DSM 5 Censorship Fails: Support From Professionals and Patients Saves Free Speech: Allen Frances

January 12, 2012 by

DSM 5 Censorship Fails: Support From Professionals and Patients Saves Free Speech by Allen Frances

Post #127 Shortlink: http://wp.me/pKrrB-1ER

Psychology Today

DSM5 in Distress
The DSM’s impact on mental health practice and research.
by Allen Frances, M.D. (Chair, DSM-IV Task Force and currently professor emeritus at Duke.)

DSM 5 Censorship Fails
Support From Professionals and Patients Saves Free Speech

Allen Frances, M.D. | January 12, 2012

Last week I described the plight of Suzy Chapman, a well respected UK patient advocate forced to change the domain name of her website by the heavy handed tactics of the publishing arm of the American Psychiatric Association. The spurious legal excuse was commercial protection of the ‘DSM 5’ trademark; the probable intent was to stifle one of the internet’s best sources of DSM and ICD information. This bullying could not have come at a worse time – just as final decisions are being made on highly controversial DSM 5 proposals and with the third and final draft due for release this spring. This is precisely when a ragged and reckless DSM 5 can most benefit from the widest and most open discussion.

Though APA’s trademark claims were patently absurd, Ms Chapman did not have the necessary resources for a protracted fight against a well staffed legal department. Visits plummeted drastically to her new web address (reaching a nadir of just one hit per day) and the site faced months of slow recovery. But the good news is that APA’s clumsy attempt at censorship has backfired, free speech will prevail, and the site is now more popular than ever.

Suzy Chapman writes:

“I want to thank the many psychiatrists, allied mental health professionals, and science writers who have spoken out in opposition to what they see as arrogant censorship on the part of the American Psychiatric Association. Their outpouring of concern has generated considerable interest on websites, blogs and social media platforms. This has increased the traffic on my site by many hundreds of visitors per day. The support of professionals and patient groups illustrates the power of the internet to resist suppression of patient advocacy and to promote free speech.”

“The purpose of my site is to raise public and stakeholder awareness of the forthcoming revisions of both DSM-5 and ICD-11. I endeavor to provide timely and accurate information about DSM-5, including: internet commentaries on proposals; flag ups of journal papers and editorials; news releases and other media statements; and updates on changes to the DSM-5 timeline. I also cover progress on ICD-11, including activities of the Revision Steering Group; documents, presentations and videos; and updates on the ICD-11 timeline. I report on developments with the forthcoming US ICD-10-CM and proceedings of a US federal Advisory Committee to HHS in relation to coding issues. Finally, I follow the advocacy campaigns and initiatives relating to DSM and ICD classificatory issues. My objective is to help stakeholders understand the issues so that they may provide the most useful feedback to the revision process.”

“Despite all the controversies, despite the calls for independent review, despite all the delays and limitations of its field trials, DSM-5 hurtles forward towards publication in May 2013. During this final, decisive year of DSM 5 decision making, I shall continue to publish information, updates and commentaries to promote the widest possible dialogue around the drafting of this most important publication. My new site, ‘Dx Revision Watch – Monitoring the development of DSM-5, ICD-11, ICD-10-CM’ can be found at: https://dxrevisionwatch.wordpress.com/

“This experience has taught me that the APA trademark claims were not only misguided, but probably legally indefensible. ‘Nominative fair use’ is permitted those who are publishing criticism within texts if use of the trademark is relevant to the subject of discussion or necessary to identify the product, service, or company. Courts have found that non-misleading use of trademarks in the domain names of critical websites (like walmartsucks.com) is to be considered ‘fair use’ by non-commercial users – so long as there is no intent to misrepresent or confuse visitors to the site and when it is clear that the site owner is not claiming endorsement by, or affiliation to, the holder of the mark.”

“Everything I have read suggests that my clearly non-commercial use of my previous subdomain name (dsm5watch.wordpress.com) – with its prominent disclaimer and no intent to mislead – falls well within the concept of ‘fair use’. This then raises the obvious question – what grounds did APA have for serving me with demands and threats of possible legal action? Several people have independently sent me materials on ‘SLAPP’ lawsuits (strategic lawsuit against public participation). These are threats of legal action intended to censor, intimidate, and silence critics by burdening them with the cost of a legal defense – so that they will abandon their criticism or opposition.”

“If you are interested in learning more about ‘SLAPP’ lawsuits, there is a good summary at
http://en.wikipedia.org/wiki/Strategic_lawsuit_against_public_participation

“The Electronic Frontier Foundation is also a very useful resource for legal advice on trademark law for blog and website owners. See http://www.eff.org/issues/bloggers/legal/liability/IP

“The surprisingly spirited and unanimous internet reaction provoked by the APA’s actions will probably discourage it from future pursuit of other ‘fair use’ site owners. I certainly hope so. But if other site owners are issued inappropriate ‘cease and desist’ claims, I do hope they have the resources to seek legal advice before complying.”

“I am very grateful for all the support received in the past week and the many emails thanking me for the work I do. It is gratifying to hear that not only do patients, caregivers and patient organizations rely on my carefully researched and presented content, but that so many professionals are also following my site and find it useful. This experience has been stressful, but I can now say confidently that APA’s actions have definitely backfired –  the many hundreds of additional viewers discovering the site each day will expand its audience and its usefulness.”

