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Transforming Diagnosis,
Apr 29 2013
In a few weeks, the American Psychiatric Association will release its new edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-V).
The weakness is its lack of validity.
The DSM diagnoses are based on a consensus about clusters of clinical symptoms, not any objective laboratory measure.
Patients with mental disorders deserve better.
NIMH has launched the Research Domain Criteria (RDoC) project to transform diagnosis.
The diagnostic system has to be based on the emerging research data, not on the current symptom-based categories.
In a few weeks, the American Psychiatric Association will release its new edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-V).
The weakness is its lack of validity.
The DSM diagnoses are based on a consensus about clusters of clinical symptoms, not any objective laboratory measure.
Patients with mental disorders deserve better.
NIMH has launched the Research Domain Criteria (RDoC) project to transform diagnosis.
The diagnostic system has to be based on the emerging research data, not on the current symptom-based categories.
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Hebephilia as Mental Disorder?;
Archives of Sexual Behavior;
41(4), 797–829,
Jun 28 2012
A Historical, Cross-Cultural, Sociological, Cross-Species, Non-Clinical Empirical, and Evolutionary Review
Blanchard et al. (2009) demonstrated that hebephilia is a genuine sexual preference, but then proposed, without argument or evidence, that it should be designated as a mental disorder in the DSM-5. A series of Letters-to-the-Editor criticized this proposal as a non sequitur. Blanchard (2009), in rebuttal, reaffirmed his position, but without adequately addressing some central criticisms.
In this article, we examine hebephilia-as-disorder in full detail. Unlike Blanchard et al., we discuss definitions of mental disorder, examine extensive evidence from a broad range of sources, and consider alternative (i.e., non-pathological) explanations for hebephilia.
We employed Wakefield's (1992b) harmful dysfunction approach to disorder, which holds that a condition only counts as a disorder when it is a failure of a naturally selected mechanism to function as designed, which is harmful to the individual in the current environment. We also considered a harmful-for-others approach to disorder (Brülde, 2007).
Examination of historical, cross-cultural, sociological, cross-species, non-clinical empirical, and evolutionary evidence and perspectives indicated that hebephilic interest is an evolved capacity and hebephilic preference an expectable distributional variant, both of which were adaptively neutral or functional, not dysfunctional, in earlier human environments. Hebephilia's conflict with modern society makes it an evolutionary mismatch, not a genuine disorder.
Though it should not be classified as a disorder, it could be entered in the DSM's V-code section, used for non-disordered conditions that create significant problems in present-day society.
A Historical, Cross-Cultural, Sociological, Cross-Species, Non-Clinical Empirical, and Evolutionary Review
Blanchard et al. (2009) demonstrated that hebephilia is a genuine sexual preference, but then proposed, without argument or evidence, that it should be designated as a mental disorder in the DSM-5. A series of Letters-to-the-Editor criticized this proposal as a non sequitur. Blanchard (2009), in rebuttal, reaffirmed his position, but without adequately addressing some central criticisms.
In this article, we examine hebephilia-as-disorder in full detail. Unlike Blanchard et al., we discuss definitions of mental disorder, examine extensive evidence from a broad range of sources, and consider alternative (i.e., non-pathological) explanations for hebephilia.
We employed Wakefield's (1992b) harmful dysfunction approach to disorder, which holds that a condition only counts as a disorder when it is a failure of a naturally selected mechanism to function as designed, which is harmful to the individual in the current environment. We also considered a harmful-for-others approach to disorder (Brülde, 2007).
Examination of historical, cross-cultural, sociological, cross-species, non-clinical empirical, and evolutionary evidence and perspectives indicated that hebephilic interest is an evolved capacity and hebephilic preference an expectable distributional variant, both of which were adaptively neutral or functional, not dysfunctional, in earlier human environments. Hebephilia's conflict with modern society makes it an evolutionary mismatch, not a genuine disorder.
Though it should not be classified as a disorder, it could be entered in the DSM's V-code section, used for non-disordered conditions that create significant problems in present-day society.
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Manufacturing Mental Disorder by Pathologizing Erotic Age Orientation;
Archives of Sexual Behavior;
2008(Publishe on line), ,
Oct 16 2008
Regrettably, [...]Blanchard et al. [2008] did not merely report on their research and draw appropriate conclusions. Instead, they recommended a potentially dramatic expansion or addition to the DSM diagnostic categories of mental disorders without any evidence or reasoning that those who would be newly included under the mental disorder rubric can be properly categorized as mentally disordered.
Blanchard et al. did not define mental disorder. They did not measure mental disorder. They did not examine associations with mental disorder. They did not provide reasoning that leads to a conclusion of mental disorder.
Regrettably, [...]Blanchard et al. [2008] did not merely report on their research and draw appropriate conclusions. Instead, they recommended a potentially dramatic expansion or addition to the DSM diagnostic categories of mental disorders without any evidence or reasoning that those who would be newly included under the mental disorder rubric can be properly categorized as mentally disordered.
Blanchard et al. did not define mental disorder. They did not measure mental disorder. They did not examine associations with mental disorder. They did not provide reasoning that leads to a conclusion of mental disorder.
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Sexual Preference for 14-Year-Olds as a Mental Disorder: You Can’t Be Serious!!;
Archives of Sexual Behavior (published on line);
2010, March 4,
This letter addresses two papers by the DSM-V Sexual and Gender Identity Disorders Workgroup member Ray Blanchard published in this Journal. [...]
A series of biased terms or logically frail arguments are provided for including hebephilia as a mental disorder.
