Why All of Medicine Should Care About DSM-5</emph
Western Psychiatric Institute and Clinic, Department of Psychiatry, University of Pittsburgh Medical Center, 3811 O'Hara St, Room 210, Pittsburgh, PA 15213, USA. JAMA The Journal of the American Medical Association
(Impact Factor: 35.29).
05/2010; 303(19):1974-5. DOI: 10.1001/jama.2010.646
Available from: Jennifer Q Morse
- "PDs have a substantial prevalence, especially in clinical settings, both medical and psychiatric (Tyrer, 2008); they are associated not only with greater utilization of treatment (Bender et al., 2001) but also with a more guarded prognosis (Grilo et al., 2005; Newton-Howes, Tyrer, & Johnson, 2006); and they are linked to chronic impairments in functioning (Skodol et al., 2002; Seivewright, Tyrer, & Johnson, 2004), the hallmark of PDs (Rutter, 1987). Given the public health significance of PDs, any new proposals should not threaten their legitimacy ( " first, do no harm " ), not only for mental health professionals but also for the broader audience of clinicians (Kupfer & Regier, 2010) and the interested lay public to whom the DSM is intended to speak. Unfortunately, the controversies surrounding the current DSM–5 proposal present a public picture that is confusing for the outside observer, either clinical or lay. "
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ABSTRACT: We review briefly the contributions of Skodol, Pincus, and Widiger (this issue) describing and critiquing the proposed changes in the assessment of personality and personality disorders for the DSM-5. Despite the hard work of the DSM-5 Work Group to date, there are shortcomings and areas of controversy in the current proposal that demand further attention and change. We discuss the controversy in the broader context of the DSM over the past 30 years. In addressing specific problems, we focus on the limitations of the proposed system for assessing traits (even as we endorse the movement toward dimensional assessment of personality) and the difficulties posed by the current "hybrid" model that attempts to include both traits and types. In moving forward, we suggest greater emphasis on decision-making regarding the presence and severity of any personality disorder (understood on the basis of generalized failures in adaptation) and greater flexibility in identifying the variants of personality disorders in order to accommodate both traits and types more inclusively during this transition toward dimensional approaches to assessment.
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ABSTRACT: Non-contacting displacement measuring systems are nowadays preferred for industrial position feedback at actuators. The systems are based on various operating principles whose properties determine the potential areas of application. In spite of the large number of solutions available on the market, there still are applications that are inaccessible to any of the familiar transducers. When linear motion in a range of up to 200 mm is involved, compromises almost always have to be made with respect to size, measuring range, durability and costs. The paper presents a worldwide innovation on this field: a new magneto-inductive sensing principle and displacement measuring system especially developed for positioning tasks in the above mentioned range. Due to its flexibility, ruggedness and compact design, it is ideal for numerous industrial applications and even opens up areas for new implementations. Consisting of a slender, rectangular sensor with fully integrated processing electronics and a permanent magnet target, the system converts the target position into an absolute, displacement-proportional voltage and current standard signal.
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