June 6th, 2012


Back in the world of technology

Boy was it nice to be out there for a while. No electricity, no flush toilets, no internet. Just fast cold water, snowy peaks, giant ponderosas, steep grasslands, birds of prey and sand beaches out there. But I'm back in town. I'm sick, too, but on the mend finally today. Somebody brought a cold to share on the trip, and most of us got it. I spent yesterday in bed. I started weeding through the ~350 emails, most of which are irrelevant. I will get back on that project today. In between starting to unpack from the trip, organize in my new home, study for boards, and get well.
fantasy river

Trying New Things Adds Up on the River

Here's a nice new post on the NRS blog by a friend of mine. It's about Staying Connected to Boating... The author gives examples of several different ways of negotiating the river, and makes the point that a full connection to river running and to the river itself comes from trying many different craft and styles.... which is in my view what adds up to true mastery. And joy.

Rundown on DSM-V Evolution

It's scheduled to come out in May 2013, and this doc (Allen Frances, MD) asks the question: is the APA going to release it because it is needed and helpful and founded for psychiatric treatment? Or because they want the income from the release of a new book?? He has a good grasp on where the system fails and what needs to happen next. He'd like to see changes based in science, and is keenly aware of the degree to which psych diagnosis is inexact and the pathophysiology of these diseases uncertain.

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Here are his concerns that the current DSM-IV does not deal with:
20x autism rates (is everybody really autistic??)
20x childhood bipolar rates
3x ADHD rates
2x adult bipolar rates
"Misuse of the label "paraphilia NOS" to sanction the questionably constitutional involuntary commitment of rapists as a veiled form of preventive detention"

And here are the things he is worried will be stuffed prematurely into the DSM-V:
Disruptive mood dysregulation disorder
Minor neurocognitive disorder
Removing the bereavement exclusion for major depressive disorder (sadness not allowed!)
Lowered ADHD threshold (by raising the allowed age of onset to 12) (how does this work??)
Lowered threshold and poor reliability for generalized anxiety disorder
Combining substance abuse w substance dependence under "addictive disorders" (low reliability and unnecessary stigma)
A category for "behavioral addictions" that will promote "Internet addiction" as a NOS diagnosis. (Next: "addictions" to sex, shopping, work, golf, boating)
Pedophilia criteria wording that tries to sneak in hebephilia (preference for early pubescent teens) and invites forensic abuse
Making binge-eating a mental disorder
An unusable personality section that the APA Assembly voted unanimously to oppose