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Diagnostic and Statistical Manual of Mental Disorders DSM-IV-TR

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This Text Revision incorporates information culled from a comprehensive literature review of research about mental disorders published since the DSM-IV(R) of 1994. Updated information is included about the associated features, culture, age & gender features, prevalence, course & familial pattern of mental disorders. The DSM-IV-TR(R) brings this essential diagnostic This Text Revision incorporates information culled from a comprehensive literature review of research about mental disorders published since the DSM-IV(R) of 1994. Updated information is included about the associated features, culture, age & gender features, prevalence, course & familial pattern of mental disorders. The DSM-IV-TR(R) brings this essential diagnostic tool to-date, to promote effective diagnosis, treatment & quality of care. One can get all the essential diagnostic information from the DSM-IV(R) along with important updates not in the '94 edition. Benefit from new research into Schizophrenia, Asperger's Disorder & other conditions. Utilize additional information about the epidemiology & other facets of DSM conditions. Update ICD-9-CM codes implemented since 1994 including Conduct Disorder, Dementia, Somatoform Disorders. Use of the manual DSM-IV-TR classification Multiaxial assessment Disorders usually 1st diagnosed in infancy, childhood or adolescence Delirium, dementia & amnestic & other cognitive disorders Mental disorders due to a general medical condition Substance-related disorders Schizophrenia & other psychotic disorders Mood disorders Anxiety disorders Somatoform disorders Factitious disorders Dissociative disorders Sexual & gender identity disorders Eating disorders Sleep disorders Impulse-control disorders not elsewhere classified Adjustment disorders Personality disorders Other conditions that may be a focus of clinical attention Additional codes Appendix A: Decision trees for differential diagnosis Appendix B: Criteria sets & axes provided for further study Appendix C: Glossary of technical terms Appendix D: Highlights of changes in DSM-IV text revision Appendix E: Alphabetical listing of DSM-IV-TR diagnoses & codes Appendix F: Numerical listing of DSM-IV-TR diagnoses & codes Appendix G: ICD-9-CM codes for selected general medical conditions & medication-induced disorders Appendix H: DSM-IV classification with ICD-10 codes Appendix I: Outline for cultural formulation & glossary of culture-bound syndromes Appendix J: DSM-IV contributors Appendix K: DSM-IV text revision advisers


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This Text Revision incorporates information culled from a comprehensive literature review of research about mental disorders published since the DSM-IV(R) of 1994. Updated information is included about the associated features, culture, age & gender features, prevalence, course & familial pattern of mental disorders. The DSM-IV-TR(R) brings this essential diagnostic This Text Revision incorporates information culled from a comprehensive literature review of research about mental disorders published since the DSM-IV(R) of 1994. Updated information is included about the associated features, culture, age & gender features, prevalence, course & familial pattern of mental disorders. The DSM-IV-TR(R) brings this essential diagnostic tool to-date, to promote effective diagnosis, treatment & quality of care. One can get all the essential diagnostic information from the DSM-IV(R) along with important updates not in the '94 edition. Benefit from new research into Schizophrenia, Asperger's Disorder & other conditions. Utilize additional information about the epidemiology & other facets of DSM conditions. Update ICD-9-CM codes implemented since 1994 including Conduct Disorder, Dementia, Somatoform Disorders. Use of the manual DSM-IV-TR classification Multiaxial assessment Disorders usually 1st diagnosed in infancy, childhood or adolescence Delirium, dementia & amnestic & other cognitive disorders Mental disorders due to a general medical condition Substance-related disorders Schizophrenia & other psychotic disorders Mood disorders Anxiety disorders Somatoform disorders Factitious disorders Dissociative disorders Sexual & gender identity disorders Eating disorders Sleep disorders Impulse-control disorders not elsewhere classified Adjustment disorders Personality disorders Other conditions that may be a focus of clinical attention Additional codes Appendix A: Decision trees for differential diagnosis Appendix B: Criteria sets & axes provided for further study Appendix C: Glossary of technical terms Appendix D: Highlights of changes in DSM-IV text revision Appendix E: Alphabetical listing of DSM-IV-TR diagnoses & codes Appendix F: Numerical listing of DSM-IV-TR diagnoses & codes Appendix G: ICD-9-CM codes for selected general medical conditions & medication-induced disorders Appendix H: DSM-IV classification with ICD-10 codes Appendix I: Outline for cultural formulation & glossary of culture-bound syndromes Appendix J: DSM-IV contributors Appendix K: DSM-IV text revision advisers

