The Social Construction of the DSM-5 & its Impact on Patient Dignity
The Diagnostic and Statistical Manual for Mental Disorder (5th Ed. or DSM-5) represents a foundational text within the psychiatric and mental health field, a document that is historically and socially positioned within the field as the global standard for diagnostic health information. Significant criticism, though, has been levelled against the DSM-5, highlighting concerns around its underlying ethnocentric positioning as well as scientific concerns around the reliability and validity of different diagnoses. This study explores the current state of the DSM-5. It seeks to understand how its development has shaped and promoted a variety of discourses within the mental health field, as well as looking at the impact these discourses have had on the dignity and day-to-day functioning of millions of patients, both younger and elder, for whom it has been conceived to offer therapeutic interventions. Drawing on Social Constructionist and Foucauldian frameworks to conduct this discursive analysis of the DSM-5, I identify the dominant discourses of the DSM-5, as well as the discursive rules which have been reinforced by the American Psychiatric Association to promote these practices. The dominant discourses identified include expertise, medicalizing normality, conceptualizations of culture, and control.