All of us owe great thanks to Ms Chapman and to the internet community whose ringing endorsement has allowed her not only to maintain, but also to enlarge, her readership. Ms Chapman will continue to provide the field with the most current and most accurate reporting on DSM 5 during its endgame. I strongly recommend her website as the best clearinghouse for information on DSM 5.

I join Ms Chapman in hoping that this embarrassing episode will discourage APA from all future efforts at abusive censorship – whether they are related to trademark, copyright, or confidentiality agreements. The field must remain vigilant in its efforts to contain APA commercialism and persistent in trying to penetrate APA’s secrecy and inbred decision making. APA must finally come to realize that DSM 5 is an open public trust, not a private business enterprise.

 

Related material:

DSM 5 A Public Trust Or An APA Cash Cow? Commercialism And Censorship Trump Concern For Quality, Allen Frances, M.D., Psychology Today, January 03, 2012

Further media coverage of the APA cease and desist v DSM-5 Watch website issue collated here:  Post #123

Article on “cease and desist” issue: Pity the poor American Psychiatric Association, Parts 1 and 2 by Gary Greenberg

 

Legal information and resources for bloggers and site owners:

1] Wipedia article: Cease and desist
http://en.wikipedia.org/wiki/Cease_and_desist

2] Wipedia article: Strategic lawsuit against public participation (SLAPP)
http://en.wikipedia.org/wiki/Strategic_lawsuit_against_public_participation

3] Electronic Frontier Foundation (EFF)
http://en.wikipedia.org/wiki/Electronic_Frontier_Foundation
http://www.eff.org/

EFF Bloggers’ Rights
https://www.eff.org/bloggers

EFF Legal Guide for Bloggers
https://www.eff.org/issues/bloggers/legal

4] Chilling Effects
http://en.wikipedia.org/wiki/Chilling_Effects_(group)

http://chillingeffects.org/

Chilling Effects FAQ on Trademark Law
http://www.chillingeffects.org/trademark/faq.cgi#QID251

Chilling Effects on Protest, Parody and Criticism Sites
http://www.chillingeffects.org/protest/

5] U.S. Trademark Law, Rules of Practice & Federal Statutes , U.S. Patent & Trademark Office, November 2011 http://www.uspto.gov/trademarks/law/tmlaw.pdf

Filed under Allen Frances, American Psychiatric Association (APA), Criticism of DSM-V, DSM-5, DSM revision process, DSM-5, DSM-5 draft proposals, DSM-5 in the media, DSM-V, ICD-10-CM, ICD-11 Tagged with , , , , , , , , ,

Psychologists call for independent review of DSM-5

January 10, 2012 by

Psychologists call for independent review of DSM-5

Post #126 Shortlink: http://wp.me/pKrrB-1DC

The Coalition for DSM-5 Reform is calling on the American Psychiatric Association to submit its draft proposals for new categories and criteria for DSM-5 to independent scientific review.

An Open Letter and Petition sponsored by the Society for Humanistic Psychology (Division 32 of the American Psychological Association), in alliance with several other American Psychological Association Divisions, attracted nearly 7000 signatures in its first three weeks. Since launching the petition, on October 22, over 10,300 mental health and allied professionals have signed up with over 40 organizations publicly endorsing the Open Letter.

You can view the Open Letter and iPetition here

Yesterday, January 09, Division 32 Open Letter Committee sent another call to the American Psychiatric Association Board of Trustees and DSM-5 Task Force to submit controversial proposals for DSM-5 to independent scrutiny.

PSYCHOLOGISTS CALL FOR INDEPENDENT REVIEW OF DSM-5

January 9, 2012

ATTENTION:                                                                                                                                                                                    David J. Kupfer, M.D., Chair of DSM-5 Task Force
Darrel A. Regier, M.D., M.P.H., Vice Chair of DSM-5 Task Force
John M. Oldham, M.D., President of the American Psychiatric Association
Dilip V. Jeste, M.D., President-Elect of the American Psychiatric Association
Roger Peele, M.D., Secretary of the American Psychiatric Association

To the DSM-5 Task Force and the American Psychiatric Association:

We appreciate your opening a dialogue regarding the concerns that the Division 32 Open Letter Committee and others have raised about the proposed DSM-5.  Your willingness to do this suggests that both the Task Force and our committee are in basic agreement that we both want the DSM-5 to be empirically grounded, credible to mental health professionals and the public, and safe to use.  In keeping with this spirit of open dialogue, we are writing in regard to what we view as a critically important issue.

You will recall that the Division 32 Open Letter Committee, along with the American Counseling Association, recently asked the DSM-5 Task Force and the American Psychiatric Association to submit the controversial portions of the proposed DSM-5 for external review by an independent group of scholars and scientists who have no ties to the DSM-5 Task Force or the American Psychiatric Association.

As you know, it is common practice for scientists and scholars to submit their work to others for independent review.  We believe it is time for an independent group of scientists and scholars, who have no vested interest in the outcome, to do an external, independent review of the controversial portions of the DSM-5.  We consider this especially important in light of the unprecedented criticism of the proposed  DSM-5 by thousands of mental health professionals, as well as mental health organizations, in the United States and Europe.

