Previously the DSM has been accepted as the Bible of psychiatric diagnosis but, right before the DSM-V comes out the National Institutes of Mental Health (NIMH) has announced that it will not use it as a standard for diagnosis in their research. This means that they will not be funding studies that use the DSM-V as a diagnostic criteria. The reason given by the NIMH is that “Unlike our definitions of ischemic heart disease, lymphoma, or AIDS, the DSM diagnoses are based on a consensus about clusters of clinical symptoms, not any objective laboratory measure." This suggests a desire for exactness which the behavioral sciences have lacked relative to the physical sciences sometime termed physics envy.
There have been advances in neuroscience and genetics which shed light on many of these disorders and made many pharmacological treatments possible but the main reliance for diagnosis is still on behavioral symptoms. The NIMH is creating a Research Domain Criteria for Diagnoses (RDoC) based on biological criteria which it believes are more objective. The behavioral symptoms are often subject to interpretation and often still not enough is known about the brain and genetics to differentiate between pathologies. Consider the figure at left. Is this a rabbit with its head held high or a duck? This image is subject to interpretation just as all behaviors and incomplete scientific data are. Science is fundamentally a human endeavor where politics often plays a role.
ADHD, Genetics, and Causality: A Chicken-Egg Problem
We Need Slightly Unstable Leaders?
The Need for Exactness