4 ms·

I wonder how much of the DSM is based on loose correlations, non-replicated or fraudulent research. I get the feeling that we understand how our brains work ab

I wonder how much of the DSM is based on loose correlations, non-replicated or fraudulent research. I get the feeling that we understand how our brains work about as well as we understand how well mitochondria work - - and I see reports of new findings on mitochondria fairly regularly...

SketchySeaBeast 1y ago
The brain is certainly difficult to study, but does it not stand to reason that there should be a collection of the current understanding of how to treat things when they go wrong? No one is calling the DSM V the final, definitive, work, there's a reason it's numbered.
brooke2k 1y ago
The DSM isn't about understanding how the brain works, it's about correlating sets of symptoms to treatments. If your issues are characterized by this broad set of symptoms, then likely you'll benefit from these sorts of treatments, and etc. We don't have a good understanding of how the brain works, but we're pretty confident that people with schizophrenia often benefit from antipsychotic medications.
- hx8 1y ago
  In some ways the financial conflicts of interest make sense, because the people that best understand a set of symptoms probably also are the ones in the best position to create new treatments. Being undisclosed makes it feel way more scummy than it might actually be.
  - p_ing 1y ago
    That should be true across medicine. A biotech is best suited to invent new medications for existing diseases consulting with or acquiring in-house talent that knows the disease inside and out. Experts generally benefit from their expertise. Nothing new, shouldn't be controversial.
    - michaelt 1y ago
      The thing is, society doesn't have to worry that the guy selling crutches is going to reinvent the definition of a broken leg to increase crutch sales.
      - hx8 1y ago
        We should worry about the guy selling crutches. He could be lobbying against safety standards that would decrease the number of broken legs. We should assume he's acting in his own best interest, and carefully consider if his actions align with our collective best interest. Disclosure is critical.
yoshuaw 1y ago
It's hard to tell honestly. I studied psychology for two years in uni, and I dropped out rather disillusioned about the field. Some of my least favorite aspects included: - Acknowledgement by our professors that P-hacking (pruning datasets to get the desired results) was not just common, but rampant - One of our classes being thrown in limbo for several months after we found out that a bunch of foundational research underpinning it was entirely made up (See: Diederik Stapel). - Experiencing first-hand just how unreproducible most research in our faculty was (SPSS was the norm, R was the exception, Python was unused). - Learning that most psychology research is conducted on white psychology students in their early/mid-twenties in the EU and US. But the findings are broadly generalized across populations and cultures. - Learning that the DSM-IV classified homosexuality as a mental disorder. Though the DSM-V has since dropped this. The DSM-V is still incredibly hostile towards trans people through a game of internal power politics and cherry-picked research. It's really bad honestly. Though I do generally hold psychologists in high regard (therapy is good), I'm not particularly impressed by psychology as a science. And in turn don't necessarily trust the DSM all that much.
- aeve890 1y ago
  >One of our classes being thrown in limbo for several months after we found out that a bunch of foundational research underpinning it was entirely made up (See: Diederik Stapel). That's mild. In one of Chile's largest and most prestigious universities, Jodorowsky "psychomagic" is teached as a real therapeutic approach.
- JBits 1y ago
  At least you're working with Rust now. As someone with zero knowledge of psychology, I'm biased against it. Partly because of my vague impression that psychology tries to fit people to models, rather than viewing models as limited approximations. For a while I've thought it would be nice to know what results the field of psychology actually has that are trusted. Was there anything at all in the taught content which you liked? I didn't realise the DSM-V was that bad. If research on trans people can be cherry-picked, then does that mean that some reliable research exists?
  - 1y ago
epgui 1y ago
This is the wrong question… The DSM is just an ontology that aims to standardize communication of otherwise ill-defined or nebulous clinical entities. It provides language for medical professionals of various backgrounds to understand each other across cultures. That’s all it is.
- cwmoore 1y ago
  Kind of like…labeling people by race? Surely there are misalignments.
- supportengineer 1y ago
  It's a sorting hat
  - cwmoore 1y ago
    So not a tinfoil sieve? EDIT: missed Harry Potter reference
IFC_LLC 1y ago
I took the liberty of indulging in some reading. I must admit, it feels a bit strange. The truth is that I learned my first steps in programming by working through large, formidable books. In fact, my very first programming book was Assembly Language for Intel-Based Computers by Kip Irvine. After that, I read even larger books, many of them multiple times. I have always been fond of reading well-written books by knowledgeable professionals. After reading such works, you come away with real understanding, greater clarity, and often new creativity. Books are valuable, and I have always respected a good one. Yet the DSM-5-TR is quite the opposite. The Preface clearly states that the work is intended for everyone: “The information is of value to all professionals associated with various aspects of mental health care, including psychiatrists, other physicians, psychologists, social workers, nurses, counselors, forensic and legal specialists, occupational and rehabilitation therapists, and other health professionals.” I happen to be a social worker, and I have read a lot of books. I know how to study. I carefully looked up any words I might have misunderstood and used the dictionary freely. But despite all my efforts, I often failed to make sense of what I was reading. One would expect a theory followed by a conclusion, or an observation leading to a conclusion, or a theorem that is then proven. Unfortunately, that structure is missing here. A typical DSM entry begins with a statement presented as fact, only to be followed by other statements that seem to contradict it. Take, for example: “The prevalence of disinhibited social engagement disorder is unknown. Nevertheless, the disorder appears to be rare, occurring in a minority of children, even those who have experienced severe early deprivation. In low-income community populations in the United Kingdom, the prevalence is up to 2%.” This kind of contradictory phrasing is standard in the DSM. Again, the DSM is publicly available, and anyone can read it here: https://www.ifeet.org/files/DSM-5-TR.pdf https://www.ifeet.org/files/DSM-5-TR.pdf I would have expected more precision from a scientific book.
- NoahZuniga 1y ago
  > This kind of contradictory phrasing is standard in the DSM. I'm not sure I see what's contradictory in your example. Could you elaborate?
  - IFC_LLC 1y ago
suggestion 1y ago
Nearly all of it, because that's the case for the overwhelming majority of the social sciences. When you do not have an objective metric to measure, prove, or hypothesize (as in physics, chemistry, etc), you're basically doing statistics on whatever arbitrary populations and bounds you choose with immeasurable confounders. That's why the replication crisis and p hacking are intrinsic properties of the social sciences

