While widely accepted among psychologists and psychiatrists, the manual has proved controversial in its listing of certain characteristics as mental disorders. The most notorious example is the listing in the DSM-II of homosexuality as a mental disorder; a classification that was removed by vote of the APA in 1973 (see also homosexuality and psychology).
Brief history
The first edition (DSM-I) was published in 1952, and had about 60 different disorders.
Both of these editions were strongly influenced by the psychodynamic approach. There was no sharp distinction between normal and abnormal, and all disorders were considered reactions to environmental events. Mental disorders existed on a continuum of behavior. This way, everyone is more or less abnormal. The people with more severe abnormalities have more severe difficulties with functioning.
The early editions of the DSM distinguished between a psychosis and a neurosis. A psychosis is a severe mental disorder characterized by a break with reality. Psychoses typically involve hallucinations, delusions, and illogical thinking. A neurosis is a milder mental disorder characterized by distortions of reality, but not a complete break with reality. Neuroses typically involve anxiety and depression.
In 1980, with DSM-III, the psychodynamic view was abandoned and the medical model became the primary approach, introducing a clear distinction between normal and abnormal. The DSM became "atheoretical", since it had no preferred etiology for mental disorders.
In 1987 the DSM-III-R appeared as a revision of DSM-III.
In 1994, it evolved into DSM-IV. This book is currently in its fourth edition.
The most recent version is the 'Text Revision' of the DSM-IV, also known as the DSM-IV-TR, published in 2000.
DSM-V, is not scheduled for publication until 2010. The APA Division of Research does not expect to begin forming DSM development workgroups until 2005 or later.
A DSM cautionary statement is required to create balance and perspective for the various diagnoses and criteria used in the Diagnostic and Statistical Manual of Mental Disorders (DSM) published by the American Psychiatric Association.
The criteria that are described in the DSM are meant to be used by clinicians and investigators.
The classificatory structure of early editions of the DSM was rooted in a distinction between two poles of mental disorder, psychosis and neurosis.
Another important aspect of the DSM diagnostic system is that the diagnoses are described strictly in terms of patterns of symptoms that tend to cluster together; the symptoms can be observed by the clinician or reported by the patient or family members.
Since the primary purpose of the early versions of the DSM was to standardize data collection administratively and to facilitate communication among clinicians, the diagnostic makeup of these early versions represented a consensus of those disorders that were being seen by psychiatrists in the United States in the 1950's and 1960's.
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