APA Press Release: DSM-5 Draft Criteria Open for Public Comment

APA Press Release: DSM-5 Draft Criteria Open for Public Comment

Post #164 Shortlink: http://wp.me/pKrrB-20I

Commentaries and media, followed by APA Press Release No. 24

(Not specific to DSM-5 third draft: Ethics complaints filed against APA.)

Psychology Today

Science Isn’t Golden
Matters of the mind and heart

Patients Harmed by Diagnosis Find Their Voices
Victims of psychiatric labeling file ethics complaints.

Paula J. Caplan, Ph.D. | April 28, 2012

The American Psychiatric Association’s 2012 Annual Meeting

This coverage is not sanctioned by, nor a part of, the American Psychiatric Association.

From Medscape Medical News > Conference News
DSM-5 Field Trial Results a Hot Topic at APA 2012 Meeting

Deborah Brauser | May 3, 2012

May 3, 2012 — Telepsychiatry, neuromodulation, the role of genetics, and updates for the upcoming Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) are just some of the hot items on the agenda of this year’s American Psychiatric Association’s 2012 Annual Meeting in Philadelphia…

(Not specific to DSM-5 third draft: Letter, AJP re DSM-5 field trial reliability and kappas.)

American Journal of Psychiatry

Letters to the Editor | May 01, 2012
Standards for DSM-5 Reliability

Am J Psychiatry 2012;169:537-537. 10.1176/appi.ajp.2012.12010083

Robert L. Spitzer, M.D.; Janet B.W. Williams, Ph.D.; Jean Endicott, Ph.D.
Princeton, N.J.
New York City

DSM5 in Distress
The DSM’s impact on mental health practice and research.

DSM 5 Rejects ‘Hebephilia’ Except for the Fine Print

Alan Frances MD | May 3, 2012

Scientific American blogs

APA Announces New Changes to Drafts of the DSM-5, Psychiatry’s New “Bible”

Ferris Jabr | May 3, 2012

Observations

Opinion, arguments & analyses from the editors of Scientific American

“…This year, the APA is holding its annual meeting from May 5 to 9 in Philadelphia, where much of the discussion will focus on the drafts of the DSM-5 and the results of “Field Trials”—dry runs of the new diagnostic criteria in clinical settings. I am attending the conference to learn more and, next week, my colleague Ingrid Wickelgren at Scientific American MIND and I will bring you a series of blogs about the DSM-5 authored by ourselves and some well-known researchers and psychiatrists. For the duration of next week, we will also publish my feature article about DSM-5 in its entirety on our website. After next week, you can still read the feature in the May/June issue of MIND. Stay tuned!”

About the Author: Ferris Jabr is an associate editor focusing on neuroscience and psychology.

1 boring old man

1 boring old man | May 3, 2012

the future of an illusion IV½…

and

the future of an illusion IV

1 boring old man | May 2, 2012

Psychology Today | DSM 5 in Distress

Wonderful News: DSM 5 Finally Begins Its Belated and Necessary Retreat
Perhaps this will be the beginning of real reform.

Alan Frances MD | May 2, 2012

MindFreedom International Newswire

Protesters, Rejecting Mental Illness Labels, Vow to “Occupy” the American Psychiatric Association Convention

MindFreedom International
Last modified: 2012-05-01T16:46:46Z
Published: Tuesday, May. 1, 2012 – 9:46 am

PHILADELPHIA, May 1, 2012 — /PRNewswire-USNewswire/ — On Saturday, May 5, 2012, as thousands of psychiatrists congregate for the American Psychiatric Association (APA) Annual Meeting, individuals with psychiatric labels and others will converge in a global campaign to oppose the APA’s proposed new edition of its “bible,” the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), scheduled for publication in 2013. Occupy the APA will include distinguished speakers from 10 a.m. to noon at Friends Center (1515 Cherry Street, Philadelphia), and a march at approximately 12:15 p.m. to the Pennsylvania Convention Center (12th and Arch Streets), where the group will protest from approximately 1 p.m. while the APA meets inside…

http://www.psychiatry.org/advocacy–newsroom/newsroom/dsm-5-draft-criteria-open-for-public-comment

Wed May 02, 2012

Contact: For Immediate Release                                  
Eve Herold, 703-907- 8640 Release No. 24
press@psych.org
Erin Connors, 703-907-8562
econnors@psych.org

DSM-5 Draft Criteria Open for Public Comment
Mental health diagnostic manual available for final online comment period

ARLINGTON, Va. (May 2, 2012) – For a third and final time, the American Psychiatric Association (APA) invites public comment on the proposed criteria for the upcoming fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). DSM is the handbook used by health care professionals as an authoritative guide to the diagnosis of mental disorders.