Will you submit the controversial proposals in DSM-5 to an independent group of scientists and scholars with no ties to the DSM-5 Task Force or the American Psychiatric Association for an independent, external  review?  

We respectfully ask that you not respond again with assurances about internal reviews and field trials because such assurances, at this point, are not sufficient.  We believe an external, independent review is critical in terms of ensuring the proposed DSM-5 is safe and credible.  If you are unwilling to submit the controversial proposals for external, independent review, we respectfully ask that you provide a detailed rationale for your refusal.  Because the DSM is used by hundreds of thousands of mental health professionals, we are publicly posting this letter and will also post your response.   We believe mental health professionals, along with concerned mental health organizations, in the United States and Europe will be very interested in this important exchange.

Sincerely,

David N. Elkins, PhD,  Chair of the Division 32 Open Letter Committee   Email:  David Elkins

Frank Farley, PhD, Member of Committee
Jonathan D.  Raskin, PhD, Member of Committee
Brent Dean Robbins, PhD,  Member of Committee
Donna Rockwell, PsyD, Member of Committee

Resources
 
 

Open Letter and iPetition

Coalition for DSM-5 Reform on Twitter    @dsm5reform

Coalition for DSM-5 Reform on Facebook

Coalition for DSM-5 Reform website

This initiative is also being covered on

The Society for Humanistic Psychology Blog

The Society for Humanistic Psychology on Twitter    @HumanisticPsych

The Society for Humanistic Psychology on Facebook

Filed under American Psychiatric Association (APA), British Psychological Society, Coalition for DSM-5 Reform, Criticism of DSM-V, DSM-5, DSM revision process, DSM-5, DSM-5 draft proposals, DSM-5 in the media, DSM-5 Petitions, DSM-V Tagged with , , , , ,

America Is Over Diagnosed and Over Medicated: Allen Frances on Huffington Post

January 9, 2012 by

America Is Over Diagnosed and Over Medicated: Allen Frances on Huffington Post #1

Post #125 Shortlink: http://wp.me/pKrrB-1Di

Today, Allen Frances, MD, who chaired the Task Force that had oversight of the development of DSM-IV has published the first of a series of blogs, on Huffington Post, on his concerns for DSM-5.

Huffington Post

Allen Frances | January 9, 2012
Professor Emeritus, Duke University

America Is Over Diagnosed and Over Medicated

“…The really bad news is that the bulk of psychiatry is no longer done by psychiatrists. Psychiatric medicines are most often prescribed by primary care doctors who are always busy and usually under trained in psychiatry. And their diagnostic and treatment decisions are heavily influenced by drug company advertising aimed directly at patients combined with aggressive marketing campaigns aimed at doctors.

“The result is massive overprescription of medicine for off label, untested, and inappropriate indications. Drug companies have more unregulated freedom in the U.S. than anywhere else in the world to push their product where it does not belong. Their success is measured in returns to shareholders, not benefits to patients…”

“…They call them ‘scientific hypotheses’ that can always be tested and corrected after DSM 5 is published. This is dead wrong and dangerously reckless. DSM 5 will have a dramatic effect on peoples lives and everything in it must be certified safe and scientifically sound.

“Final decisions on DSM 5 will be made soon. I will post a series of blogs highlighting its worst proposals and updating the efforts to shoot them down before they can become official…”

Read on here Allen Frances on Huff Po #1

Filed under Allen Frances, American Psychiatric Association (APA), DSM revision process, DSM-5, DSM-5 consultation, DSM-5 draft proposals, DSM-5 in the media, DSM-5 Petitions, DSM-V

Resources and media coverage: American Psychiatric Association “cease and desist” v DSM-5 Watch website

January 4, 2012 by

Post #123 Shortlink: http://wp.me/pKrrB-1Bi

Update: Commentary on APA’s threats of legal action in paper by Dr Monica Greco:

Monica Greco (2016) What is the DSM? Diagnostic manual, cultural icon, political battleground: an overview with suggestions for a critical research agenda, Psychology & Sexuality, 7:1, 6-22, DOI: 10.1080/19419899.2015.1024470

Dr. Monica Greco is a Reader in the Department of Sociology at Goldsmiths, University of London and a Fellow of the Humboldt Foundation. She is the author of Illness As a Work of Thought: A Foucauldian Perspective on Psychosomatics (Routledge, 1998) and of articles on psychosomatics, vitalism, medical humanities and the sociology of unexplained symptoms.

Click to access Greco%20-%20What%20is%20the%20DSM%20for%20GRO.pdf

Media coverage: American Psychiatric Association (APA) “cease and desist” v DSM-5 Watch website;

Legal information and resources for bloggers and site owners

Media coverage and blogger commentaries on “APA ‘cease and desist’ use of DSM 5 mark in domain name” issue

Neurobonkers

APA Shut Down DSM-5 Blogger

Knight Science Journal Tracker

Psychiatrists issue legal threat, silencing blogger critical of diagnostic manual.

