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The DSM, of course, is the list of diagnoses written by and for psychiatrists who are dispensing pharmaceuticals which are covered by insurance. The DSM does not consider the possible causes of the disorders listed, nor allow for the possibility that simple lifestyle changes might be adequate to "cure" a disorder. The book is used to authorize the mental health professional to dispense psychoactive medications. No conflicts of interest there (ahem).
The National Institute of Mental Health (NIMH instead of just NIH) has decided that the basis of the DSM is not scientific enough, and it is not using those diagnoses as a foundation for ongoing research. The new Research Domain Criteria (RDoC) project to is intended to transform diagnosis by incorporating genetics, imaging, cognitive science, and more to create a new classification system. The new system of knowledge will be based on biology as well as symptoms, and will consider specific brain circuits, genetics, and experiences without regard for DSM categories. In fact the NIH is looking to support research projects that look across or subdivide current categories.
This is superb and hopeful to every person who has even been stuck with a diagnosis that didn't fit, or medicated when a simpler solution wasn't even entertained. My congratulations to the NIH for being independent enough to seek the truth.
SOURCE
http://www.nimh.nih.gov/about/director/2013/transforming-diagnosis.shtml
The National Institute of Mental Health (NIMH instead of just NIH) has decided that the basis of the DSM is not scientific enough, and it is not using those diagnoses as a foundation for ongoing research. The new Research Domain Criteria (RDoC) project to is intended to transform diagnosis by incorporating genetics, imaging, cognitive science, and more to create a new classification system. The new system of knowledge will be based on biology as well as symptoms, and will consider specific brain circuits, genetics, and experiences without regard for DSM categories. In fact the NIH is looking to support research projects that look across or subdivide current categories.
This is superb and hopeful to every person who has even been stuck with a diagnosis that didn't fit, or medicated when a simpler solution wasn't even entertained. My congratulations to the NIH for being independent enough to seek the truth.
SOURCE
http://www.nimh.nih.gov/about/director/2013/transforming-diagnosis.shtml
Tags:
- anxiety,
- autism,
- bipolar,
- brain,
- depression,
- diagnosis,
- ocd,
- personality,
- psych,
- science
QotD: Crazy
May. 28th, 2013 08:54 amWe are all, to some extent, crazy. If you come to know any human being well enough, you eventually gain access to the basement where the traumas and wounds and deprivations are stored; rummage in there for a while, and you begin to understand the neuroses and fixations that shape his or her personality. The successful, reasonably happy people I've known are nuts in a way that works for them. Those who struggle and suffer fail to turn their preoccupations to some meaningful use. Next week, the American Psychiatric Association release the latest version of its bible of mental illnesses, the DSM-5, which catalogs about 300 categories of crazy. Critics of all kinds have lined up to assail this dictionary of disorders as subjective and lacking in scientific validity--assembled primarily to justify the prescribing of pills of dubious value.
About 50 percent of the population, the APA admits, will have one of its listed disorders at some point in their lives. Shy, like Emily Dickinson? You have "avoidant personality disorder." Obsessed with abstractions and numbers? You have "autistic spectrum disorder," like Isaac Newton. Suffer form "narcissistic personality disorder," with some hypersexuality thrown in? You must be a politician. To be skeptical of these neat categories isn't to deny that minds get broken, stuck, or lost, and need help finding their way out of misery. But psychotherapy remains an art, not a science; there is no bright line between nuts or not. If you're an old lady who lives amid piles of newspapers and personal treasures, you have "hoarding disorder." If you're a CEO who exploits sweatshop labor to pile up countless billions, you're on the cover of Forbes.
--William Faulk (editor-in-chief) in The Week, May 24, 2013 issue.
About 50 percent of the population, the APA admits, will have one of its listed disorders at some point in their lives. Shy, like Emily Dickinson? You have "avoidant personality disorder." Obsessed with abstractions and numbers? You have "autistic spectrum disorder," like Isaac Newton. Suffer form "narcissistic personality disorder," with some hypersexuality thrown in? You must be a politician. To be skeptical of these neat categories isn't to deny that minds get broken, stuck, or lost, and need help finding their way out of misery. But psychotherapy remains an art, not a science; there is no bright line between nuts or not. If you're an old lady who lives amid piles of newspapers and personal treasures, you have "hoarding disorder." If you're a CEO who exploits sweatshop labor to pile up countless billions, you're on the cover of Forbes.
--William Faulk (editor-in-chief) in The Week, May 24, 2013 issue.
Rundown on DSM-V Evolution
Jun. 6th, 2012 07:55 pmIt's scheduled to come out in May 2013, and this doc (Allen Frances, MD) asks the question: is the APA going to release it because it is needed and helpful and founded for psychiatric treatment? Or because they want the income from the release of a new book?? He has a good grasp on where the system fails and what needs to happen next. He'd like to see changes based in science, and is keenly aware of the degree to which psych diagnosis is inexact and the pathophysiology of these diseases uncertain.
