Psychiatry’s Bias Problem

The Association for Women in Psychology (AWP) is continually analyzing and advocating about bias, particularly gender-related, in psychiatric diagnosis, but they’ve got their eyes on the prize these days: the DSMV, set to be published in 2013. For those who aren’t familiar, the DSM, Diagnostic and Statistical Manual of Mental Disorders, is essentially the bible of psychiatry, the manual by which folks are diagnosed and prescribed treatment. As you probably already know, there have been various controversies about the ways in which disorder is defined and the ways in which various facets of personality, genetics, and a mix of the two are pathologized. There have been five revisions since the DSM was first published in 1952. Each version is concurrent with a new battle over which disorders should be removed and which should be added. These seemingly logistical questions are actually wrestling matches over meaning, culture, gender, sex, race, and science.
The AWP has a series of articles that break down some of the most pressing controversies facing us with this new version of the DSM, including: “Anorexia Nervosa and the DSM, Borderline Personality Disorder: The Disparagement of Women through Diagnosis, Female Sexual Dysfunction Diagnoses, Gender Interupted: Controversy and Concerns about Gender Identity Disorder (GID), Should Obesity Be Called a Mental Illness?, Problems with Parental Alienation Syndrome, and Social Class and Classism in Psychiatric Diagnosis.”
In sum, there are a lot of red flags this time around, not the least of which is the current DSM committee’s “fortress-like mentality.” The AWP explains:

In addition, despite the secrecy surrounding the process, additional alarming information about what committee members are considering has already appeared. For instance, a committee was appointed to consider whether “racism” should appear in the DSM-V, a step that would disguise a social evil by making it seem “merely” an individual problem, a mental illness. One danger of such a diagnostic category is that people who commit hate crimes would blame their crimes on alleged mental illnesses and thus avoid criminal punishment (Profit, 2004). This is similar to the category of “rapism,” which was proposed for DSM-III-R and which feminists successfully battled (Caplan, 1995).

So what do we do about it? Unfortunately, because of the secrecy and bureacracy involved, it’s difficult for the layperson to advocate. The AWP has created this clearing house for information on bias in the next edition, in an attempt to inform its members and the press as quickly as possible when things go awry:

Unfortunately, many changes in past editions have been made at the last minute and without the public’s knowledge, so that serious problems have become widely known only after the editions were published; those problems have persisted for many years. Indeed, in the case of the widely publicized claim in the early 1970s that “homosexuality” was being removed from the next edition of the manual – a claim that is still generally believed to be true – it emerged that “ego-dystonic homosexuality” actually remained in the next edition after all (Metcalfe & Caplan, 2004).[1] Situations like this make it difficult to think how to protect the public and how to educate the public and professionals about ways to stop the DSM-V authors from causing harm. We hope that this website will provide some resistance to the DSM-V steamroller.

We’ll certainly do our part to follow this story and keep the Feministing community informed.