Is the Diagnostic and Statistical Manual of Mental Disorders Effective?


11/24/03





Before, writing this paper I knew very little about the DSM. I know I learned about the DSM in the psychology 101 class I had but, all I could remember was a vague definition about it being a “diagnostic tool”. The only one thing I could truly remember about the DSM was a telephone conversation that I had with my mother a year earlier. At that time I had just changed my major from computer science (a field that my parents know nothing about) to behavioral science (a field that my parents both hold advanced degrees in). Because of my change in majors, my parents somehow thought that wanted to know everything they where doing at work. This lead too many painfully long phone conversation about psychological issues that would end with them asking me questions (e.g. testing me) about what we just talked about. Needless to say I came to loath their phone calls, but I knew the calls meant a lot to my parents so I did not complain too much. The call in question, happen on a school day, about 9:30 in the morning. My mother had called to tell me that she was having trouble diagnosing a new patent of hers, and asked me if I thought diagnosis and the DSM was necessary in the treatment of a patent. At the time I had no idea what the DSM was, but I did not want to sit thought the long winded definition that I was sure she would give, so I stalled the conversation long enough for me to look up the definition on the Internet. Armed with a two sentence definition I had found through www.google.com, I was able to answer the question to my mother’s satisfaction. After which I was pretty cocky and thought I knew all about the DSM. Little did I know I was wrong.


In the last two weeks, I have learned that there is much more to the DSM then I had previously believed. What I have found is that, the Diagnostic Statistical Manual of mental disorder (DSM) is the handbook by which all work in clinical psychology is based, but its role in psychology is a controversial one. There are some who swear by the DSM, using it more like a bible than a handbook. Others say the DSM is nearly useless, and its usage should be stopped immediately. From the reading I have done and from lecture, I have come to believe that, the DSM is an ineffective classification system. With its high comorbidity and formal approach, the DSM hinders the overall diagnosis and treatment of patents. But it is the only system we have, and cannot do without it.


What is the DSM?


The history of the DSM begins in the mid to late 1800’s, when mental disorders first started to be studied within a scientific framework. From the start, it was clear that to further the study of mental disorders, a classification system was needed. Hard sciences had been using classification systems with great success, most notably in the field of medicine. It was only logical to assume that if other sciences had such success with these systems, that psychology should be no different. However it would take many different attempts, and not until nearly a decade later was an accepted set classification system created. In 1882 the first set psychological classification system was developed in the United Kingdom. From the start, this system was believed to be flawed, and after many revisions the system failed to catch on. In 1948 another major attempt to create a scheme was made. In that year the World Health Organization added abnormal behavior to its list in the International Statistical Classification of Disease, injuries, and causes of death (ICD). The ICD was widely used and accepted, yet the mental disorder section of the ICD was not (Davison, 2001). Finally in 1952 the American Psychiatric Association published the first DSM (DSM I), which would evolve into the standard of the field. The DSM I was a thin pamphlet that had 106 different classifications within it. Some of these classification were very vague, and heavily based on Freudian believes, needless to say the DSM was