A rationale for DSM-III's medical model.

Defends the medical model in treating psychological disorders in response to T. Schacht and P. E. Nathan's (see record 1978-29497-001) etiologic regrouping of Diagnostic and Statistical Manual of Mental Disorders (DSM-III) diagnostic categories. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

On DSM-III.

Claims that, despite T. Schacht and P. E. Nathan's (see record 1978-29497-001) criticisms of the Diagnostic and Statistical Manual of Mental Disorders (DSM-III), they seem to have accepted the basic premises of the DSM-III. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

DSM-III and the politics–science dichotomy syndrome: A response to Thomas E. Schacht's "DSM-III and the politics of truth."

Contends that T. E. Schacht's (see record 1986-11891-001) definition of politics is so broad in his discussion of the Diagnostic and Statistical Manual of Mental Disorders (DSM-III), science, and politics that no one could deny that there are political dimensions of scientific activities. Employing Schacht's definition, the present author presents other political elements in DSM-III to demonstrate that, as chairperson of the DSM-III task force, he did not suffer from the politics–science dichotomy syndrome. It is suggested that for Schacht the acknowledgment of politics is the end of the analysis, while it should be the beginning. (18 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Review of Mad travelers: Reflections on the reality of transient mental illness.

Reviews the book, Mad travelers: Reflections on the reality of transient mental illness by Ian Hacking (see record 1998-08112-000). The American Psychiatric Association produced its first Diagnostic and Statistic Manual (DSM) in 1952. It took 16 years to make the revisions that were published as DSM II, 12 years to produce DSM-III, 7 to produce DSM-III Revised, and a mere 7 more to create DSM-IV. It appears that the official accounts of mental, emotional, and behavioural problems change over the years. Moreover, some disorders change so drastically that they can assume epidemic proportions in one situation, while virtually non-existent in another. Such disorders are the focus of Hacking's book. The book is based on talks he gave in the Page-Barbour lecture series at the University of Virginia in 1997. Hacking's purpose is to explore what he calls "transient mental illnesses," those that seem to be confined to a particular time and place—an ecological niche that permits and even nourishes them. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The issue of sex bias in DSM-III: A critique of "A Woman's View of DSM-III" by Marcie Kaplan.

Criticizes M. Kaplan's (see PA, 71:6606) theory that 1 explanation for certain mental disorders being diagnosed more frequently in women is because of masculine-biased assumptions about what behaviors are healthy that are codified in DSM-III. Kaplan makes the faulty assumption that recognizing a societal problem (e.g., sexism) excludes the utility of clinical diagnosis of the individual. Examination of the sex ratios for the DSM-III Axis I clinical syndromes in the DSM-III field trials reveals many categories that are more commonly diagnosed in men, providing no support to Kaplan's thesis. (9 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Whatever happened to interpersonal diagnosis? A psychosocial alternative to DSM-III.

Based on concerns about the scientific and clinical shortcomings of the pending Diagnostic and Statistical Manual of Mental Disorders (DSM-III), it is proposed that psychology consolidate its knowledge in the form of an interpersonal behavior taxonomy. It is argued that a substantial body of literature suggests that the most useful aspects of current psychiatric diagnostic schemata are psychosocial in nature and that most diagnoses of "functional mental disorders" are made on the basis of observed interpersonal behavior. A review of social behavior coding models suitable for clinical use and a discussion of how L. S. Benjamin's structural analysis of social behavior could be used for developing an interpersonal nosology are included. The clinical and scientific advantages of such a nosology over traditional psychiatric nomenclature are emphasized. The application of the Benjamin model to clinical practice is illustrated with a brief case history of a 5-yr-old boy, and a specific example of how a DSM-III diagnosis might be translated into this model is given. (69 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

An empirical study of the issue of sex bias in the diagnostic criteria of DSM-III Axis II Personality Disorders.

Responds to M. Kaplan's (see record 1984-06847-001) assertion that society encourages women to behave histrionically and dependently and then through the use of sex-biased diagnostic criteria, such as the DSM-III, labels these same women as mentally ill. To test Kaplan's hypothesis, the sex ratios of all of the DSM-III Axis II personality disorders were determined in 2 samples of 2,712 and 531 patients. Histrionic and dependent personality disorders were more commonly diagnosed in females, and antisocial personality disorder was more commonly diagnosed in males. The finding that there was no overall tendency for a female S to receive a personality disorder diagnosis more often than a male S provides no support for Kaplan's theory of sex bias in the DSM-III. (7 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Categorical distinctions in the study of personality disorder: Implications for classification.

Discusses the historical underpinnings of psychiatric classification and examines empirical evidence relevant to (1) whether personality disorders are distinct from each other and from normal personality and (2) whether personality disorders should be classified separately from other mental disorders. At the phenotypic level, research evidence strongly supports the use of a dimensional model to delineate personality disorders; evidence about their genotypic representation is less conclusive though still supportive. Neither empirical nor rational arguments indicate strong justification for separating personality disorders from other mental disorders, as has been done in both the Diagnostic and Statistical Manual of Mental Disorders-III (DSM-III) and DSM-IV. Distinctions between abnormal and disordered personality are considered, and suggestions are made for more satisfactory diagnostic classificatory schemes. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Interrelationships of conversion, psychogenic pain, and dissociative disorder symptoms.

Among 29 male hysterics, psychogenic pain and conversion symptoms were positively correlated but were inversely related to dissociative symptoms. This suggests that conversion and pain disorders be merged into 1 diagnosis and that dissociative disorders be considered a separate, although related, entity. Data support the DSM-II scheme for hysteria better than its DSM-III counterpart. (2 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

DSM-III and the future of applied social science.

