{"id":27159,"date":"2012-09-11T01:46:41","date_gmt":"2012-09-11T05:46:41","guid":{"rendered":"http:\/\/1boringoldman.com\/?p=27159"},"modified":"2012-09-11T17:52:34","modified_gmt":"2012-09-11T21:52:34","slug":"the-silent-treatment","status":"publish","type":"post","link":"https:\/\/1boringoldman.com\/index.php\/2012\/09\/11\/the-silent-treatment\/","title":{"rendered":"the silent treatment&#8230;"},"content":{"rendered":"\n<p align=\"justify\">I&#8217;m running out of titles &#8211; <em><strong><font color=\"#200020\">all quiet on the western front<\/font><\/strong><\/em>, <em><strong><font color=\"#200020\">the sounds of silence<\/font><\/strong><\/em>, <em><strong><font color=\"#200020\">the silent treatment<\/font><\/strong><\/em> &#8211; ways to describe the status of the DSM-5 Revision. There&#8217;s suddenly nothing to say. The full report on the field trials has yet to appear. The PR site, DSM-5 Facts, won&#8217;t even come up right now, but on my last fly-by, it looked the same as it looked in May. Google news finds neither David Kupfer nor Darrel Regier in anything recent. My understanding is that the DSM-5 Task Force is to present the final product to the APA Board of Trustees in November, a month or so hence. <a target=\"_blank\" href=\"http:\/\/www.psychologytoday.com\/blog\/dsm5-in-distress\"><u><strong><font color=\"#200020\">Dr. Allen Frances<\/font><\/strong><\/u><\/a> has gone quiet. Suzy Chapman&#8217;s blog, <u><strong><font color=\"#200020\">dxrevisionwatch.com<\/font><\/strong><\/u>, the usual resource for matters DSM-5 is likewise quiet. She did report that HHS announced a delay until October 2014 for the implementation of the ICD-10-CM &#8211;       <\/p>\n<p align=\"center\"><a href=\"http:\/\/www.hhs.gov\/news\/press\/2012pres\/08\/20120824e.html\" target=\"_blank\"><img loading=\"lazy\" decoding=\"async\" width=\"500\" height=\"351\" border=\"0\" src=\"http:\/\/1boringoldman.com\/images\/hhs-1.gif\" \/><\/a><br \/>         <sup>[<a target=\"_blank\" href=\"http:\/\/www.hhs.gov\/news\/press\/2012pres\/08\/20120824e.html\">click the graphic for the original<\/a>]<\/sup><\/p>\n<p align=\"justify\">&#8211; and wondered if the HHS decision might spark a delay with the DSM-5, but it didn&#8217;t. Apparently the DSM-5 is on schedule. As for the DSM-5 site, if it has been updated recently, I can&#8217;t find where. During these several months of silence, I&#8217;ve thought about the DSM-5 off and on. Silence would be a good space for pondering, but there&#8217;s nothing much to ponder.   <\/p>\n<div align=\"justify\">From my vantage as someone watching from the outside, it seems like the DSM-5 effort was begun at the crest of a movement, setting out to extend the biological paradigm to new heights with <a target=\"_blank\" href=\"http:\/\/www.amazon.com\/Research-Agenda-DSM-V-David-Kupfer\/dp\/0890422923\/ref=sr_1_1?ie=UTF8&#038;qid=1335739848&#038;sr=8-1\"><u><strong><font color=\"#200020\">A Research Agenda for DSM-5<\/font><\/strong><\/u><\/a>:<\/div>\n<ol>\n<div align=\"justify\"><sup>In   the ongoing quest to improve our psychiatric diagnostic system, we   are  now searching for new approaches to understanding the etiological   and  pathophysiological mechanisms that can improve the validity of our    diagnoses and the consequent power of our preventive and treatment    interventions venturing beyond the current DSM paradigm and DSM-IV    framework. This thought-provoking volume produced as a partnership    between the American Psychiatric Association, the National Institute of    Mental Health, the National Institute on Alcohol Abuse and Alcoholism,    and the National Institute on Drug Abuse represents a far-reaching    attempt to stimulate research and discussion in the field in preparation    for the eventual start of the DSM-V process, still several years   hence.  The book:<\/sup><\/div>\n<ul><sup>       <\/p>\n<li>\n<div align=\"justify\">Explores a variety of basic nomenclature issues,   including  the desirability of rating the quality and quantity of   information  available to support the different disorders in the DSM in   order to  indicate the disparity of empirical support across the   diagnostic  system.<\/div>\n<\/li>\n<li>\n<div align=\"justify\">Offers a neuroscience research agenda to guide   development of a  pathophysiologically based classification for DSM-V,   which reviews  genetic, brain imaging, postmortem, and animal model   research and  includes strategic insights for a new research agenda.