Final day: Submissions to third DSM-5 stakeholder review

Final day: Submissions to third DSM-5 stakeholder review

Post #183 Shortlink: http://wp.me/pKrrB-2fn

The third and final stakeholder review is scheduled to close today, Friday, June 15.

I am collating copies of submissions on these pages.

A copy of my own comment is published below in text and PDF format. If you are unable to submit your own letter or short of time, please consider endorsing Mary Dimmock’s submission or one of the other submissions or one from last year with a note to say that although the criteria have been revised since last year, the underlying concerns remain.

 

Submission from UK advocate Suzy Chapman

Full text in PDF:     Chapman DSM-5 submission 2012

For the attention of the Somatic Symptom Disorders Work Group: Chair Joel E. Dimsdale, M.D.

Submitted by Suzy Chapman, advocate and parent/carer of young adult with chronic illness.
Website owner of https://dxrevisionwatch.wordpress.com formerly http://dsm5watch.wordpress.com

Submission in response to J 00 Somatic Symptom Disorder

I note that at June 14, APA has published no report on the results of the DSM-5 field trials. The majority of stakeholders wishing to provide feedback on this third release of draft proposals have no information on the make-up of the SSD study groups, the numbers studied within each of the three arms or the resulting data.

  • Stakeholders have been obliged to submit comment without the benefit of scrutiny of field trial results to inform their submissions. This is not acceptable.

For the first and second release of draft proposals, a 7 page “Disorders Description” document and a 14 page “Rationale/Validity Propositions/Justification of Criteria” document accompanied proposals and expanded on the website Proposals, Criteria, Rationale and Severity content for this category section. In the case of the latter, this included five pages of references to published and unpublished papers, including a number of papers authored or co-authored by members of the SSD Work Group. With the release of this third and final draft, no updated versions of these two documents were published that reflect significant revisions to SSD criteria between the second and third draft. The unrevised versions have been removed from the website.

  • Stakeholders have been denied access to the more expansive rationales and validity propositions set out within these two documents, the research papers that have been relied on and more detailed explanations for the revisions made to criteria between the second and third iterations in response to field trial results and internal/external input. If the Work Group considered these documents essential background information for the first and second drafts it is unreasonable not to have provided stakeholders with updated versions for this third draft.

The “Rationale/Validity Propositions/Justification of Criteria” document (as published May 4, 2011, for the second public review) states:

“…It is unclear how these changes would affect the base rate of disorders now recognized as somatoform disorders. One might conclude that the rate of diagnosis of CSSD would fall, particularly if some disorders previously diagnosed as somatoform were now diagnosed elsewhere (such as adjustment disorder). On the other hand, there are also considerable data to suggest that physicians actively avoid using the older 6 diagnoses because they find them confusing or pejorative. So, with the CSSD classification, there may be an increase in diagnosis.”

Continued on Page 2

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

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

Post #150 Shortlink: http://wp.me/pKrrB-1Z6

Update @ March 1, 2012

Additional commentary:

Neurobonkers, March 1, 2012

APA Shut Down DSM-5 Blogger

—————-

Knight Science Journal Tracker, Paul Raeburn, March 1, 2012

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

also

National Association of Science Writers

—————-

On Monday, investigative health reporter, William Heisel, published Part One of his report on the two “cease and desist” letters served to me on December 22, on behalf of the publishing arm of the American Psychiatric Association.

You can view these letters and correspondence here:

    APA correspondence

 

Read Part One of William Heisel’s report here:

Slap: American Psychiatric Association Pressures Brit DSM5 Blogger Suzy Chapman

 

Today, William Heisel continues the story:

Reporting on Health

William Heisel’s Antidote Investigating Untold Health Stories

William Heisel | February 29, 2012

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

From the way the American Psychiatric Association threatened UK writer Suzy Chapman, one would think APA is fighting legal battles everywhere to protect its trademarks.

But Chapman appears to be in an elite category. Antidote wrote Monday about how APA forced Chapman to change the name and URL of her DSM-5 and ICD-11 Watch site, saying it infringed on APA’s trademark for its main guidebook, the Diagnostic and Statistical Manual of Mental Disorders (DSM).

But similar sites and uses of APA trademarks abound. Why hasn’t the APA gone after them?

Read on

 

Related posts:

Earlier commentaries:

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

Is DSM 5 A Public Trust Or An APA Cash Cow? Commercialism And Censorship Trump Concern For Quality by Allen Frances APA forces domain name change for DSM-5 and ICD-11 Watch site

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

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


William Heisel’s Antidote: Slap: American Psychiatric Association Pressures Brit DSM5 Blogger Suzy Chapman

William Heisel’s Antidote: Slap: American Psychiatric Association Pressures Brit DSM5 Blogger Suzy Chapman

Post #149 Shortlink: http://wp.me/pKrrB-1Yx

On December 22, I was served with two “cease and desist” letters on behalf of the publishing arm of the American Psychiatric Association, publishers of the Diagnostic and Statistical Manual of Mental Disorders – the DSM.

Which disorders go into the next DSM and how those disorders are defined is a public interest issue. Public interest and public trust are best served by an open and transparent development process – not by issuing threats of legal action against those providing internet platforms on which patients and professionals rely for timely and accurate information around the DSM-5 development process and how they might participate in that process, as stakeholders.

The American Psychiatric Association’s publishing arm has the right to protect its intellectual property and pursue trademark infringements where a case for improper use can be made. But employing heavy-handed, punitive, partial and legally questionable tactics against “fair use” of the DSM 5 mark, forcing internet site owners to change web addresses, is putting commercial interests before public participation – a PR fail and a disturbing abuse of power.

    APA correspondence

William Heisel takes up the story:

Reporting on Health

William Heisel’s Antidote Investigating Untold Health Stories

Slap: American Psychiatric Association Pressures Brit DSM5 Blogger Suzy Chapman

http://www.bit.ly/ydSocK

William Heisel | February 27, 2012

If you have a serious interest in a brand, product or company, you can, in a few minutes, set up your own website with a clever domain name that includes your target.

Jim Romenesko did this with Starbucks Gossip. A group of unions and activists did this with Making Change at Wal-Mart. And a team of obsessive Clark Kent loyalists did this with the Superman Super Site.

A few years ago, British writer Suzy Chapman started tracking the proposed changes by the American Psychiatric Association (APA) to psychiatry’s guidebook: the Diagnostic and Statistical Manual of Mental Disorders (DSM)…

Read on

Related posts:

Is DSM 5 A Public Trust Or An APA Cash Cow? Commercialism And Censorship Trump Concern For Quality by Allen Frances APA forces domain name change for DSM-5 and ICD-11 Watch site

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

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

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


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

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