You have to create a login to read here:
http://www.medscape.com/viewarticle/763886?src=mp&spon=38
Here are his concerns that the current DSM-IV does not deal with:
20x autism rates (is everybody really autistic??)
20x childhood bipolar rates
3x ADHD rates
2x adult bipolar rates
"Misuse of the label "paraphilia NOS" to sanction the questionably constitutional involuntary commitment of rapists as a veiled form of preventive detention"
And here are the things he is worried will be stuffed prematurely into the DSM-V:
Disruptive mood dysregulation disorder
Minor neurocognitive disorder
Removing the bereavement exclusion for major depressive disorder (sadness not allowed!)
Lowered ADHD threshold (by raising the allowed age of onset to 12) (how does this work??)
Lowered threshold and poor reliability for generalized anxiety disorder
Combining substance abuse w substance dependence under "addictive disorders" (low reliability and unnecessary stigma)
A category for "behavioral addictions" that will promote "Internet addiction" as a NOS diagnosis. (Next: "addictions" to sex, shopping, work, golf, boating)
Pedophilia criteria wording that tries to sneak in hebephilia (preference for early pubescent teens) and invites forensic abuse
Making binge-eating a mental disorder
An unusable personality section that the APA Assembly voted unanimously to oppose
You have to create a login to read here:
http://www.medscape.com/viewarticle/763886?src=mp&spon=38
Here are his concerns that the current DSM-IV does not deal with:
20x autism rates (is everybody really autistic??)
20x childhood bipolar rates
3x ADHD rates
2x adult bipolar rates
"Misuse of the label "paraphilia NOS" to sanction the questionably constitutional involuntary commitment of rapists as a veiled form of preventive detention"
And here are the things he is worried will be stuffed prematurely into the DSM-V:
Disruptive mood dysregulation disorder
Minor neurocognitive disorder
Removing the bereavement exclusion for major depressive disorder (sadness not allowed!)
Lowered ADHD threshold (by raising the allowed age of onset to 12) (how does this work??)
Lowered threshold and poor reliability for generalized anxiety disorder
Combining substance abuse w substance dependence under "addictive disorders" (low reliability and unnecessary stigma)
A category for "behavioral addictions" that will promote "Internet addiction" as a NOS diagnosis. (Next: "addictions" to sex, shopping, work, golf, boating)
Pedophilia criteria wording that tries to sneak in hebephilia (preference for early pubescent teens) and invites forensic abuse
Making binge-eating a mental disorder
An unusable personality section that the APA Assembly voted unanimously to oppose
The autistic fellow was on the river with us again. He wasn't really paddling with us; he paddles alone. He looks to be in his 40-50's, with a salt and pepper beard and a long brown ducky. He scouts where he likes, talks to no one, and then runs the rapids, generally with good style. He runs his own shuttle. We look out for him when he's around, and so far he has never needed any help. He did splat pretty hard on the rock below the helicopter move at Toby's. We wonder if he'd participate in a rescue if someone else needed help. I theorize that he might come up with a completely independent and original approach. There's no conversing with him, so there's no way to know. I think river running might be an excellent activity for young autists because it engages the part of them that is well developed. The trick would be in inducing enough group behavior to provide a minimum of safety coverage.
( notes from the weekend )
( notes from the weekend )Take the Test: Are you an Asshole?
Feb. 13th, 2012 12:05 pmhttp://electricpulp.com/guykawasaki/arse/
(Found this on an autism page;
seems like lots of autists score pretty high.)
(Found this on an autism page;
seems like lots of autists score pretty high.)
QotD: Overcompensating
Feb. 13th, 2012 11:59 amPeople with disabilities
are never more disabled
than when they are overcompensating.
--Siebers
are never more disabled
than when they are overcompensating.
--Siebers
Shadowing a New Doc Starting Today
Jan. 10th, 2012 08:11 amI have to leave in a few minutes. This doc specializes in children with autism. I'm told she is quite excellent at working with parents. I am very curious and have an assortment of ideas and theories that I'd like to test against the real thing. Hello autists!
Lewy, MD, PhD, been studying melatonin and light effects on sleep and depression xlongtime
cartoon: "Portland weather calls for severe depression with a 30% chance of suicide."
( more notes )
cartoon: "Portland weather calls for severe depression with a 30% chance of suicide."
( more notes )QotD: Dissociation
Aug. 25th, 2011 09:11 amWhat survivors do...dissociate from the body and withdraw into the head.