Paul Raeburn | March 1, 2012

also

National Association of Science Writers

Reporting on Health

William Heisel’s Antidote

Investigating Untold Health Stories

Part One: February 27, 2012

Slap: American Psychiatric Association Pressures Brit DSM5 Blogger Suzy Chapman

Part Two: February 29, 2012

William Heisel: Slap: American Psychiatric Association Targets One DSM5 Critic, Ignores Others

Psychiatry Update (Australia)

DSM 5 blogger bounces back

Kate Aubusson | January 19, 2012

Behaviorism and Mental Health

An alternative perspective on mental disorders

Philip Hickey, Ph.D.

What’s New? APA Threats, Xanax, Etc.

Philip Hickey  | January 23, 2012

From a Polish blogger, January 16, 2012

From a Spanish psychologist, January 9, 2012

From a Spanish blogger, January 7, 2012

Salty Current

APA bullies blogger

SC (Salty Current) | January 18, 2012

“…I think what we may be witnessing with the broad challenges to the DSM-5 is the beginning of the end for this psychiatric model. Its flaws, failures, and cooptation by corporate interests are becoming more widely known, and it’s unraveling. Efforts at evasion and intimidation like these merely dramatize the process.”

retired doc’s thoughts

James Gaulte

Southwest, United States
Trained in and practiced internal medicine and pulmonary disease
Interests: current state of medicine from a technical and philosophical point of view

American Psychiatric Association “Slapps” down web site critical of DSM5

James Gaulte | January 12, 2012

“Dr. Bernard Carroll, former head of psychiatry at Duke, writing on the blog Health Care Renewal, writes about an interesting conflict between the APA and a former editor of DSM. See here

“Dr. Allen Francis who edited DSM4 has been highly critical of the DSM process and particularly of the yet to be released DSM5. He expresses concern that psychiatry is being practiced less by psychiatrists and more by primary care physicians, who are busy and often not very well trained in managing psychiatric problem and at times strongly influenced by marketing.

“His criticism includes the charge that with the publication of DSM5, not yet released, there will be more patients diagnosed with DMS defined mental conditions as new diagnoses are being added and the criteria for others have been broadened. His comments regarding his view of the problems with DSM were appearing on at least one web site.

“Now the APA, who owns DSM and profits from its publication and use, has sent out a cease and desist threat to the website previously known as “dsm5watch”…”

Full commentary

1 Boring Old Man

1 Boring Old Man | January 16, 2012

“But this is about more than just Suzy’s site, it’s about the worst kind of arrogance – the worst kind because the people at the APA and the APPI don’t seem to have a clue how arrogant they really are.”

Nederlog

Good news: “DSM-5-censorship fails”

Maarten Maartensz M.A. Psy, B.A. Phil | January 14, 2012

Is the American Psychiatric Association a terrorist organization?

Maarten Maartensz M.A. Psy, B.A. Phil | January 04, 2012

Psychology Today

DSM5 in Distress
The DSM’s impact on mental health practice and research.
by Allen Frances, M.D. (Chair, DSM-IV Task Force and currently professor emeritus at Duke.)

DSM 5 Censorship Fails
Support From Professionals and Patients Saves Free Speech

Allen Frances, M.D. | January 12, 2012

“Last week I described the plight of Suzy Chapman, a well respected UK patient advocate forced to change the domain name of her website by the heavy handed tactics of the publishing arm of the American Psychiatric Association. The spurious legal excuse was commercial protection of the ‘DSM 5’ trademark; the probable intent was to stifle one of the internet’s best sources of DSM and ICD information. This bullying could not have come at a worse time – just as final decisions are being made on highly controversial DSM 5 proposals and with the third and final draft due for release this spring. This is precisely when a ragged and reckless DSM 5 can most benefit from the widest and most open discussion.”

Read on 

PLoS Blogs

Neuroanthropology

About Neuroanthropology

Neuroanthropology forms part of PLoS Blogs, and is one of eleven founding blogs that joined with PLoS.org, everyONE and Speaking of Medicine to provide a comprehensive network that covers science and medicine…Daniel Lende is Associate Professor in Anthropology at the University of South Florida. He trained in medical, psychological, and biological anthropology and public health at Emory University…

Wednesday Round Up #160

Daniel Lende  | January 11, 2012

“This week I lead off with some controversy over the new edition of the Diagnostic and Statistical Manual, DSM 5, which is due out in 2013. This is not the first time the DSM 5 has come into the public’s eye (it’s been there pretty much since it got announced), but the focus has zoomed in on the machinations of the American Psychiatry Association, the force behind DSM 5, in protecting its DSM 5 brand while also maintaining closed control over the production of the new set of diagnoses.”

Read on here

Mindhacks

Mindhacks | January 07, 2012

The manual that must not be named

Science Isn’t Golden
Matters of the mind and heart
by Paula J. Caplan, Ph.D.

Top Psychiatrists Again Try to Quash Debate
APA shuts down website critical of DSM-5

Paula J. Caplan, Ph.D. in Science Isn’t Golden | January 06, 2012

American Psychiatric Association Shuts Down Critical Website

“As you read the following, think what an outcry there would be if the silencing came from a third-world dictator (or maybe even the U.S. government) and was directed against pro-democracy protestors or protestors against any real harm.”

Thought Broadcast

Two New Ways To Get Sued

Steve Balt, MD | January 06, 2012

“The last week hasn’t been a very uplifting one for psychiatrists who pay attention to the news. For as much as we complain about shrinking reimbursements, the undue influence of Big Pharma, and government meddling in our therapeutic work, we psychiatrists now have two new reasons to be concerned.

