The Book of Woe: The DSM and the Unmaking of Psychiatry (44 page)

8.
“the syndromes are more alike than unalike”:
Wing, “Asperger’s Syndrome,” 121.

9.
“the term is helpful”:
Ibid., 124.

10.
Of the nearly one thousand subjects:
Volkmar et al., “Field Trial for Autistic Disorder in DSM-IV.”

11.
“The Little Professor Syndrome”:
Lawrence Osborne, “The Little Professor Syndrome,”
The New York Times Magazine
, June 18, 2000.

12.
“Some things made sense”:
Michael Carley and CC interview, October 13, 2011.

13.
“I . . . have yet to stand successfully”:
Carley,
Asperger’s from the Inside Out
, 4.

14.
“At GRASP we envision a world”:
http://grasp.org/page/mission-statement.

15.
She ballparked it:
Wing, “Asperger’s Syndrome,” 119–20.

16.
Eric Fombonne, an epidemiologist working in England, reviewed:
Fombonne, “The Epidemiology of Autism: A Review.”

17.
“secular increase”:
Ibid., 777.

18.
a rate of 34 per 10,000:
Yeargin-Alsopp, “Prevalence of Autism in a U.S. Metropolitan Area,” 53.

19.
these results were “an underestimate”:
Ibid., 81.

20.
As of 2002, the CDC reported:
All CDC figures can be found in Autism and Developmental Disabilities Monitoring Network, “Prevalence of Autism Spectrum Disorders,” available at http://www.cdc.gov/ncbddd/autism/documents/ADDM-2012-Community-Report.pdf.

21.
“opening Pandora’s Box”:
Wing, “Reflections on Opening Pandora’s Box.”

22.
a prevalence rate in a city in Korea:
Kim et al., “Prevalence of Autism Spectrum Disorders,” 907.

23.
blitzed the media:
“New Study Reveals Autism Prevalence in South Korea,” Autism Speaks, news release, May 9, 2011.

24.
“the need for improved and wider autism screening”:
“Top Ten Autism Research Achievements of 2011,” Autism Speaks, news release, December 20, 2011, http://www.autismspeaks.org/about-us/press-releases/top-10-autism-research-achievements-2011.

25.
“a stigmatizing hereditary disorder”:
Kim et al., “Prevalence of Autism,” 910.

26.
“Lower rates in 9- and 10-year-olds”:
Yeargin-Alsopp, “Prevalence of Autism in a U.S. Metropolitan Area,” 53.

27.
“Diagnosis of ASDs”:
Charman, “The Highs and Lows of Counting Autism,” 874.

28.
“canaries [who] sensed before anyone else”:
Lethem,
The Ecstasy of Influence
, 73.

29.
“premature to add Asperger’s”:
Michael First e-mail, March 20, 2012.

30.
“We probably were premature”:
Allen Frances e-mail, February 20, 2012.

31.
“It involves a use of treatment resources”:
Amy Harmon, “A Specialists’ Debate on Autism Has Many Worried Observers,”
The New York Times
, January 20. 2012.

32.
“The goal was not to change prevalence”:
Catherine Lord interview, March 29, 2012.

33.
most important factor in determining which diagnosis:
Lord et al., “A Multisite Study of the Clinical Diagnosis of Different Autism Spectrum Disorders,” 309–11.

Chapter 14

1.
“People say, ‘What’s in a name?’”:
Dilip Jeste, “State of Classification of Neurocognitive Disorders,” American Psychiatric Association annual meeting, May 17, 2011.

2.
“Attire is ‘aloha business/casual’”:
http://web.archive.org/web/20110523195007/http://www.psych.org/annualmeeting.

3.
“invent[ing] out of thin air”:
Thomas Widiger, “The DSM-5 Personality Disorder Dimensional Model,” American Psychiatric Association annual meeting, May 15, 2011.

4.
“I do sense a reactionary element”:
David Shaffer, “State of the Science on Diagnostic Classification: Implications for DSM-5,” American Psychiatric Association annual meeting, May 17, 2011.

5.
“Allen and I have a big disagreement”:
Michael First interview, March 2, 2012.

6.
First stuck to small ball:
Michael First, “The Future of Psychiatric Nosology,” Association for the Advancement of Philosophy and Psychiatry annual meeting, May 15, 2011.

7.
Kupfer and Regier demonstrate:
David J. Kupfer and Darrel A. Regier, “Diagnostic Assessment in DSM-5: Approaches and Examples,” American Psychiatric Association annual meeting, May 16, 2011.

