#Diagnostic and Statistical Manual

[theexodvs]

"If the cult of Eros is a religion, does it have a holy text of some sort?"

"Yes. Its adherents regularly point to the DSM-5 when confronted with compulsive sexual behavior disorder and pornography-induced erectile dysfunction, as if the absence of these conditions from this document necessitates an absence from reality."

#cult of eros #cult #cults #dsm-5 #dsm 5 #dsm v #Diagnostic and Statistical Manual #dsm #Just because the authors of your favored book don't claim to be religious doesn't mean claims made based on this book alone aren't fanatic #When will the cult of Eros fight the neurodiversity crowd? #The nd folks passionately despise the DSM-5 for calling autism a disorder #P 0 rn addicts and Thomas the Train fans duking it out is the holy war I want to see! #CSBD #erectile dysfunction #PIED

[gwydionmisha]

#Charles Silverstein #The Joy of Gay Sex #Queer History #Diagnostic and Statistical Manual #May His Memory Be a Blessing

[princesskuragina]

Her ass diagnosed with that shit from the BDSM-5

#(Bondage and Discipline and Diagnostic and Statistical Manual)

[thejakeformerlyknownasprince]

Genuine question, what’s wrong with the DSM?

[OP refers to the Diagnostic and Statistical Manual of Mental Disorders, which I mentioned being unpopular among mental health professionals.] Disclaimer: I'm not a psychiatrist, I'm not a therapist, and I'm not trained in counseling. I'm a social psychology researcher. If a therapist contradicts me, listen to the therapist.

The problem with the DSM as I understand it: a lot of counselors/ psychiatrists/ etc. want to move away from a category- and source-based diagnostic system, toward a symptom-based treatment system. For example, think about Pepto Bismol: you feel nauseous, you chew pink tablets, it ends your nausea. It doesn't matter if your nausea is indigestion or seasickness or lactose intolerance. You match a treatment (pink bismuth) to a symptom (nausea) and don't waste time or money on diagnosis unless that treatment proves ineffective.

A large percent of counselors etc. would like to take the same approach to mental health. So we'd be researching treatments for nightmares (neurofeedback? MDMA?) in the long-term, and giving clients treatments for nightmares (meditation! Ambien!) in the short-term. All without worrying too much about whether the nightmares are caused by General Anxiety Disorder or a phobia or Seasonal Affective Disorder. There are many strengths to that approach.

Only, see, there's this big purple dinosaur holding us back.

[Image ID: Hardcover copy of the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, DSM-5, American Psychiatric Association; the title is white text on a purple background.]

So if everyone who uses the DSM also hates the DSM, why does it still exist and why do we keep buying it every time a $100 text revision gets published? Two reasons, in order of importance:

Insurance

Communication

Insurance is, I kid you not, the DSM's #1 reason for existence. American insurance companies won't cover treatment unless it's for a diagnosed illness, and so therapists put diagnosed illnesses on what they'd often be more comfortable describing as "bro, this dude is hella distressed and I'm trying to help undistress him." Note the word American on the cover; other countries have other manuals, and no other country's counselors are as chained to theirs as we are to ours. This means that the DSM helps — yay, affordable therapy! It means the DSM hurts — sets of symptoms get grouped artificially, spectra get split into categories, and diagnosis happens way too early in the therapeutic process.

Another comparison to unmental health: I don't have carpal tunnel syndrome, but my insurance provider thinks I do. I only announce that I don't because I haven't told you who I am or where I live. (If the insurance companies find us... Well, we just won't let them find us. The thing you should know is everyone is getting screwed by health insurance. Yeah, even you.) I have wrist pain and tingling. It has the wrong antecedents for carpal tunnel, and it has weird manifestations — pressure on the base of my thumb causes pain in my pinky — but my OT wrote down "Carpal Tunnel" on the forms because the alternative was a $500+ round of diagnostic scans. No one cares whether my median nerve is inflamed or not; occupational therapy still looks like "try this stretch, that stretch, this brace, that brace, and these activity changes; keep whichever combination makes the pain and tingling go away."

This kind of thing also happens in mental health all the time. Many therapists don't care — and neither should you — if your serotonin levels are low; if you're miserable and an SSRI prevents the misery, take the dang SSRI. If your mother was harshly critical and now you feel panic at any hint of criticism, it doesn't matter whether that better fits C-PTSD or NPD; it matters whether you cope with soothing self-talk or if you cope with alcohol. Put something from the DSM on the forms, and focus on finding which stretches (breathing exercises) make the tingling (panic) go away.

Communication is the biggest strength of the DSM. It means that clients can benefit from labels ("I'm not lazy, I'm ADHD") and consistent standards of treatment can be applied across different clients in different states. The DSM has huge lists of things like "if your client shows memory problems, be sure to check for alcohol abuse" or "if they have self-harm, make sure it's non-suicidal before you do anything else" that are tremendously helpful. It can help therapists who encounter a set of behaviors they've never seen before to go "client is rigid, rule-bound, and lacks insight... huh, looks like I'd better refer them to an OCPD specialist." (It's also the source of a lot of toxic misinformation on social media when symptom lists get taken out of context without that all-important differential diagnosis information, but I digress.)

