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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)

#201

Post by suggestion »

autoexec wrote: post #200
suggestion wrote: post #181

Earlier quoted context omitted.

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…

Asian Americans and East Asians have lower suicide rates than Americans (over 60% lower), and especially American white males, you've fallen for a false trope, which is exactly what I expected when I posed the question. I knew that you would immediately appeal to this false trope because you're looking for an excuse.

They outperform by the metrics that matter for a clinical diagnosis and the West is so quick to jump to the conclusion that they're "under diagnosed", it's a uniquely Western and especially American conclusion.

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

#202

Post by bgilroy26 »

suggestion wrote: post #137
bgilroy26 wrote: post #131

Earlier quoted context omitted.

>I bet if you knew your house would burn down if you didn't do "normal" things you would have done them no problem Getting yourself to do things in a boring situation that you might only do in an exciting situation is a big challenge in ADHD management If everything was a "house on fire" level emergency, many ADHDers would get more done but would eventually collapse from running around on adrenaline for days These pr…

The point is it's obviously a problem of perspective. Things are not important because they aren't considered important. If the stakes are higher they are elevated in importance and more demanding of attention. To pretend that humans are hedonic beasts incapable of cognitive adaption is ridiculous. We do not operate purely on impulse save for pharmaceutical intervention. We can force ourselves to give things more or…

The situation you're describing is circular. Perspective taking and prioritization are executive functioning skills and executive functioning skills are precisely what are lacking in a person who has ADHD

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

#203

Post by moi2388 »

dns_snek wrote: post #185
ddq wrote: post #180

Earlier quoted context omitted.

Can you provide evidence-based numbers of how many people's lives have been saved or improved vs how many have been ruined or ended in part due to the guidelines DSM? Or what the outcomes would have been had psychiatry not continued to rely on it as the gold standard? Without a comparison, a vague, unsubstantiated claim such as that is worthless.

I'm not familiar with every diagnosis in the DSM-5, but I'm very familiar with ADHD. The DSM lays down the diagnostic criteria, brain scans of people diagnosed according to those criteria have confirmed structural and functional differences, and even more extensive studies have confirmed the overwhelming efficacy of the medication used to treat the disorder. Is that worthless? Claiming that DSM-5 is "worthless" simpl…

Homosexuality was in the DSM. As was hysteria.

Because they looked at clusters of symptoms, rather than actual causes.

Precisely my point.

As for ADHD etc; you do realise they changed the treatments and clustering precisely because of insight in physical processes?!

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

#204

Post by suggestion »

bgilroy26 wrote: post #202
suggestion wrote: post #137

Earlier quoted context omitted.

The point is it's obviously a problem of perspective. Things are not important because they aren't considered important. If the stakes are higher they are elevated in importance and more demanding of attention. To pretend that humans are hedonic beasts incapable of cognitive adaption is ridiculous. We do not operate purely on impulse save for pharmaceutical intervention. We can force ourselves to give things more or…

The situation you're describing is circular. Perspective taking and prioritization are executive functioning skills and executive functioning skills are precisely what are lacking in a person who has ADHD

This is a gross over exaggeration of ADHD and under exaggeration of the effectiveness of non pharmacological treatments

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

#205

Post by rrsp »

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?

Why does psychiatry need to have an ‘equivalent’ of a sprained ankle?

Most people recognise a sprained ankle, at least mild ones, as a self limiting illness. An issue with psychiatric diagnoses is that they are often not taken to be self limiting and often become a large part of a patients self image. While sometimes this can be helpful and help inform treatment it can also be harmful and I have seen this harm first hand in patients I see.

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

#206

Post by dns_snek »

moi2388 wrote: post #203
dns_snek wrote: post #185

Earlier quoted context omitted.

I'm not familiar with every diagnosis in the DSM-5, but I'm very familiar with ADHD. The DSM lays down the diagnostic criteria, brain scans of people diagnosed according to those criteria have confirmed structural and functional differences, and even more extensive studies have confirmed the overwhelming efficacy of the medication used to treat the disorder. Is that worthless? Claiming that DSM-5 is "worthless" simpl…

Homosexuality was in the DSM. As was hysteria. Because they looked at clusters of symptoms, rather than actual causes. Precisely my point. As for ADHD etc; you do realise they changed the treatments and clustering precisely because of insight in physical processes?!

Those things make it flawed, not worthless. Your "precise" point was that the DSM-5 is worthless, please don't move the goalposts now.

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

#207

Post by dns_snek »

suggestion wrote: post #197
dns_snek wrote: post #194

Earlier quoted context omitted.

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 pharmaco…

> You're absolutely insistent that virtually any amount of "negative effects" is sufficient for diagnosis

There you go again, I'm doing nothing of the sort. They complained of severe difficulties and called some of them "torture".

You took that, minimized their complaints and accused me of wanting to medicate anyone suffering "virtually any amount of negative effects" which apparently includes the person who self-described it as torture.

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

#208

Post by tsoukase »

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.

You are wrong. Medicine does not need physical mechanisms for any diagnosis or therapy. It is preferable but not obligatory. A mere grouping of a symptom cluster forms a diagnosis as well as a therapeutic target.

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

#209

Post by epgui »

aleph_minus_one wrote: post #104
epgui wrote: post #77

Earlier quoted context omitted.

I’ve had a bunch of neuro/psycho classes and this was always well understood. This stuff is complicated. People are going to get it wrong. That sucks. But if you’re going to judge the book, judge it by how it presents itself, don’t judge it by how a third party misrepresents it.

> But if you’re going to judge the book, judge it by how it presents itself, don’t judge it by how a third party misrepresents it. As long as the boards don't go after the shrinks who "misrepresent" the DSM, I would claim that this misrepresentation is systemic of (and possibly even intended by) the psycho-industrial complex.

Boards are expected to “go after” professionals who do not provide a certain standard of care, but that has very little (if anything) to do with the DSM.

I think this comment just reinforces a misunderstanding of what the DSM actually is.

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

#210

Post by jychang »

rrsp wrote: post #205
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?

Why does psychiatry need to have an ‘equivalent’ of a sprained ankle? Most people recognise a sprained ankle, at least mild ones, as a self limiting illness. An issue with psychiatric diagnoses is that they are often not taken to be self limiting and often become a large part of a patients self image. While sometimes this can be helpful and help inform treatment it can also be harmful and I have seen this harm first…

That sounds like not the psychologist’s fault. Don’t blame the doctor if their patient makes a sprained ankle their identity.

If someone smokes a lot of cigarettes and gets lung cancer, we don’t blame the doctor for the lung cancer. This shit is the patient’s responsibility.

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