While Steve and I were visiting Dalrymple and his wife this summer, the 5th edition of the Diagnostic and Statistical Manual of Mental Disorders (aka, DSM-5) arrived in their mail, and we had a fun hour or two sitting around with it open, calling out the supposed psychiatric disorders, listed therein, from which we apparently suffered. (I was obviously afflicted with tobacco use disorder years ago, until it suddenly disappeared – coincidentally, at the exact moment I decided smoking was stupid.)
In City Journal Dalrymple addresses this diagnostic inflation, and I don’t have nearly enough space to list all the absurd examples he gives, such as “intermittent explosive disorder”:
To call the habit of losing one’s temper and destroying things or hurting people a medical condition (from which, according to the DSM-5, 2.5 percent or so of the adult population suffers in a given year) empties it both of meaning and moral content, all in the service of a spurious objectivity. The notion of an outburst of temper grossly out of proportion to whatever provoked it implies moral judgment as to what constitutes appropriate and inappropriate displays of anger. Appropriateness is an irreducibly moral concept, requiring conscious judgment; no number of functional MRI scans, of the amygdala or of any other part of the brain, will assist in that judgment.
The DSM-5 then informs us that more than one in seven people have such a lifelong disorder—adding up to 45 million Americans and even more Europeans. These astonishing numbers give the authors not a moment’s pause (any more than does the fact that their own prevalence rates suggest that the average American suffers from more than two psychiatric disorders in any one year). Several undesirable characteristics must be present in an individual for a diagnosis of personality disorder to apply. Considering those characteristics, and that such a significant portion of the Western population supposedly exhibits many of them, either a mass outbreak of human nastiness and inability to deal with everyday life must have occurred, or the whole business of diagnosis must be dubious or even ridiculous.