SocraticGadfly: Needed - psychological meta-structure

January 13, 2011

Needed - psychological meta-structure

Where? In DSM-V, if we really want to do mental health diagnosis and treatment better, Scientific American says. If not there, then in the next edition after that.

The idea is that the various categories in the current Diagnostic and Statistical Manual of Mental Disorders are too rigid for reality.
(A)n enormous number of family and genetic studies have not only failed to validate the major DSM disorders as natural kinds, but instead have suggested that they are more akin to chimaeras. ...

I would argue, is that, at least for the purposes of research, the current DSM diagnoses do not work. They are too narrow, too rigid, altogether too limited. Reorganization of the DSM is hardly a panacea, but science cannot thrive if investigators are forced into a cognitive straitjacket.

Agreed on that.

So, what's this about meta-structure?
Genetic studies focused on finding variations in DNA sequences associated with mental disorders have repeatedly found shared genetic risks for both schizophrenia and bipolar disorder. Other studies have found different sequence variations within the same genes to be associated with schizophrenia and autism spectrum disorders.

The bottom line is in these two points:
First, DSM disorders do not breed true. What is transmitted across generations is not discrete DSM categories but, perhaps, complex patterns of risk that may manifest as one or more DSM disorders within a related cluster. Second, instead of long-term stability, symptom patterns often change over the life course, producing not only multiple co-occurring diagnoses but also different diagnoses at different times of life.

The rest of the very insightful story tells us more.

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