30 review for Diagnostic and Statistical Manual of Mental Disorders DSM-IV-TR

  1. 5 out of 5

    Marvin

    My three cats Maslow, Ashley and Fanci were browsing my book shelf again. Ashley's gray paw caught on a big silver book that crashed to the floor. "Ashley, what did I tell you about helping yourself to the books" "Sorry." Ashley looked a little peeved. "Frankly I would rather help myself to the tuna cans." Maslow looked the book over. "What's a Dasm Fourster?" I checked it out. "Oh, you mean the DSM-IV-TR also known as the Diagnostic and Statistical Manual of Mental Disorders-Fourth Edition Revised. My three cats Maslow, Ashley and Fanci were browsing my book shelf again. Ashley's gray paw caught on a big silver book that crashed to the floor. "Ashley, what did I tell you about helping yourself to the books" "Sorry." Ashley looked a little peeved. "Frankly I would rather help myself to the tuna cans." Maslow looked the book over. "What's a Dasm Fourster?" I checked it out. "Oh, you mean the DSM-IV-TR also known as the Diagnostic and Statistical Manual of Mental Disorders-Fourth Edition Revised." Maslow and Ashley were interested but I noticed Fanci had fallen asleep by the time I got to "Statistical". Having read the DSM-IV, I knew the feeling. "So?" Maslow persisted. "What the heck is it?" "It is a book that categorizes the various forms of mental disorders that humans experience. Its main purpose is for the billing for insurances, giving doctors a label to place their diagnoses but barring that somewhat cynical outlook, I've found it helpful in my career as a clinical social worker for identifying groups of symptoms and designing treatments." Now Ashley's eyes started to glaze over. I knew I've gone on too long for felines. If you want to have a decent conversation with most cats, you have to mention food every three or four words. However Maslow was intrigued. "Have you read the entire book?" "It's mainly for reference. But I've used it so much that it feels like I've read the entire book." "Do you mean I can use this book to analyze Ashley and Fanci? "Well, I wouldn't recommend you do that but..." "Or analyze you?" "Well.." "Is there an Internet Addiction Disorder?" "Not Yet, but it is being considered for the fifth edition." "So now you're normal but you might be neurotic next year?" Now I was starting to get nervous. Time to change the tone of the conversation. "Actually, Maslow. It's not in the book but I've noticed that certain animals show traits of some human disorders. Like most dogs fit into Dependent Personality Disorder and most parrots are Paranoid Schizophrenic" "Yeah. I remember that blue-crowned conure you had. Always talking to himself. But what about cats?" "Easy. Cats are Narcissistic Personalities." "Meaning?" "They think they're the center of the universe." Maslow thought about that. "And that is a bad thing?" "Maslow, old buddy. If you're going to be Wonder Cat and take up reading, maybe you should start with something a little easier.' Maslow perused the book shelf. "How about this one?" I read the title. The Origin of Consciousness in the Breakdown of the Bicameral Mind. Now this should be interesting.

  2. 5 out of 5

    Tanya

    I feel the need to use the DSM to psychoanalyze the reviewers of this book. Whoa. It seems like people are personally offended by the existence of the DSM. Well, I for one, as a mental health professional, am quite glad that it exists because without it, I would be left to my own devices. There are many crazy therapists out there who would be diagnosing people with the most outlandish things possible if there weren't some guidelines in place. The DSM is not any of the following and if you're goi I feel the need to use the DSM to psychoanalyze the reviewers of this book. Whoa. It seems like people are personally offended by the existence of the DSM. Well, I for one, as a mental health professional, am quite glad that it exists because without it, I would be left to my own devices. There are many crazy therapists out there who would be diagnosing people with the most outlandish things possible if there weren't some guidelines in place. The DSM is not any of the following and if you're going to review it, keep this in mind: 1. Lite summer reading for by the pool. 2. Interesting to anyone who doesn't work in the field or 3. Speaking about you personally. I was just surprised to see how fired up people get about this. I certainly don't put much stock in some of the diagnoses and I'm looking forward to the DSM V update but I find it to at the very least be a necessary evil. It's kinda like if people were to complain that the dictionary didn't entertain them, is too rigid, or that words should not be defined by letters. Everything--including mental illness--has to have some language associated with it to better allow people to talk about it and address problems. What people chose to do with the labels within the DSM is the bigger problem. Diagnosis is one tool of many that the clinician works with. It shouldn't be the only consideration and it certainly doesn't define the totality of a person. For those of you who left scathing reviews of this book, I ask you to consider the alternative. If there was no DSM, diagnosing wouldn't disappear. As others mentioned, it's a requirement of the insurance companies. So would you rather have people pulling names of made up illnesses out of a hat? At least there are some guidelines in place.