This letter addresses two papers by the DSM-V Sexual and Gender Identity Disorders Workgroup member Ray Blanchard published in this Journal. [...]
A series of biased terms or logically frail arguments are provided for including hebephilia as a mental disorder.
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New mental health 'bible' will lead to almost everyone having a disorder, warn experts,
Jul 28 2010
British experts have warned the trend of diagnosing yet more mental health disorders was 'leaking into normality'.
An updated edition of a mental health bible for doctors could mean that soon no-one will be classed as normal, experts warned today.
Diagnoses for 'disorders' could be based on symptoms including toddler tantrums, mild mood swings and binge eating.
Sweeping changes are being made to the U.S Diagnostic and Statistical Manual of Mental Disorders (DSM), which influences practitioners around the world.
British experts have warned the trend of diagnosing yet more mental health disorders was 'leaking into normality'.
An updated edition of a mental health bible for doctors could mean that soon no-one will be classed as normal, experts warned today.
Diagnoses for 'disorders' could be based on symptoms including toddler tantrums, mild mood swings and binge eating.
Sweeping changes are being made to the U.S Diagnostic and Statistical Manual of Mental Disorders (DSM), which influences practitioners around the world.
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Defining Paraphilia: Excluding Exclusion;
Open Access Journal of Forensic Psychology;
2010(2), 241-272
The development of the classification of the paraphilias is considered, with emphasis on justifications for their inclusion in DSM-III in light of the declassification of homosexuality. These justifications are found to be tenuous and do not work for the paraphilias in DSM-III-R because of changes made. Rationale for these changes is discussed based on inquiries made to DSM-III-R paraphilias committee members. Changes in DSM-IV and DSM-IV-TR are also discussed. After considering and critiquing more recent arguments for including the paraphilias in the DSM, recommendations are made for proposals in the DSM-5, whether the paraphilias belong in the DSM, and whether they should be used in SVP commitment.
The development of the classification of the paraphilias is considered, with emphasis on justifications for their inclusion in DSM-III in light of the declassification of homosexuality. These justifications are found to be tenuous and do not work for the paraphilias in DSM-III-R because of changes made. Rationale for these changes is discussed based on inquiries made to DSM-III-R paraphilias committee members. Changes in DSM-IV and DSM-IV-TR are also discussed. After considering and critiquing more recent arguments for including the paraphilias in the DSM, recommendations are made for proposals in the DSM-5, whether the paraphilias belong in the DSM, and whether they should be used in SVP commitment.
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Why the Rush to Create Dubious New Sexual Disorders?;
Archives of Sexual Behavior;
(online),
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Hebephilia : Quintessence of Diagnostic Pretextuality;
Behavioral Sciences and the Law;
(online),
Hebephilia is an archaic term used to describe adult sexual attraction to adolescents. Prior to the advent of contemporary sexually violent predator laws, the term was not found in any dictionary or formal diagnostic system. Overnight, it is on the fast track toward recognition as a psychiatric condition meriting inclusion in the upcoming ?fth edition of the em>Diagnostic and Statistical Manual of Mental Disorders. This article traces the sudden emergence and popularity of hebephilia to pressure from the legal arena and speci?cally to the legal mandate of a serious mental abnormality for civil commitment of sex offenders. Hebephilia is proposed as a quintessential example of pretextuality, in which special interests promote a pseudoscienti?c construct that furthers an implicit, instrumental goal. Inherent problems with the construct’s reliability and validity are discussed. A warning is issued about unintended consequences if hebephilia or its relative, pedohebephilia, make their way into the DSM-5, due out in 2013. Copyright 2010 John Wiley & Sons, Ltd.
Hebephilia is an archaic term used to describe adult sexual attraction to adolescents. Prior to the advent of contemporary sexually violent predator laws, the term was not found in any dictionary or formal diagnostic system. Overnight, it is on the fast track toward recognition as a psychiatric condition meriting inclusion in the upcoming ?fth edition of the em>Diagnostic and Statistical Manual of Mental Disorders. This article traces the sudden emergence and popularity of hebephilia to pressure from the legal arena and speci?cally to the legal mandate of a serious mental abnormality for civil commitment of sex offenders. Hebephilia is proposed as a quintessential example of pretextuality, in which special interests promote a pseudoscienti?c construct that furthers an implicit, instrumental goal. Inherent problems with the construct’s reliability and validity are discussed. A warning is issued about unintended consequences if hebephilia or its relative, pedohebephilia, make their way into the DSM-5, due out in 2013. Copyright 2010 John Wiley & Sons, Ltd.
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Hebephilia plethysmographica: A partial rejoinder to Blanchard et al. (2008);
Archives of Sexual Behavior;
321-322
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The Public Policy Implications of ‘‘Hebephilia’’: A Response to Blanchard et al. (2008);
Archives of Sexual Behavior;
38, 319-320,
Oct 16 2008
Blanchard et al. (2008) present their article on "hebephilia" as an objective analysis of research data. In fact, it is a textbook example of subjective values masquerading as science. Avoiding the crucial public policy implications of their argument, Blanchard et al. advance hebephilia as if it exists in a cultural vacuum. Their recommendations are even more troubling in light of their study's methodological flaws.
Blanchard et al. (2008) present their article on "hebephilia" as an objective analysis of research data. In fact, it is a textbook example of subjective values masquerading as science. Avoiding the crucial public policy implications of their argument, Blanchard et al. advance hebephilia as if it exists in a cultural vacuum. Their recommendations are even more troubling in light of their study's methodological flaws.