The recent changes in the DSM-5-TR with Dr. Altha Stewart

Summary

Dr. Alexis Stewart, former APA president and DSM-5 TR representative, discusses the APA's efforts to address concerns about race, racism, and ethno-racial differences in the DSM. A work group of cultural psychiatry experts revised the DSM-5 TR to use inclusive language, avoiding terms that conflate race with genetics. They replaced 'minority' with more inclusive terms and endorsed 'Latinx'. They also reviewed articles for accuracy and provided disclaimers for context, aiming to keep race, ethnicity, and nationality considerations at the forefront in mental health.

Takeaways

• 📚 Dr. Alexis Stewart is a past president of the American Psychiatric Association and was part of the DSM-5 revision process focusing on ethno-racial equity and inclusion.
• 🌟 The APA and mental health community have expressed concerns about how race and racism are addressed in the DSM, which were taken into account during the DSM-5 revision.
• 🔍 A work group with experts in cultural psychiatry was formed to create a framework for change, considering the complexity of the DSM and the literature that supports it.
• 🏛️ The revision process aimed to challenge the notion that race and genetics are synonymous by using terms like 'racialized' or 'ethnoracial' instead of 'racial'.
• 🚫 The term 'minority' was eliminated to avoid classifying races of people as inferior or lesser, reflecting a shift towards more inclusive language.
• 🌐 Efforts were made to promote gender-inclusive terminology, such as using 'Latinx' instead of 'Latino' or 'Latina'.
• 📝 Hundreds of articles were reviewed and verified to ensure the DSM-5 content is accurate, up-to-date, and informative.
• ⚠️ Disclaimers or clarifications were provided when necessary to give context, especially when discussing higher prevalence rates of disorders in certain communities.
• 🌱 The changes made in the DSM-5 are believed to have addressed many concerns, making the manual stronger and setting a precedent for future considerations of race, ethnicity, and nationality.

Q & A

Who is Dr. Alexis Stewart?

Dr. Alexis Stewart is a past president of the American Psychiatric Association and the African-American representative on the DSM-5 Task Force, Ethno-racial Equity and Inclusion Work Group.

What concerns have been raised by APA members about the DSM?

APA members and others in the mental health community have raised concerns about how race, racism, and ethno-racial differences have been handled within the DSM.

How did the DSM-5 revision process address these concerns?

The DSM-5 revision process involved creating a work group with experts in cultural psychiatry representing different professions across mental health. This group laid a framework for change that considered the complexity of the DSM structure and the literature used to inform and support the text.

What changes were made to the language used in the DSM-5 to challenge certain views?

The DSM-5 revision process committed to using language that challenged the view that race and genetics are the same thing. Terms such as 'racialized' or 'ethnoracial' were used instead of 'racial' to highlight that race is a construct determined by cultural, social, legal, and political factors.

Why were terms like 'minority' eliminated from the DSM-5?

The term 'minority' was eliminated to avoid classifying races of people as inferior or lesser than status, and because these groups are increasingly becoming the larger proportion of the population in the U.S. and worldwide.

How does the DSM-5 promote gender inclusivity in its terminology?

The DSM-5 promotes gender inclusivity by endorsing the use of 'Latinx' to replace 'Latino' and 'Latina', which is a gender-neutral term.

What steps were taken to ensure the DSM-5 content is accurate and up-to-date?

Hundreds of articles were reviewed and verified to ensure the DSM-5 content is correct, up-to-date, and informative. Disclaimers or clarifications were provided whenever needed to give readers background information.

Why are disclaimers or clarifications provided in the DSM-5?

Disclaimers or clarifications are provided in the DSM-5 to offer readers background information, such as when higher prevalence rates of disorders are reported in certain communities, to ensure a better understanding of the context.

How does addressing these concerns make the DSM stronger?

Addressing these concerns by revising the language and content of the DSM makes it stronger by providing a more accurate and culturally sensitive representation of mental health, which is crucial for the credibility and utility of the manual.

What is the goal for the future in terms of race, ethnicity, and nationality in the DSM?

The goal for the future is to keep race, ethnicity, and nationality at the forefront of discussions and considerations in the DSM, ensuring that the manual continues to evolve and address the needs of diverse populations.