The Diagnostic and Statistical Manual of Mental Disorders (abbreviation: DSM) is a publication of works that classify psychiatric disorders. The DSM is created and published by the American Psychiatric Association.
Criticisms
There are a number of different criticisms that have been leveled against the DSM and its usefulness as a diagnostic manual.
Lack of Objective Analysis
The DSM does not require the use of objective analysis.
Questionable Pathologization
Homosexuality
The DSM-I and DSM-II classified homosexuality as personality disorders under abnormal sexual deviations.[1][2]
Transvestitism
Transvestism was classified in the DSM-I and DSM-II as a sexual deviation; while the subsequent iterations classify it as a paraphilic disorder.[1][2][3][4] This classification has garnered controversy from transvestites as they argue that classification associates transvestism with stigma and imply that transvestism is a mental disorder.
Sadism & Masochism
Sadism and masochism was classified in the DSM-I and DSM-II as a sexual deviation;[1][2] while the subsequent iterations classify them as a paraphilic disorder.[3][5][6] This classification has garnered criticism from BDSM practitioners for potential discrimination of general BDSM practitioners; there was no requirement for clinically significant impairment; and perpetuation of stigma around BDSM.[7] However, the DSM-5 introduced a criterion that Sexual Sadism and Masochism Disorder must cause clinically significant distress.[8]
Financial conflicts of interest
A large portion of the designing staff of the DSM-IV had received funding, in some method, from pharmaceutical companies.[9]
Further Reading
- Diagnostic and Statistical Manual - Mental Disorders (1952). [LG]
- Diagnostic and Statistical Manual of Mental Disorders: Second Edition (1968). [LG]
- Diagnostic and Statistical Manual of Mental Disorders: Third Edition (1980). [LG]
- Diagnostic and Statistical Manual of Mental Disorders: Third Edition (Revision) DSM-III-R (1987). ISBN 9780890420195 [LG]
- Diagnostic and Statistical Manual of Mental Disorders: Fourth Edition (1994). ISBN 9780890420614 [LG]
- Diagnostic and statistical manual of mental disorders: Fourth Edition (Text Revision). (DSM-IV-TR) (2005). ISBN 9780890420256 [LG]
- Diagnostic and Statistical Manual of Mental Disorders, 5th Edition: DSM-5 (2013). ISBN 9780890425558 [LG]
- American Psychiatric Association (2022). Diagnostic and Statistical Manual of Mental Disorders, 5th Edition Text Revision: DSM-5-TR. ISBN 9780890425770 [LG]
References
- ↑ 1.0 1.1 1.2 “Sexual Deviation:
This diagnosis is reserved for deviant sexuality which is not symptomatic of more extensive syndromes, such as schizophrenic and obsessional reactions. The term includes most of the cases formerly classed as "psychopathic personality with pathologic sexuality." The diagnosis will specify the type of the pathologic behavior, such as homosexuality, transvestism, pedophilia, fetishism and sexual sadism (including rape, sexual assault, mutilation).”
American Psychiatric Association (1952). Diagnostic and Statistical Manual - Mental Disorders: 'B. Definition of Terms; II' (pp. 38-39). - ↑ 2.0 2.1 2.2 “302 Sexual deviations
This category is for individuals whose sexual interests are directed primarily toward objects other than people of the opposite sex, toward sexual acts not usually associated with coitus, or toward coitus performed under bizarre circumstances as in necrophilia, pedophilia, sexual sadism, and fetishism. Even though many find their practices distasteful, they remain unable to substitute normal sexual behavior for them. This diagnosis is not appropriate for individuals who perform deviant sexual acts because normal sexual objects are not available to them.
302.0 Homosexuality
…
302.3 Transvestitism
…
302.4 Exhibitionism
302.5* Voyeurism*
302.6* Sadism*
302.7* Masochism*”
DSM-II Diagnostic and Statistical Manual of Mental Disorders (Second Edition) (1968) (p. 44). - ↑ 3.0 3.1 “Paraphilias
…
302.30 Transvestism
302.83 Sexual masochism
302.84 Sexual sadism”
Diagnostic and Statistical Manual of Mental Disorders: Third Edition: 'The Diagnostic Categories: Text and Criteria; Psychosexual Disorders' (1980) (p. 18). - ↑ “B. The fantasies, sexual urges, or behaviors cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.”
Diagnostic and Statistical Manual of Mental Disorders, 5th Edition: DSM-5 (p. 734). ISBN 9780890425558 - ↑ “The Paraphilias are characterized by recurrent, intense sexual urges, fantasies, or behaviors that involve unusual objects, activities, or situations and cause clinically significant distress or impairment in social, occupational, or other important areas of functioning. The Paraphilias include Exhibitionism, Fetishism, Frotteurism, Pedophilia, Sexual Masochism, Sexual Sadism, Transvestic Fetishism, Voyeurism, and Paraphilia Not Otherwise Specified.”
Diagnostic and Statistical Manual of Mental Disorders: Fourth Edition: 'Sexual and Gender Identity Disorders' (p. 493). ISBN 9780890420614 - ↑ Diagnostic and Statistical Manual of Mental Disorders, 5th Edition: DSM-5 (p. 726). ISBN 9780890425558
- ↑ Merissa Nathan Gerson (2015-01-13). "BDSM Versus the DSM"
- ↑ “B. The fantasies, sexual urges, or behaviors cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.”
Diagnostic and Statistical Manual of Mental Disorders, 5th Edition: DSM-5 (p. 726). ISBN 9780890425558 - ↑ Cosgrove, L., Krimsky, S., Vijayaraghavan, M., & Schneider, L. (2006). Financial Ties between DSM-IV Panel Members and the Pharmaceutical Industry. Psychotherapy and Psychosomatics, vol.75(3) (pp. 154–160). doi: 10.1159/000091772 [HUB]