  3. 4 out of 5

    Billie Rain

    know your enemy

  4. 5 out of 5

    Lesley

    In my experience, seasoned, sensitive, forward-thinking clinicians - the ones mostly interested in, like, helping people with their problems and, like, listening without judgment - claim to be kinda down on the DSM. It's an insurance company handbook, they say. It's a pharmaceutical company catalog. It's subjectivity masquerading as objective medical fact. Good points. I mean if you've ever had any doubt at all about the cultural impact on perceptions of mental illness, you need only compare DSM In my experience, seasoned, sensitive, forward-thinking clinicians - the ones mostly interested in, like, helping people with their problems and, like, listening without judgment - claim to be kinda down on the DSM. It's an insurance company handbook, they say. It's a pharmaceutical company catalog. It's subjectivity masquerading as objective medical fact. Good points. I mean if you've ever had any doubt at all about the cultural impact on perceptions of mental illness, you need only compare DSM-I (1952, roughly 100ish pages long) to DSM-IV-TR (2000, roughly 900 pages long). That said, I'm totally into the DSM-IV-TR and totally excited about DSM-V (slated for release around 2010, I think). New pathologies are fun! Personally, I'd like to see another Personality Disorder or two in DSM-V. Granted I'm less interested in using the DSM to diagnose clients as I am in using it to diagnose friends, family, acquaintances, and strangers in the supermarket for my own personal amusement.

  5. 4 out of 5

    Jeffrey Guterman

    Where do I begin? It's hard to say that this is a "good" book or that this is a "bad" book. This is a diagnostic manual used to diagnose mental disorders. But maybe I should not be so quick to conclude that this is all the DSM is. The DSM is also a cultural artifact. It is the product of a so-called scientific community, largely the psychiatric profession, that for better and/or worse, has powerful effects. One of the biggest shortcomings of the DSM is that it fails to understand the ethical imp Where do I begin? It's hard to say that this is a "good" book or that this is a "bad" book. This is a diagnostic manual used to diagnose mental disorders. But maybe I should not be so quick to conclude that this is all the DSM is. The DSM is also a cultural artifact. It is the product of a so-called scientific community, largely the psychiatric profession, that for better and/or worse, has powerful effects. One of the biggest shortcomings of the DSM is that it fails to understand the ethical imperative to recognize the necessary connection between observer and observed. To see that its mental disorders say more about the diagnosticians than the so-called patients that they are diagnosing. Except for a handful of the mental disorders in the DSM (e.g., schizophrenia) which may some day be more clearly understood as brain disorders, most of the diagnoses in this manual are social constructions. I teach psychopathology in Masters level courses for a counseling program and encourage students to challenge taken-for-granted assumptions about diagnosis, pathology, and traditional hierarchical relationships between clinicians and clients. I also suggest, however, that in a society where a medical model prevails, there are good reasons to use the DSM, including insurance reimbursement. I say, what's all the fuss? The DSM, itself, points out that its manual does not diagnose people but, rather, conditions. Moreover, I recommend that one view any given diagnosis as a set of if-then criteria. If you accept that an individual meets such criteria, then they have that diagnosis. Simple, right? Well, not really. Our biases, assumptions influences what we do and do not observe; hence, some clinicians will look for and observe some criteria, whereas others will observe other criteria. Mental health counseling is not like drawing blood for a medical test. Inter-rater reliability, from my experience, is not very good when it comes to the DSM. It could be said that a mental health diagnostic interview is often a projective test--for the therapist!