“And, maybe, to lawyer up.

“I. APA Threatens Blogger
Most readers who follow this blog will certainly have seen this story already, after first being reported in Allen Frances’ Psychology Today blog. So I know I’m just preaching to the choir here, but frankly, in my opinion, this story cannot receive too much attention.”

Gary Greenberg

About the author

Gary Greenberg Blog

http://www.garygreenbergonline.com/

Pity the poor American Psychiatric Association, Part 1

Pity the poor American Psychiatric Association, Part 2

Gary Greenberg | January 05, 2012

“Why the APA would make themselves into a Goliath is not clear to me. The DSM offers Paranoid Personality Disorder, but this episode makes me wish Frances hadn’t shied away from his proposal for a Self-Defeating Personality Disorder. Because it is not clear to me how they win this one.”

Beyond Meds
Alternatives to psychiatry

APA for DSM5 takes legal action against a website with the URL: http://dsm5watch.wordpress.com/

giannakali | January 04, 2012

“Seems to me the APA is feeling the heat and digging themselves in even deeper.”

I Speak of Dreams

Passions: Effective parenting and education, learning disabilities, non-profit management, horses, and fun!

Yet More Legal Thuggery, This Time from the American Psychiatric Association

I Speak of Dreams | January 05, 2012

“I am not an attorney or in any way educated in the legal system, but this seems to me to be intimidation, pure and simple.”

Behavioral.net

1984 Revisted, II: Big Brother on the Run

“The American Psychiatric Association keeps on undermining its credibility, or more to the point, plays a mean big brother.”

Jack Carney, DSW | January 04, 2012

Hooked: Ethics, Medicine and Pharma blog

Updates and Commentary related to HOOKED: ETHICS, THE MEDICAL PROFESSION, AND THE PHARMACEUTICAL INDUSTRY, by Howard Brody, MD, PhD (Rowman and Littlefield, January, 2007)

From Health Care Renewal: Egregious Behavior of the APA

Howard Brody | January 04, 2012

“Dr. Carroll makes a number of on-target observations in his post. He notes that this action by the APA amounts to what’s called “SLAPP,” which as I discussed in HOOKED means “strategic lawsuit against public participation.” In this case it would be a threatened SLAPP rather than a true SLAPP, as no lawsuit was filed, but the fear of having to go up individually against the deep legal pockets of the APA forced the UK blogger to knuckle under promptly.”

The Carlat Psychiatry Blog
Keeping Psychiatry Honest Since 2007

APA Threatens to Sue “dsm5watch” Website

Dan Carlat | January 04, 2012

“It all seems rather heavy-handed to me. After all, the New York Times appears to have no problem with the anti-Times site called TimesWatch. In a democratic society, healthy dissent and debate is part of the package. It may be annoying, but that doesn’t excuse the bullying tactics that the APA has chosen.”

University Diaries

A professor of English describes university life.
Aim: To change things.

The Stalking Cure

Margaret Soltan | January 04, 2012

Health Care Renewal

Addressing threats to health care’s core values, especially those stemming from concentration and abuse of power. Advocating for accountability, integrity, transparency, honesty and ethics in leadership and governance of health care.

SELF INFLICTED DAMAGE

“It is bad enough that the APA resorts to this legal artifice to stifle public discussion. When they do it through their lawyers and business entities rather than through their medical and scientific officers, they sink to a lower level yet. The parallels with corporate sleaze that we have discussed so often on this blog are obvious. For shame.”

Bernard Carroll | January 04, 2012

1 Boring Old Man

DSM-5™…

1 Boring Old Man | January 03, 2012

“Phrases like “of all the lame-brained…”, “you’ve got to be kidding…”, or “what were they thinking?” came immediately to mind on reading this most recent post from Dr. Allen Frances in Psychology Today. After pondering for a bit, I still can’t find anything sensible about playing the trademark card on DSM-5™.”

Soulful Sepulcher

Allen Frances, MD- ” I am surprised and saddened by APA’s ill-conceived attempt to restrict Suzy Chapman’s free expression on DSM 5″

Stephanie at Soulful Sepulcher | January 03, 2012

APA Use Restraints on Blogger

SEROXAT SUFFERERS – STAND UP AND BE COUNTED
A blog by Bob Fiddaman

Bob Fiddaman | January 04, 2012

“The field of psychiatry is doing itself no favours by using intimidation tactics against people that criticize their opinion, let’s face it, the whole premise of psychiatry is based on opinion, I’ve not yet seen any scientific evidence of the chemical imbalance the field of psychiatry tout when someone is depressed or has a psychiatric disorder.

“Chapman’s blog can be read at her new web address HERE. Her work/opinion continues to spread, much to the annoyance of the APA who have probably shot themselves in the foot with their intimidation tactics.

“Memo to the APA – Intimidate a blogger and you put them on a pedastal, you highlight what it is that they have to say… here endeth your first lesson in psychology.”

DSM5 in Distress
The DSM’s impact on mental health practice and research.
by Allen Frances, M.D (Dr Frances was chair of the DSM-IV Task Force and is currently professor emeritus at Duke.)

