The MCMI and DSM-III: a brief rejoinder to Million (1985)

Millon (1985) presented eight criticisms of the article by Widiger, Williams, Spitzer, and Frances (1985) on the MCMI as a measure of DSM-III. This article is a brief rejoinder. The major point we wish to make is that one should be cautious in interpreting the MCMI as a measure of DSM-III disorders because there has not yet been any research published on the relationship between the MCMI and DSM-III. We believe this position has not been refuted by Millon's critique.     

Monotic and dichotic presentation of phonemic elements in a backward recognition-masking paradigm

Summary Auditory processing was examined in eight normal subjects using monotic and dichotic presentations of phonemic elements in an auditory backward recognition-masking paradigm. Experimental trials consisted of the presentation of one of three equiprobable consonant-vowel targets (/ba/,/da/,/ga/) followed by a vowel masker (/a/), separated by a variable silent interstimulus interval (ISI). For the dichotic condition, the mean percentage of correct recognition scores for target identification improved systematically with increases in ISIs, reaching an asymptote followed by an apparent plateau. In contrast, mean performance accuracy for the monotic condition revealed a U-shaped function for signal pairs having short temporal offsets. Although the dichotic presentations resulted in overall lower mean recognition scores, comparability between listening conditions was observed at prolonged ISIs. Observed differences in performance between the monotic and dichotic conditions at short-duration ISIs suggested the existence of different processing mechanisms, correlated with integration and interruption of phonemic pairs, for target-mask interactions occurring in close temporal succession.     

Harmful dysfunction and the DSM definition of mental disorder.

Physicians, including psychiatrists, give a lot of thought in their everyday work to answer the question of whether or not a particular patient has a disorder; they rarely give much thought to the broader issue of what constitutes a disorder. Remarkably, and consistent with the harmful dysfunction (HD) analysis, there is a broad consensus in both the general public and the medical and health professions as to what conditions are disorders--even though there is no consensus definition of disorder. The HD analysis is a substantial advance over previous attempts to define disorder in specifying the nature of what is not working in the individual (the dysfunction). The adoption of the HD analysis in DSM-V (Diagnostic and Statistical Manual of Mental Disorders, 5th ed.) would probably have little if any effect on the list of categories of mental disorders. Its main value would be in helping make revisions in the diagnostic criteria more valid as true indicators of disorder.     

An outsider-insider's views about revising the DSMs

After having a leadership role in the development of the 3rd edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-III; American Psychiatric Association, 1980) and its revision (DSM-III-R; American Psychiatric Association, 1987), I now comment as an outsider-insider on the development of DSM-IV. Many features of the DSM-IV process, such as systematic literature reviews and focused field trials, represent significant advances that will increase the role of empirical findings in the decision-making process in this latest edition of the DSM. However, it is likely that when final decisions are made about DSM-IV, the decisions will still be based primarily on expert consensus, rather than on data, as was the case with DSM-III and DSM-III-R.     

Genetic Counseling for Confined Placental Mosaicism: A Case Report

New technologies can lead to unforeseen discoveries which in turn can lead to diagnostic and counseling dilemmas. A case which involved confined placental mosaicism for trisomy 16 is presented to illustrate such a situation. While interpreting data and explaining a newly described phenomenon created uncertainties for the genetic counseling team, the patient and her husband were primarily dealing with grief surrounding the loss of a wanted pregnancy. It is important to recognize that the counseling issues may be different for the professionals and the families. Genetic counselors must be cognizant of their own reactions and those of their clients and be prepared to use all of their counseling skills to address these varying needs.     

Decade of the Mind

In the Fall of 2007, ten neuroscientists published a proposal for an interdisciplinary research initiative, the Decade of the Mind, that would focus on four "broad but intertwined areas": mental health, research on high-level cognitive functions, education, and computational applications (such as intelligent machines). I review the basic ideas behind the proposal and discuss the four proposed areas of research. I argue that for research on higher cognitive functions and in particular, for research and practice in education, the Decade of the Mind is a welcome initiative that may change our lives for the better. Therefore, the proposal, which is scientifically interdisciplinary in nature, has to be politically international.     

Dissoziative Störungen (Konversionsstörungen)

The ICD-10 diagnostic category of dissociative disorders encompasses very different clinical pictures. The so called dissociative disorders of consciousness are characterized by functional disturbances to the psychic domains of consciousness, identity, autobiographic memory and experience of self and the world. The core features of conversion disorders are functional alterations in the sensorimotor systems. The phenomenological heterogeneity is reflected by prevalence rates ranging from very rare to 30% in clinical populations. Traumatic experiences play a crucial role in the etiology and pathogenesis of these disorders. High rates of comorbid disorders, a tendency to a chronic course and a somatic illness concept in patients with conversion disorders complicate the psychotherapeutic approach. Depending on the therapeutic goals, both psychodynamic and cognitive-behavioral treatment forms are suitable.