The public comment period will last six weeks, beginning May 2 and continuing until June 15. All responses submitted via the DSM-5 website will be considered by the DSM-5 Work Groups, which are charged with assessing the latest scientific evidence and recommending the disorder definitions and criteria to be included in the manual. Nearly 10,800 comments from health care professionals, mental health advocates, families and consumers were submitted in the first two public comment periods in 2010 and 2011.

“The comments we have received over the past two years have helped sharpen our focus, not only on the strongest research and clinical evidence to support DSM-5 criteria but on the real-world implications of these changes,” said APA President John M. Oldham, M.D. “We appreciate the public’s interest and continued participation in the DSM-5 development process.”

In preparation for this final comment period, members of the DSM-5 Task Force and Work Groups have updated their proposals for diagnostic criteria. The revised criteria reflect recently published research, results from DSM-5 field testing of the criteria and public comments received since 2010.

Key changes posted for this round of public review include:

Revised proposals to place Attenuated Psychosis Syndrome and Mixed Anxiety Depressive Disorder in Section III of the manual, covering conditions that require further research before their consideration as formal disorders

 Added language to Major Depressive Disorder criteria to help differentiate between normal bereavement associated with a significant loss and a diagnosis of a mental disorder

Added rationale for changes to Personality Disorders, with field trial data now supporting the reliability of dimensional measures and the categorical diagnosis of Borderline Personality Disorder

Modified diagnostic criteria for Pedophilic Disorder to make the category more consistent with the World Health Organization’s International Classification of Diseases

Condensed diagnoses within Communication Disorders to only include Language Disorders and Speech Disorders

A proposal for a new diagnosis of Suicidal Behavioral Disorder

Modified diagnostic criteria for numerous disorders, including some in the Neurocognitive Disorders and Anxiety Disorders chapters

A proposed Cultural Formulation Interview, which includes specific questions to help clinicians more effectively assess cultural aspects of psychiatric diagnosis

A detailed list of changes made to draft proposals since July 2011 can be found on www.DSM5.org .

Revisions to DSM reflect scientific advances in the field and new knowledge gained since the last manual was published in 1994. Since 1999, more than 500 mental health and medical researchers and clinicians from the United States and abroad have been involved in the planning, review and deliberations for DSM-5. Field trials in both large academic medical centers and routine clinical practices have tested select criteria.

Feedback to the proposed diagnostic criteria can be submitted through www.DSM5.org , which will be available until the comment period ends June 15. After that, the site will remain viewable but will be closed to comments as the Work Groups and Task Force complete revisions and submit criteria for evaluation by the Scientific Review Committee and the Clinical and Public Health Committee. The Task Force will then make final recommendations to the APA Board of Trustees. The final version of DSM-5 is expected to go before the Board of Trustees in December 2012.

“As with every stage in this thorough development process, DSM-5 is benefiting from a depth of research, expertise and diverse opinion that will ultimately strengthen the final document,” noted David J. Kupfer, M.D., chair of the DSM-5 Task Force.

Publication of DSM-5 is expected in May 2013.

The American Psychiatric Association is a national medical specialty society whose physician members specialize in the diagnosis, treatment, prevention and research of mental illnesses, including substance use disorders. Visit the APA at www.psychiatry.org  and www.HealthyMinds.org .

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Practice Central on ICD-10-CM transition; APA Monitor and WHO Reed on ICD-11

Two articles on forthcoming classification systems: the first on ICD-10-CM from Practice Central; the second on ICD-11 from the February 2012 edition of the American Psychological Association’s “Monitor on Psychology”

Post #140 Shortlink: http://wp.me/pKrrB-1Tt

Update: Medicare could delay burdensome rules on doctors | Julian Pecquet, for The Hill, February 14, 2012

“The acting head of the Medicare agency said Tuesday that she is considering giving the nation’s doctors more time to switch to a new insurance coding system that critics say would cost millions of dollars for little gain to patients.