8.
“That’s why we are doing a field test”:
Darrel Regier interview, September 14, 2010.

9.
“two rigorous study designs”:
American Psychiatric Association, “APA Announces Start of Field Trials for DSM-5,” press release, October 5, 2010.

10.
“I’m surprised”:
Darrel Regier e-mail, October 6, 2010.

11.
“People’s expectations of what reliability should be”:
Kraemer, “DSM-5 Field Trials,” American Psychiatric Association annual meeting, May 17, 2011.

12.
Spitzer “could have employed”:
Kirk and Kutchins,
The Selling of DSM
, 61–62.

13.
“We’d better get smart about measuring”:
Lawson Wulsin, “DSM-5 Research and Development,” American Psychiatric Association annual meeting, May 16, 2011.

Chapter 15

1.
“You have to understand”:
Allen Frances interview, July 9, 2011.

2.
“If it seems like this is coming”:
Allen Frances interview, August 16, 2010.

3.
“My narcissism couldn’t survive the teenage insight”:
Allen Frances e-mail, April 22, 2010.

4.
“over a period of at least 6 months”
 . . . “The fantasies, sexual urges”:
DSM-IV, 528.

5.
“the symptom criteria alone”:
First and Frances, “Issues for DSM-V,” 1240.

6.
“While we have been preoccupied”:
Linda Bowles, “Kinder Gentler Pedophilia,” WorldNetDaily,
http://www.wnd.com/1999/05/228/.

7.
“acknowledge the ‘APA’s clear opposition’”:
Linda Bowles, “Pedophilia: Good News Bad News,” WorldNetDaily,
http://www.wnd.com/1999/06/231/.

8.
if someone “has acted on these urges”:
DSM-IV-TR, 572.

9.
“Fewer than half of child molesters”:
Michael First e-mail, April 22, 2012.

10.
“too polemical”:
Kutchins and Kirk,
Making Us Crazy
, 164–65.

11.
“a tendency to feel inordinately threatened
”
:
Pantony and Caplan, “Delusional Dominating Personality Disorder,” 127–30.

12.
“I really wasn’t sure”:
Kutchins and Kirk,
Making Us Crazy
, 171.

13.
“It is disruptive to constantly tinker”:
Ibid., 172.

14.
Caplan did give Frances a shout-out:
Paula Caplan, “DSM-5 Heads’ Comments Reveal Lack of Compassion and of Respect for Science,”
When Johnny and Jane Come Marching Home
(blog), http://whenjohnnyandjanecomemarching.weebly.com/1/post/2011/05/dsm-5-heads-new-comments-reveal-lack-of-compassion-and-of-respect-for-science.html.

15.
On the appointed day:
This account is from Caplan, “Letter from DSM-5 Task Force Head Leaves Major Concerns Unanswered,”
Science Isn’t Golden
(blog), http://www.psychologytoday.com/blog/science-isnt-golden/201106/letter-dsm-5-task-force-head-leaves-major-concerns-unanswered-part-1. The public relations firm that arranged the conference call declined to comment.

16.
“the continued and continuous medicalisation”:
British Psychological Society, “Response to the American Psychiatric Association
:
DSM-5 Development,” http://apps.bps.org.uk/_publicationfiles/consultation-responses/DSM-5%202011%20-%20BPS%20response.pdf.

17.
Regier made clear in his official response:
See “Society’s Critical Response to DSM-5,”
The Psychologist News
, July 13, 2011, http://www.thepsychologist.org.uk/blog/blogpost.cfm?threadid=2102&catid=48.

18.
“previous failures”:
Melville,
The Confidence-Man
, 77.

19.
“stranger entering”:
Ibid.

20.
“general resistance or indifference”:
Blanchard et al., “Pedophilia, Hebephilia, and the DSM-V,” 336.

21.
“discriminable erotic age-preference”:
Ibid., 335.

22.
“Your neighbors’ 7-year-old girl”:
Blanchard et al., “IQ, Handedness, and Pedophilia in Adult Male Patients,” 292.

23.
“to minimize his embarrassment”:
Blanchard et al., “Pedophilia, Hebephilia, and the DSM-V,” 339.

24.
“hebephilia exists”:
Ibid., 347–48.

Chapter 16

1. “
We are . . . test piloting”:
APA Research e-mail, July 8, 2011.

