, expensive, and often quite harmful”

(2) Unforeseen consequences, where DSM5 options often have an “insensitivity to possible misuse in forensic settings. Work Group members cannot be expected to anticipate the many ways lawyers will try to twist their good intentions.”

You can explore the legal aspects more over at In the News.

For specific diagnoses, Dr. Petra has particularly good coverage on the proposed changes in sexual disorders. Liz Spikol looks at the diagnosis of childhood bipolar disorder with a critical eye.

For more reading, Furious Seasons has some good initial thoughts on the DSM-5. Additional coverage can be found at the NY Times and New Scientist.

The Sociology of Neuroscience: A Call for Papers

Volume 11 of “Advances in Medical Sociology” will be dedicated to the theme Sociological Reflections on Neuroscience. You should send abstracts detailing potential contributions by next Monday, February 15th, 2010. Details on abstract submission are at the bottom of the post.

Sociological Reflections on Neuroscience will be edited by Ira van Keulen (Rathenau Institute) and Martyn Pickersgill (University of Edinburgh). Here’s the call for papers:

The Advances in Medical Sociology book series seeks submissions for a new volume on sociological reflections on the neurosciences. Neuroscience is an increasingly influential and prestigious branch of biomedicine, gaining ever more traction within a variety of policy, professional and public cultures. In some respects, neuroscientific ideas and concepts are replacing genetics as a paradigm for understanding the body, the mind and social order, and the relationships between these domains.

Neuroscience therefore demands attention from sociologists. However, to-date, debate around the ‘new brain sciences’ has been limited within sociology, and it has mostly been ethicists who have opened up discussions on the important ethical and epistemological issues neuroscience raises. As a consequence, many of the discussions on the social, ethical, legal and policy implications of the rapidly growing field of the neurosciences have been primarily speculative and theoretical. Thus for this volume of Advances in Medical Sociology: Sociological Reflections on Neuroscience we are specifically looking for articles based on empirical research, from socio-historical analysis to ethnographic research, from surveys to in-depth interviews.

This edited volume of Advances in Medical Sociology aims to be a benchmark text in sociological analyses of neuroscientific research and practice. Accordingly, we call for papers addressing a wide variety of issues pertaining to the sociology of neuroscience, including – but not limited to – the following topics:

1 Knowledge representation in (medical) neuroimaging studies.

2 Changing perceptions of neurological conditions (e.g. Alzheimer’s Disease, Parkinson’s Disease) and ‘cognitive functions’ (e.g. attention, memory) within the clinic and in wider society.

3 The neuroscientific (re)construction of psychopathology (e.g. autism, ADHD, depression).

4 The links between neuroscience, clinical practice and subjectivity (including the politics and meanings of ‘neurodiversity’).

5 The rise of novel clinical neurotechnologies (e.g. neurofeedback, deep brain stimulation and transcranial magnetic stimulation).

6 Representations of the (diseased) brain within and beyond the media.

7 Changing perceptions of the mind-body relationship.

8 The governance and regulation of medical neuroimaging (including the development and implementation of clinical neuroethics).

9 The international production and flow of neuroscientific concepts, knowledge and technology.

10 Neuroscientific understandings of ‘sociological’ terms and concepts such as gender and racism.

This list should be treated as suggestive rather than prescriptive, and we welcome papers that with other germane issues (such as the degree to which longstanding sociological concepts like ‘biographical disruption’ and ‘medicalisation’ have explanatory or descriptive power in thinking about neuroscience, and the potential contribution neuroscience might make to sociology).

Potential contributors should email a 300-500 word abstract by Monday February 15th 2010 to: socofneuroscience@rathenau.nl. Informal enquiries to this address are also welcome. Name and institutional affiliation of author(s) should also be supplied, including full contact details of the main author. Proposals will be reviewed by the editors, and authors notified by 5th April. The deadline for full submissions (7500-8500 words) will be 1st September. Publication of the volume is expected in late 2011.

Wednesday Round Up #102

Top of the List

ScienceDaily, Ancient Human Teeth Show That Stress Early in Development Can Shorten Life Span
George Armelagos, a professor of mine at Emory, is featured in Science Daily with some excellent work showing how stressful events occurring early in life, as indicated by tooth enamel, can mean a shorter life span.

Susan Carey, The Origin of Concepts
The Harvard professor has a video lecture over at Cognition & Culture, where she discusses her new book The Origin of Concepts

Jane Brody, Rules Worth Following, for Everyone’s Sake
Michael Pollan’s new book, Food Rules: An Eater’s Manual, is reviewed very favorably over at the NY Times. I also liked his earlier interview with Tara Parker-Pope, where he presented this book as the practical version of Omnivore’s Dilemma and In Defense of Food. Anthropologists could pay great heed to what he says:

I’ve spent 10 years looking at agriculture, food and health. I’ve done it mostly as a reporter with a lot of research and adventures and explorations. At the end of the day people want to know what to do with this information. What’s the practical import of what you’ve learned? It’s the question I always get when I’m speaking to readers… I kept hearing the word pamphlet, and I wanted to write a book that would reach as many people as possible. It’s a real radical distillation of everything I’ve been working on. It’s really just to help people to act. It’s about daily practice more than theory.

