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Who determines mental disorders?

DSM V Future Manual

We are expecting the latest word about whether we are mentally well or ill -  DSM V.  A preview version will appear tomorrow. I am talking about the fifth edition of the  Diagnostic and Statistical Manual of Mental Disorders created and published by the American Psychiatric Association. I am a member of the American Psychological Association so I am biased. Psychiatry and psychology represent two different perspectives on human behaviour and the mind. Psychiatry favours a biological model while psychology favours a multiperspectival model. The authors of the DSM hold to a disease model. This "medical model" has its strengths especially when there is consensus as to what is a "problem" in simple cause-effect relationships.

Which model should we use - the medical?

However, the "medical model" has many limitations. Some of the more obvious ones are:

  • relying on "categories", "ideals", and "objectivity"
  • not recognising sufficiently internal (subjective) experiences
  • insufficient importance given to the role individuals play in their own development
  • lack of recognition for the contribution of culture or context in behaviour.

Or the psychological?

Psychology, on the contrary proposes many models of human behaviour that attempt to consider multiple influences from genetics, development, psychodynamics, cognition, culture and society, just to name a few. The resulting perspective is much more fluid and does not consider behaviours as normal or diseased. Human behaviour seems to be too complex to contain in one simple model.

Hope and trepidation

Because of the importance that the DSM has in the psychiatric and pharmaceutical fields, I await the publication tomorrow with hope and trepidation.

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