The DSM: mindful science or mindless power? A critical review.

Bassam Khoury,Francesco Pagnini,Ellen J Langer

doi:10.3389/fpsyg.2014.00602

Bassam Khoury, Francesco Pagnini + Show 1 more

Open Access

https://doi.org/10.3389/fpsyg.2014.00602

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Abstract

In this paper we review the Diagnostic and Statistical Manual of mental health (DSM), its scientific bases and utility. The concepts of “normality,” “pathology,” and boundaries between them are critically reviewed. We further use the concepts of mindfulness and mindlessness, and evidence from cognitive and social sciences to investigate the DSM clinical and social impact and we argue against its assigned overpower. We recommend including alternative perspectives to the DSM, such as mindfulness and positive psychology. We also argue for including mindfulness training in psychiatric residency and clinical psychology programs.

Highlights

THE SCIENCE AND UTILITY OF THE DSM A central aim of the DSM taskforce was to set appropriate cutoff points between what is considered “normal” from what is “pathological,” in order to treat the individuals belonging to the latter category
The criteria set for cut-offs between “normal” and “pathological” are “arbitrary” and subjective because there is no laboratory test or biological markers to set the boundary between “normal” and “pathological.” In addition, there is not scientific link between basic science and clinical psychiatry
Last, when normality is set in relationship to the ability of understanding reality, it is arguable that reality itself is constantly changing and hard or even impossible to grasp

Summary

Introduction

THE SCIENCE AND UTILITY OF THE DSM A central aim of the DSM taskforce was to set appropriate cutoff points between what is considered “normal” from what is “pathological,” in order to treat the individuals belonging to the latter category. The taskforce failed to fully implement dimensions in the new DSM and kept its categorical aspect and reduced the thresholds for many diagnostic criteria, which can lead to a wide increase in pathologizing previously considered “normal” individuals (Frances, 2013) making the population almost totally saturated with mental disorders.

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Conclusion