Since the early 1960s, the D.S.M. has had a major role to play in treating patients with mental disorders. When the first edition of this publication came out, the creators were hailed as pioneers in their field; however, in an influential 1974 paper written by Robert Spitzer and Joseph L. Fleiss demonstrated that the ... DSM was an unreliable diagnostic tool1. From the very beginning, the Diagnostic and Statistical Manual of Mental Disorders has had its critics. Many researchers and psychologists believe that this system of diagnosing mental disorders – by using broad categories instead of in-depth analysis – hinders the progress of research and also offers poor treatment to the patients.
In 2011, Dr. Thomas Insel, of National Institute of Mental Health, proposed a new method of diagnosing mental disorders / illnesses. The Research Domain Criteria (RDoC) program cuts across traditional diagnostic categories to identify relationships among observable behavior, neurobiological measures, and patient self-report of mental status2. This new mechanism for approaching mental disorders deals much more with targeting individuals with mental problems and diagnosing them on an exclusive level, not so much using charts and definitions to determine disorders but using personal information to design a custom form of treatment.
Dr. Stewart Shankman, of the University of Illinois at Chicago, spoke on the switch from the DSM model to the RDoC model and explained what he thought were the keys of the more efficient RDoC system. The most recently revised edition of the DSM (DSM-5) was released in May of 2013, and already there are calls to issue a fresh edition. Dr. Shankman argues that the RDoC model can eventually replace the DSM system because it will help researchers develop new and more targeted treatments, and help clinicians classify and treat their patients3. In other words, due to the dimensional form of RDoC – as opposed to the outdated categorical form of DSM – patients would be better treated for their disorders. Certain symptoms may rest under a specific category in DSM, but they could be a result of an illness in a different section; however, in RDoC, these symptoms can correlate to different disorders, and aided with first-hand experience and family history, can personalize the treatment even more4.
Times are changing, and it is best that the methods to improve mental health develop at the same rate as the accessible technology. Otherwise, many distraught Americans will continue to go untreated for years to come.
References:
1 Belluck, Pam, and Benedict Carey. "Psychiatry’s New Guide Falls Short, Experts Say - The New York Times." The New York Times - Breaking News, World News & Multimedia. N.p., 6 May 2013. Web. 4 Mar. 2016. http://www.nytimes.com/2013/05/07/health/psychiatrys-new-guide-falls-short-experts-say.html?_r=0
2 “NIMH RDoC Initiative Strives to Reshape Mental Health Research” N.p., 17 Sept. 2015. Web. 4 Mar. 2016. <http://www.psychologicalscience.org/index.php/publications/observer/2015/october-15/nimh-rdoc-initiative.html>.
3 Shankman, Stewart A., and Stephanie M. Gorka. "Psychopathology research in the RDoC era: Unanswered questions and the importance of the psychophysiological unit of analysis. "International Journal of Psychophysiology 98.2 (2015): 330-337. Print.
4 Spitzer, R. L., and J. L. Fleiss. "A Re-analysis of the Reliability of Psychiatric Diagnosis." The British Journal of Psychiatry 125.4 (1974): 341-347. Print.
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