  6. 4 out of 5

    Morgan Blackledge

    I gave it 5 stars just to be a dick. But really! It's just a fucking book. Relax already. I know managed care sucks. But try to imagine what the fields of psychiatry and clinical psychology were like before diagnostic criteria and strict licensure standards. Running with scissors anyone? P.S. check out Nicole's review. She has read it "front to back several times"?Wow! That's hard core. I love nerding out on this stuff as much as the next guy, but dangalang, reading (and re-reading) a reference I gave it 5 stars just to be a dick. But really! It's just a fucking book. Relax already. I know managed care sucks. But try to imagine what the fields of psychiatry and clinical psychology were like before diagnostic criteria and strict licensure standards. Running with scissors anyone? P.S. check out Nicole's review. She has read it "front to back several times"?Wow! That's hard core. I love nerding out on this stuff as much as the next guy, but dangalang, reading (and re-reading) a reference manual? Cover to cover? Its like 900 pages. Why would anyone willingly do that?

  7. 4 out of 5

    Sarah

    i learned that it is possible to diagnose friends, loved ones, and myself with many disorders. I also learned that it is probable that there's nothing wrong with any of us. Still waiting for the DSM to focus on what's right!

  8. 5 out of 5

    Brian

    I am not a believer is DSM manuals. Each one of us is unique; no one comes with bullet points.

  9. 5 out of 5

    Shu-ning

    Bottom line, this is a diagnostic manual used to diagnose mental disorders, which in my opinion cannot be measured and is largely affected, or I should say "manipulated," by various variables such as the interviewee's culture background, ethnicity, communication, perception, in the moment emotions, etc, to name a few and the interviewer's interviewing skills, cultural sensitivity, personal bias and ingrained assumptions, etc, to name a few. Because of its unmeasurability, the constantly changing Bottom line, this is a diagnostic manual used to diagnose mental disorders, which in my opinion cannot be measured and is largely affected, or I should say "manipulated," by various variables such as the interviewee's culture background, ethnicity, communication, perception, in the moment emotions, etc, to name a few and the interviewer's interviewing skills, cultural sensitivity, personal bias and ingrained assumptions, etc, to name a few. Because of its unmeasurability, the constantly changing social constructions and numerous variables that cannot be controlled, DSM-IV is NOT scientifically based. It may provide a platform for mental health professionals to exchange psychiatric jargons but it should be the least tool to be used to label a person, or worst, justify pharmacological treatment. What a person presents is their "symptoms," as DSM-VI would call it; what a person doesn't tell is their "story," a story that needs to be heard. BTW, if you take out the criteria "the symptoms must cause marked distress or significant impairment in daily functioning" listed in every disorder, you will find that you have a little bit flavor of most disorders.

  10. 4 out of 5

    Tony

    DSM IV is the latest installment of a series that has captured the hearts of readers. Brimming with erotic excitement and plot turns that keep you guessing until the last page, this is an instant classic for fans of the statistical-diagnostic-spy-thriller genre.

  11. 5 out of 5

    Dereck

    For some reason, I thought I'd be the only nerd to put this on his list. It's a great reference, and handy to have for any psychology major or for any reference geek. It's pretty easy to find what you need. It's well organized, and very informative. The DSM books are also regularly updated, which is good because you get the most current information on psychological disorders.

  12. 5 out of 5

    Nicole

    Of course I didn't read the whole thing! C'mon! I have read a lot of it though.

  13. 5 out of 5

    SmarterLilac

    In my humble, non-professionals opinion, a lot of really sketchy "disorders" made their way into these pages. (Body Dysomorphic Disorder, AKA, "Broken Mirror Syndrome"? Please.)

  14. 5 out of 5

    Sarah

    If you keep this on your coffee table, it will certainly freak out your friends and family. It can also be used to liven up dull cocktail parties.

  15. 5 out of 5

    Leonardo

    Seligman noted that psychologists had created an enormous manual, known as the “DSM” (the Diagnostic and Statistical Manual of Mental Disorders), to diagnose every possible mental illness and behavioral annoyance, but psychology didn't even have a language with which to talk about the upper reaches of human health, talent, and possibility. The Happiness Hypothesis Pág.167

