My first thought is, criticized by whom?
I don’t know many mental health professionals who are overly critical of DSM-5.
There is always a clinical component to diagnostics. Tools like DSM-x give us data and we interpret that data along with other physical data and personal observations.
There is no single point of data collection that can, on its own, diagnose a psychological condition.
It’s an arbitrarily compiled “consensus” based diagnostic manual that sucks at diagnosis. Many of the criteria given enable one set of symptoms to fall into a dozen categories depending on who is doing the diagnosis. Previous versions considered female arousal as a mental disorder (hysteria), for example of how Wikipedia like it is.
Psychiatrist here. So most of the issues with the DSM stem from the core issue that we do not have enough understanding about how the brain really works. We are unable in many diagnoses to link the disorder with a clear biological process. This is also why many of our treatments involve trying multiple things to find out what works. The brain is very complex and due to stigma and other such issues neuroscience is in many ways behind other medical fields.
This lack of understanding has lead to psychiatric diagnoses being based on descriptions of symptoms rather than specific biological mechanisms. And this ambiguity has lead to our diagnoses being corrupted by campaign groups wanting things to be defined in specific ways to suit their agendas. Which has in turn made our diagnoses unreliable and constantly getting regrouped based on pressure or fads.
There are some diagnoses that we have a clearer understanding of such as schizophrenia and bipolar. But despite physicians being able to clearly identify both of these diagnoses, unfortunately the diagnoses get tossed into patient notes incorrectly.
For example, schizophrenia the biologic process has a very clear history and progression. However from reading of the DSM, a person with long term brain damage from methamphetamine use can have all the symptoms of schizophrenia and therefore be falsely diagnosed with schizophrenia. They meet the dsm criteria for schizophrenia but the biologic process is completely different. And the treatment/ expected disease course is very different.
Validity and reliability. The criteria for diagnoses are subjective and vague. Different professionals will make difference diagnoses based on the same criteria.
We aren’t even sure if what we are diagnosing is real and we can’t all agree on what constitutes those diagnoses anyway.
Basically the DSM is a compendium of current opinions by groups of people deemed appropriate. It changes significantly every few years based on everything from new research to changing politics and social mores.
It’s vaguely useful but it’s not valid nor reliable in the scientific sense.
Latest Answers