Abstract
The just-published psychiatric diagnostic manual, the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5), American Psychiatric Association (2013), has been lauded by its organizers (e.g., Regier, Kuhl, and Kupfer in World Psychiatry 12, pp. 92–98, 2013), but has been criticized on multiple grounds, as well. Several of its major diagnostic categories concern the area of psychological injury and law (e.g., tort cases involving posttraumatic stress disorder (PTSD), chronic pain, and traumatic brain injury (TBI)). The one for chronic pain seems the one most greatly changed. The approach to chronic pain in the Diagnostic and Statistical Manual of Mental Disorders, 4th edition, text revision (American Psychiatric Association 2000) and the DSM-5 are compared, leading to an alternative diagnostic criteria list partly based on the changes in the DSM-5. The DSM-5 should be used with caution in forensic assessments. This applies especially to the psychological injury patient, including the pain one, given the high stakes involved and the need for accuracy in assessment based on a reliable and valid diagnostic system. Future iterations of the manual should be improved in both these regards.
Similar content being viewed by others
References
American Psychiatric Association. (2000). Diagnostic and Statistical Manual of Mental Disorders: DSM-IV-TR (4th ed., text rev.). Washington, DC: Author.
American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders: DSM-V (5th ed.). Washington, DC: Author.
Cosgrove, L., & Krimsky, S. (2012). A comparison of DSM-IV and DSM-5 panel member's financial associations with industry: a pernicious problem persists. PloS Medicine, 9, e1001190.
Cosgrove, L., & Wheeler, E. E. (2013). Industry's colonization of psychiatry: ethical and practical implications of financial conflicts of interest in the DSM-5. Feminism & Psychology, 23, 93–106.
First, M. B. (2010). The PTSD stressor criterion as a barrier to malingering: DSM-5 draft commentaries. Psychological Injury and Law, 3, 255–259.
First, M. B. (2011). DSM-5 proposals for mood disorders: a cost-benefit analysis. Current Opinions in Psychiatry, 24, 1–9.
Frances, A. (2013a). The new somatic symptom disorder in DSM-5 risks mislabeling many people as mentally ill. British Medical Journal.
Frances, A. (2013b). DSM-5 somatic symptom disorder. The Journal of Nervous and Mental Disease, 201, 530–531.
Frances, A., & Chapman, S. (2013). DSM-5 somatic symptom disorder mislabels medical illness as mental disorder. Australian and New Zealand Journal of Psychiatry, 47, 483–489.
Frances, A., & Widiger, T. (2012). Psychiatric diagnosis: lessons from the DSM-IV past and cautions for the DSM-5 future. Annual Review of Clinical Psychology, 8, 109–130.
Gatchel, R. J., Peng, Y. B., Peters, M. L., Fuchs, P. N., & Turk, D. C. (2007). The biopsychosocial approach to chronic pain: scientific advances and future directions. Psychological Bulletin, 133, 581–624.
Kessler, R. C., & Wang, P. S. (2008). The descriptive epidemiology of commonly occurring mental disorders in the United States. Annual Review of Public Health, 29, 115–129.
Melzack, R., & Katz, J. (2006). Pain in the 21st century: The neuromatrix and beyond. In G. Young, A. W. Kane, & K. Nicholson (Eds.), Psychological knowledge in court: PTSD, pain, and TBI (pp. 129–148). New York: Springer Science + Business Media.
Melzack, R., & Katz, J. (2012). Pain. WIREs Cognitive Science, 4, 1–15.
Moffitt, T. E., Caspi, A., Taylor, A., Kokaua, J., Milne, B. J., Planczyk, G., & Poulton, R. (2010). How common are common mental disorders? Evidence that lifetime prevalence rates are doubled by prospective versus retrospective ascertainment. Psychological Medicine, 40, 899–909.
Regier, D. A., Kuhl, E. A., & Kupfer, D. J. (2013). The DSM-5: classification and criteria change. World Psychiatry, 12, 92–98.
Rief, W., Mewes, R., Martin, A., Glaesmer, H., & Brähler, E. (2011). Evaluating new proposals for the psychiatric classification of patients with multiple somatic symptoms. Psychosomatic Medicine, 73, 760–768.
Sirri, L., & Fava, G. A. (2013). Diagnostic criteria for psychosomatic research and somatic symptom disorders. International Review of Psychiatry, 25, 19–30.
Sykes, R. (2012). The DSM 5 website proposals for somatic symptom disorder: three central problems. Psychosomatics, 53, 524–531.
Wollburg, E., Voigt, K., Braukhaus, C., Herzog, A., & Löwe, B. (2013). Construct validity and descriptive validity of somatoform disorder in light of proposed changes for the DSM-5. Journal of Psychosomatic Research, 74, 18–24.
Wortzel, H. S. (2013). The DSM-5 and forensic psychiatry. Journal of Psychiatric Practice, 13, 238–241.
Young, G. (2010). Chronic pain in the DSM-IV and the DSM-5 draft: the pain of it all. Psychological Injury and Law, 3, 289–294.
Young, G. (2014). Malingering, feigning, and response bias in psychiatric/psychological injury - Implications for practice and court. New York: Springer Science + Business Media.
Young, G., & Haynes, S. (2014). Causality of normal and abnormal behavior: Emergence in biology, brain, mind, development, and free will. New York: Springer Science + Business Media.
Young, G., Kane, A. W., & Nicholson, K. (Eds.). (2007). Causality of psychological injury: Presenting evidence in court. New York: Springer Science + Business Media.
Author information
Authors and Affiliations
Corresponding author
Additional information
Note that I have no conflicts of interest to report. I do assess plaintiff complainants typically. William Deardorff provided salient comments and corrections on the draft of the article, as did independent reviewers.
Rights and permissions
About this article
Cite this article
Young, G. Ill-Treatment of Pain in the DSM-5. Psychol. Inj. and Law 6, 307–313 (2013). https://doi.org/10.1007/s12207-013-9178-3
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s12207-013-9178-3