However, diagnosis should never be the beginning point for therapy — it's impossible to know your client's mind without first building trust and transference — but reliance on the DSM for insurance often forces it to be. Diagnosis should never be the end point for therapy — knowing your perceptions don't match others' because of Bipolar I won't stop you hearing the dang hallucinations — but home use of the DSM often acts that way. Categorical diagnosis is limiting if your therapist is primarily interested in how depressed you are but the Beck Depression Inventory uses an absolute cutoff point for "depressed" or "non-depressed." Categorical diagnosis is useless if over 50% of people diagnosed with a depression are later diagnosed with an anxiety disorder, and vice versa. So it's an imperfect book that does a lot of things well and a few things badly, and many of its heaviest users would argue that it shouldn't exist at all.

For further reading, I recommend The Body Keeps the Score by Bessel van der Kolk. I don't agree with all the axes he grinds or all the ways he grinds them, but he's got decades of psychiatry experience and is (I hope) predicting the next paradigm shift in mental health.

For instance, van der Kolk argues that it doesn't matter if at intake your client has long blond hair and is named Linda, only to show up the next time with no hair and the name Gerald, only to come next time with short red hair and the name Taylor. The therapist should only be asking "how does the client feel about these changes?" and "what are these changes doing for the client?" If Linda can't remember what Gerald did, then focus on the terrible memory gaps that alter identities create. If Taylor became Gerald to try and please you, then focus on teaching mindfulness and self-compassion. If this is a happily genderqueer person, then figure out why they're seeking help and don't worry about the appearance changes. If this is someone who thinks in absolutes and regards their personality as constantly changing, then work on teaching them to see the world and themself with moral complexity. It doesn't matter whether Dissociative Identity Disorder exists or not; just ask your client what they need and how you can help, then go from there.

Anyway, the DSM is an imperfect solution to a complex problem, and a lot of mental health practitioners view it as a relic of a more paternalizing era. No one has come up with a really good solution for how to remove and replace it, so for now it's the least-bad option.

#dsm #dsm 5 #psychology #psychological research #therapy #counseling #mental health #diagnostic and statistical manual of mental disorders #psychiatry #diagnosis #long post #(almost) nothing to do with animorphs #depression mention #ptsd mention #suicide mention #american politics #to be 100% clear: I *do not know enough* to have an opinion about whether or not Dissociative Identity Disorder exists #i only know that some very expert people have argued for it *and* that some very expert people have argued against it #and that all these very expert people absolutely agree on listening to the client howsoever the client chooses to identify #more research is needed #I reiterate: I AM NOT A THERAPIST AND NONE OF THIS IS MEANT AS MENTAL HEALTH ADVICE

[avocadosockz]

you’re in her dms

i’m in her dsm-5

we are not the same

#i came up with this myself hehehe #grace does jokes #diagnostic statistical manual #aka the book of slays #and mental disorders whatever

[rodrickonfire]

DSM-V TR - Gender Dysphoria.PDF 2022

If anyone wants a PDF here it is

#transgender #trans #trans rights #dsm v tr #dsm #gender dysphoria #Diagnostic and Statistical Manual of Mental Disorders (DSM-5-TR) #Diagnostic and Statistical Manual of Mental Disorders

[seventeen-sideblogs]

PSA to all trans people that feel invalid:

The DSM 5 has an entire section on gender and gender dysphoria. Don’t lose hope, there are still organizations that believe you.

#for anyone that doesn’t know the dsm 5 is the #diagnostic and statistical manual of mental disorders fifth edition #it was made by the American psychiatric association and is basically considered the Bible of psychology

[capybapybara]

just doing a bit of light reading *pulls out DSM-5*

#my favorite bedtime story #diagnostic and statistical manual of mental disorders #kicking my feet like a school girl

[snailgirlpancreas]

kinky sex got me feeling like a bug psychiatrist the way it's Bee DSM time

#ub original #text #funny #psychology #and you call them the diagnostic and statistical manual despite the fact they are obviously statisticless? #DSM #Bees

[theexodvs]

Going to start referring to cumbrains as "Kinseyans," and insisting they accept different "interpretations" of the DSM-V so that it doesn't *really* deny the existence of pornography addiction.

Also going to note how the members of the governing bodies that determined the content of the DSM 5 were surrounded from youth by Hooters, Victoria's Secret, and adult video stores on all sides, so their denial of porn addiction needs to be placed in its proper cultural and historical context.

#Alfred Kinsey #dsm 5 #DSM-5 #Kinseyanity #Kinseyans #Addiction #addiction recovery #hermeneutics #Anthropology of religion #Secular creed #Secular cults #Fundamentalism #Not so funny once your reversed texts are put under the lens of historical criticism is it? #dsm #diagnostic statistical manual 5

[prozac-shaped-urn]

lmao just typed in "football documentary ncaa" in youtube and i think i went down the wrong rabbit hole. my tennessee vols orange blood is boiling at the thought of watching any of these.

