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Volume 29 • Number 1

January 2015



Revision and Representation: The Controversial Case of DSM-5

by Dominic Sisti and Rebecca Johnson

After over a decade in development, the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) was published in May 2013. It has been described as a living document and will include regular online updates and revisions (e.g., DSM 5.1, 5.2, etc.). In addition to its clinical, legal, and social significance, the DSM serves as the hub of a larger system of mental health care, research, and financing. This is to say, the DSM is very powerful. Therefore, in light of recent controversies and the churn of new revisions, it is important to understand and examine the way the revision process for DSM-5 occurred and will continue to unfold.

For the first time in the history of the DSM, draft proposals were made available on three occasions for public scrutiny and comment on the APA's (American Psychiatric Association) public website, This process stood in con- trast to that of previous revisions, where the review of proposed categories had been confined to a select group of expert psychiatrists, psychologists, and other MD- or PhD-level researchers appointed by the APA. The open invitation to the public elevated hopes that decisions about DSM categories might be made more democratically and include considerations about patient identity, their lived experiences, access to services, and other nonscientific concerns. leaders of the revision promoted the "unprecedented level of transparency" and inclusiveness of the new process.

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ISSN: 2152-0542