SketchySeaBeast 1y ago

The brain is certainly difficult to study, but does it not stand to reason that there should be a collection of the current understanding of how to treat things when they go wrong? No one is calling the DSM V the final, definitive, work, there's a reason it's numbered.

brooke2k 1y ago

The DSM isn't about understanding how the brain works, it's about correlating sets of symptoms to treatments. If your issues are characterized by this broad set of symptoms, then likely you'll benefit from these sorts of treatments, and etc. We don't have a good understanding of how the brain works, but we're pretty confident that people with schizophrenia often benefit from antipsychotic medications.

hx8 1y ago
In some ways the financial conflicts of interest make sense, because the people that best understand a set of symptoms probably also are the ones in the best position to create new treatments. Being undisclosed makes it feel way more scummy than it might actually be.
- p_ing 1y ago
  That should be true across medicine. A biotech is best suited to invent new medications for existing diseases consulting with or acquiring in-house talent that knows the disease inside and out. Experts generally benefit from their expertise. Nothing new, shouldn't be controversial.
  - michaelt 1y ago
    The thing is, society doesn't have to worry that the guy selling crutches is going to reinvent the definition of a broken leg to increase crutch sales.
    - hx8 1y ago
      We should worry about the guy selling crutches. He could be lobbying against safety standards that would decrease the number of broken legs. We should assume he's acting in his own best interest, and carefully consider if his actions align with our collective best interest. Disclosure is critical.

