More on secrecy behind the new book of human troubles

Advances in the History of Psychology has just alerted me to a new programme on NPR Radio about the debates over the ‘in revision’ version of the American Psychiatric Association’s diagnostic manual that defines mental illness for significant parts of the world.

It covers some of the most contentious potential diagnoses in the to-be-released DSM V and doesn’t have the most balanced discussion in some cases (e.g. the guy claiming that people against the diagnoses of gender identity disorder – transexualism – just ‘see the stigma’ of the condition).

Most interestingly though, it quotes part of the non-disclosure agreement that members of the DSM committee have had to sign, making a legally binding restriction against discussing:

All work product unpublished manuscripts and draft and other prepublication materials, group discussions, internal correspondence, information about the development process and any other written or unwritten information, in any form, that emanates from, or relates to, my work with the APA task force or work group.

Yes, there is a legal restriction banning members from discussing the development of one of the most important documents in medicine.

The DSM committee vice-chair Darrel Regier says this is a good thing because otherwise “it would just be cacophony and mass confusion” – presumably referring to the annoying tendency of public debate to raise points that you hadn’t thought of before.

Diagnoses decided by an unelected committee in secret sessions that are legally prevented from discussing their work. Science marches on.

Link to NPR Radio on DSM-V development (via AHP).

3 thoughts on “More on secrecy behind the new book of human troubles”

  1. Ahh, thanks for bringing this topic out for discussion. Given that this is such a significant document – not only used for diagnostic and treatment, but more importantly for some, to determine whether therapists will get paid by insurers – it seems strange that NO discussion is being encouraged (or have I answered my own question?).

  2. Maybe the authors would prefer an environment in which they are free to say things without fear of ridicule or public pillory. People are more honest and open when they can talk in private.

  3. If you clink the link in the original post above with “DSM-V” or go to you will find the site set up by the APA to disseminated information about the development of the book.
    They have a list of the workgroups, their members, and their reported financial disclosures. They also have official “update” releases from each workgroup that explain what the process has been so far. To this point it has basically been laying out the big questions each workgroup would like to cover.
    There is also a way to send info/questions to specific workgroups, and I imagine the emails of workgroup members aren’t so hard to find if you prefer the personal touch.
    All in all, I think that the “secrecy” issue is overblown a bit. APA could always do more and better, but it does make sense to have an organized statement and comment process. To have every group member disclosing what and when they want to would really muddy things. For example, a member with an unpopular or minority position could speak out as an “APA Workgroup Member” and confuse the public and media by appearing to be a spokesman with some scientific consensus behind him or her.
    When there is a big complex trial, having the lawyers for both sides come on the talk shows every other night doesn’t increase the fairness of the trial. Increase transparency, yes, but it’s a double edged sword.

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