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Diagnostic Manuals

Diagnostic Manuals

Psychiatric diagnoses are listed in manuals produced by the American Psychiatric Association (APA). The first such manual (DSM-1) was produced in 1952. Subsequent versions were produced. Up to recent times the latest revision was DSM-IV-TR which was published in 2000. The latest edition (DSM-5) was published on May 31st 2013. Whilst there are quite marked changes in the latest edition it still suffers from massive inherent weaknesses.

Berrios (1993) provided a historical account of the European origins of the DSM-III-R category, personality disorder, and made a differentiation between the history of terms, patterns of behaviours, and concepts. The concept of ‘disorder of character (personality) developed in the nineteenth century, and was possible after notions such as character, constitution, temperament, and self received a psychological definition, and after the insanities became transformed into €˜psychoses. Terms such as €˜type and €˜trait€™ were in turn ushered into the nineteenth century by faculty psychology and the phrenological tradition.

Until the end of that century, personality€™ referred to the subjective aspects of the self, and ‘personality disorder€™ meant alteration of consciousness (e.g., hysterical dissociation); the behavioural patterns dealt with by DSM-III-R as personality disorders were then called disorders of character and explained as states of volitional failure, or loss of coherence between cognitive, emotional, and cognitive functions, or of automatism€™, i.e., the manifestation of lower (more primitive or animal) forms of behaviour escaping the control of higher (human) ones. Character types and disorders were first considered as forms of attenuated insanity, and later on were made into a separate group whose membership could be attained via the visitation of a degeneration taint, neurological disease (e.g., encephalitis), or plain ill-breeding”.

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