yoshuaw 1y ago

It's hard to tell honestly. I studied psychology for two years in uni, and I dropped out rather disillusioned about the field. Some of my least favorite aspects included: - Acknowledgement by our professors that P-hacking (pruning datasets to get the desired results) was not just common, but rampant - One of our classes being thrown in limbo for several months after we found out that a bunch of foundational research underpinning it was entirely made up (See: Diederik Stapel). - Experiencing first-hand just how unreproducible most research in our faculty was (SPSS was the norm, R was the exception, Python was unused). - Learning that most psychology research is conducted on white psychology students in their early/mid-twenties in the EU and US. But the findings are broadly generalized across populations and cultures. - Learning that the DSM-IV classified homosexuality as a mental disorder. Though the DSM-V has since dropped this. The DSM-V is still incredibly hostile towards trans people through a game of internal power politics and cherry-picked research. It's really bad honestly. Though I do generally hold psychologists in high regard (therapy is good), I'm not particularly impressed by psychology as a science. And in turn don't necessarily trust the DSM all that much.

aeve890 1y ago
>One of our classes being thrown in limbo for several months after we found out that a bunch of foundational research underpinning it was entirely made up (See: Diederik Stapel). That's mild. In one of Chile's largest and most prestigious universities, Jodorowsky "psychomagic" is teached as a real therapeutic approach.
JBits 1y ago
At least you're working with Rust now. As someone with zero knowledge of psychology, I'm biased against it. Partly because of my vague impression that psychology tries to fit people to models, rather than viewing models as limited approximations. For a while I've thought it would be nice to know what results the field of psychology actually has that are trusted. Was there anything at all in the taught content which you liked? I didn't realise the DSM-V was that bad. If research on trans people can be cherry-picked, then does that mean that some reliable research exists?
- 1y ago

epgui 1y ago

This is the wrong question… The DSM is just an ontology that aims to standardize communication of otherwise ill-defined or nebulous clinical entities. It provides language for medical professionals of various backgrounds to understand each other across cultures. That’s all it is.

cwmoore 1y ago
Kind of like…labeling people by race? Surely there are misalignments.
supportengineer 1y ago
It's a sorting hat
- cwmoore 1y ago
  So not a tinfoil sieve? EDIT: missed Harry Potter reference

IFC_LLC 1y ago

I took the liberty of indulging in some reading. I must admit, it feels a bit strange. The truth is that I learned my first steps in programming by working through large, formidable books. In fact, my very first programming book was Assembly Language for Intel-Based Computers by Kip Irvine. After that, I read even larger books, many of them multiple times. I have always been fond of reading well-written books by knowledgeable professionals. After reading such works, you come away with real understanding, greater clarity, and often new creativity. Books are valuable, and I have always respected a good one. Yet the DSM-5-TR is quite the opposite. The Preface clearly states that the work is intended for everyone: “The information is of value to all professionals associated with various aspects of mental health care, including psychiatrists, other physicians, psychologists, social workers, nurses, counselors, forensic and legal specialists, occupational and rehabilitation therapists, and other health professionals.” I happen to be a social worker, and I have read a lot of books. I know how to study. I carefully looked up any words I might have misunderstood and used the dictionary freely. But despite all my efforts, I often failed to make sense of what I was reading. One would expect a theory followed by a conclusion, or an observation leading to a conclusion, or a theorem that is then proven. Unfortunately, that structure is missing here. A typical DSM entry begins with a statement presented as fact, only to be followed by other statements that seem to contradict it. Take, for example: “The prevalence of disinhibited social engagement disorder is unknown. Nevertheless, the disorder appears to be rare, occurring in a minority of children, even those who have experienced severe early deprivation. In low-income community populations in the United Kingdom, the prevalence is up to 2%.” This kind of contradictory phrasing is standard in the DSM. Again, the DSM is publicly available, and anyone can read it here: https://www.ifeet.org/files/DSM-5-TR.pdf https://www.ifeet.org/files/DSM-5-TR.pdf I would have expected more precision from a scientific book.

NoahZuniga 1y ago
> This kind of contradictory phrasing is standard in the DSM. I'm not sure I see what's contradictory in your example. Could you elaborate?
- IFC_LLC 1y ago

suggestion 1y ago

Nearly all of it, because that's the case for the overwhelming majority of the social sciences. When you do not have an objective metric to measure, prove, or hypothesize (as in physics, chemistry, etc), you're basically doing statistics on whatever arbitrary populations and bounds you choose with immeasurable confounders. That's why the replication crisis and p hacking are intrinsic properties of the social sciences