Is DSM 5 A Public Trust Or An APA Cash Cow?
Commercialism And Censorship Trump Concern For Quality

Allen Frances, M.D. |  January 03, 2012

“I am surprised and saddened by APA’s ill-conceived attempt to restrict Suzy Chapman’s free expression on DSM 5. It can only be in the service of the equally unworthy goals of censorship and/or commercialism. I simply can’t imagine that anything should ever be kept secret in the preparation of a diagnostic manual and wonder what in Suzy Chapman’s web site could possibly be so frightening to APA.

“Using a trademark to suppress comment is a violation of APA’s public trust to produce the best possible DSM 5. This is another indication that DSM has become too important for public health and for public policy for its revisions to be left under the exclusive control of one professional organization – particularly when that organization’s own financial future is at stake. This basic conflict of interest can be cured only by creating a new institutional framework to supervise the future DSM revisions. Censorship and commercial motivations must not warp the development of a safe and scientifically sound diagnostic manual.”

Read full commentary

Legal information and resources for bloggers and site owners:

1] Wipedia article: Cease and desist
http://en.wikipedia.org/wiki/Cease_and_desist
2] Wipedia article: Strategic lawsuit against public participation (SLAPP)
http://en.wikipedia.org/wiki/Strategic_lawsuit_against_public_participation
3] Electronic Frontier Foundation (EFF)
http://en.wikipedia.org/wiki/Electronic_Frontier_Foundation
http://www.eff.org/
EFF Bloggers’ Rights
https://www.eff.org/bloggers
EFF Legal Guide for Bloggers
https://www.eff.org/issues/bloggers/legal
4] Chilling Effects
http://en.wikipedia.org/wiki/Chilling_Effects_(group)
http://chillingeffects.org/
Chilling Effects FAQ on Trademark Law
http://www.chillingeffects.org/trademark/faq.cgi#QID251
Chilling Effects on Protest, Parody and Criticism Sites
http://www.chillingeffects.org/protest/
5] U.S. Trademark Law, Rules of Practice & Federal Statutes, U.S. Patent & Trademark Office, November 2011: http://www.uspto.gov/trademarks/law/tmlaw.pdf

 

Filed under Allen Frances, American Psychiatric Association (APA), Criticism of DSM-V, DSM-5, DSM revision process, DSM-5, DSM-5 draft proposals, DSM-5 in the media, DSM-5 Petitions, DSM-V, Internet censorship

Psychiatric creep – Erasing the interface between psychiatry and medicine

January 3, 2012 by

Psychiatric creep – Erasing the interface between psychiatry and medicine

Post #121 Shortlink: http://wp.me/pKrrB-1A5

As reported in an earlier post, the third draft of proposals for changes to DSM-IV categories and criteria is delayed because DSM-5 field trials are running behind schedule.

This third and final draft is now expected to be released for public review and comment, “no later than May 2012”, according to DSM-5 Task Force Vice-chair, Darrel Regier, MD [1].

 

DSM-5 Somatic Symptom Disorders

One focus of this site has been the proposals of the DSM-5 Somatic Symptom Disorders Work Group

Proposed criteria, as they stood in May, last year, are set out on the DSM-5 Development site here: http://tinyurl.com/Somatic-Symptom-Disorders

There are two key PDF documents which expand on the proposals as currently posted:

         Disorders Description  Key Document One: “Somatic Symptom Disorders”

         Rationale Document  Key Document Two: “Justification of Criteria — Somatic Symptoms”

 

Erasing the interface between psychiatry and medicine 

 

I first reported on Co-Cure, over two years ago, in May 2009, that the conceptual framework the Somatic Symptom Disorders Work Group was proposing would:

“…allow a diagnosis of somatic symptom disorder in addition to a general medical condition, whether the latter is a well-recognized organic disease or a functional somatic syndrome such as irritable bowel syndrome or chronic fatigue syndrome.” [2]

(“Somatic” means “bodily” or “of the body”.)

The most recent version of the Somatic Symptom Disorders Disorders description proposals document states:

“This group of disorders is characterized predominantly by somatic symptoms or concerns that are associated with significant distress and/or dysfunction…Such symptoms may be initiated, exacerbated or maintained by combinations of biological, psychological and social factors.”

“These disorders typically present first in non-psychiatric settings and somatic symptom disorders can accompany diverse general medical as well as psychiatric diagnoses. Having somatic symptoms of unclear etiology is not in itself sufficient to make this diagnosis. Some patients, for instance with irritable bowel syndrome or fibromyalgia would not necessarily qualify for a somatic symptom disorder diagnosis. Conversely, having somatic symptoms of an established disorder (e.g. diabetes) does not exclude these diagnoses if the criteria are otherwise met.”

“The symptoms may or may not be associated with a known medical condition. Symptoms may be specific (such as localized pain) or relatively non-specific (e.g. fatigue). The symptoms sometimes represent normal bodily sensations (e.g., orthostatic dizziness), or discomfort that does not generally signify serious disease.” [3]

 

Psychiatric creep

While the media has focused on the implications for introducing new disorder categories into the DSM and lowering diagnostic thresholds for existing criteria, there has been little scrutiny of the proposals of the Somatic Symptom Disorders Work Group.