Frans B. M. de Waal, The Evolution of Empathy
How empathy is essential to who we are, in the context of apes and other animals also exhibiting this trait.

Vaughan Bell, Death of a Gladiator
A gladiator graveyard is discovered in Turkey. Really cool research on how scientists determine the gladiators’ cause of death, with a focus on traumatic brain injuries.

Owen Slot, A Great Sporting Achievement
“Why the key to becoming a successful athlete is using less, not more, of your brain.”

Mind

Daniel Carlat, Lilly: “Execute the *%#&*! out of them!”
How drug companies manipulate science and doctors in order to sell their drugs.

Continue reading “Wednesday Round Up #102”

Cross-Cultural Psychiatry: A Special Report from Psychiatric Times


Psychiatric Times issues periodic special reports, and the latest one features a wealth of articles and ideas on cross-cultural psychiatry.

Ronald Wintrob, chair of the World Psychiatric Association–Transcultural Psychiatry Section, writes the Introduction to Cross-Cultural Psychiatry for this special report. He notes how migration has increased over the past 20 years, and that 12.86% of the US population are immigrants. Psychiatrists have put increasing effort into engaging these populations.

One of the most practical applications of cultural psychiatry to clinical practice in all fields of medicine is the open-ended questioning of patients and their families about their personal and family background characteristics. This includes identifying features of race, ethnicity, religion, and socioeconomic class, relevant immigration history, experiences of acculturative stress, and personal and family aspirations. A discussion of these background characteristics can lead naturally to the clinician’s exploration of the presenting clinical symptoms and history. Knowledge of the patient’s background will increase rapport with patients and families and aid the process of collecting a more reliable history. In addition, it will improve the likelihood of treatment adherence. This process has been described as “cultural case formulation.”

Three main articles comprise the special issue:

Religion, Spirituality, and Mental Health by Simon Dein, senior lecturer of anthropology and medicine at University College London. This piece provides an in-depth examination of what is currently known about the relationships between religion and mental health, and also includes a handy set of four check points that summarize the main themes of the article.

Cultural Considerations in Child and Adolescent Psychiatry, by Toby Measham, Jaswant Guzder, Cécile Rousseau, and Lucie Nadeau, all in the department of psychiatry at McGill, which presents a series of guidelines and suggestions for how to handle cross-cultural issues in practice with children and adolescents

Cultural and Ethnic Issues in Psychopharmacology, by Keh-Ming Lin, professor emeritus in psychiatry at UCLA. This piece goes from the placebo effect to genetic variation, and argues that “cultural and ethnic influences… should be regarded as central in determining the success of treatment interventions.”

Under the whole category of cross-cultural psychiatry at Psychiatric Times, you can also find other articles, including this one by J. David Kinzie on A Model for Treating Refugees Traumatized by Violence.

Link to the Introduction to the Special Report on Cross-Cultural Psychiatry.

SlowTV: Mind and Its Potential


The Mind and Its Potential Conference was hosted in Sydney, Australia back in November.

Mind & Its Potential is your opportunity to hear the world’s top scientists, psychologists and philosophers explain how to apply the new science of the brain in education, medicine, business and your life.

After we previewed it, Paul wrote up a nice review of the conference. Now SlowTV is featuring the videos of several of the talks.

Michael Valenzuela, Neuroplasticity and the ‘Use it or Lose it’ Brain

“Dr Michael Valenzuela describes the concept of neuroplasticity in the brain. He cites the tangible benefits that mental and physical activity have on the development and ongoing functioning of the brain to demonstrate how our neural pathways work on a ‘use it or lose it’ basis.”

Dr Daniel Siegel MD on We Feel, Therefore We Learn: The Neuroscience of Social Emotion.

Here Siegel speaks about “Interpersonal Neurobiology…an interdisciplinary view of life experience that draws on over a dozen branches of science to create a framework for understanding of our subjective and interpersonal lives.”

Baroness Susan Greenfield, The Brain, the Mind and Life in the 21st Century.

“A lively presentation” on “mind function and dysfunction in the modern world,” i.e., technology is killing your brain, but within the broader context of how the brain helps you be you (snarky, I know, but actually it’s a good presentation on relating plasticity with individuality and experience up until 14:50 or so).

And a group discussion featuring Susan Greenfield, Daniel Siegel, Michael Valenzuela, and Jane Burns that is hosted by Alan Saunders, Changing the Brain: Mind over Matter?

“This expert panel addresses how recent discoveries in neuroscience have changed the way we conceive of brain function. Recent thinking proposes that the brain is an infinitely malleable organ, constantly changing and heavily influenced by its surroundings and by the functions that it is required to perform.”

As a bonus, you can also get Prof Jason Mattingley on SlowTV speaking on What Can Neuroscience Tell Us about Consciousness?

“Mattingley looks at the different understandings of consciousness and what the field of neuroscience can add to our collective understanding of how the mind works.”