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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)

#81

Post by isbwkisbakadqv »

BobbyTables2 wrote: post #65

I have particular issue with “diseases” defined as done for osteopenia. Rather than define an objective measure of the problem, they (by definition) effectively define the percentage of the population affected. In other words, osteopenia is defined in such a way that it is not curable, preventable, etc. What is the point saying, “disease X affects 5% of the population by definition”. It’s like throwing away half the…

That’s not accurate in the case of osteopenia. It’s defined by a T score. The quantile of the distribution of bone density measurements of young, healthy people that matched the bone density of this patient. Treatments for osteopenia are basically making sure you’re getting enough calcium, vitaD, and high impact exercise…if everyone did all those things (and they worked), the rate of osteopenia would drop to zero.

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

#82

Post by potato3732842 »

dalemhurley wrote: post #80

Next there will be a paper on the accountants that set accounting standards have a financial interest in accounting.

I'm pretty sure we have tablets from Babylon wherein homeowners are complaining that the building code was ghost written by the mud brick lobbyists.

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

#83

Post by phren0logy »

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?

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

#84

Post by fsckboy »

yoshuaw wrote: post #39
readthenotes1 wrote: post #14

I wonder how much of the DSM is based on loose correlations, non-replicated or fraudulent research. I get the feeling that we understand how our brains work about as well as we understand how well mitochondria work - - and I see reports of new findings on mitochondria fairly regularly...

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

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

#85

Post by plandis »

noosphr wrote: post #79
connicpu wrote: post #57

Earlier quoted context omitted.

But conceptually in the DSM most disorders are defined by whether they cause hardship in the patient's life. Whether that means some disorders would not have to be considered disorders in an ideal society is irrelevant for this context, because people need help navigating the society we have.

Remember that in the US slaves wanting freedom was a mental disorder that made it past peer review: https://en.wikipedia.org/wiki/Drapetomania

What is your point?

Surely you’re not trying to draw some conclusion between an entire countries modern day medical field and a theory a person proposed in the 1800s, right?

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

#86

Post by [deleted] »

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?

[deleted]

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

#87

Post by IFC_LLC »

readthenotes1 wrote: post #14

I wonder how much of the DSM is based on loose correlations, non-replicated or fraudulent research. I get the feeling that we understand how our brains work about as well as we understand how well mitochondria work - - and I see reports of new findings on mitochondria fairly regularly...

I took the liberty of indulging in some reading.

I must admit, it feels a bit strange. The truth is that I learned my first steps in programming by working through large, formidable books. In fact, my very first programming book was Assembly Language for Intel-Based Computers by Kip Irvine. After that, I read even larger books, many of them multiple times.

I have always been fond of reading well-written books by knowledgeable professionals. After reading such works, you come away with real understanding, greater clarity, and often new creativity. Books are valuable, and I have always respected a good one.

Yet the DSM-5-TR is quite the opposite. The Preface clearly states that the work is intended for everyone:

“The information is of value to all professionals associated with various aspects of mental health care, including psychiatrists, other physicians, psychologists, social workers, nurses, counselors, forensic and legal specialists, occupational and rehabilitation therapists, and other health professionals.”

I happen to be a social worker, and I have read a lot of books. I know how to study. I carefully looked up any words I might have misunderstood and used the dictionary freely.

But despite all my efforts, I often failed to make sense of what I was reading. One would expect a theory followed by a conclusion, or an observation leading to a conclusion, or a theorem that is then proven. Unfortunately, that structure is missing here.

A typical DSM entry begins with a statement presented as fact, only to be followed by other statements that seem to contradict it.

Take, for example:

“The prevalence of disinhibited social engagement disorder is unknown. Nevertheless, the disorder appears to be rare, occurring in a minority of children, even those who have experienced severe early deprivation. In low-income community populations in the United Kingdom, the prevalence is up to 2%.”

This kind of contradictory phrasing is standard in the DSM.

Again, the DSM is publicly available, and anyone can read it here: https://www.ifeet.org/files/DSM-5-TR.pdf

I would have expected more precision from a scientific book.

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

#88

Post by bjornsing »

brooke2k wrote: post #55
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.

A "disorder" is just a collection of symptoms that have been empirically shown to benefit from certain treatments. If someone doesn't think they have those symptoms then they can just not seek a diagnosis or treatment. Nobody is forcing a diagnosis on somebody who doesn't want it.

If you look into the history of psychiatry I think you’ll find quite a lot of examples when diagnosis and treatment was forced on people who didn’t want it. It’s not hard to find contemporary such examples either.

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

#89

Post by NoahZuniga »

IFC_LLC wrote: post #87
readthenotes1 wrote: post #14

I wonder how much of the DSM is based on loose correlations, non-replicated or fraudulent research. I get the feeling that we understand how our brains work about as well as we understand how well mitochondria work - - and I see reports of new findings on mitochondria fairly regularly...

I took the liberty of indulging in some reading. I must admit, it feels a bit strange. The truth is that I learned my first steps in programming by working through large, formidable books. In fact, my very first programming book was Assembly Language for Intel-Based Computers by Kip Irvine. After that, I read even larger books, many of them multiple times. I have always been fond of reading well-written books by know…

> This kind of contradictory phrasing is standard in the DSM.

I'm not sure I see what's contradictory in your example. Could you elaborate?

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

#90

Post by bjornsing »

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?

I think it will be hard to expand psychiatry to that level while keeping it professional. The fundamental issue is that people ascribe personality flaws to others instinctually and also have strong feelings around being subjected to such treatment, in a way that they don’t have around sprained ankles. In everyday life it’s called badmouthing or trash-talking. It’s a part of human nature.
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