  16. 5 out of 5

    Tim

    I used to be very anti-label, but after going back to school for social work and working as a counselor at a methadone clinic I have reversed my opinion of this very critical reference book. The point of this book is to identify problematic behaviors so as to allow for treatment of such. Unfortunately, and far too often, the nature of this book gets abused, and at times certainly those who are responsible for its compilation have hurt their own cause with regard to at-large social understanding. I used to be very anti-label, but after going back to school for social work and working as a counselor at a methadone clinic I have reversed my opinion of this very critical reference book. The point of this book is to identify problematic behaviors so as to allow for treatment of such. Unfortunately, and far too often, the nature of this book gets abused, and at times certainly those who are responsible for its compilation have hurt their own cause with regard to at-large social understanding. The "illness society" in which we seem to have grown into however, has meant this work can very much be a double edged sword. Take it with a grain of salt if you must, but dont dismiss it just because you fear it. I was thinking about writing the DSM of Ordered Thought, I wonder what that might look like. If I have one major critique, it is that...the only focus is on what's "wrong", its assumed everyone knows whats "right"...which is a very dangerous assumption to make as we turn into a global society and cultures combine and collide.

  17. 5 out of 5

    Jason

    The lack of strength based approached here is seriously lacking. It is too tightly restrictioned to ridged normative culture, rather than using a scale. This is self evident and clearly displayed in its autistic, and bipolar sections. Clinical perspectives I'd missing and a review of spirituality on any level missing. The writing is very clear and easily understood. Deficit based thinking plagues these pages in a strict manner that only serves to label one as sick and pathological. This is not v The lack of strength based approached here is seriously lacking. It is too tightly restrictioned to ridged normative culture, rather than using a scale. This is self evident and clearly displayed in its autistic, and bipolar sections. Clinical perspectives I'd missing and a review of spirituality on any level missing. The writing is very clear and easily understood. Deficit based thinking plagues these pages in a strict manner that only serves to label one as sick and pathological. This is not very constructive given cbt, solution focused, etc models. There is a real lack of attention on subjective client interpretation as well as scant issues focusing on person in environmental as well as ecosystem contributions. Isolated to objective observations the client gets lost and resources and here information is not relevant. Used as a guideline among other resources and is extremely relevant in diagnosing but not in prognosis or working with clients. Essential for billing

  18. 5 out of 5

    Jessica

    Parts of this are a bit slow, it's redundant at times, and certain sections (e.g., gender identity disorder) already seem ridiculously dated. Despite all that -- and partly because of it -- this is a vastly entertaining read. I especially recommend the Personality Disorders, which you can just keep returning to again and again. I also find there's a certain kind of poetry to many of the parasomnias, while the Factitious disorders make a nice read, and it goes without saying that the paraphilias Parts of this are a bit slow, it's redundant at times, and certain sections (e.g., gender identity disorder) already seem ridiculously dated. Despite all that -- and partly because of it -- this is a vastly entertaining read. I especially recommend the Personality Disorders, which you can just keep returning to again and again. I also find there's a certain kind of poetry to many of the parasomnias, while the Factitious disorders make a nice read, and it goes without saying that the paraphilias are classic.

  19. 5 out of 5

    Kaley B

    This is the encyclopedia of mental disorders. I am finally a grad student, studying to get a Master's of Social Work and the DSM IV TR is a center piece to clinical social work. To be quite honest, I hate it thus far. Not because it is somewhat difficult to use, but because I battle with the concept of diagnosing people and the speed at which our society diagnosis and "treats" mental issues. My primary battle enemy: ADHD diagnosis in kids.

  20. 4 out of 5

    Aimee

    Can can your really rate the DSM? Its not like I sit up at night turning and turning the pages completely engrossed in the psychological dysfunction of mankind. Hence the 2 star rating....but that being said, I am happy there is a resource for psychological stuff. I'm not a huge fan of slapping a diagnosis on a person until absolutely necessary but of course I am going to need this as a therapist down the road. 2 stars. 4 stars for resource value.

  21. 5 out of 5

    J. Keck

    Having spent years within the covers of this book, I really appreciate the reviews of the Humorists and the Social/Anthropological readers. When the computer with emails began to proliferate in offices and homes, I began to wonder how long it would be before there was a diagnosis for "Information Overload Disorder."

  22. 4 out of 5

    Mark

    This book is a political document. As science, it is a fraud.

  23. 4 out of 5

    Abnoos

    what can I say. The Bible.

  24. 5 out of 5

    Ryan

    Bullshit.

  25. 4 out of 5

    Kieran Long

    Interesting, but can't wait to read about spectrum approach instead of this books categorical approach.

