Hoarders beware

"Hoarders beware" Continued...

Issue: "O Jerusalem," April 10, 2010

Some may continue to refer to themselves as "Aspies" in spite of any changes. Carley, who was himself twice diagnosed with Asperger's, said the redefinition would be a "shift" for him, but he doesn't want to play doctor either. Scientifically, he sees no reason to keep the two labels separate-the faces of autism are far too varied to make its diagnosis simple: "If this pushes all of us, collectively, to be able to truly grasp how complicated this is . . . after some trepidation, I think that this is actually a very good thing."

Wakefield believes some of the new diagnoses complicate matters a little too much: "There's a new disorder called hoarding disorder that's going to be the joy of all beleaguered spouses who are fed up with their partner saving everything." Another, binge eating disorder, would qualify those who overeat once a week for three months. "I call that 'wedding and bar mitzvah syndrome,'" chuckled Wakefield.

He added that a new category of "behavioral addictions," which would include the existing pathological gambling diagnosis, could pave the way for other addictions some psychiatrists would like to include, such as "internet addiction." Another questionable one: hypersexual disorder, applied to those whose desires disrupt their lives.

Narrows of the APA said the revision team had been careful to distinguish the new disorders from "high sex drive" or "routine overeating."

Frances, the former Duke psychiatrist, hopes a reaction from doctors and the public will prompt the DSM team to reconsider the changes it's proposed. He and Wakefield both said the team has been too secretive during the revision process of the last three years, using confidentiality agreements to prevent dialogue with other experts in the field. "Many of these issues should have been aired long ago," said Wakefield.

But Narrows disputed that, claiming the revision process "has been the most open and transparent DSM process to date," with media interviews and regular research presentations at science conferences. The proposed revisions are posted at dsm5.org, where the public can comment on the changes until April 20.

Daniel James Devine
Daniel James Devine

Daniel is managing editor of WORLD Magazine and lives in Indiana. Follow Daniel on Twitter @DanJamDevine.


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