“Marilyn Tavenner, the acting administrator of the Centers for Medicare and Medicaid Services, told a conference of the American Medical Association (AMA) that her agency could delay adoption of the so-called ICD-10 system. Current law calls for physicians to adopt the new codes next year…

“…Speaking to reporters after her prepared remarks, Tavenner said her office would formally announce its intention to craft new regulations “within the next few days.”

ICD-10 Deadline Review Update | Andrea Kraynak, for HealthLeaders Media, February 15, 2012

“Big news regarding the ICD-10-CM/PCS implementation timeline came Tuesday morning during the American Medical Association (AMA) National Advocacy Conference in Washington, DC.”

“Per CMS acting administrator Marilyn Tavenner, CMS plans to revisit the current implementation deadline of October 1, 2013. Tavenner said CMS wants to reexamine the pace of implementing ICD-10 and reduce physicians’ administrative burden, according to an AMA tweet…”

Practice Central: Resources for Practicing Psychologists

Practice Central, a service of the APA Practice Organization (APAPO), supports practicing psychologists in all settings and at all stages of their career. APAPO is a companion organization to the American Psychological Association. Our mission is to advance and protect your ability to practice psychology.

http://www.apapracticecentral.org/update/2012/02-09/transition.aspx

Practice Update | February 2012

Transition to the ICD-10-CM: What does it mean for psychologists?

Psychologists should be aware of and prepare for the mandatory shift to ICD-10-CM diagnosis codes in October 2013

By Practice Research and Policy staff

February 9, 2012—Beginning October 1, 2013 all entities, including health care providers, covered by the Health Insurance Portability and Accountability Act (HIPAA) must convert to using the ICD-10-CM diagnosis code sets. The mandate represents a fundamental shift for many psychologists and other mental health professionals who are far more attuned to the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM).

Most psychologists were trained using some version of DSM. For other health care providers, the World Health Organization’s International Classification of Diseases and Related Health Problems (ICD) – which contains a chapter on mental disorders – is the classification standard.

Over the years, efforts to harmonize these two classifications have resulted in systems with similar (often identical) codes and diagnostic names. In fact, even if psychologists record DSM diagnostic codes for billing purposes, payers recognize the codes as ICD-9-CM – the official version of ICD currently used in the United States. Since 2003, the ICD-9-CM diagnostic codes have been mandated for third-party billing and reporting by HIPAA for all…

Read full article here

 

Dr Geoffrey M. Reed, PhD, Senior Project Officer, WHO Department of Mental Health and Substance Abuse, is seconded to WHO through IUPsyS (International Union for Psychological Science). Dr Reed co-ordinates the International Advisory Group for the Revision of ICD-10 Mental and Behavioural Disorders.

Meetings of the International Advisory Group are chaired by Steven Hyman, MD, Harvard University, Cambridge, MA, a former Director of the National Institute of Mental Health (NIMH) and DSM-5 Task Force Member.

The Department of Mental Health and Substance Abuse will also be managing the technical part of the revision of Diseases of the Nervous System (currently Chapter VI), as it is doing for Chapter V.

February 2012 edition of the American Psychological Association’s “Monitor on Psychology”:

http://www.apa.org/monitor/2012/02/disorder-classification.aspx

Feature

Improving disorder classification, worldwide

With the help of psychologists, the next version of the International Classification of Diseases will have a more behavioral perspective.

By Rebecca A. Clay

February 2012, Vol 43, No. 2

Print version: page 40

What’s the world’s most widely used classification system for mental disorders? If you guessed the Diagnostic and Statistical Manual of Mental Disorders (DSM), you would be wrong.

According to a study of nearly 5,000 psychiatrists in 44 countries sponsored by the World Health Organization (WHO) and the World Psychiatric Association, more than 70 percent of the world’s psychiatrists use WHO’s International Classification of Diseases (ICD) most in day-to-day practice while just 23 percent turn to the DSM. The same pattern is found among psychologists globally, according to preliminary results from a similar survey of international psychologists conducted by WHO and the International Union of Psychological Science.

