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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)

#191

Post by UpsideDownRide »

ohthehugemanate wrote: post #176
suggestion wrote: post #124

Earlier quoted context omitted.

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…

That's a hell of a journey! Congratulations on the accomplishment and thank you for sharing. Like many other biological systems, neurological wiring is multidimensional and not a natural fit into our arbitrary culturally defined abstractions, or even language. And the dimensions themselves are multifaceted expressions of multiple genes and environmental factors. I am happy to hear stories like yours, of people who ca…

You are overselling ADHD meds by quite a bit. There is plenty of data in literature that quite a bit of people will not respond positively to meds. So if they work for you that's great. But lightly shaming someone by implying they might be anti medicine is super uncool and as an ADHD person you really should know better. Lets not invalidate each other just because experiences are not exactly the same.

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

#192

Post by suggestion »

dns_snek wrote: post #189
suggestion wrote: post #183

Earlier quoted context omitted.

They were incomprehensibly difficult for me, so yes. My mind and body literally entered fight or flight at the thought of not doing a compulsion or forcing myself to focus on doing a task I didn't want to do. "Quality" is an arbitrary definition that means nothing, that's one of the problems we're talking about in psychiatry. The OP clearly mentioned that there was minimal impact on academic, professional, or social…

> "Quality" is an arbitrary definition that means nothing, that's one of the problems we're talking about in psychiatry. Why is that a problem? It's not completely objective but it's the best we have. That criteria is typically combined with more objective neuropsychological testing for a well rounded assessment. > The OP clearly mentioned that there was minimal impact on academic, professional, or social functioning…

So you've clearly just restated what I said which is that it was principally a matter of discomfort, not clinical outcomes or justification, which is the defining characteristic for diagnosis in the DSM.

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

#193

Post by richgroot »

ndr wrote: post #165
moi2388 wrote: post #144

The DSM is a bunch of nonsense. As long as they don’t provide physical mechanisms for disorders, it’s worthless. It clusters symptoms without knowing the underlying causes. It’s like going to the doctor with a runny nose, who the claims it’s influenza, due to the runny nose, without testing for Covid.

While I agree that DSM is likely a bunch of nonsense: > As long as they don’t provide physical mechanisms for disorders, it’s worthless This reasoning will dismiss too many things. We don't know the physics of almost anything, it's all progressive levels of approximation. For the longest time we knew nothing about the physical mechanisms of anesthetics, or how a plane wing works. Science doesn't need the mechanism. I…

Yep. Quantum mechanics, for example, works, even though we don't understand the underlying thing that the model describes.

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

#194

Post by dns_snek »

suggestion wrote: post #192
dns_snek wrote: post #189

Earlier quoted context omitted.

> "Quality" is an arbitrary definition that means nothing, that's one of the problems we're talking about in psychiatry. Why is that a problem? It's not completely objective but it's the best we have. That criteria is typically combined with more objective neuropsychological testing for a well rounded assessment. > The OP clearly mentioned that there was minimal impact on academic, professional, or social functioning…

So you've clearly just restated what I said which is that it was principally a matter of discomfort, not clinical outcomes or justification, which is the defining characteristic for diagnosis in the DSM.

I didn't restate anything, I corrected you because you take every opportunity to downplay negative effects that these disorders have on people's lives, and you've done it again by simply labeling it "discomfort".

You find it problematic that the other person was diagnosed with ADHD simply because their life wasn't a total disaster but I'd like to remind you that it's an attention deficit/hyperactivity disorder and not a "Can't Hold Down a Job" or "Total Failure At Life" disorder and your desire to have it redefined it in those terms wouldn't help anyone.

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

#195

Post by tsoukase »

I am doctor recieving financial support for over two decades. This is a weak and fragile correlation between unspecified financial support and a specific role of a doctor.

1) the support might be given for totally different purposes

2) how much directed material value can a _Diagnostic_ suggestion bring? Follow the editors of therapeutic protocols and you might find something

3) there are a dozen other more problematic arguments about DSM. Eg the choice of the panel comes before any support.

