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Undisclosed financial conflicts of interest in DSM-5 (2024)

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Re: Undisclosed financial conflicts of interest in DSM-5 (2024)

#121

Post by zeckalpha »

sedivy94 wrote: post #95
Retric wrote: post #94

Earlier quoted context omitted.

> What’s the psychiatric equivalent of a sprained ankle? A concussion? Obviously it’s not considered a psychiatric condition but concussions check a lot of the right boxes abstractly.

What’s the right word to differentiate this from a psychiatric diagnosis? Neurological?

Not in my understanding. The line between neurological and psychiatric is more about history than about anatomy.

Instead, I would point to the physical trauma of a concussion as the differentiating factor.

Re: Undisclosed financial conflicts of interest in DSM-5 (2024)

#122

Post by KPGv2 »

suggestion wrote: post #117
phren0logy wrote: post #83

I’m a psychiatrist, so if you consider that a significant bias I’m disclosing it. While there has been a level of diagnostic expansion that I don’t think is helpful, it’s also important to consider: What’s the psychiatric equivalent of a sprained ankle? Does something have to be catastrophic to warrant a diagnosis?

There isn't one because a sprained ankle is a binary diagnosis. One of the biggest problems with psychiatry is that every diagnosis is a spectrum, and over time it's become more and more obvious that the boundaries for what is considered "neurotypical" are way too narrow. Depression being a chemical imbalance was a complete lie to sell more medication, and how prolific this type of occurrence is within the industry i…

> only the catastrophic is worth addressing

This is a very privileged view of the mind. I have ADHD (and autism). But I also have a quite high IQ, if one cares about such things. I'm pretty successful, professionally.

But it took until around 40yo to get the ADHD diagnosis and get a prescription for medication that has been life-altering. Was I suffering from catastrophic failures? Absolutely not: married, have kids, in the 1%, etc.

But have the meds had an incredibly positive influence on my life? Hell yes. I can do things that everyone else acted like was normal, but I straight up couldn't do it before. Housework is a prime example. It was like torture. Sitting around waiting for people to finish their sentences because they're "talking as slow as molasses" made for often unenjoyable social experiences.

But with the meds, this stuff is either tolerable or fun. My life is significantly better thanks to medical interventions. Instead of my wife blowing up because I didn't do something like mop the kitchen floor, I actually get it done (without meds I straight up cannot hold that kind of task in my mind if I'm not in the room looking at the mess; I will flit between ten other things in a different part of the house, then walk through the kitchen to get into my car to pick up the kids, see the kitchen, and think "ah, fuck me")

I'm happy that you're neurotypical and have a great life, but that's not true for a lot of us, and the idea that "only catastrophic mental issues should be dealt with by professionals" is you just telling on yourself and your ignorances.

Re: Undisclosed financial conflicts of interest in DSM-5 (2024)

#123

Post by ben_sisko »

The DSM diagnostic categories are glorified billing codes that everybody (who actually has real ground contact with mental health care for real for real) recognizes as primitive, Stone Age relics.

In five or ten years, these categories will feel like missteps of the past (akin to calling all mental illness “hysteria”).

Re: Undisclosed financial conflicts of interest in DSM-5 (2024)

#124

Post by suggestion »

KPGv2 wrote: post #122
suggestion wrote: post #117

Earlier quoted context omitted.

There isn't one because a sprained ankle is a binary diagnosis. One of the biggest problems with psychiatry is that every diagnosis is a spectrum, and over time it's become more and more obvious that the boundaries for what is considered "neurotypical" are way too narrow. Depression being a chemical imbalance was a complete lie to sell more medication, and how prolific this type of occurrence is within the industry i…

> only the catastrophic is worth addressing This is a very privileged view of the mind. I have ADHD (and autism). But I also have a quite high IQ, if one cares about such things. I'm pretty successful, professionally. But it took until around 40yo to get the ADHD diagnosis and get a prescription for medication that has been life-altering. Was I suffering from catastrophic failures? Absolutely not: married, have kids,…

Why do you presume I'm neurotypical and undiagnosed with any psychiatric disorder? I'm formally diagnosed with severe OCD, depression, and ADHD. I was on SSRI, then SNRI and additionally methylphenidate for years. Eventually I got tired for feeling like a shell of a human being, and weaned off of the SNRI. It took a lot of effort to induce neuroplasticity and ease my OCD and depression, but I did it. Eventually, I weaned off the methylphenidate because I believed I could do it if I tried. Later in life, I also gained and eventually lost weight, which was a similar acceptance that "bad" things, like hunger, are ok and a symptom of something good, my body consuming fat. Then the same for sore muscles at the gym. Over time, I accepted discomfort and the fight or flight my brain was constantly trying to force onto me was a lie, and eventually my brain and nervous system caught up. My physical and mental health improved, my social life, my professional life, etc.

I bet if you knew your house would burn down if you didn't do "normal" things you would have done them no problem.

Stimulants make otherwise unenjoyable things enjoyable? Who would have thought? Do you think people that do "normal" things enjoy them? Is it necessary to enjoy everything all the time?