<\/div>\n<\/li>\n<li>\n<div align=\"justify\">Presents  highlights of recent progress in  developmental neuroscience,  genetics,  psychology, psychopathology, and  epidemiology, using a  bioecological  perspective to focus on the first  two decades of life,  when rapid  changes in behavior, emotion and  cognition occur&hellip;<\/div>\n<\/li>\n<p>      <\/sup><\/ul>\n<\/ol>\n<div align=\"justify\">It&#8217;s important to note that this was a dramatic change. This was not the atheoretical descriptive DSM-III, this was to be the neuroscience based DSM-5 &#8211; something quite different from before. It was the dream of Robins and Guze coming to life at last. And for four years they had a series of <a href=\"http:\/\/1boringoldman.com\/index.php\/2012\/05\/16\/dreams-of-our-fathers-vii\/\" target=\"_blank\"><strong><u><font color=\"#200020\">conferences<\/font><\/u><\/strong><\/a> with experts discussing the clinical neuroscientific aspects of psychiatric conditions. <strong><font color=\"#200020\">During that four years, they failed to notice two things &#8211; what happened and what didn&#8217;t happen. <\/font><\/strong>  <\/div>\n<p align=\"justify\"><strong><font color=\"#200020\">What happened?<\/font><\/strong> Academic Psychiatry and the Pharmaceutical Industry were increasingly implicated in a series of scandals culminating in a Senate investigation of prominent academic psychiatrists for payola and suits against the companies for fraud. &quot;Psychiatric Expertise&quot; was under suspicion. <strong><font color=\"#200020\">What didn&#8217;t happen?<\/font><\/strong> The anticipated neuroscience breakthroughs failed to materialize &#8211; the best that came from research was still <em>promising<\/em> or less. And the large NIMH drugs trials were hardly inspiring. The lofty goals from&nbsp;<strong><font color=\"#200020\"><a target=\"_blank\" href=\"http:\/\/www.amazon.com\/Research-Agenda-DSM-V-David-Kupfer\/dp\/0890422923\/ref=sr_1_1?ie=UTF8&#038;qid=1335739848&#038;sr=8-1\"><u><strong><font color=\"#200020\">A Research Agenda for DSM-5<\/font><\/strong><\/u><\/a> <\/font><\/strong>didn&#8217;t materialize. Had they noticed along the way, they could&#8217;ve changed gears and taken on improving the DSM-IV [their task in the first place]. <strong><font color=\"#200020\">But that&#8217;s not what they did.<\/font><\/strong> They added a bunch of idiosyncratic things and didn&#8217;t do much to fix the DSM-IV&#8217;s problems. When they began to talk publicly about where they were headed, their predecessors were aghast&nbsp; and sounded alarms. Even then, they could&#8217;ve still turned things around. <strong><font color=\"#200020\">But that&#8217;s not what they did.<\/font><\/strong><\/p>\n<p align=\"justify\">So it became too late. Their research agenda went nowhere &#8211; a failed enterprise. The delegated task of actually revising the DSM-IV stayed on the back burner too long and didn&#8217;t get done &#8211; so much for the other half which became an equally failed endeavor. The one-shot Field Trials were embarrassing. Throw in some arrogance in a time for humility and those peculiar diagnoses, and you have a perfect storm. The DSM-5 revision has allowed itself to become associated with the general disappointment  in an oversold psychopharmacology, a lack of palpable progress in  neuroscience, and the waves of scandal involving the the relationship  between commercial enterprises and academic psychiatry.<\/p>\n<p align=\"center\"><img decoding=\"async\" width=\"500\" border=\"1\" src=\"http:\/\/bobsadviceforstocks.tripod.com\/bobsadviceforstocks\/perfectstorm.jpg\" \/>&nbsp;<\/p>\n<div align=\"justify\">There really isn&#8217;t much left to ponder in their silence&#8230;  <\/div>\n","protected":false},"excerpt":{"rendered":"<p>I&#8217;m running out of titles &#8211; all quiet on the western front, the sounds of silence, the silent treatment &#8211; ways to describe the status of the DSM-5 Revision. There&#8217;s suddenly nothing to say. The full report on the field trials has yet to appear. The PR site, DSM-5 Facts, won&#8217;t even come up right [&hellip;]<\/p>\n","protected":false},"author":2,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_bbp_topic_count":0,"_bbp_reply_count":0,"_bbp_total_topic_count":0,"_bbp_total_reply_count":0,"_bbp_voice_count":0,"_bbp_anonymous_reply_count":0,"_bbp_topic_count_hidden":0,"_bbp_reply_count_hidden":0,"_bbp_forum_subforum_count":0,"footnotes":""},"categories":[2],"tags":[],"class_list":["post-27159","post","type-post","status-publish","format-standard","hentry","category-politics"],"_links":{"self":[{"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/posts\/27159","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/comments?post=27159"}],"version-history":[{"count":47,"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/posts\/27159\/revisions"}],"predecessor-version":[{"id":27211,"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/posts\/27159\/revisions\/27211"}],"wp:attachment":[{"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/media?parent=27159"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/categories?post=27159"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/tags?post=27159"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}