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Entries in American Psychiatric Association (3)

Monday
Dec242012

NRA Takes Fire for Stance on Mental Illness

KAREN BLEIER/AFP/Getty Images(NEW YORK) -- The National Rifle Association has come under fire by an association of psychiatrists for its characterization of people who commit violent crimes as "monsters," "lunatics" and "insane."

The American Psychiatric Association, which represents more than 30,000 mental health professionals, released a statement that expressed its "disappointment" over the gun lobby's use of those terms in the wake of the massacre at the Sandy Hook Elementary school in Newtown, Conn., where Adam Lanza, 20, slaughtered 20 children, six school staffers and his mother.

In a news conference last week, NRA CEO Wayne LaPierre repeatedly used the word "monsters" and "insane" to describe people who carry out mass shootings.

In his news conference, LaPierre blamed the tragedy on Hollywood, the media, video games and the courts. His remarks also appeared to explicitly scapegoat those with mental illness.

"How many more copycats are waiting in the wings for their moment of fame …" LaPierre said. "A dozen more killers? A hundred? More? How can we possibly even guess how many, given our nation's refusal to create an active national database of the mentally ill?"

APA's President Dr. Dilip Jeste said in a statement over the weekend that LaPierre's comments were unfair and inaccurate.

"Only 4 to 5 percent of violent crimes are committed by people with mental illness," Jeste said. "About one quarter of all Americans have a mental disorder in any given year, and only a very small percentage of them will ever commit violent crimes."

APA's CEO Dr. James H. Scully added that LaPierre's remarks serve to perpetuate the idea that mental illness and evil are one and the same. "This is simply a relic of the past and has no place in our public dialogue. People who are clearly not mentally ill commit violent crimes and perform terrible acts every day. Unfortunately, Mr. LaPierre's statements serve only to increase the stigma around mental illness and further the misconception that those with mental disorders are likely to be dangerous," Scully said.

The NRA remains unmoved. Their director of public affairs, Andrew Arulanandam, said he hadn't seen the APA statement and he wouldn't comment specifically on the Newtown shootings because he said he wasn't aware of any official information about Lanza's mental state -- but it wouldn't be unreasonable for anyone evaluating the Newtown killings to conclude the killer was mentally ill.

"Look at other similar shooting incidences. All of these shooters exhibited warning signs. The signs were there and people ignored them," Arulanandam said. "If the media wants to suggest that there was nothing wrong with these people, that's their concern but we believe -- and believe most Americans will agree -- these people were deranged."

Bob Carolla, a spokesman for the National Alliance on Mental Illness said he agreed with the APA's statements and also pointed out that it hasn't been established that Lanza suffered from any sort of mental illness. Authorities have nothing but anecdotal information on Lanza's mental state at the time of the shootings.

"One of the things that may be especially distressing for individuals who have a mental health condition and their families is this automatic leap based on stereotyped perceptions linking mental illness and violence," Corolla said. "Statistically we know the relationship is very small."

According to Corolla, one in four American adults experience a mental health problem in any given year, yet the U.S. Surgeon General determined over a decade ago that the overall contribution of mental disorders to the total level of violence in society is exceptionally small. He added that people with mental disorders are far more likely to be the victims of crimes, rather than the perpetrators.

Copyright 2012 ABC News Radio

Tuesday
Mar132012

Mental Health 'Bible' Criticized for Financial Conflicts of Interest

Stockbyte/Thinkstock(BOSTON) -- Controversy continues to swell around the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders, better known as DSM-5. A new study suggests the 900-page bible of mental health, scheduled for publication in May 2013, is ripe with financial conflicts of interest.

The manual, published by the American Psychiatric Association, details the diagnostic criteria and recommended treatments -- many of which are pharmacological -- for each and every psychiatric disorder. After the 1994 release of DSM-4, the APA instituted a policy requiring expert advisors to disclose drug industry ties. But the move toward transparency did little to cut down on conflicts, with nearly 70 percent of DSM-5 panel members reporting financial relationships with pharmaceutical companies -- up from 57 percent for DSM-4.

"Organizations like the APA have embraced transparency too quickly as the solution," said Lisa Cosgrove, associate professor of clinical psychology at the University of Massachusetts-Boston and lead author of the study published Tuesday in the journal PLoS Medicine. "Our data show that transparency has not changed the dynamic."