“The ICD is the global standard for health information,” says psychologist Geoffrey M. Reed, PhD, senior project officer in WHO’s Department of Mental Health and Substance Abuse. “It’s developed as a tool for the public good; it’s not the property of a particular profession or particular professional organization.”

Now WHO is revising the ICD, with the ICD-11 due to be approved in 2015. With unprecedented input from psychologists, the revised version’s section on mental and behavioral disorders is expected to be more psychologist-friendly than ever—something that’s especially welcome given concerns being raised about the DSM’s own ongoing revision process. (See “Protesting proposed changes to the DSM” .) And coming changes in the United States will mean that psychologists will soon need to get as familiar with the ICD as their colleagues around the world…

Read full article here

For more information about the ICD revision, visit the World Health Organization.

Rebecca A. Clay is a writer in Washington, D.C

American Psychiatric Association rejects call for independent review of DSM-5 proposals

American Psychiatric Association rejects psychologists’ call for independent review of controversial DSM-5 proposals

Post #135 Shortlink: http://wp.me/pKrrB-1KF

On January 9, 2012, the Coalition for DSM-5 Reform, an ad hoc committee of the Society for Humanistic Psychology (Division 32 of the American Psychological Association), sent another call to the American Psychiatric Association’s Board of Trustees and DSM-5 Task Force to submit controversial proposals for DSM-5 to independent scrutiny.

American Psychiatric Association president, John Oldham, M.D., issued a response last Friday, January 27.

“…There is in fact no outside organization that has the capacity to replicate the range of expertise that DSM-5 has assembled over the past decade to review diagnostic criteria for mental disorders. In addition, the posting of the criteria on the www.dsm5.org Web site for an international review; the ongoing consultation and coordination with the WHO Mental Disorder Advisory Group for ICD-11; and the several internal reviews provided by the Scientific Review Committee, a Clinical and Public Health Committee review, and the Task Force as a whole, collectively provide the most far reaching review ever undertaken for any DSM revision…”   

                        John Oldham M.D. President, on behalf of American Psychiatric Association

For a copy of the Coalition’s letter see Post #126: Psychologists call for independent review of DSM-5    

Full response from John Oldham, M.D., on behalf of the American Psychiatric Association, here:

      APA Response on 01.27.12 to Coalition for DSM-5 Reform letter of 01.09.12

 

Text

American Psychiatric Association

1000 Wilson Boulevard
Suite 1825
Arlington, VA 22209
Telephone 703.907.7300
Fax 703.907.1085
Email apa@psych.org
Internet www.psych.org

David N. Elkins, Ph.D.
President
Society for Humanistic Psychology
750 First Street, N.E.
Washington, DC 20002Ͳ4242

January 27, 2012

Dear President Elkins:

We appreciate the January 9, 2012, open letter from you and the members of the Division 32 Open Letter Committee to the American Psychiatric Association and developers of DSM-5 regarding the need for a more thorough external review process in revising the manual.

We echo your desire to ensure that “the proposed DSM-5 is safe and credible.” To that end, the DSM-5 Task Force and Work Groups have been purposefully assembled to include clinicians and researchers with diverse backgrounds and expertise, representing nearly 100 different academic and medical institutions from around the world. Our November 21, 2011, letter to the American Counseling Association provides a more complete listing of the steps we have taken to obtain an independent review of the DSM-5 proposals.

(This can be viewed at: https://dxrevisionwatch.files.wordpress.com/2011/11/apa_letter_to_aca_11-21-11.pdf)

[Ed: URL provided in Dr Oldham’s letter returns 404, substituting file from Dx Revision Watch.]

There is in fact no outside organization that has the capacity to replicate the range of expertise that DSM-5 has assembled over the past decade to review diagnostic criteria for mental disorders. In addition, the posting of the criteria on the www.dsm5.org

Web site for an international review; the ongoing consultation and coordination with the WHO Mental Disorder Advisory Group for ICD-11; and the several internal reviews provided by the Scientific Review Committee, a Clinical and Public Health Committee review, and the Task Force as a whole, collectively provide the most far-reaching review ever undertaken for any DSM revision. However, we recognize that there will not be universal agreement with all of the final decisions made in response to these reviews. As with all scientific classifications applied to clinical practice, research will continue to refine our understanding of these disorders, and revisions to the DSM-5 as a living document will be made after publication of DSM-5 in 2013.

