Related Experiment Video
Updated: Mar 7, 2026
09:55
Use of a Psychophysiological Script-driven Imagery Experiment to Study Trauma-related Dissociation in Borderline Personality Disorder
Published on: March 8, 2018
13.3K
Seeking Legitimacy for DSM-5: The Bereavement Exception as an Example of Failed Process
James E Sabin1, Norman Daniels2
1Clinical professor in the Departments of Population Medicine and Psychiatry at Harvard Medical School in Boston and director of the ethics program at Harvard Pilgrim Health Care, a not-for-profit regional health services program, and a fellow of the Hastings Center and a member of the American Medical Association Council on Ethical and Judicial Affairs.
AMA Journal of Ethics
|February 23, 2017
Summary
The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) removed the bereavement exclusion for major depression, sparking controversy. Applying the "accountability for reasonableness" framework could improve ethical and policy decisions in mental health.
Area of Science:
- Psychiatry
- Mental Health Policy
- Medical Ethics
Background:
- The 2013 publication of the Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5) by the American Psychiatric Association (APA) faced significant criticism.
- A primary point of contention was the removal of the "bereavement exclusion" criterion for diagnosing major depressive disorder.
Purpose of the Study:
- To analyze the legitimacy of the APA's decision-making process regarding the DSM-5's bereavement exclusion.
- To explore the utility of the "accountability for reasonableness" framework in resolving ethical and public policy conflicts within mental health.
Main Methods:
- Critical analysis of the APA's authority in scientific versus ethical domains.
- Application of the "accountability for reasonableness" framework to the DSM-5 bereavement exclusion controversy.
Main Results:
- The APA possesses scientific authority but lacks legitimacy in resolving ethical and public policy issues.
- The "accountability for reasonableness" framework offers a structured approach to enhance the legitimacy of health policy decisions.
Conclusions:
- The DSM-5's handling of the bereavement exclusion highlights the need for a more robust ethical and policy-making process.
- Adopting frameworks like "accountability for reasonableness" can lead to more equitable and publicly acceptable resolutions in psychiatric nosology and policy.
More Related Videos
Related Concept Videos
01:27Diagnostic and Statistical Manual of Mental Disorders (DSM)
1.4K
The Diagnostic and Statistical Manual of Mental Disorders (DSM) serves as the primary classification system for mental health disorders, providing standardized diagnostic criteria for clinicians and researchers. First published by the American Psychiatric Association (APA) in 1952, the DSM has undergone several revisions to reflect evolving psychiatric understanding. The fifth edition, DSM-5, released in 2013, introduced key updates that expanded diagnostic categories and modified diagnostic...
1.4K
01:17Bonanno's Theory of Grieving
1.2K
Grieving is a complex psychological and emotional process that varies significantly among individuals. George Bonanno's research on bereavement identified four distinct patterns of grieving, offering a nuanced understanding of how people cope with significant loss, such as the death of a spouse, over extended periods. These patterns — resilience, recovery, chronic dysfunction, and delayed grief — highlight the diversity in emotional responses and adaptive mechanisms.
Resilience
Resilience
1.2K
01:21Kubler Ross's Stages of Dying
1.6K
Elisabeth Kübler-Ross significantly advanced psychology's understanding of the process of dying with her influential book, On Death and Dying (1969). She focused on studying terminally ill individuals and outlined five stages commonly experienced when coping with death: denial, anger, bargaining, depression, and acceptance.
In denial, individuals reject the reality of their condition, often thinking, "This isn't true; I feel fine," as a way to protect themselves from...
In denial, individuals reject the reality of their condition, often thinking, "This isn't true; I feel fine," as a way to protect themselves from...
1.6K
01:21Dissociative Amnesia
810
Dissociative amnesia is a complex psychological condition that manifests as an inability to recall personal information, often tied to traumatic or stressful events. Unlike general amnesia, individuals with this condition retain the ability to perform routine activities and procedural tasks, such as operating a phone or navigating public transportation, yet experience profound gaps in autobiographical memory. These lapses may encompass significant life events, such as suicide attempts or...
810
01:30Dissociative Identity Disorder
1.3K
Dissociative Identity Disorder (DID), previously termed multiple personality disorder, is a complex psychological condition characterized by the presence of two or more distinct identities or personality states. Each identity exhibits unique patterns of behavior, voice, and mannerisms and may possess separate memories and emotional responses. The alternating control between identities can result in memory gaps and challenges in recalling daily activities, often exacerbating the individual's...
1.3K
01:27Depressive Disorders: Etiology
808
Depressive disorders result from a complex interplay of biological, psychological, and sociocultural factors, each contributing uniquely to the development and persistence of the condition. Understanding these factors provides critical insight into the multifaceted nature of depression.
Biological Factors in Depression
Biological predispositions significantly influence the risk of developing depressive disorders. Genetic studies highlight the role of variations in the serotonin transporter...
Biological Factors in Depression
Biological predispositions significantly influence the risk of developing depressive disorders. Genetic studies highlight the role of variations in the serotonin transporter...
808