DSM-5 SSD submissions 2011

Responses by professional bodies

Response by the British Psychological Society response, June 2011
Extract from:

http://apps.bps.org.uk/_publicationfiles/consultation-responses/DSM-5%202011%20-%20BPS%20response.pdf

DSM-5 2011

British Psychological Society response, June 2011

[…]

“This response was prepared on behalf of the Society by Professor Peter Kinderman, CPsychol, AFBPsS, Chair of the Division of Clinical Psychology (DCP), with contributions from Susan van Scoyoc, CPsychol, CSci, AFBPsS, committee member of the DCP and member of the Division of Heath Psychology (DHP); Dr David Harper, CPsychol, AFBPsS, Professor David Pilgrim CPsychol, AFBPsS, and Professor Richard Bentall, FBPsS, all members of the DCP; Lucy Johnstone, CPsychol, AFBPsS, committee member of the DCP; Dr Amanda C de C Williams, CPsychol, member of both the DCP and the DHP, and Professor Pamela James, CPsychol, AFBPsS, committee member of the Division of Counselling Psychology. We would like to thank Berry Neil for informing aspects of this response. We hope you find our comments useful.”

Dr C A Allan, CPsychol, CSci, AFBPsS

Chair, Professional Practice Board

Response to the American Psychiatric Association:

DSM-5 Development

Page 17 of 26

J00 Complex Somatic Symptom Disorder

As stated in our general comments, we are concerned that clients and the general public are negatively affected by the continued and continuous medicalisation of their natural and normal responses to their experiences; responses which undoubtedly have distressing consequences which demand helping responses, but which do not reflect illnesses so much as normal individual variation.

We believe that classifying these problems as ‘illnesses’ misses the relational context of problems and the undeniable social causation of many such problems. For psychologists, our well-being and mental health stem from our frameworks of understanding of the world, frameworks which are themselves the product of the experiences and learning through our lives.

Many of these concerns also apply to this area.

It is good to see the assumptions implicit in ‘somatization’ terminology have been removed, but we retain concerns about the criteria used.

Concern about medical seriousness arises from the universal experience of pain as a warning signal of something wrong, as in many acute pains. Until and unless an adequate explanation is given to the person with persistent pain, distinguishing it from the ‘alarm signal’ of acute pain, they continue to search for a medical explanation as is the case in acute pain. “Reassurance” that nothing shows on investigation often exacerbates the patient’s concerns that what they have is hard to detect or diagnose. The judgment of what is ‘disproportionate’ or ‘excessive’ is a subjective, value-laden, issue.

J01 Simple Somatic Symptom Disorder

[As above]

J02-06 Somatic Symptom Disorders

As stated in our general comments, we are concerned that clients and the general public are negatively affected by the continued and continuous medicalisation of their natural and normal responses to their experiences; responses which undoubtedly have distressing consequences which demand helping responses, but which do not reflect illnesses so much as normal individual variation.

We believe that classifying these problems as ‘illnesses’ misses the relational context of problems and the undeniable social causation of many such problems. For psychologists, our well-being and mental health stem from our frameworks of understanding of the world, frameworks which are themselves the product of the experiences and learning through our lives.

Many of these concerns also apply to this area.

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