Timely and interesting suggestions! I wonder why you (and Jonathan Shedler) think that the word "disorder" sidelines psychotherapy as a treatment. There is so much evidence for the helpfulness of psychotherapy for conditions such as major depressive disorder, bipolar disorder, and even schizophrenia.
Thanks Miriam! I don't know how much I personally believe that. I was quoting him more so to emphasize the first part (What if DSM had chosen to present itself as a compendium of mental and emotional difficulties rather than disorders?) I don't think "disorder" characterization is supposed to sideline psychotherapy as a treatment and clearly psychotherapies are quite effective for the conditions designated so, but I do think there is some degree of bias in the general public such that "disorder" has the connotations of a "medical problem requiring a medical solution" with an accompanying bias that psychotherapy is not seen as a proper medical treatment. I have encountered attitudes like these at times, but they are based on various sorts of misconceptions.
thank you, this is a helpful read! is i have a few separate responses/thoughts
-i'm imagining such clarifications would result in guiding clinicians towards clearer diagnostic conceptualizations and treatment matching (the latter, in my opinion can be mismatched or even guessed)
-i can see a role in research as well as functional medicine, exploring biological markers and/or genetics in certain disorders (anxiety, depression, PTSD, psychotic disorders first comes to mind)
-i have for some time struggled with the relationship and limits between IDC and DSM- thanks for acknowledging it- somehow i am relieved :) --- HiTOP is refreshing
-empirical validation a fantastic idea, i can see that significantly (& positively) impacting treatment, course of care and weight of a diagnosis.... how arbitrary thresholds can be is a bit disturbing... in curious how this impacts (my field) addiction.
a side thought- Ive had the following discussion with colleagues, I would like a way to understand extreme violence/mass shootings in the US, the tendency for media/public to quickly to categorize it as a mental health issue stomps into the field and (i think) is confusing or misleading, (so far) Ive found it challenging to understand it from the lens of DSM...
To further point 5 - it's clear that a pluralistic framework is required to effectively conceptualise and classify psychopathology/psychological functioning. HiTOP alone would be a start, but perhaps the DSM-6 could be an opportunity to integrate unique insights from taxonomies with greater theoretical validity and/or clinical utility.
The ICF provides a more comprehensive classification of relevant components, permitting more detailed and idiographic descriptions of presentations.
Clinical Staging models continue to show the benefit of considering the temporal nature of pathologies, and staging them correctly can inform treatment.
Network Analysis Frameworks provide statistically robust, and conceptually intuitive, models of understanding the dynamic nature of interrelated symptoms and how to consider comorbidity, moving away from a latent variable perspective.
By the time DSM-6 is, if at all, in development, advancements in RDoC, or Evolutionary Psychopathology/Life-History Theory, may even allow a glimpse at constructing an explanatory, not just descriptive, taxonomy.
One is to hope.
Perhaps an updated review of the unique benefits other frameworks could provide is in order!
Timely and interesting suggestions! I wonder why you (and Jonathan Shedler) think that the word "disorder" sidelines psychotherapy as a treatment. There is so much evidence for the helpfulness of psychotherapy for conditions such as major depressive disorder, bipolar disorder, and even schizophrenia.
Thanks Miriam! I don't know how much I personally believe that. I was quoting him more so to emphasize the first part (What if DSM had chosen to present itself as a compendium of mental and emotional difficulties rather than disorders?) I don't think "disorder" characterization is supposed to sideline psychotherapy as a treatment and clearly psychotherapies are quite effective for the conditions designated so, but I do think there is some degree of bias in the general public such that "disorder" has the connotations of a "medical problem requiring a medical solution" with an accompanying bias that psychotherapy is not seen as a proper medical treatment. I have encountered attitudes like these at times, but they are based on various sorts of misconceptions.
Yes, I'm wondering about why psychotherapy is not thought of as a "medical treatment." Does medicine = pharma and surgery?
thank you, this is a helpful read! is i have a few separate responses/thoughts
-i'm imagining such clarifications would result in guiding clinicians towards clearer diagnostic conceptualizations and treatment matching (the latter, in my opinion can be mismatched or even guessed)
-i can see a role in research as well as functional medicine, exploring biological markers and/or genetics in certain disorders (anxiety, depression, PTSD, psychotic disorders first comes to mind)
-i have for some time struggled with the relationship and limits between IDC and DSM- thanks for acknowledging it- somehow i am relieved :) --- HiTOP is refreshing
-empirical validation a fantastic idea, i can see that significantly (& positively) impacting treatment, course of care and weight of a diagnosis.... how arbitrary thresholds can be is a bit disturbing... in curious how this impacts (my field) addiction.
a side thought- Ive had the following discussion with colleagues, I would like a way to understand extreme violence/mass shootings in the US, the tendency for media/public to quickly to categorize it as a mental health issue stomps into the field and (i think) is confusing or misleading, (so far) Ive found it challenging to understand it from the lens of DSM...
To further point 5 - it's clear that a pluralistic framework is required to effectively conceptualise and classify psychopathology/psychological functioning. HiTOP alone would be a start, but perhaps the DSM-6 could be an opportunity to integrate unique insights from taxonomies with greater theoretical validity and/or clinical utility.
The ICF provides a more comprehensive classification of relevant components, permitting more detailed and idiographic descriptions of presentations.
Clinical Staging models continue to show the benefit of considering the temporal nature of pathologies, and staging them correctly can inform treatment.
Network Analysis Frameworks provide statistically robust, and conceptually intuitive, models of understanding the dynamic nature of interrelated symptoms and how to consider comorbidity, moving away from a latent variable perspective.
By the time DSM-6 is, if at all, in development, advancements in RDoC, or Evolutionary Psychopathology/Life-History Theory, may even allow a glimpse at constructing an explanatory, not just descriptive, taxonomy.
One is to hope.
Perhaps an updated review of the unique benefits other frameworks could provide is in order!