View Full Version : the Dsmv-IV -Diagnosis for Dummies?


velvetcactus
05-29-04, 03:34 PM
I have often wondered just who contributes to this beloved bible of diagnostics. My biggest question is, can it be trusted? How much can we rely on it? We need to remind ourselves that ADHD is neurological in origin, not psychological, and it does those of us challenged with it a great disservice on many counts. Firstly, the criterion was based on the behaviour of young boys. So that rules out girls, women and men. Adults cannot hope to meet the age of onset criterion of age 6, since there is indeed adult onset. Anymore than they would be likely to be observed climbing trees or unable to finish their homework! Girls have gone significantly untreated because they primarily have inattention issues and thus do not present the behaviours likely to draw attention to themselves. The research on the behavioural manifestations of women with ADHD are just at the tip of the iceberg stage. As someone who has experienced a marked lack of knowledge on the part of the medical community on the subject of ADHD and who has had ADHD behaviours psychologized to death, I would like to caution others that the DSM must be taken with a great big bag of salt!

Tara
05-29-04, 03:41 PM
Many AD/HD experts are trying very hard to change the criteria for AD/HD in adults and females.

mctavish23
05-29-04, 05:34 PM
Very well said.I look at it like a guidepost. The diagnoses are scrutinized every 10 yrs or so, hence the current DSM-IV TR (Text Revision). This is where the large volume copy contains the updated research that either supports the continuation of the diagnosis or it gets removed.

You rasied some great points about the normative sample being weighted towards boys, with the oldest being 16. Ive posted other threads about using age referenced norms for adults as well as on why the Conners and the ADHD-IV are the best checklists(psychometrically) because theyre normed on both boys and girls/men and women. Ive also posted on why continous performance tests(computerized) dont work for diagnosis. Slowly but surely I think more and more clinicans seem to be getting it.

I attended a special ed workshop last Sat that was put on by the Minn Disability Law Center on the need for more emphasis on Transitioning older (14-21) spec ed kids from school to the workforce. The advocate who presented it is one of the best in the midwest. At the break we talked about those same issues. I was impressed (but not surprised) to see that she already knew the Conners was normed on both populations and was also aware of computerized testing as being inappropritate for
diagnosis.

Thanks for the post.

Chicky75
06-01-04, 12:23 PM
I do agree that the DSM-IV is highly inadequate, but I'm confused by velvetcactus' claim that "there is indeed adult onset."

Pretty much everything I've read agrees on one thing -- that ADD isn't something one gets as an adult. The problems it causes in a person's life might not be very noticable or interfere with their life until they are an adult, but it is always something that the person was born with or that started in early childhood. And that any good diagnosis of ADD will include a childhood history, which will generally show ADD traits from a very early age.

Am I misinterpreting the first post?

paulbf
06-01-04, 04:02 PM
The DSM is determined by comittee through politics. I heard a radio program recently about the removal of homosexuality from the DSM & it was definitely a political process. Public protests even had a big impact. As such it is subject to financial influence (indirectly at least) and generally very slow to change. I don't think that means it's worthless, I agree homosexuality should have been removed I'm just saying it's not perfect and is arbitrary to some extent. Psychology & psychiatry are not hard sciences.