This Work Group has been quietly redefining DSM’s Somatoform Disorders categories with proposals that will have the potential for a “bolt-on” diagnosis of a “somatic symptom disorder” for all medical diseases, whether “established general medical conditions or disorders”, like diabetes or angina, or conditions presenting with “somatic symptoms of unclear etiology.”

These radical proposals for rebranding the Somatoform Disorders categories as Somatic Symptom Disorders and combining a number of existing, little-used categories (somatization disorder, hypochondriasis, pain disorder, and undifferentiated somatoform disorder) under a proposed portmanteau term, Complex Somatic Symptom Disorder (CSSD), and the more recently proposed, Simple Somatic Symptom Disorder (SSSD), which requires symptom duration of as little as one month, have the potential for bringing many thousands more patients under a mental health banner.

Complex Somatic Symptom Disorder (CSSD) criteria are here: http://tinyurl.com/DSM-5-CSSD 

Simple Somatic Symptom Disorder (SSSD) criteria are here: http://tinyurl.com/DSM-5-SSSD

These proposals have the potential for expanding markets for psychiatric services, antidepressants and behavioural therapies, like CBT, for the “modification of dysfunctional and maladaptive beliefs about symptoms and disease, and behavioral techniques to alter illness and sick role behaviors”  for all patients with somatic symptoms, if the clinician decides that the patient’s response (or in the case of a child, a parent’s response) to bodily symptoms and concerns about their health are “excessive”, or the perception of their level of disability “disproportionate”, or their coping styles “maladaptive.”

Under the guise of “eliminating stigma” and eradicating “terminology [that] enforces a dualism between psychiatric and medical conditions” by “de-emphasizing the concept of ‘medically unexplained'”, the American Psychiatric Association appears hell bent on colonising the entire medical field by licensing the potential application of a mental health diagnosis to all medical diseases and disorders.

Continued on Page 2

Filed under American Psychiatric Association (APA), Criticism of DSM-V, DSM-5, DSM revision process, DSM-5, DSM-5 draft proposals, DSM-5 in the media, DSM-V, Functional Somatic Syndrome (FSS), Somatic Symptom Disorder, Somatoform Disorders

Is DSM 5 A Public Trust Or An APA Cash Cow? Commercialism And Censorship Trump Concern For Quality by Allen Frances

January 3, 2012 by

Is DSM 5 A Public Trust Or An APA Cash Cow? Commercialism And Censorship Trump Concern For Quality

APA forces domain name change for DSM-5 and ICD-11 Watch site

Post #122 Shortlink: http://wp.me/pKrrB-1Ah

3 January, 2012

On December 22, with just one working day left before offices closed down for the Christmas and New Year holidays, I received two communications from the Licensing and Permissions department of American Psychiatric Publishing, A Division of American Psychiatric Association, informing me that the unauthorized use of the DSM 5 mark in my domain name is improper and in violation of United States Trademark Law.

I was advised that my actions may subject me to contributory infringement liability including increased damages for wilful infringement. I was requested to immediately cease and desist any and all use of the DSM 5 mark, remove the DSM 5 mark from my domain name and provide documentation confirming I had done so, and that any further use would be considered an infringement.

Given the difficulties of liaising from the UK with American Psychiatric Publishing and with my Californian based site hosts, WordPress, over the holiday and mindful of the implied consequences should I delay taking action, I considered I had little option but to change the site’s domain and title.

Since December 23, this site has been operating under the title Dx Revision Watch and the site’s domain name has been changed to

https://dxrevisionwatch.wordpress.com/

As a result of changing the domain name, links on websites, forums and social media platforms for posts published prior to December 23 and for pages cached on Google and other search engines before that date will no longer point to this site and will return a “site deleted” or 404 message.

If you have bookmarked or are linking to this site please update your links.

Today, on Psychology Today, Allen Frances, MD, who had chaired the DSM-IV Task Force, has blogged on the actions American Psychiatric Publishing has taken against this site:

DSM5 in Distress
The DSM’s impact on mental health practice and research.
by Allen Frances, M.D

Is DSM 5 A Public Trust Or An APA Cash Cow?
Commercialism And Censorship Trump Concern For Quality

Allen Frances, M.D. |  January 03, 2012

http://www.psychologytoday.com/blog/dsm5-in-distress/201201/is-dsm-5-public-trust-or-apa-cash-cow

Published on January 3, 2012 by Allen J. Frances, M.D. in DSM5 in Distress

DSM 5 will have a big impact on how millions of lives are led and how scarce mental health resources are spent. Getting the right diagnosis and treatment can be life enhancing, even life saving. Incorrect diagnosis can lead to the prescription of unnecessary and potentially harmful medication and to the diversion of services away from those who really need them and toward those who are better left alone. Preparing DSM 5 should be a public trust of the highest order.

But DSM 5 is also an enormously profitable commercial venture. DSMs are perpetual best sellers (at least one hundred thousand copies sold every year) netting the American Psychiatric Association yearly profits exceeding five million dollars.

From the very start of work on DSM 5, APA took unprecedented steps to protect its commercial interest – but in the process betrayed its obligation to the public trust. Work group members were recruited only on condition that they first sign confidentiality agreements – thereby squelching the free flow of ideas that is absolutely necessary to produce a quality diagnostic manual. ‘Intellectual property’ has been the priority – a safe, scientifically sound DSM 5 has been the victim.