  26. 5 out of 5

    Stephanie Allen

    Loved this book! Very educational and informative. Now reading the DSM V, which is an updated version based on newest research!! I am using the DSM V for the research base for my new book.

  27. 5 out of 5

    Shai

    My bible.

  28. 5 out of 5

    Dudegreen

    Hmmm where to start. I remember my fascination with the intrigue and allure of the human psyche when I started my medical studies. I absolutely KNEW I was going to be a neuro/psych guy. I engulfed my neuro and psych courses in the pre-clinical years. The neuro syndromes and the ways neurological disorders could present fascinated me (they still do). The academics of psychiatric illness blew me away. To think a person's very soul could be studied was something that filled me intellectual enthusia Hmmm where to start. I remember my fascination with the intrigue and allure of the human psyche when I started my medical studies. I absolutely KNEW I was going to be a neuro/psych guy. I engulfed my neuro and psych courses in the pre-clinical years. The neuro syndromes and the ways neurological disorders could present fascinated me (they still do). The academics of psychiatric illness blew me away. To think a person's very soul could be studied was something that filled me intellectual enthusiasm and eagerness. The dance between the physical and the metaphysical whirled through my mind leaving it exhausted and utterly spent. Then, I started my clinical rotations; making sure psychiatry was first. I have never experienced disillusionment so completely and fully either before or since. I watched as people were labeled into broad categories. I watched as people were given huge doses of medicine that robbed them of their spirit. There was no interest into what was causing the person's illness, but rather only into what could be immediately done. I quickly found the source of this absurd approach. This disgusting book. This book makes "professionals" feel like they have the upper hand on the human spirit. They want sterility and this book makes them feel clean. Psychiatry is the most absurd and disgraceful profession as it stands presently. A monkey could be trained to do what they do. Psychologists and social workers could take a one semester pharmacology class and do a far better job. ER physicians could handle the rest. This book should not exist. It is garbage. It tries to contain the human spirit within 1000 pages. It fails.

  29. 4 out of 5

    James

    As of March 2008, the most current edition of the primary reference for psychology and psychiatry, used to diagnose mental health problems and form the basis for treatment planning. This book is produced by the American Psychiatric Association and uses the "medical model" approach, similar to the way purely physical diseases or injuries are diagnosed, providing a list of objectively observable symptoms to determine or rule out the existence of a wide number of problems, grouped in categories suc As of March 2008, the most current edition of the primary reference for psychology and psychiatry, used to diagnose mental health problems and form the basis for treatment planning. This book is produced by the American Psychiatric Association and uses the "medical model" approach, similar to the way purely physical diseases or injuries are diagnosed, providing a list of objectively observable symptoms to determine or rule out the existence of a wide number of problems, grouped in categories such as addictions, thought disorders (e.g. psychoses), mood disorders (depression, bipolar disorder, etc.), anxiety disorders (PTSD, etc.) and quite a few others. Although this approach is subject to valid criticisms, e.g. its bias toward Western cultural norms and the tendency of too many in the mental health field to ignore anything that is not captured by its definitions, it represents a big step forward beyond the vague and subjective (or moralistic and judgmental) attempts to understand psychological problems found in most work in this area before the first DSM was published.

  30. 5 out of 5

    Shannon

    My views on the DSM have changed over time and I have some mixed feelings on the manual. I understand that providing diagnoses are a way to help people have services covered that they want and/or need by insurance companies. This is not ideal, but how the broken system works. A label can provide some form of explanation for experiences that can be freeing for some. And I do see the need for being able to categorize research on effective techniques. On the other hand, labeling human beings can be My views on the DSM have changed over time and I have some mixed feelings on the manual. I understand that providing diagnoses are a way to help people have services covered that they want and/or need by insurance companies. This is not ideal, but how the broken system works. A label can provide some form of explanation for experiences that can be freeing for some. And I do see the need for being able to categorize research on effective techniques. On the other hand, labeling human beings can be dangerous and destructive. The DSM, built on the medical model of disease, pathologizes human beings based on abnormality. Who is to say what is normal and abnormal? Some disorders are pathological in my opinion, such as Pedophilia. However, I think the DSM in general over pathologizes human behavior. Until 1973, the DSM II categorized homosexuality as a mental disorder and there are similar mistakes in thinking in the current DSM-5. I'm more in favor of viewing people through a growth model in therapy vs. the disease model.

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