Re: Undisclosed financial conflicts of interest in DSM-5 (2024)

#125

Post by ben_sisko »

suggestion wrote: post #117
phren0logy wrote: post #83

I’m a psychiatrist, so if you consider that a significant bias I’m disclosing it. While there has been a level of diagnostic expansion that I don’t think is helpful, it’s also important to consider: What’s the psychiatric equivalent of a sprained ankle? Does something have to be catastrophic to warrant a diagnosis?

There isn't one because a sprained ankle is a binary diagnosis. One of the biggest problems with psychiatry is that every diagnosis is a spectrum, and over time it's become more and more obvious that the boundaries for what is considered "neurotypical" are way too narrow. Depression being a chemical imbalance was a complete lie to sell more medication, and how prolific this type of occurrence is within the industry i…

“Chemical imbalance” lol.

You have inadvertently outed yourself as not having a clue by your reply. It’s nothing personal but you just clearly don’t have a clue and/or don’t have skin in the game.

It’s fine. I don’t know anything about professional juggling because I have zero skin in that game.

Paging Dr. Brochacho: fMRI and brain networks have been around for a while!

Re: Undisclosed financial conflicts of interest in DSM-5 (2024)

#126

Post by ben_sisko »

vjulian wrote: post #38

What counts as a “disorder” is often not based on empirical evidence but on what is determined as undesirable, maladaptive, or outside the social norm…by Americans. The DSM in many ways represents the worst of so-called social science.

The exercise and food science people are the worst of social science buddy. Or just “social” something, because it’s not science. “Science-based” always makes me laugh.

The DSM only matters if somebody is actively seeking treatment for something that they have a problem with in their own situation. So what’s in there is totally irrelevant for the public at large. It’s only if somebody shows up and says there’s something going on that they don’t like. It’s really just billing codes, man. The reality is far different anyway, and it just gets distilled down to these primitive codes.

Re: Undisclosed financial conflicts of interest in DSM-5 (2024)

#127

Post by ben_sisko »

aleph_minus_one wrote: post #99
reorder9695 wrote: post #44

Earlier quoted context omitted.

How else would you do it? Unlike an e.g. viral infection there is no positive test you can look at. Generally a disorder is considered something that significantly impacts someone's life, getting in the way of things like working, social life, life enjoyment. I don't think you can be totally objective about this, and you get into things like if i.e. autism is mild is it a disorder? It's pretty clear to me it should b…

> Generally a disorder is considered something that significantly impacts someone's life, getting in the way of things like working, social life, life enjoyment. With the same argument, we could arguue that working and social life are getting in the way how I am, thus working and social life should be considered disorders.

Sounds like you need to read better books Bromaster General!

Re: Undisclosed financial conflicts of interest in DSM-5 (2024)

#128

Post by erikerikson »

fsckboy wrote: post #84
yoshuaw wrote: post #39

Earlier quoted context omitted.

It's hard to tell honestly. I studied psychology for two years in uni, and I dropped out rather disillusioned about the field. Some of my least favorite aspects included: - Acknowledgement by our professors that P-hacking (pruning datasets to get the desired results) was not just common, but rampant - One of our classes being thrown in limbo for several months after we found out that a bunch of foundational research…

> P-hacking rampant give us your best academic hypothesis as to why p-hacking is rampant: I'll bet it will sound like psych analysis

Incentives. Straight outta the dismal science.

Re: Undisclosed financial conflicts of interest in DSM-5 (2024)

#129

Post by KPGv2 »

dluan wrote: post #111
fsiefken wrote: post #107

Earlier quoted context omitted.

> Experiencing first-hand just how unreproducible most research in our faculty was (SPSS was the norm, R was the exception, Python was unused). How did you experience this? Did you fail to reproduce the same results when doing the research again while using R? This is how I interpret your statement, but I think it's not what you mean. If SPSS was the norm, R or SciPy shouldn't have made a difference in reproducibilit…

obviously p-hacking wouldnt be as prevalent if we just re-wrote DSM in rust

there'd be way too many personality traits included tho

Re: Undisclosed financial conflicts of interest in DSM-5 (2024)

#130

Post by interstice »

suggestion wrote: post #124
KPGv2 wrote: post #122

Earlier quoted context omitted.

> only the catastrophic is worth addressing This is a very privileged view of the mind. I have ADHD (and autism). But I also have a quite high IQ, if one cares about such things. I'm pretty successful, professionally. But it took until around 40yo to get the ADHD diagnosis and get a prescription for medication that has been life-altering. Was I suffering from catastrophic failures? Absolutely not: married, have kids,…

Why do you presume I'm neurotypical and undiagnosed with any psychiatric disorder? I'm formally diagnosed with severe OCD, depression, and ADHD. I was on SSRI, then SNRI and additionally methylphenidate for years. Eventually I got tired for feeling like a shell of a human being, and weaned off of the SNRI. It took a lot of effort to induce neuroplasticity and ease my OCD and depression, but I did it. Eventually, I we…

If I knew my house would burn down if I forgot where my keys where it wouldn't do much more than turn me into a paranoid barely functional mess. Higher stakes do not automatically help. Although ironically part of being ADHD is functioning well in high stakes situations, it's not healthy to create high stakes situations in order to function (although some people do this).
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