Cut off from the body, one doesn't feel vulnerable. By identifying the self with the ego, one also gains the illusion of power. Since the will is the instrument of the ego, one truly believes "where there's a will, there's a way" or "one can do whatever one wills." This is true as long as the body has the energy to support the ego's directive. But all the willpower in the world is no help to a person who lacks the energy to implement the will. Healthy individuals do not operate in terms of willpower except in an emergency. Normal actions are motivated by feelings rather than by the will. One doesn't need willpower to do what one wants to do. There is no need to use the will when one has a strong desire. Desire itself is an energetic charge which activates an impulse leading to actions that are free and generally fulfilling. An impulse is a flowing force from the core of the body to the surface, where it motivates the musculature for action. The will, on the other hand, is a driving force that stems from the ego--the head--to act counter to the body's natural impulses. Thus, when one is afraid, the natural impulse is to run away from the threatening situation. However this may not always be the best action. One cannot always escape a danger by running. Confronting the threat may be the wiser course, but this is difficult to do when one is frightened and there is an impulse to run. In such situations mobilizing the will to counter the fear is a positive action.
--Alexander Lowen, MD, in Joy; The Surrender to the Body and to Life, page 81-82.
Cut off from the body, one doesn't feel vulnerable. By identifying the self with the ego, one also gains the illusion of power. Since the will is the instrument of the ego, one truly believes "where there's a will, there's a way" or "one can do whatever one wills." This is true as long as the body has the energy to support the ego's directive. But all the willpower in the world is no help to a person who lacks the energy to implement the will. Healthy individuals do not operate in terms of willpower except in an emergency. Normal actions are motivated by feelings rather than by the will. One doesn't need willpower to do what one wants to do. There is no need to use the will when one has a strong desire. Desire itself is an energetic charge which activates an impulse leading to actions that are free and generally fulfilling. An impulse is a flowing force from the core of the body to the surface, where it motivates the musculature for action. The will, on the other hand, is a driving force that stems from the ego--the head--to act counter to the body's natural impulses. Thus, when one is afraid, the natural impulse is to run away from the threatening situation. However this may not always be the best action. One cannot always escape a danger by running. Confronting the threat may be the wiser course, but this is difficult to do when one is frightened and there is an impulse to run. In such situations mobilizing the will to counter the fear is a positive action.
--Alexander Lowen, MD, in Joy; The Surrender to the Body and to Life, page 81-82.
Tags:
I heard it on NPR. Wakefield is the doctor who linked autism to vaccines. They're blaming current outbreaks of measles and mumps on him. They're not discussing his actual research or findings, beyond saying that some of Wakefield's small sample were children who already had symptoms of autism. Wakefield's study involved looking at the microbes in his patient's guts. It was interesting. I do not know anything about his integrity, but he has lost his medical license and now his reputation is tattered.
No one study proves anything, it only suggests. Scientific findings must be repeatable to be believed. The conventional line now is that there is absolutely no link between vaccines and autism, but the science supporting that assertion is not beyond question. We shall see what people say a decade hence.
BMJ = British Medical Journal
SOURCES NOT YET EXPLORED (I gotta go to class!)
http://www.medscape.com/viewarticle/735354?src=mpnews&spon=34
http://news.discovery.com/human/vaccine-autism-doctor-accused-of-deliberate-fraud.html
http://www.sfgate.com/cgi-bin/blogs/lshumaker/detail?entry_id=80422
http://news.google.com/news/quote?hl=en&expIds=17259,18167,27846,27955&sugexp=ldymls&xhr=t&cp=5&ie=UTF-8&qsid=k--ZTkiUlIjWvM&ei=1d0lTa6PG4rmsQPfg9CcAQ&sa=X&oi=news_quote_result&ct=more-results&cd=1&resnum=1&ved=0CCMQ0gYoADAA
http://minnesota.publicradio.org/display/web/2010/12/17/somali-autism/
No one study proves anything, it only suggests. Scientific findings must be repeatable to be believed. The conventional line now is that there is absolutely no link between vaccines and autism, but the science supporting that assertion is not beyond question. We shall see what people say a decade hence.
BMJ = British Medical Journal
SOURCES NOT YET EXPLORED (I gotta go to class!)
http://www.medscape.com/viewarticle/735354?src=mpnews&spon=34
http://news.discovery.com/human/vaccine-autism-doctor-accused-of-deliberate-fraud.html
http://www.sfgate.com/cgi-bin/blogs/lshumaker/detail?entry_id=80422
http://news.google.com/news/quote?hl=en&expIds=17259,18167,27846,27955&sugexp=ldymls&xhr=t&cp=5&ie=UTF-8&qsid=k--ZTkiUlIjWvM&ei=1d0lTa6PG4rmsQPfg9CcAQ&sa=X&oi=news_quote_result&ct=more-results&cd=1&resnum=1&ved=0CCMQ0gYoADAA
http://minnesota.publicradio.org/display/web/2010/12/17/somali-autism/
