None of the DSM editions had ever been scientific lmao.
“our understanding of the biology of mental disorders has been slow in coming.”
There’s no biology in mental disorders; none of them have objective phenomena and they are arbitrarily given and created.
Someone help me understand this. From what I know they are arbitrarily created to make it easier to categories groups of symptoms and try to understand mental conditions by approximating them to very similar circumstances.
Mental disorders is still a new field and for the DSMs it was always expected to only capture the newest discoveries of that time, as the field is slowly progressing our understanding of mental health.
But aren’t they just describing symptoms and phenomena? From what I’ve heard they are supposed to make it easier to understand mental conditions and magically create phenomena; they are supposed to describe what we see and support theories and relate to similar phenomena, so a therapist or psychologist knows how to proceed.
Please correct if I’m wrong because I am not a medical professional, I’ve only been at the receiving end of therapy.
I am not a doctor but did some neuroscience graduate studies and will try to provide a basic explanation.
The biggest problem with our current understanding of mental illness is we cannot directly connect the cause of mental illnesses to the symptoms like we can in other illnesses of the body. We run into a problem due to the complexity of the brain. For example, Parkinson’s disease is generally caused by degradation of the substantia nigra. This causes problems with dopamine signalling leading to paralysis. However, there are psychiatric disorders, for example the catatonic subtype of schizophrenia, which are defined by periods of paralysis that are not affected by the same medications used to treat Parkinson’s disease. To use Major Depressive Disorder as an example we have multiple classes of drugs that work on different chemical levels (serotonin and norepinephrine being the most common) and systems in the brain but don’t have a one size fits all treatment.
The focus of the DSM is a diagnosis guide that focuses on standardization of symptomology and diagnosis. It has guides on best treatment practices but it is not the primary purpose of the DSM.
Neither the diagnoses nor their criteria are arbitrarily created. Researchers look at clinical data and notice that some symptoms of mental illness co-occur at higher rates that cannot be due to random chance, and when they isolate a group of symptoms that co-occur fairly regularly, that becomes the basis for a new diagnosis. It’s far from a perfect system, but it’s the best one we’ve got while the brain remains the mystery it is. And it is scientific, it’s just on the softer side due to a necessary reliance of “soft” data like self-reporting.