The use of DSM-IV?

Question

What are some of the controversial issues that the use of DSM-IV by medical and legal professionals raises? And how does it influence socialization norms and expectations, social perceptions, individual attitudes and behavior?

Answer 1

The DSM has been controversial in the past for different reasons,and since you only asked about the DSM IV I will try to focus only on this. The DSM IV has been shown to be more reliable and valid (but it could still do better validity wise) than previous editions and has eliminated much of the distiction between organically and psychologically based disorders. The multiaxial format allows professionals to consider the bigger picture when diagnosing disorders.
MEDICAL/PSYCHOLOGICAL
However, the distinction between the categories of the DSM IV can be quite "blurry" at times. Individuals are sometimes diagnosed with several disorders and don't neatly fall into one category or another. Sometimes there is a temptations to "force" them into a category in which they don't belong. Some suggestions have been that if the individual has such comorbidity that another classification system should be made for them. The second problem with the categories is that some of the criteria was decided upon by a committee of professionals. For example a disorder has to be present for six months... well, what about if it was five months? Why is six months that magic moment? It was simply the best agreed upon time period. How does this raise medical questions? Well if you can't properly understand or classify a disorder clearly its hard to treat it.

Related to this is that the current categories lack treatment specificity. It also has been suggested it needs to emphasize the causes of the disorders more. The current system does not "help uncover underlying causes or create new treatments (Barlow 2005)"
SOCIAL
A social problem associated with being diagnosed with a disorder is labeling. Sometimes negative stigmas are attached to these disorders and consequently the names have had to be changed such as the use of "moron" and "idiot" as clinical terms.
Additionally society tends to generalize and naturally wants to lump all individuals with one label together and the label then becomes a definining feature of that person. "Susy is bipolar" rather than "Susy is a person with bipolar disorder"
Individuals may tend to see the label first and choose not to socialize with the person or expect less of them because of their diagnosis.
When given a label occassionally and individual may begin to idenitify with the negative aspects of that label and their self esteem may suffer. Ex- "I have mental retardation- I can't do anything right."

LEGAL
FIrst of "insanity" is a legal term and not a medical one. Insanity is determined by the courts.
One problem with the DSMIV and the courts is that the legal definition of mental illness does not match the DSM's definition. Additionally in the past it has been difficult for psychologists to predict violent behavior for longer than 30 days after evaluation.
Secondly the validity of the DSM is somewhat of a problem here. Even though it is more valid than previous versions it still can be faked.
Lastly the insanity defense has gotten a bad rap over the years because of its highly publicized use- and often these media cases are ridiculous examples. There was a study done in 1994, by I forget who that showed that the public believes the insanity defense is used and gotten away with more often than it is actually used.

I hope this helped!

Answer 2

Many people view the DSM as the Bible of mental health. Just about anything you need to know about diagnosing a mental health condition is located in one of those series of books. IV is the newest. Many other people believe that the DSM series is way over rated. Years ago a child could not be diagnosed as bi-polar, now it happens every day. Unfortunately children cannot be diagnosed, still, as sociopathic; even though I see early on symptoms that go untreated until the child reaches the age where he/she can be diagnosed and by then it is so way too late it's not even funny.

Legal and medical are constantly at opposition over diagnosis because mental issues are sensitive; non exact; change over time and cannot be defined as in concrete. Legal hate this...to much wiggle room, loop holes if you will.

As for socialization norms, it is very hard to fit a square peg into a "normal" society. There is a fine line between self expression and insanity.

Social perception of mentally ill people is still in the dark ages. Society does not understand mental illness. They think that a person with depression should "just get over it and quit feeling sorry for yourself." It is truly not just a sad feeling. It is a debilitating condition where a person is not sure if life is really worth getting out of bed for. And expectation says just take a pill and it all goes away. NOT HARDLY. The same medication that helps a schizophrenic level out to a "normal" state is the same medication that person believes may be poison....a vicious cycle to say the least. Society neither accepts or wants responsibility for the schizophenic person.

