Happy 5th Anniversary, BloggingHeads.
The statistics on black boys in schools are incredibly depressing.
Tyler Cowen isn't happy with the NYT's article on a rare chromosome club. He writes, "Rare copy variations also may be a significant source of human progress and, for that matter, individual contentment."
Apt. 11d 
The Cowen comment is missing the point. The only reason these rare chromosomal variations are discovered because the children have behavioral/physiological problems to begin with. Someday, maybe people who have unusual talents are going to go off and get themselves tested, too, and then maybe there will be rare chromosome clubs for other people. I’m not looking forward to that, the club for people, say who have the xxyy35 deletion, and are really good at scrabble.
I think the discovery of these rare variations is interesting, especially in light of the new revision of the DSM V manual, in which they plan to define all clinical conditions without regard to physiology or genetics. They’re removing Rett’s syndrome (a genetic syndrome with some autism-like characteristics) because it’s defined primary genetically. So in the future, the DSM will describe clinically significant mental differences, ignoring their etiology.
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“I think the discovery of these rare variations is interesting, especially in light of the new revision of the DSM V manual, in which they plan to define all clinical conditions without regard to physiology or genetics. They’re removing Rett’s syndrome (a genetic syndrome with some autism-like characteristics) because it’s defined primary genetically. So in the future, the DSM will describe clinically significant mental differences, ignoring their etiology.”
That’s a really weird direction to go. As a layperson, I thought that we were moving more toward physiological and genetic explanations of mental conditions.
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So in the future, the DSM will describe clinically significant mental differences, ignoring their etiology.
I agree with Amy that that’s really odd, as, in a very large number of cases, it’s only by understanding the etiology of a condition that we can make serious progress on understanding the condition and dealing with it. Furthermore, if outwardly similar “symptoms” have different underlying causes, we might mis-treat many of them. So, this seems like a seriously wrong-headed step. (Imagine trying to treat “chest pain” without trying to determine whether it was caused by angina, a heart attack, gas, heart-burn, a strained muscle, etc. This barely seems more plausible.)
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It makes sense. The DSM is written by mental health professionals, for mental health professionals. Admitting that there are genetic causes for psychological problems (which genetic research seems to indicate ever more these days) would logically present a threat to many lucrative methods of treatment. You can make a good living helping people confront childhood traumas.
If a mental condition had a physical cause, it might have a physical treatment, such as surgery or drugs. The surgeons and Pharma companies would profit.
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Well, Cranberry’s conspiracy explanation can’t be dismissed out of hand, because there’s clearly battles between different medical professionals about who gets domain over a particular disorder. I’ve followed this most closely in the battle between developmental optometrist and ophthalmologists. The ophtalmologists think that optometrists want to sell expensive and useless eye training exercises and the optometrists think the ophtalmologiss like to do surgery.
But, I think the exclusion of genetic disorders from the DSM is that the DSM is a symptomology manual. It defines sets of symptoms, that are severe enough to require clinical intervention. The manual does this, because though mental disorders must be caused by physiology, we know very little about the physiological cause of even the ones where we know a little bit. It’s a ripe area for research.
Oh and since psychiatrists can prescribe drugs, I don’t think they’re the ones that would slow the magic pill approach. In fact, I find that most of the psychiatrists I know think that everyone should take drugs (usually the legal kind).
(and, knowing the genetic etiology doesn’t usually help very much at all Rett’s is no less variable because we know it’s genetic, and neither is Downs).
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I’m several years out of date in this, but I assume anything with a known genetic cause is probably going to get punched in by the ICD code if the DSM doesn’t help. I also don’t see how that would shift much with diagnosis for the big affective and psychosis related disorders since all they really have to go by for most of that is symptomatology (and age, as treating dementia is the booming thing).
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Cowen has written a lot about he diagnosed himself as an Aspie as an adult. He feels that (slight) autism is actually a benefit today’s modern economy. I suspect that he’s concerned that efforts to identify and eliminate genetic differences will also lead to eliminating potential advantages from genetic differences.
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“Cowen has written a lot about he diagnosed himself as an Aspie as an adult. ”
The DSM V plan to subsume the Asperger’s diagnoiss into the ASD diagnosis addresses this particular use in their notes: “There may be some individuals with subclinical features of Asperger/ASD who seek out a diagnosis of ‘Asperger Disorder’ in order to understand themselves better. . . it is outside the scope of DSM, which explicitly concerns clinically-significant and impairing disorders.”
The point of the DSM is to identify disorders, ones that impair one’s ability to function, not to describe variations in the human population. To the extent that a phenotype (like say, height) could vary, the question is not whether one is short or tall, but whether one is so short or so tall that impairs one’s ability to function. That’s when it becomes a clinical concern. The same is to for variations in behavior and cognitive/psychological function.
It’ll be interesting to see how the new variations in the DSM survive both the field testing and the public input.
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