Since there is no “gold standard” for defining mental disorders and many other medical disorders without pathognomonic biological markers, each revision of diagnostic criteria has been seen as the best current set of diagnostic criteria that are meant to be used in clinical practice and tested for their validity. Validity criteria first published by Robins and Guze in 1970 for the Feighner criteria have formed the basic framework for testing the Research Diagnostic Criteria, DSM-III, DSM-III-R, DSM-IV, and the ICD-10. The work groups and the review groups have closely attended to these and an expanded set of validity criteria that are contained in the Guidelines for Making Changes to DSM on the http://www.dsm5.org website: (http://www.dsm5.org/ProgressReports/Documents/Guidelines-for-Making-Changes-to-DSM_1.pdf).

The work groups are accessing more than 30 years of research since the DSM-III was first published in making their recommendations. Some of the proposed changes, such as the inclusion of more dimensional components, have been recommended by members of previous Task Forces and by many participants in the National Institutes of Health-sponsored conference series leading up to the Task Force. We will also have empirical data from our field trials on how these and other proposed changes are working. Final decisions about the revisions will only be made after all of these reviews are completed.

We hope that this additional information is responsive to your members, colleagues, and individuals who use mental health services to clarify that we are undertaking an exceptionally extensive review process involving an international and multidisciplinary clinical and scientific group of experts.

As we continue to refine the proposals for DSM-5 and further progress to development of DSM-5.1 and beyond, we look forward to maintaining an open and ongoing dialogue with your organization, colleagues, and the mental health field at large.

Sincerely,

John M. Oldham, M.D.
President

 

Resources

Coalition for DSM-5 Reform on Dx

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

Psychologists call for independent review of DSM-5

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

Pity the poor American Psychiatric Association, Parts 1 and 2: Gary Greenberg

Pity the poor American Psychiatric Association, Parts 1 and 2: Gary Greenberg

Post #124 Shortlink: http://wp.me/pKrrB-1Ca

On January 03, I reported that the Licensing and Permissions department of American Psychiatric Publishing, A Division of American Psychiatric Association, served me with two “cease and desist” letters, just before Christmas, claiming use of the registered trademark DSM 5 within my site’s subdomain name was improper, in violation of United States Trademark Law, and that my unauthorized 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 and that the DSM 5 mark is removed from the domain name http://dsm5watch.wordpress.com/.

Whether American Psychiatric Publishing might be considered to have a case against me or whether the use of the DSM 5 mark within my subdomain name might be found by a court to be legitimate under “fair use” – given that my site is non commercial, carries a clear disclaimer, with no intent to confuse, mislead or misrepresent my relationship with the APA or its publishing arm – I elected to change the site’s URL the following day.

The second letter demanded that I cease and desist immediately any and all use of the “DSM 5 mark” in the domain names of three additional internet platforms.

I do not own any of these three platforms or have any responsibility for them.

Evidently American Psychiatric Publishing’s Licensing and Permissions department omitted to establish ownership before issuing me with “cease and desist” demands and threats of legal action, on behalf of the American Psychiatric Association. I have received no apology nor explanation for their error. (I am not in a position to disclose the content of the second “cease and desist” letter since it relates to matters concerning a third party.)

Allen Frances, MD, professor emeritus at Duke, chaired the Task Force that had oversight of the development of DSM-IV and has been a fierce critic of the revision process towards the forthcoming edition of the Diagnostic and Statistical Manual of Mental Disorders, DSM-5. On Tuesday, Frances publicly supported my position in a commentary published on his DSM5 in Distress blog, hosted at Psychology Today.

Other blogging psychiatrists, allied mental health professionals and the author, Gary Greenberg, are supporting Frances in what they see as a heavy-handed, arrogant, bizarre and politically damaging move on the part of American Psychiatric Publishing’s Licensing and Permissions department in exercising trademark rights and making threats of legal action against a non commercial, responsible UK patient advocate who provides information and publishes commentary around the revision of two internationally used classification systems.