The DSM is developed by APA-appointed panels consisting of experts in various fields of psychiatry. But many of these experts serve as paid spokespeople or scientific advisors for drug companies, or conduct industry-funded research. Some of most conflicted panels are those for which drugs represent the first line of treatment, with two-thirds of the mood disorders panel, 83 percent of the psychotic disorders panel and 100 percent of the sleep disorders panel disclosing "ties to the pharmaceutical companies that manufacture the medications used to treat these disorders or to companies that service the pharmaceutical industry," according to the study.

"We're not trying to say there's some Machiavellian plot to bias the psychiatric taxonomy," said Cosgrove, who is also a research fellow at Harvard's Edmond J. Safra Center for Ethics. "But transparency alone cannot mitigate unintentional bias and the appearance of bias, which impact scientific integrity and public trust."

The DSM-5 has also drawn criticism for introducing new diagnoses that some experts argue lack scientific evidence. Dr. Allen Frances, who chaired the revisions committee for DSM-4, said the new additions would "radically and recklessly" expand the boundaries of psychiatry.

"They're at the boundary of normality," said Frances, who is professor emeritus of psychiatry at Duke University. "And these days, most diagnostic decisions are not made by psychiatrists trained to distinguish between the two. Most are made by primary care doctors who see a patient for about seven minutes and write a prescription."

Under the new criteria, grief after the loss of a loved one, mild memory loss in the elderly and frequent temper tantrums in kids would constitute psychiatric disorders. An online petition challenging the proposed changes, which would label millions more Americans as mentally ill, has accrued more than 12,000 signatures.

"We're not opposed to the proper use of psychiatric drugs when there's a real diagnosis and when a child or an adult needs pharmacological intervention," said David Elkins, president of the American Psychological Association's society for humanistic psychology and chairman of the committee behind the petition. "But we are concerned about the normal kids and elderly people who are going to be diagnosed with these disorders and treated with psychiatric drugs. We think that's very, very dangerous."

Elkin said he's "dismayed" that seven in 10 panel members has ties to drug companies.

APA medical director and CEO Dr. James Scully insisted the DSM-5 development process "is the most open and transparent of any previous edition of the DSM."

"We wanted to include a wide variety of scientists and researchers with a range of expertise and viewpoints in the DSM-5 process. Excluding everyone with direct or indirect funding from the industry would unreasonably limit the participation of leading mental health experts in the DSM-5 development process," he said in a statement.

Cosgrove said she believes there are plenty mental health professionals with no financial ties to drug companies. If necessary, experts with conflicts could still participate in the process as non-voting advisors, she said.

Copyright 2012 ABC News Radio

Thursday
May262011

Asperger's Syndrome Set to Lose Its Name

Comstock/Thinkstock(ARLINGTON, Va.) -- The American Psychiatric Association formalized the diagnosis of Asperger's -- a syndrome marked by impaired social interaction and sensory overload -- in 1994, 50 years after it was first described by Austrian pediatrician Hans Asperger.

But the association plans to remove the term "Asperger's" from its new diagnostic manual, set for release in 2013 -- a decision that has sparked criticism from advocacy groups.

"When the term 'Asperger's' started to get used, it was a tremendous relief for families of children and adults with the syndrome.  They finally had a name for what was going on; they could finally understand what the struggle in their lives was about," said Dania Jekel, executive director of the Asperger's Association of New England. "My worry is that we'll go back 16 years to a time when folks with Asperger's syndrome will not be recognized."

But members of the American Psychiatric Association's Neurodevelopment Disorders Workgroup, the group spearheading the change, said removing the term "Asperger's" from its manual and instead refering to it as an autism spectrum disorder will help focus the diagnosis on an individual's special skills and needs at that moment in time.

"The Asperger's distinction is based on early language delay, but many people come in as adults and have difficulty reporting this reliably," said Francesca Happe, professor of cognitive neuroscience at the Institute of Psychiatry in London, and a member of the workgroup. "We have known for years that autism is a spectrum, which is enormously heterogeneous...There is no good basis to distinguish Asperger's from high-functioning autism. The distinction doesn't make scientific sense."

The term "high-functioning" refers to language and intellectual ability -- skills that set Asperger's apart from other disorders on the spectrum.  But Jekel worries that removing the term "Asperger's" might open the door for misinterpreting it as just a mild form of autism.

"For many, Asperger's is not mild," she said.  "If you have an IQ that's fairly high and you're verbal, people expect you to be like everyone else and get along in the world.  But this is something that really can be very, very difficult for people to live with."

Copyright 2011 ABC News Radio







ABC News Radio