DSM 5 commercialism and heavy handed censorship have recently assumed a new and troubling form. APA is exercising its ‘DSM 5’ trademark to unfairly stifle an extremely valuable source of information. Suzy Chapman, a patient advocate from England, runs a highly respected and authoritative site providing the best available information on the preparation of both DSM and ICD. Her writings can always be relied upon for fairness, accuracy, timeliness, and clarity. The site has gained a grateful following with over 40,000 views in its first two years.

Ms Chapman recently sent me the following email describing her David vs Goliath struggle with the APA and its disturbing implications both for DSM 5 and for internet freedom:

“Until last week, my website published under the domain name http://dsm5watch.wordpress.com/.

On December 22, I was stunned to receive two emails from the Licensing and Permissions department of American Psychiatric Publishing, claiming that the domain name my site operates under was infringing upon the DSM 5 trademark in violation of United States Trademark Law and that my unauthorized actions may subject me to contributory infringement liability including increased damages for willful infringement. I was told to cease and desist immediately all use of the DSM 5 mark and to provide documentation within ten days confirming I had done so.”

“Given my limited resources compared with APA’s deep pockets, I had no choice but to comply and was forced to change my site’s domain name to https://dxrevisionwatch.wordpress.com.

“Hits to the new site have plummeted dramatically and it will take months for traffic to recover – just at the time when crucial DSM 5 decisions are being made.”

“Was APA justified in seeking to exercise its trademark rights in this situation? Or do APA’s actions fly in the face of accepted internet trademark practice, common sense, and good public relations? I am not a lawyer, but I have made a careful study of ‘U.S. Trademark Law, Rules of Practice & Federal Statutes, U.S. Patent & Trademark Office, November 8, 2011’ and of many other available sources. My conclusion is that APA is making excessive and unwarranted claims for its DSM 5 trademark. Courts have found that using a trademark in a domain or subdomain name is ‘fair use’ if the purpose is non commercial, where there is no intent to mislead, where use of the mark is pertinent to the subject of discussion, and where it is clear that the user is not implying endorsement by, or affiliation with, the holder of the mark.”

“The home page of my site clearly defines its purpose – ‘DSM-5 and ICD-11 Watch – Monitoring the development of DSM-5, ICD-11, ICD-10-CM’ and carries this disclaimer,

‘This site has no connection with and is not endorsed by the American Psychiatric Association (APA), American Psychiatric Publishing Inc., World Health Organization (WHO) or any other organization, institution, corporation or company. This site has no affiliations with any commercial or not-for-profit organization…This site does not accept advertising, sponsorship, funding or donations and has no commercial links with any organization, institution, corporation, company or individual.'”

“It puzzles and worries me that APA would seek to suppress my clearly non commercial resource created only to provide information and commentary on the revision process of two internationally used classifications. My only purpose is to inform interested stakeholders and those patient groups whose medical and social care may potentially be impacted by proposals for changes to diagnostic categories and criteria.”

“There is a paradox here. The APA has promoted its commitment to transparency of process, but has rarely demonstrated it. Much has been made of the posting of drafts for public review and soliciting feedback. But to usefully participate in this process, patients, patient groups, and advocacy organizations need to know about proposed changes and when and by what means they can input comment during public review periods. Now, because of APA’s arbitrary actions, it will be harder for them to find the information they need – just when they most need it.”

I am surprised and saddened by APA’s ill-conceived attempt to restrict Suzy Chapman’s free expression on DSM 5. It can only be in the service of the equally unworthy goals of censorship and/or commercialism. I simply can’t imagine that anything should ever be kept secret in the preparation of a diagnostic manual and wonder what in Suzy Chapman’s web site could possibly be so frightening to APA.

Using a trademark to suppress comment is a violation of APA’s public trust to produce the best possible DSM 5. This is another indication that DSM has become too important for public health and for public policy for its revisions to be left under the exclusive control of one professional organization – particularly when that organization’s own financial future is at stake. This basic conflict of interest can be cured only by creating a new institutional framework to supervise the future DSM revisions. Censorship and commercial motivations must not warp the development of a safe and scientifically sound diagnostic manual.

[ENDS]

References:

1] Legal Guide for Bloggers:
https://www.eff.org/issues/bloggers/legal/liability/IP

2] U.S. Trademark Law, Rules of Practice & Federal Statutes, U.S. Patent & Trademark Office, November 8, 2011: http://www.uspto.gov/trademarks/law/tmlaw.pdf

3] Dx Revision Watch: https://dxrevisionwatch.wordpress.com/

4] Dr Allen Frances MD, former chair, DSM-IV Task Force, blogs at “DSM5 in Distress” on “Psychology Today”: http://www.psychologytoday.com/blog/dsm5-in-distress

5] APA’s DSM-5 Development site: http://www.dsm5.org/Pages/Default.aspx

Suzy Chapman

Filed under Allen Frances, American Psychiatric Association (APA), Criticism of DSM-V, DSM-5, DSM revision process, DSM-5, DSM-5 consultation, DSM-5 draft proposals, DSM-5 in the media, DSM-V, Internet censorship

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