To recap: Certain members of the American Psychiatric Association (the "APA") have proposed sweeping revisions to the DSM-IV, which is used to diagnose, among other things, autism. With respect to autism and other conditions, the proposed DSM-V will include "dimensional ratings" and "subclinical" designations. This is said to represent a paradigm shift. The chair of the DSM-IV task force, Allen Frances, sharply criticized the proposed revisions and the lack of transparency of the process. The APA came out swinging with its rebuttal, in which it accused Frances of bias and financial motivation: the DSM V revisions will render the DSM-IV handbook, which Frances authored, obsolete.
- Predictably, Frances took umbrage. Those royalties he'll be forfeiting when DSM V is published? $10,000 per year. Which, for him, is probably nothing. He doesn't write that, because that would be crass, but that's the implication. Frances also challenges the APA to be tranparent and make public the exact wording of the proposed revisions, and the research in support thereof.
- One of the members of the Workgroup on Disorders and Childhood and Adolescence has resigned in protest. This is the group that is deliberating over the inclusion of sensory processing disorder in the DSM V. She writes:
"I am increasingly uncomfortable with the whole underlying principle of rewriting the entire psychiatric taxonomy at one time. I am not aware of any other branch of medicine that does anything like this....There seems to be no good scientific justification for doing this, and certainly none for doing it in 2012."
So even if SPD were included in the DSM V, who is going to respect it? The process appears to have little integrity.