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

#196

Post by birn559 »

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,…

I stopped using house work as example because people always answer "oh yeah, I also dislike housework". People just don't get it when this example is used. I switched to "not able to go outside for a walk even though I like being in nature" and "often not able to follow or participate in long talks with multiple persons".

There also is a good chance I don't have children because just being alive and by myself was super exhausting before I got diagnosed in my late 30. Having children was unthinkable until then.

But was it catastrophic? I don't know. I finished college except it took two times as long and got a job where I of course suffered pretty much the whole time.

But that was all very normal for me, just the way I was, at least that's what I used to believe.

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

#197

Post by suggestion »

dns_snek wrote: post #194
suggestion wrote: post #192

Earlier quoted context omitted.

So you've clearly just restated what I said which is that it was principally a matter of discomfort, not clinical outcomes or justification, which is the defining characteristic for diagnosis in the DSM.

I didn't restate anything, I corrected you because you take every opportunity to downplay negative effects that these disorders have on people's lives, and you've done it again by simply labeling it "discomfort". You find it problematic that the other person was diagnosed with ADHD simply because their life wasn't a total disaster but I'd like to remind you that it's an attention deficit/hyperactivity disorder and no…

I'm using the definition of the threshold necessary for a clinical diagnosis as defined in psychiatry, which is not merely "negative effects" or as I've repeatedly stated "discomfort".

It's something that persistently prevents someone from living a "normal" life, which is also defined far too narrowly.

You're absolutely insistent that virtually any amount of "negative effects" is sufficient for diagnosis and pharmacological intervention which is absolutely not the case.

Nobody is saying it's easy or the discomfort and difficulties aren't real.

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

#198

Post by birn559 »

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.

My inability of being in nature without a feeling of being tortured comes from my brain not working correctly and it's not "undesired behavior". Luckily, my ADHD meds are able to fix that.

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

#199

Post by dotancohen »

autoexec wrote: post #166
dotancohen wrote: post #157

Earlier quoted context omitted.

If the DSM merely described sets of symptoms and gave them names, I'd buy that. But by also mentioning (e.g. suggesting) specific treatments, the book is used as a prescription tool, not just a diagnostic tool. > But if you’re going to judge the book, judge it by how it presents itself Quite so. I just as we judge people by their actions, not their words, I judge the DSM by how it's actual content is structured, not…

Why shouldn't it include a bunch of treatments if they've been shown to be beneficial? How would it be better if people had to go to some other book and look up those same conditions using the names listed in the DSM in order to find out which treatments might be useful? Doctors (at least the good ones) aren't usually going in blind and just doing whatever the DSM tell them to as if they were following a flowchart or…

  > Why shouldn't it include a bunch of treatments if they've been shown to be beneficial?
It most certainly should, I'm not saying it shouldn't. My argument is that, by suggesting specific treatments, the DSM is a prescription tool. Not merely a diagnostic tool.

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

#200

Post by autoexec »

suggestion wrote: post #181
autoexec wrote: post #161

Earlier quoted context omitted.

A person's treatment doesn't depend on what's "normal" it depends on the level of impairment/improvement. Why do you even care if somebody takes medication for a condition they have and it makes their lives easier? Why should anyone avoid a "quick fix" to a major problem because you think they should suffer more discomfort?

East Asians are "impaired" the least, and the presumption among Western scientists, particularly American scientists regarding Asian Americans, is that they are simply undiagnosed despite their out performance in nearly every metric of success. Why do you think that is?

I'm sure it must have nothing at all to do with cultural stigma. If that were true we'd see signs of mental struggles in their home countries. In the US I'm sure all the model minority bullshit people project on them doesn't cause them any extra pressure or anxiety right?

Asian Americans are so successful that they certainly must not have disproportionately higher rates of suicide right? That might be a sign of some "impairment" going unaddressed! Or maybe you see the rate at which they're killing themselves as yet another metric of success? Those scrappy East Asians are just so good at doing stuff!

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