Individual attitudes and behavior are just that, individual.
Why do you ask? Nana

Answer 3

The DSM-IV-TR gives names to just about any common human mental dysfunction. Some would argue that it pathologizes people's struggles. Any common behavioral, emotional or cognitive aberration can be found somewhere in that big gray book.

One of the controversies surrounding the DSM-IV as it applies to legal matters is the use of ONLY certain mental conditions as a means by which to find criminals not guilty. Psychosis (schizophrenia and related disorders) is often the only way a person can be found "not guilty by reason of insanity".

The reason this is controversial is that most mental health professionals would argue that ALL mental disorders are not the fault of the afflicted. Therefore, a person with Conduct Disorder or Antisocial Personality Disorder shouldn't necessarily be found guilty and locked away for life. Most individuals could be expected to improve with adequate treatment, but the legal system overlooks almost all mental disorders except for the psychotic ones.

The DSM's controversy in the medical profession is multi-fold. The main argument is that the DSM-IV is a very rigid, simplistic way to categorize people into certain diagnoses. People's problems are comprised of and due to a complex variety of environmental and biological factors. The DSM is meant to simplify people's struggles so that their treatment can be justified. Treatment NEEDS to be justified if professionals are to receive reimbursements from insurance companies.

The consequences of simplifying people's struggles into neat little categorized diagnoses are potentially many. For one, it tends to cause psychiatrists, psychologists, social workers and other therapists to implement treatment that is generalized rather than tailored to the individual. For another, different disorders have overlapping symptom criteria. "Poor concentration" is a symptom of PTSD, some other anxiety disorders, major depression, Attention Deficit/Hyperactivity Disorder, and others. So if someone has a trainwreck of problems and one is a lack of concentration, it is up to the clinician's better judgment (or guess) as to what disorder is responsible for the symptom. It's a guessing game, a lot of ruling out, and it's a very rigid, mechanical and simplistic way to compartmentalize people's struggles.

Answer 4

How not elementary is it to make a differential prognosis??-Very! although, the DSM is approximately arising an invaluable means of categorizing somebody's symptom image. As yet another respondant stated, it is valuable for the customer, the scientific care team, and for billing and insurance applications. it fairly is hard to get an extremely final, precise prognosis at cases for a kind of motives which includes, loss of advice, minimization or exaggeration on the customer's area, genuinely modifications interior the customer's presentation, and the actuality that there could be distinctive interpretations of the customer's behaviors. So, for those motives (and an excellent form of others) interior the real international of top of the selection psychological well being, treating the prognosis isn't practically as significant as treating the guy. although, while you're fairly drawn to giving it your terrific guess, you are able to attempt to collect as lots advice as a danger from different ingredients (the customer, kin, previous records, psychological finding out, criminal records). Then examine out all the diagnostic categories that would probably describe this symptom image. From there, take a closer examine out each and every of the help you have, use your individual instinct, ask different clinicians (or classmates), and initiate the technique of ruling issues out. This became into my concepts-set in grad college for the imaginary sufferers we had to diagnose. interior the real international of psychological well being, then you would desire to allow extra of the puzzle to evolve and be versatile. maximum shoppers that stay in psychological healthcare for any length of time will acquire different prognosis. As a facet be conscious, many cases interior the path of scientific care, clinicians will later come to a call that a particular prognosis isn't the terrific in superb condition, yet no person fairly bothers to alter it each and every so often out of sheer laziness and different cases as a results of ego. worry. of path you are able to purpose for accuracy. yet, so what in case you do not get it suitable the 1st time?? as long because of the fact the guy is getting significant interventions, the little field we examine off to place up insurance claims isn't all that significant interior the grand scheme of issues.

Answer 5

I'm a psychology major and I think I remember talking about this in class. Before they revised the older editions they had Homosexuls and "crazy" as actual mental disorders. Now they are saying that some of the medical terms or conditions are politically incorrrect and that when it comes to the courts and such lawyers are using "insanity" for almost every cause to prevent the person from going to jail. It creates bias and puts labels on kids in school because even tho they may have a mild case of some mental disorder as a child they are taken out of the normal classes and are put in ones to meet their needs but they never get the chance to out grow this when they go to high school and are considered "retarded".
That's all I remember...