Psychiatry in the News and the Medicalization of the Emotional Life

The brain in an adult human female as seen from in a cut-away side view. © National Institute of Health | nihseniorhealth.gov

In an article in The New York Times last week, “Psychiatry’s Guide is Out of Touch with Science, Experts Say,” science reporters, Pam Belluck and Benedict Carey, describe an important new initiative by the National Institute of Mental Health (NIMH), the largest source of federal funding for mental health research. The new initiative criticizes the soon to be published fifth edition of the Diagnostic & Statistical Manual of Mental Disorders (DSM-5), offering a new framework for guiding research and focusing funding priorities in mental health research. Belluck and Carey’s article emphasizes the optimism and excitement shared by a number of prominent experts about the adoption of this new framework, known as the Research Domain Criteria (RDoC). In order to understand the true significance of this development, it is important for us to have a greater appreciation of the broader context in which this important change is taking place. I am ambivalent, some significant problems are being addressed, but other problems may be exacerbated in this latest development in the politics of the sciences of the mind and the brain.

Towards the end of May, the American Psychiatric Association will release its new edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). This long awaited update of the DSM (colloquially referred to by some as the “Bible of Psychiatry”) has been the focus of considerable prepublication controversy among mental health professionals and has been discussed extensively in important media outlets including The New York Times. Previous editions of the DSM have also received media attention. But DSM-5 has raised the intensity of the controversy to unprecedented heights, in part because of the widely publicized criticisms of psychiatry insiders including Allan Frances (the chair of the task force that developed DSM-4) and Robert Spitzer (who chaired the DSM-3 task force). Criticisms of DSM-5 are similar in nature (if not intensity) to those leveled at both DSM-4 and DSM-3. For example, claims for the degree of reliability of diagnostic categories are exaggerated, evidence . . .

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