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  • Jane Costello Resignation Letter From DSM-V Task Force To Danny Pine March 27, 2009

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    Dr. Sanjay gupta is resigning from the Child and Adolescent Disorders workgroup. He says he is uncomfortable with idea of rewriting entire psychiatric taxonomy at once. There seems to be no good scientific justification for doing this, he says, and certainly none for 2012.

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    Jane Costello Resignation Letter from DSM-V Task Force to Danny Pine March 27, 2009

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    Dr. Sanjay gupta is resigning from the Child and Adolescent Disorders workgroup. He says he is uncomfortable with idea of rewriting entire psychiatric taxonomy at once. There seems to be no good scientific justification for doing this, he says, and certainly none for 2012.

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    3K views2 pages

    Jane Costello Resignation Letter From DSM-V Task Force To Danny Pine March 27, 2009

    Uploaded by

    dcarlat
    Dr. Sanjay gupta is resigning from the Child and Adolescent Disorders workgroup. He says he is uncomfortable with idea of rewriting entire psychiatric taxonomy at once. There seems to be no good scientific justification for doing this, he says, and certainly none for 2012.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as DOC, PDF, TXT or read online from Scribd
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    of 2

    Dear Danny;

    As we discussed at the DSM-V meeting last week, I am resigning from the Child and
    Adolescent Disorders workgroup. As you know, I have been thinking about this for some
    time, but have been reluctant to take this step because I very much enjoy working with
    this extraordinary group of people, and learning so much from them. However, I cannot
    in good conscience continue. These are my reasons:
    1. I am increasingly uncomfortable with the whole underlying principle of rewriting
    the entire psychiatric taxonomy at one time. I am not aware of any other branch of
    medicine that does anything like this. (The ICD revisions make no attempt to
    rewrite the details of each diagnosis.) There seems to be no good scientific
    justification for doing this, and certainly none for doing it in 2012.
    2. When we began this process, we agreed that changes would only be made if there
    were empirical evidence to support them. Sometimes (as with Charlie’s work on
    preschool PTSD) this has been the case. But as time has gone by, the gap between
    what we need to know in order to make revisions and what we do know has
    grown wider and wider, while the time to fill these gaps is shrinking rapidly. More
    and more, changes seem to be made for reasons that have little basis in new
    scientific findings or organized clinical or epidemiological studies.
    3. Efforts by Pat Cohen and myself in 2007 to provide data to fill some of the gaps
    in the knowledge base were rejected. One reason given by David was that the
    answers to questions were needed within 6 months, i.e., by the end of 2007. Now
    Prudence’s grant has a favorable review and may be funded by the fall of 2009,
    with data available perhaps in 2010. As far as I am aware there is not yet a process
    in place for feeding to Prudence the questions that the data sets could be used to
    answer, so any results are likely to be even more delayed. This, as we have all
    agreed, makes no sense.
    4. One reason why it took so long to get a data base in place was that a decision was
    made that the work had to be done via a grant application to NIMH, with all the
    time delays entailed by that process. The reason given was that the funding
    allocated by the APA for research for DSM-V was not enough to support the
    necessary work. I continue to be shocked that the APA would even consider
    revising the DSM without being willing to allocate the funding necessary to carry
    out the underlying scientific studies. A drug company that tried to bring a product
    to market on the basis of inadequately-funded research would rightly be censured.
    This is what the APA is doing, and now that it is quite clear what is happening I
    am afraid that I cannot bring myself to be part of the process any longer.
    5. The tipping point for me was the memo from David and Darrell on February 18,
    2009, stating “Thus, we have decided that one if not the major difference between
    DSM-IV and DSM-V will be the more prominent use of dimensional measures in
    DSM-V”, and going on to introduce an Instrument Assessment Study Group that
    will advise workgroups on the choice of old scale measures or the creation of new
    ones. Setting aside the question of who “decided”, on what grounds, anyone with
    any experience of instrument development knows that what they proposed last
    month is a huge task, and a very expensive one. The possibility of doing a
    psychometrically careful and responsible job given the time and resources
    available is remote, while to do anything less is irresponsible.
    It has taken me a long time to reach this conclusion, largely because I greatly value
    and enjoy working with you and the workgroup, and respect your commitment to the
    DSM-V process. I honor your position – that given DSM-V is going to be written, the
    best people should do it. You know that, as always, I am ready, as in the past, to carry
    out any data analyses that could be helpful to your decision-making on specific
    issues. Please give my greetings to the rest of the workgroup, and feel free to share
    with them as much of this as you choose.
    Very best wishes;

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