Commentaries from bloggers are being collated in this post:

Media coverage: American Psychiatric Association (APA) ”cease and desist” v DSM-5 Watch website; Legal information and resources for bloggers and site owners

Today, Gary Greenberg, author of Manufacturing Depression, and Inside the Battle to Define Mental Illness, Wired, December 27, 2010, has published a two part article on his website.

Read Part 1 here:

Pity the poor American Psychiatric Association, Part 1

Read Part Two, here, or published below, with the author’s permission:

Pity the American Psychiatric Association, Part 2

Gary Greenberg Blog

http://www.garygreenbergonline.com/

January 5th, 2012

In the last installment, we found out that the APA is trying to thread a camel through the eye of a needle. In their own view, they have to revise the DSM. To do this, they have to address the reification problem – i.e., that many of us, civilians and clinicians alike, have taken the DSM too seriously and treated the disorders it lists as actual diseases rather than fictive placeholders. To address it, they have to admit that it is a problem, and that they don’t have a solution. They have to fix the plane while it is airborne, but they don’t have the tools or the knowhow to do so, and the more it becomes clear that the plane is in trouble, and the more the mechanics are swearing and banging belowdecks, the more likely it is that the passengers will find out and start asking for a quick landing and a voucher on another airline.

So it is very important to try to keep the passengers in the dark as long as possible. Or, to put it another way, the APA has a product to protect, and the best way to do that, from a corporation’s point of view, is to control the narrative, as the pundits say, about the DSM.

Now, even before the recent events, which I’ll get to in a second, I knew this, because last year I wrote an article about the DSM revision for Wired about the argument between Allen Frances and Michael First, the major players in the DSM-IV revision, and Darrel Regier and David Kupfer, their counterparts on DSM-5. The article was no great shakes, just your usual lunchbucket magazine piece, fair and balanced and bland and forgettable as a soy hot dog with French’s mustard on it. I think Frances came out a little better, but that’s because I think he’s closer to the truth of the matter, and, as one of his colleagues has reminded me about a million times, he’s retired, so he can afford to speak truth to power. And the APA sounded at least reasonable in its willingness to acknowledge that the DSM is more provisional than it is generally made out to be.

Anyway, the forgettable magazine piece is in the process of becoming a book which will probably also be forgettable. And so I went back to my transcripts of conversations with the APA/DSM folks and of course found out all the questions I’d failed to ask and the points I’d failed to get clarified. So I emailed the APA pr apparatchicks and asked them to enlighten me. When exactly did the APA stop taking money from the drug companies for their educational programs, and how exactly was the embargo worded? And did I understand Regier correctly about a highly technical point that I won’t bore you with.

Here’s what I got back for a response.

Dear Gary,

We have received several requests from you for access to APA experts and positions on issues related to the DSM for the book you’re writing. I wanted you to know that we will not be working with you on this project. Last year we gave you free access to several of our officers and DSM experts for the article you wrote for Wired. In spite of the fact that we went to considerable lengths to work with you, the article you produced was deeply negative and biased toward the APA. Because of this track record, we are not interested in working with you further as we have no reason to expect that we would be treated any more fairly in your book than we were in the Wired article.

Now, why the APA would want to hand me such first-rate evidence of its own paranoia – and spare me having to listen to their talking points, not to mention preemptively decline to have a crack at responding to my book– is beyond me. It’s as incomprehensible as the letter itself, or at least the part where they complain that I was “biased toward” them. But I gather they think that they will make it harder for me to write my book, that maybe if they don’t cooperate I won’t do it. It is in any event evidence of an awfully thin skin, and of a bunker mentality. More disturbingly, it is evidence that they don’t really take their public trust too seriously. Especially when you contrast this to the National institutes of Mental Health, and its director Tom Insel, of whose work I’ve been much more directly critical, and who took the time to read it, and who still bent over backwards to get me an hour of face time that was cordial and fascinating. It’s enough to make you a fan of the government.

