Wednesday, August 05, 2009

Dave - Social Anxiety and DSM-V


Arrived in Rio safely after a terribly long flight. I managed to do a bit of work on the plane, but the space is so small it’s really cramped typing. And of course there’s no power to recharge the battery in economy! I can see the advantage of business class, apart from the extra cost, of course.

After the queue at passport control I got a taxi to the hotel. Pleasant room and if I stand on the balcony and look down the street I can see the Atlantic.

Spent most of yesterday putting the finishing touches to my presentation. Tonight is Registration and Welcome, so I’ll get some idea of how many people are attending. Be interesting to see who’s here from Europe.

In my paper I’m touching on social anxiety disorder and stuttering. One of the problems, which Mark Irwin refers to (Stuttered Speech Syndrome), is that DSM IV (Diagnostic and Statistical Manual of Mental Disorders) excludes a diagnosis of social anxiety disorder if the anxiety is mainly focused on symptoms associated with the stuttering ( and also other conditions such as Parkinson’s Disease). I’ve known for some time that DSM V is currently being produced, but primarily in secret. You can see some of the debate here: MIWatch and here: Wall Street Journal. The official web site is here: APA.

Which all goes to show that: a) psychologists and psychiatrists just don’t get on, b) the more secret things are, the more suspicious everyone is, c) don’t hold your breath that there will be much new about stuttering here if everyone is bickering amongst themselves!

If anyone knows anyone on any of the panels involved in this revision some lobbying may be in order.

6 comments:

Tom Weidig said...

There is no doubt in my mind that the vast majority of stutterers experience social anxiety, and drives many lives, especially for teenagers. It certainly drove my life and still does but to a much smaller degree and only in some situations.

Of course, this social anxiety is not really a disorder, i.e. driven by biological dysfunctioning of the social anxiety pathways in the brain, but a consequence of stuttering. But you could argue that it now looks AS IF it was biologically driven.

Of course, who cares about such arguments!!

I quote Jerry Maguire vaguely along the lines: Well stuttering might not be a mental disorder but it would be good if it stays classified like one because then the health insurance (at least in the US) keeps on paying the bills!

Jerry Maguire said...

Hi, Tom and Dave. I am in Brazil attending the IFA as well. I presenting on this topic with Nan Ratner tomorrow at 4pm during the conference. Nan and I have been working with the DSM V committee on a potential revised criteria for stuttering. I will be happy to share everything with you. Please provide me any comments as well. I will be honored to take your feedback and the feedback from others on the blog forward. I am eager to hear your presentation, Dave.

Sincerely,

Jerry

Gerald A. Maguire, M.D.
Associate Professor of Clinical Psychiatry
University of California, Irvine

Silva said...

Last year, a New Zeland researcher challenged the notion that stuttering could be linked to personal anxiety. Her study was very levelheaded. Look here.

Dave Rowley said...

Well I must say that Jerry Maguire and Nan Ratner gave a highly entertaining and informative talk about the potential revisions to DSM. The audience was really pleased with what they have suggested. In addition to trying to move the location of stuttering in DSM to somewhere more suitable (away from eating disorders, compulsive masturbation, etc.) they want to get rid of the exclusion problem I mentioned in my original post. So, good news here!

Pam said...

I hope Dr Maguire and Ms Ratner's finding are summarized either here or somewhere else on the web. I know that a lot of people are hopeful that stuttering will indeed be separated from the compulsive disorders. It is neurologically based, and manifests itself in countless different ways. Far too many people, including doctors, have no idea what stuttering is and how to really help. Hpefully, Dr Maguire's work will inspire others in the medical field to become more aware of stuttering complexities.

Anthony Diclemen said...

Stress and some unpleasent experiences may lead to anxiety. Some natural anxiety remedies to look into are St.John's Wort, SAMe, L-Theanine, and Tryptophan. There's also cognitive behavioral therapy (CBT) and programs like Panic Away and The Linden Method, to name a few. Hope this helps!