i <3 DSM IV TR

can i just say (of course i can, its my blog!) that i LOVE Television Without Pity recaps! they are so wonderfully snarky! i love snark!

in the most recent recap for Lost (last week's episode) the recapper mentions the DSM. not only do they mention the DSM, but they mention it by edition -- the DSM IV! im impressed. not as impressed as if they'd have referred to the DSM IV TR (text revision of the DSM IV -- i think they just adjusted some of the descriptions to reflect new research without changing much in terms of diagnostic categories and criteria...when they do that, i think they will name it DSM V...thats my understanding, tho i could be wrong).

so anyway...here is the quote (no real spoilers here, so it should be ok to read if you missed last week's episode):

"The cubicle denizen informs him (with a head bobble, but no finger waggin') that it's her business because if the state is going to continue to pay his disability, she needs to determine if his condition has improved. Improved by hypothetically seeking out the biological parents that abandoned him to foster care as a child? How would that improve anyone's condition? Unless your condition is "Painful Pursuits" or "Unhappy Endings." Are those in the DSM IV?"

hehe, maybe we can push to have these diagnoses included in DSM V??

actually...Painful Pursuit and Unhappy Ending type things are most likely to end up classified as an Adjustment Disorder. man, i am a nerd. but i know my DSM! i wrote a research paper about it last year - about the history of its development, its strengths and weaknesses, etc. leave it to me to enjoy a boring topic like this, while other people were writing papers about unethical sexual misconduct between patients and therapists, or suicide.

my biggest beef with the DSM is that its heavily influenced by cultural issues and beliefs. for example, the inclusion and removal of homosexuality as a diagnosis in the DSM (this is the short version -- it was actually included, then changed in a way that people at the time thought was more appropriate, but was later determined to just be a different way of stigmatizing gay and lesbian people). another example is eating disorders. perhaps eating disorders do occur more frequently in women vs men...but when we include gender specific criteria (i.e. amenorrhea, which is when a women stops getting her period, in this case because she is undernourished)in the diagnosis, we sure do tip the scales in that direction, dont we? (as an aside -- im not saying this criteria should be removed, but there should be an equivalent criteria for men...or it should be a more general item the gist of which is that the person is undernourished and experiencing physical signs of it).

i also think its interesting how strong a pull there is to make psych follow a medical model. when the DSM was in the works...the medical field was already in full swing, and the desire to have a classification system like the DSM in part came from using the medical model as a guide. on the one hand, its good in the sense of encouraging the scientific side of psychology. but, its also constraining to try to make psych fit a medical model because its not the same. take 10 people with the common cold. they would all have nearly the same symptoms. take 10 people with depression, and theres a good chance they will have a lot of different symptoms. and its because the criteria for diagnosing a mental illness work very differently. there are 9 different criteria for diagnosing depression and a person only has to meet 5 to be diagnosed. and if they are diagnosed, they can have anywhere between 5 and 9 of the symptoms. so imagine how many different possible symptom combinations there are for this one illness!

oh. my. god. i am such a nerd! but i love when things like this pop up, and i get all into it, and i remember all ive learned. it reminds me that i really do love this stuff...i made the right choice to pursue psych. :)