So to the recent events. Suzy Chapman is a patient advocate from the UK. Her website was an excellent compendium of information, archival material, reports, and, yes, criticism of the DSM-5. I have been using it in my research and admiring her tenacity and her fairmindedness. She has opinions but they are way in the background and neither shrill nor strident.

Chapman called her website DSM-5 and ICD Watch: Monitoring the Development of DSM-5, ICD-11 and ICD-10-CM. (The ICD’s are diagnostic systems run by the World Health Organization, and they are also under revision), and her subdomain name was

http://dsm5watch.wordpress.com

She also put in a disclaimer, made it clear that she had nothing to do with APA, that she wasn’t dispensing medical, legal, or technical advice. But that didn’t stop the APA from going after her. Not long after they got their DSM-5 trademark approved, and right before Christmas, they sent her this nice holiday card, which she’s kindly allowed me to post here, with her redactions.

Name: Redacted
Email: Redacted
Message: December 22, 2011

Suzy Chapman

http://dsm5watch.wordpress.com/

RE: DSM 5 Trademark Violation

Dear Ms. Chapman:
It has come to our attention that the website http://dsm5watch.wordpress.com/ is infringing upon the American Psychiatric Association’s trademark DSM 5 (serial number 85161695) and is in violation of federal law by using it as a domain name.

According to our records, the American Psychiatric Association has not authorized this use of the DSM 5 trademark. Consequently, this use of the DSM 5 mark is improper and is in violation of United States Trademark Law. Your unauthorized actions may subject you to contributory infringement liability including increased damages for willful infringement. We request that you immediately cease and desist any and all use of the DSM 5 mark. Furthermore, we request that the DSM 5 mark is removed from the domain name http://dsm5watch.wordpress.com/ . The American Psychiatric Association has a good-faith belief that the above-identified website’s use of the DSM 5 name and marks is not authorized by the American Psychiatric Association, its agents, or the law. I declare under penalty of perjury that the foregoing is true and correct and that I am authorized to act on behalf of the American Psychiatric Association.

Please confirm, within the next ten (10) days of the date of this letter, that you will stop using our trademark in http://dsm5watch.wordpress.com/ , and provide documentation confirming that you have. Any further use will be considered an infringement.

Thank you for your prompt cooperation in resolving this issue.

Very truly yours,

[Redacted]
Licensing and Permissions Manager American Psychiatric Publishing, A Division of American Psychiatric Association
1000 Wilson Boulevard Suite 1825 Arlington, VA 22209
E-mail: Redacted

Chapman, not in a position to fight, complied almost immediately. Her website is now available at

https://dxrevisionwatch.wordpress.com/

where you can also read about this kerfuffle in more detail.

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. Not that I really care, at least not about the APA’s fortunes, but are they trying to prove Frances right about his recent, somewhat incendiary, claim that the APA no longer deserves the DSM franchise?

I did ask one of the APA’s trustees about this. He wrote:

As for whether the intellectual property angle was driving them to crush the lady in Great Britain or their wanting to crush her because she was being critical, I think when the history is finally known, it will be the former. Maybe we can think of someone using “DSM-5″ who is friendly and note the reaction.

I do like this idea of conducting an experiment. And he may well be correct, that this is the APA worrying about its intellectual property rather than just trying to make Suzy Chapman miserable or squash dissent. Will they go after the sites that have popped up predictably in the wake of publicity of their enforcement action, like www.dsm5sucks.com and the twitter account @dsm5nonsense (whose owner dares the APA to come after them)? But in the meantime, this only proves two points:

First, this organization is at least terribly tone deaf. Going after Suzy Chapman is sort of like Lowe’s yanking its ads from a tv show depicting Muslims as normal people – a hugely blunderous action taken to please a tiny constituency, which can’t possibly earn them anything but scorn and opprobrium. Either they don’t know how they come off or they don’t care. Either way, it’s pretty disturbingly arrogant behavior for an organization that has so much to say about how public money is spent.

Second, the APA is a corporation that, like any other, will do anything to protect itself from harm, real or imagined. And it spends a lot of time imagining dangers. That’s probably because it knows its primary product – the DSM, which accounts for ten percent of its income and a great deal of its clout – is faulty, and it knows that it doesn’t quite know how to fix it without risking making it much much worse.

[Ends]

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/

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

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