|Behavioral Perspectives on the DSM-5 and the Biomedical Model of Mental Disorders
|Sunday, May 25, 2014
|9:00 AM–9:50 AM
|W179a (McCormick Place Convention Center)
|Area: CBM/TPC; Domain: Theory
|Chair: Stephen E. Wong (Florida International University)
|CE Instructor: Stephen E. Wong, Ph.D.
This symposium will examine the newest psychiatric diagnostic manual and the dominant biomedical model of mental disorders from a behavior-analytic viewpoint. Presentations will critique the logic of clustering problematic behaviors into purported mental disorders, the adequacy of data used to define these categories, the internal inconsistency and incoherence of the resulting nosology, and the principal beneficiaries of this classification system. Curious and absurd aspects of the manual will be highlighted. Presenters will also briefly review the low efficacy of drug treatments linked with psychiatric diagnoses, and the immense professional and industrial advertising campaigns that promote the biomedical approach.
|Keyword(s): critique DSM-5
Behavior Analysis Revisits Schizophrenia: What's in a DSM-5 Diagnosis?
|STEPHEN E. WONG (Florida International University)
This presentation will begin by briefly reviewing the origins of applied behavior analysis in studies conducted in the late 1950s teaching skills to and reducing problem behavior in persons with psychotic disorders, including schizophrenia. It will then examine problems in the current diagnosis of schizophrenia including reliance on questionable data, arbitrary criteria and categorization, inadequate precision for assessment and treatment evaluation, and omission of information on historical and current environmental factors that might have caused and now maintain the psychotic behavior, respectively. Some alternatives to the DSM-5 will be discussed including continuous recording of clients specific problems and goals, and functional assessments and functional analyses. The presentation will discuss how biomedical assumptions implicit in the DSM-5 diverts mental health workers attention from behavioral interventions for mental disorders, thereby perpetuating the biomedical monopoly of mental health services.
|Doctor! There's a Behavior Analyst in My DSM-5!
|MERRILL WINSTON (Professional Crisis Management, Inc.)
|Abstract: The DSM has undergone numerous revisions over the years, sometimes expanding diagnoses to be more inclusive, sometimes narrowing the scope of a diagnostic category and at other times creating new diagnoses. Regardless of the Roman or Arabic numerals that follow it, the DSM is essentially an attempt to categorize various aspects of human behavior that fall at either end of the bell shaped curve of “normal” behavior. Adding diagnostic labels to clusters of behavior and/or lack thereof adds nothing to our understanding of the problems and provides us with no real treatment directions. In fact these diagnoses are mostly useful for billing purposes and little else. Mental health diagnoses are too quickly reified into palpable “brain problems” that people have and soon become the reason for the behavior instead of a convenient description. Diagnoses are not so much what we “have” but what we do and do not do. More specifically, one can categorize any mental health diagnoses in terms of fundamental dimensions of behavior including frequency, magnitude and duration. Other diagnoses are mostly problems that are related to aberrant reinforcers/aversives, skills deficits, and faulty stimulus control.
|The Walking Dead of Pseudo-Explanation: Rise of the DSM-5
|W. JOSEPH WYATT (Marshall University)
|Abstract: The latest version of the Diagnostic and Statistical Manual, DSM-5, was published in 2013 by the American Psychiatric Association. Development of the widely used diagnostic nomenclature will be reviewed, with emphasis on the minimal employment of science in the process of this latest revision. An especially unfortunate implication of the revision is its inexorable contribution to circular “explanations” of behavioral disorders. Specific suggestions will be made to aid attendees as they function within systems where yet another highly-touted version of the DSM is erroneously thought of as explanatory.