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What the heck is DSM-III and why should I care?

Updated: Dec 13, 2018

WHAT IS DSM-III?

The 3rd edition of the Diagnostic and Statistical Manual of Mental Disorders was published in February 1980 with a BANG! At least, the impact of the manual was presumably greater than many could have expected (or feared). DSM-III was a revolutionary manual in many ways, but mainly because it formed a new basis for how mental health disorders were diagnosed from then on, and thus officially created new kind of boundaries between psychiatric disorders and normality. At the same time DSM-III created a much-needed common language for the field of psychiatry, which as a profession had been going through a rough image-crisis in the 1970s.



WHY IS DSM-III IMPORTANT?

One of the big changes in the DSM-III was the new diagnostic criteria ("a symptom checklist approach"), which was created to enhance reliability amongst clinicians and researchers. Symbolically, DSM-III also ended the golden period of psychoanalysis in American psychiatry; it shifted psychiatry closer to a biological model and to the rest of medicine. If you are interested in the current DSM-5, the ongoing debate on the questions of overdiagnosis, growing antipsychiatric mood or the notion of normality, you first really need to understand the history and impact of DSM- III.


WHY IS DSM SO CONTROVERSIAL?

Honestly, the list is longer than now presented to you, but here are a few examples to get us started: the DSM-III was considered at least by some a biological revolution within the profession, and thus it created grudge amongst the profession. The manual is published by the American Psychiatric Association that also collects the profits from its sales. Plus, some argue that DSM system is used for political purposes. Nonetheless, one of the most widely used accusation is that the DSM system has narrowed the concept of "normal" by lowering thresholds and expanding milder conditions as psychiatric disorders.


Nonetheless, few things are sure. There is not one easy way to understand:


1) why the DSM-III became so popular and so disliked at the same time


2) why a diagnostic tool has gotten a powerful nickname: "the bible of psychiatry"


3) why it still stirs such vastly polarized discussions.


I believe that by looking at multiple contexts and different pressures of the time-period we can create a better understanding of these resilient controversies.



My dissertation focuses on development of the DSM-system know widely as the "bible of psychiatry." My aim is to create a better understanding on why the DSM-III became such a controversial “bible” of psychiatry, and why it actually might be a terrible nickname for the DSM-system? As a historian, I will give a thorough interpretation of the socio-economic context and the many pressures that affected the field of psychiatry during the years 1980-1994, from DSM-III to DSM- III-R and DSM-IV.

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