What is it?

According to the American Psychiatric Association, the DSM-5-TR or Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision is an assistive written text used by healthcare professionals to aid or facilitate in the diagnostic process of determining whether or not a condition exists given a set of criterion as specified by the manual¹.

The Manual itself originally started life as “The American Medical Association’s Standard Classified Nomenclature of Disease “ in 1917² Furthermore, it has gone through several iterations and naming conventions until its present-day name of the DSM-5-TR hereto shall be referred to as “The DSM” for simplicity.

Features of the DSM As taken and interpreted from the APA Website

The DSM has three major components:

• Diagnostic Classification: This is a list of mental disorders recognized within the Manual. It includes a diagnostic code for each listed condition. These codes are for billing, collection, and transmission of data between and by healthcare professionals and agencies.
• Diagnostic Criteria Sets: For the lack of better verbiage, this is the general rule set used for making a diagnosis; it first lists the symptoms of the given condition for how long those symptoms should be present and other conditions that would rule it out before making a final diagnosis.

• Descriptive text: as the name implies, describes each condition provided with each listed disorder. The most recent edition of the DSM provides the following descriptors under the following headings:
• Recording Procedures
• Specifiers
• Diagnostic Features
• Associated Features
• Prevalence
• Development and Course
• Risk and Prognostic Factors
• Culture-Related Diagnostic Issues
• Sex and Gender-Related Diagnostic Issues
• Association With Suicidal Thoughts or Behavior
• Functional Consequences
• Differential Diagnosis
• Comorbidity

Weakness of the DSM

I cannot really express more than what I have already expressed in a previously written work, so I shall just re-iterate what I have already said

For over ten years, I worked as a technical support specialist in a call center and seven years as a field service technician for a small wireless internet service provider. As a Diagnostician, I have seventeen years of experience if I combine the knowledge from those two jobs. The jobs involved troubleshooting cell phones, computers, network infrastructure, and people.

Over that time, several colleagues and I attempted to write a Troubleshooting manual for computer, cell phone, and network-related issues; oh yes, and let’s remember people. Have You seen our book? No, you have not; why is this? There were many attempts, but the book never made it off the many pages written. The reasons for this were simple: the possible scenarios were too numerous, and the classification of issues became too cumbersome on cross reference, as were the potential fixes. In short, the unwritten book to help fix the broken became broken. It was too complex in its working and lacked fluidity; it in itself lacked the reasoning power of the Human Brain. And then there was a need for future updates. Yes, the book idea broke.

In walks the DSM, a diagnostic aid for. Wait one minute; please see the previous paragraph.

In addition to this, one may want to look at more scholarly works where issues are identified with measuring psychiatric illness. I will reference in particular, here the determination of ADHD utilizing the E-Swan test, which is a questionnaire utilized in diagnosing ADHD based on the criteria set out within the DSM IV and DSM-5. Both the papers listed below express issues with the wording utilized within the questionnaires, and both list potential issues with comprehension of the test by its recipients. How can The DSM set out the criterion for determining a condition if definitive, accurate tests cannot be established to satisfy its specification? Is the problem the test, The DSM’s criterion, or both?

Blume, F., Buhr, L., Kuehnhausen, J., Köpke, R., Weber, L. A., Fallgatter, A. J., … Gawrilow, C. (2020, June 25). Validation of a Self-Report Version of the German Strengths and Weaknesses of ADHD Symptoms

Normal Behavior Scale (SWAN-DE-SB). https://doi.org/10.31234/osf.io/x6bpd and Alexander, L.M., Salum, G.A., Swanson, J.M. and Milham, M.P. (2020), Measuring strengths and weaknesses in dimensional psychiatry. J Child Psychol Psychiatr, 61: 40-50. https://doi.org/10.1111/jcpp.13104

1https://www.psychiatry.org/psychiatrists/practice/dsm/about-dsm

2https://www.psychiatry.org/psychiatrists/practice/dsm/about-dsm/history-of-the-dsm