Development of the DSM-III and DSM-III – R


Development of the DSM-III and DSM-III-R

      The DSM-III began being created in 1974 and was published in 1980( American Psychiatric Association), and it contained many drastic changes from the DSM-II, which made it a controversial topic among mental health professionals.  You can imagine the surprise when the DSM-III came out with 494 pages, compared to the 134 pages in the DSM-II.  While the DSM-III was taken critically by many professionals at the time, we will see how it had a long standing effect on the way we diagnose mental disorders today.

     The purpose of the DSM-II was primarily to provide a way for psychologists to keep records of their patient’s diagnoses, and to provide the mental health professionals with brief descriptions of the 83 mental disorders that were listed within the DSM-II.  In contrast, the DSM-III provided a multi-axial system which provided a more comprehensive method of diagnosing, as well as giving in-depth descriptions of disorders with detailed diagnostic criteria.  Some people felt that this took away from the “art” of psychology, by forcing mental health professional’s focus on diagnostic criteria, rather than their gut instinct.  With this new in depth system of diagnosing, the DSM-III broke away from using the same diagnostic criteria as the World Health Organization used in their ICD-9, which coded mental disorders.  This break away from the ICD-9 allowed mental health professionals to better diagnose patients by providing clearer diagnostic criteria (Spitzer, 2001).

     The DSM- III contained 265 diagnoses, many of which were new to the DSM-III ( Many mental health professionals were starting to be frustrated by the fact that many of the disorders that they saw and treated were not actually listed as disorders in the DSM-II.  Things such a Borderline Personality Disorder (BPD) and Post Traumatic Stress Disorder (PTSD) were not yet recognized as legitimate, diagnosable mental disorders.  The developers of the DSM-III took these concerns into account, and had mental health professionals provide what they considered to be symptoms of these disorders, and looked to see if a reliable and valid diagnosis could be made for these disorders that were being requested to be put in.  Disorders such as PTSD and BPD made it into the DSM-III, while other suggestions, such as the Atypical Child, did not.  Another significant change to the DSM-III was the removal of homosexuality as a mental illness, which was a very controversial topic as well. (Spitzer, 2001).

     Due to the many problems and critical reviews that the DSM-III received, a revised edition, the DSM-III-R was released only seven years after the DSM-III in 1987.  Initially, the idea behind the DSM-III-R was for it to be a follow up guide to the DSM-III to assist it’s users in properly diagnosing patients.  However, the DSM-III-R ended up being so different from the DSM-III, and contained 32 new disorders that it could easily be considered a whole new DSM edition.  ( University of Georgia).

This page was created by Mary Hannick

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