{DSM-5} The Sexual Disorders Work Group has strayed furthest off the reservation. It has made a series of radical and dangerous suggestions that need to be dropped.
Now when wwas the last time you heard an eminent psychiatrist call a psychologist reckless?
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DSM5 in Distress
The DSM's impact on mental health practice and research.
by Allen Frances, MD
Allen Frances MD was chair of the DSM-IV Task Force and is currently professor emeritus at Duke. See full bio
DSM5 and SEXUAL DISORDERS- JUST SAY NO
DSM 5 sexual disorders make no sense
Published on March 14, 2010
A major general problem in the preparation of DSM5 is that the various Work Groups have been given far too little guidance and support. This explains why: 1)most of the criteria sets are written so obscurely and inconsistently; 2) the rationales for change vary so widely in depth and quality across Work Groups,and; 3) so many suggestions that should have no chance at all have made it this far without being tossed.
The Sexual Disorders Work Group has strayed furthest off the reservation. It has made a series of radical and dangerous suggestions that need to be dropped.
Sexuality is an inherently difficult arena for psychiatric diagnosis because: 1) the field has generated remarkably little research and few researchers; 2) there are no consensus norms in sexual behavior to provide a useful boundary in deciding what constitutes a sexual mental disorder; 3) individual and cultural biases play a large and difficult to sort out role,and; 4) decisions regarding the diagnosis of sexual disorders can have profound and unanticipated forensic and societal implications.
For all these reasons, changes in the definition of the Sexual Disorders should be especially cautious and evidenced based. Instead, the Work Group has taken full and reckless advantage of the DSM5 spirit of innovation. To get a flavor for this, review their postings yourself (at http://www.DSM5.org)
Each of the Work Group's suggestions is based on the thinnest of research support-usually a handful of studies often done by members of the committee making the suggestion. None has been subjected to, or could possibly survive, anything resembling a serious risk/benefit or forensic analysis. I will discuss separately the problems with each proposal, but will not keep repeating that none of them has anything but a veneer of research support.
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