Psychiatry's emerging new Diagnostic and Statistical Manual of Mental Disorders (DSM-III) extends current psychiatric thinking by encompassing scores of new behavioral disturbances within the "medical model" and by defining mental disorders circumstantially in terms of psychiatric practice. A conception of behavioral disturbance as a sociobehavioral phenomenon is presented. (21 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Discriminant validity of the Psychopathy Checklist in a forensic psychiatric population.

The association between psychopathy and other mental disorders was investigated in 80 male forensic patients. Psychopathy was assessed with the Psychopathy Checklist (PCL; R. D. Hare [see PA, Vol 67:2477]). Diagnoses of other mental disorders were based on Axis I and Axis II criteria listed in the third edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-III) and on two standardized psychiatric rating scales. PCL diagnoses were significantly related only to antisocial and histrionic personality disorder (PD) and to nonalcohol substance abuse disorders. PCL ratings were also positively correlated with prototypicality ratings of antisocial, histrionic, and narcissistic PD and negatively correlated with ratings of avoidant PD. The results provide evidence for the convergent and discriminant validity of the PCL and are consistent with the view that psychopathy is a distinct clinical syndrome. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The DSM-III personality disorders section: a commentary

The author reviews the DSM-III section on personality disorders, discusses several of its more controversial diagnoses, and suggests some possible alternatives. He attributes the continued low reliability of personality diagnoses, compared with the other major sections of DSM-III, to two inherent obstacles: the lack of clear boundaries demarcating the personality disorders from normality and from one another, and the confounding influence of state and role factors. Nonetheless, the DSM-III multiaxial system highlights the importance of personality diagnosis and, together with the provision of clearly specified diagnostic criteria, achieves a considerably improved reliability compared with previous nomenclatures.     

Review of Psychopathology in the mentally retarded.

Reviews the book, Psychopathology in the mentally retarded by Johnny L. Matson and Rowland P. Barrett (see record 1985-97358-000). This book is an important contribution to the available literature on emotional and behavioral disorders in clients with the additional disability of mental retardation. This text is intended to provide the clinician and researcher with a broad view of existing empirical data dealing with mentally retarded individuals who exhibit psychopathology. As such, it provides a valuable review of much empirical research, especially that with a clear behavioral formulation. The text also is updated to include a DSM-III formulation of psychiatric disorders. The book is successful in achieving the goal of providing broad, empirical data. The book would be a wise purchase for the skilled clinician, although it is not a clinical handbook or "how-to" manual. The behaviorally oriented clinician will be most comfortable with the general approach and organization of the material. The book is essential to the library of the researcher in the field. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Sex patterns in DSM-III: Bias or basis for theory development.

Discusses M. Kaplan's (see record 1984-06847-001) assertions of sexist bias in the DSM-III and presents an overview of sex and developmental patterns of DSM-III diagnoses. It is argued that this overview shows that the most important issue is not the presence or absence of bias, but the significance of these sex patterns for childrearing, education, theories of psychopathology, and psychotherapy. For both sexes, certain behavioral patterns, which may be incorrectly labeled as disorders, may reflect dissatisfaction with stereotypical roles and expectations as well as pressures and lack of support for pursuing innovative and multiple roles. (5 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

DSM-III—R personality disorders and the five-factor model of personality: An empirical comparison.

Examined the relationship between the 5-factor model (FFM) of personality and the Diagnostic and Statistical Manual of Mental Disorders-III-Revised (DSM-III-R) personality disorders in a sample of 54 psychiatric outpatients. Correlations between raw scores on the NEO-Personality Inventory (NEO-PI) and the number of DSM-III—R personality disorder symptoms rated present using a semistructured interview were computed. In addition, correlations between NEO-PI scores and scores on 2 self-report personality disorder inventories were also examined to determine which results replicated across instruments. Results indicate that the FFM personality dimensions of Neuroticism, Extraversion, and Agreeableness were most apparent in the DSM-III—R conceptualizations of the personality disorders. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Relationship between hypomania and personality disorders before and after successful treatment

OBJECTIVE: To examine the effect of hypomanic states on maladaptive personality traits and personality disorders, the authors evaluated personality traits and disorders of patients during an episode of hypomania and after successful somatic treatment. METHOD: The authors used the Structured Interview for DSM-III Personality Disorders to study 66 outpatients who had a lifetime diagnosis of bipolar disorder and who met the minimum Research Diagnostic Criteria for hypomania. All patients had a knowledgeable informant separately undergo the Structured Interview for DSM-III Personality Disorders during the patient's hypomanic state. Outpatients who successfully recovered from the hypomanic episode (N = 47) and their informants were read-ministered the interview 4-8 weeks after the initial assessment. RESULTS: During the hypomanic state, informants generally reported higher levels of maladaptive personality traits among patients than patients themselves. For the patients who recovered successfully from the hypomanic episode, a reduction in all maladaptive personality traits except schizoid and dependent traits was reported by both patients and their informants; however, the decrease reported by patients generally was much greater than that reported by informants. In addition, schizoid traits actually increased after successful treatment according to patient reports but were unchanged according to informant reports. CONCLUSIONS: Hypomania may be associated with an exacerbation of maladaptive personality traits, which may be attenuated after successful treatment. Even with the attainment of euthymic mood, however, about 50% of the cohort had at least one personality disorder, which suggests that a high degree of comorbidity may exist between bipolar disorders and maladaptive personality traits or personality disorders.