2. “
The most common reason”:
Now found at http://www.findthatpdf.com/search-80840213-hPDF/download-documents-ft-20note-20for-20web-20site.pdf.htm.

3. “
We have learned”:
Eve Moscicki e-mail, September 9, 2011.

4.
“Thanks for your candid note”:
Ibid.

5.
another note from Kupfer and Regier:
APA Research e-mail, September 20, 2011.

6.
DSM-5 proposal for Generalized Anxiety Disorder:
This once appeared at www.dsm5.org/ProposedRevisions1.2011/Pages/proposedrevision5478.html?rid=167.

7.
the old one:
DSM-IV-TR, 476.

8.
“A Personality Disorder is an enduring pattern”:
DSM-IV-TR, 685.

9.
“ensures that consideration will be given”:
DSM-IV-TR, 28.

10.
“I think this is the best way”:
Allen Frances e-mail, May 1, 2012.

11.
“I have never really been a doctor”:
Gay,
Freud
, 681.

12. “
They have the lowest reliability”:
Allen Frances e-mail, May 12, 2012. See Frances, “The DSM-III Personality Disorders Section: A Commentary.”

13.
The kappas were .56 to .65:
Spitzer et al., “DSM-III Field Trials: I. Initial Interrater Diagnostic Reliability.”

14.
“the personality disorders are not at all clearly distinct”:
Frances, “The DSM-III Personality Disorders Section,” 1050.

15.
“Rather than being diagnosed”:
Ibid., 1051.

16.
“committed dimensionalist”:
Allen Frances e-mail, May 17, 2012.

17.
“I believe I was chosen”:
Thomas Widiger e-mail, May 21, 2012.

18.
“under active investigation”:
DSM-IV, 633–34.

19.
a paper, published just before DSM-IV:
Frances, “Dimensional Diagnosis of Personality Disorders—Not Whether but When and Which.”

20.
“It might be more consistent”:
First et al., “Personality Disorders and Relational Disorders,” 130.

21.
“uniform classification of general personality functioning”:
Ibid., 131.

22.
“That is why I pushed”:
Michael First e-mail, May 15, 2012.

23.
Regier, he said, had asked him:
Thomas Widiger e-mail, May 21, 2012.

24.
According to Widiger’s distillation:
See Widiger and Simonsen, “Alternative Dimensional Models of Personality Disorder.”

25.
“basic science research”:
Ibid., 123.

26.
“The devil, of course”:
Ibid., 126.

27.
“Nobody on the work group”:
Thomas Widiger e-mail, May 21, 2012.

28.
“a sense of self-identity”:
For the original proposal, see http://web.archive.org/web/20100323205756/http://www.dsm5.org/ProposedRevisions/Pages/PersonalityandPersonalityDisorders.aspx.

29.
insufficient “empirical evidence”:
Skodol, “Personality Disorder Types Proposed for DSM-5,” 138.

30.
“We knew we couldn’t incorporate”:
Andrew Skodol interview, May 24, 2012.

31.
“embarrassingly bad”:
Thomas Widiger e-mail, September 23, 2010.

32.
“lost opportunity” that “negates years of progress”:
Livesley, “Confusion and Incoherence in the Classification of Personality Disorder,” 307.

33.
“cumbersome hodgepodge”:
Frances, “The DSM-5 Personality Disorders,”
DSM-5 in Distress
(blog),
http://www.psychologytoday.com/blog/dsm5-in-distress/201004/the-dsm5-personality-disorders-great-intentions-unusable-result.

34.
“an unwieldy conglomeration”:
Shedler et al., “Personality Disorders in DSM-5,” 1027.

Chapter 17

1.
“There has been a continual struggle”:
Helena Hansen, e-mail, September 27, 2011.

2.
“This is amazing!”:
Helena Hansen e-mail, September 28, 2011.

3.
“Approaching endgame”:
Allen Frances e-mail, November 14, 2011.

4.
“A random and geographically diverse”:
Allen Frances e-mail, October 31, 2011.

5.
“pretty Spockean”:
Allen Frances e-mail, September 21, 2010.

6.
an open letter to the APA:
Available at http://www.ipetitions.com/petition/dsm5/.

7.
a letter on behalf of his 115,000:
Available at http://www.counseling.org/Resources/pdfs/ACA_DSM-5_letter_11-11.pdf.

8.
“bring Darrel to see DSM-5”:
Allen Frances e-mail, August 28, 2010.