One of which is valid and the other less so.

Secrecy should be anathema to any scientific or medical endeavor. The strength of the DSM since 1980 has been the openness and review. Homosexuality was modified from a straightforward "disorder", to one that was a disorder if it was "ego dystonic" (i.e. unwanted by the person who was homosexual), to completely eliminated. Other disorders were merged as evidence of their evolution improved (DSM III R had "overanxious disorder of childhood", which was simply the childhood precurser to "generalized anxiety disorder"). Having a secretive cabal deciding what is and is not a disorder does not advance the scientific process. This issue is clearly a valid point in the article.

HOWEVER.....

Mental health professionals treat more than diseases of the brain. We also treat behavioral problems and advocate for resources for people with other emotional and cognitive limitations. Yes, the DSM is used for coding for insurance. But that does not make it a book to pathologize all human behaviors.

There are people for whom excessive shopping, internet use, or sexual behaviors cause tremendous problems in their lives - bankruptcy, marital problems, job problems, legal problems, etc. A key way to effectively help people is to identify the problem, and for the professional community to share what has worked and what hasn't. No, not everyone who uses the internet more than "aging psychiatrists" has a mental disorder, or even a behavioral problem. The key issue in most if not all disorders if the impact on the person's life. The failure to recognize this is the main reason that a person can read through the DSM in a cursory fashion and leave thinking either they have a dozen different disorders, or that psychiatry is all hokum and quackery. No harm, no foul. If you do not have a significant impact in your life from the behaviors or symptoms, you do not have a disorder.

You're right, the DSM ITSELF is not a book to pathologize all human behaviors.
Psychologists and psychiatrists do a fine job of misusing it for that, though. That's not to say that they ALL do it, but in my experience, a significant minority or possibly even a majority do.

Oh, and what's with sorting out all different kinds of names for compulsive behaviors? Shopaholic, sexaholic, binge eating, etc.,s o on so forth...it's basically the same compulsive behavior, isn't it?

Anyway, Dberne, I'm sure you're a fine psychologist, but your profession in general needs to get out of the pockets of drug companies and start using cognitive/behavioral therapy as a first resort rather than drugging a patient and letting them go. Drugs certainly have a place in treatment, but I see far to many instances of people getting their quarterly med check and nothing else.

I agree with dberne, especially on the second point.

I work in substance abuse treatment and research. There's currently some disagreement in the field on what, exactly, can be addictive. I think the evidence for alcohol and heroin is pretty clear. But gambling? Shopping? Eating? There is research in neuroimaging showing similarities between the brains of people with substance problems and those who gamble excessively. (I'm defining excessive like dberne did-- gambling that interferes with the rest of the individual's life.) There's also a sizeable overlap between people with substance problems and people with non-substance problems (like gambling). In short, I do not believe that including these diagnoses in the DSM-V (as well as sub-threshold categories) is pathologizing every human behavior.

The secretiveness of the committees making the decisions, however, is a cause for concern...

The basic problem which you fuckers fail to see is that whether or not something causes a person "problems" has no bearing on whether or not it's a disorder.

The implicit equation of the DSM is "if certain thing cause social problems, then certain thing disorder." But society itself is disordered.

Job problems? Being a homo could cause you job problems. Marital problems? Having a healthy sexual appetite could do that, if your spouse doesn't share your desires. Bankruptcy problems? Maybe we should diagnose "politicians that allow credit card companies to charge you 35% interest disorder."

ZoeCat, you should understand that it is psychiatrists not psychologists who prescribe drugs, and that psychologists do use cognitive behavioral (or similar) as a first resort rather than drugging their patients. The people on psychiatric drugs who get a quarterly med check from their psychiatrist are just receiving close supervision of their drug treatment, and the psychiatrist is likely to be working with a psychologist who is providing hour long weekly sessions of psychotherapy (CBT or similar). If those med checks are shorter and less frequent it's only because that's all that's required for med checks, and because prescribing psychiatrists are fairly raren and in high demand.