#back up back up baCK UP #UNDO #BIG MISTAKE #ABORT MISSION #oof this ahs meets dsm idea might not be the best one folks #ahs = american horror story; dsm = diagnostic and statistical manual of mental disorders #irl post #writing

[bradfordblitz]

"I'm coming over, you better not be a book about diagnosing mental illnesses when I get there!"

My unruly ass:

#dsm 5 #Diagnostic and Statistical Manual of Mental Disorders #shitposting #chaoscore

[vlupshittous]

When the APA released the DSM they really said "let's make a book and fill it with The Horrors"

#DSM #diagnostic and statistical manual of mental disorders #apa #american psychiatric association #the horrors

[adhdbisexualramblings]

Lmao look what I made

I’m using it to study >:D

#The plan is to spin the wheel and read and study a diagnosis every week or when I can #Not even for a class I just wanna do it for funsies #I fuckin love psychology #psychology #dsm-5 #diagnostic and statistical manual of mental disorders #Version 5 text revision #Studying

[aurpiment]

Becoming increasingly convinced that the neurotypical does not exist and he was invented to sell more copies of the diagnostic and statistical manual.

#mt #and yes he’s a man obv

[opencommunion]

Understanding the theory’s ascent from fringe forums to scientific journals to the halls of Congress helps clarify some of the moral panic and pernicious logic employed to restrict the autonomy and rights of trans people today. It also serves as a vivid example of how questionable science can be weaponized to achieve political goals.

A number of studies on trans youth have taken on “misinformational afterlives,” says TJ Billard, an assistant professor of communications at Northwestern University and executive director of the Center for Applied Transgender Studies. Among them are four papers published between 2008 and 2013 that have together been used to claim that most children “grow out” of gender dysphoria and opt not to transition. All have been shown to have numerous shortcomings. In some, nearly 40% of young people surveyed did not meet the criteria for the official gender dysphoria diagnosis in the Diagnostic and Statistical Manual of Mental Disorders edition used at the time. In two, researchers classified some subjects as having detransitioned—or reversed their transition—purely on the basis of whether a parent or third party said it happened. A 2018 study found that three of the papers labeled those who had stopped responding to researchers as detransitioners; and in one, a subject who identified as nonbinary was classified as detransitioning.

“There’s a wealth of bad science that is out there, and this science doesn’t stay in journals,” Billard says. Parents unfamiliar with trans issues, who don’t understand gender-affirming health care and don’t have the expertise to read the studies themselves, often fall under its sway.

... When Littman took up the question, she decided to survey parents, who she felt would be easier to reach than trans youths themselves. In her Methods section, she writes that “to maximize the chances of finding cases meeting eligibility criteria”—meaning youths who suddenly became gender dysphoric, according to their parents—she turned to three websites: 4thwavenow.com, a “community of people who question the medicalization of gender-­atypical youth”; transgendertrend.com, which says it’s concerned about “the unprecedented number of teenage girls suddenly self-identifying as ‘trans’”; and youthtranscriticalprofessionals.org, a now-private website that was “concerned about the current trend to quickly diagnose and affirm young people as transgender.”

The results were in line with what one might expect given those sources: 76.5% of parents surveyed “believed their child was incorrect in their belief of being transgender.” More than 85% said their child had increased their internet use and/or had trans friends before identifying as trans. The youths themselves had no say in the study, and there’s no telling if they had simply kept their parents in the dark for months or years before coming out. (Littman acknowledges that “parent-child conflict may also explain some of the findings.”) 

Arjee Restar, now an assistant professor of epidemiology at the University of Washington, didn’t mince words in her 2020 methodological critique of the paper. Restar noted that Littman chose to describe the “social and peer contagion” hypothesis in the consent document she shared with parents, opening the door for biases in who chose to respond to the survey and how they did so. She also highlighted that Littman asked parents to offer “diagnoses” of their child’s gender dysphoria, which they were unqualified to do without professional training.  It’s even possible that Littman’s data could contain multiple responses from the same parent .... But politics is blind to nuances in methodology. And the paper was quickly seized by those who were already pushing back against increasing acceptance of trans people. ... Many people who are citing Littman’s work probably haven’t even read the study or seen the correction, Billard says: “People are citing a Reddit post in which somebody invoked the idea of Littman and her research.” Littman agrees with this characterization. “It boggles my mind how people are comfortable holding forth on topics that they haven’t actually read papers [about],” she says. 

... Lawmakers in more than 25 states have introduced anti-trans bills during 2022 legislative sessions. Politicians writing such legislation have plenty of questionable studies, partisan doctors, and associations that lobby against transgender rights to draw on. Littman’s ROGD study is often a go-to. The Coalition for the Advancement & Application of Psychological Science wrote in 2021 that many of the “over 100 bills under consideration in legislative bodies across the country that seek to limit the rights of transgender adolescents” are “predicated on the unsupported claims advanced by ROGD.”