A guide to the American Psychiatric Association's new diagnostic nomenclature.
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DSM-III will be published early this year. In the first part of this article the authors describe some of the major achievements of DSM-III: the process of its development, reaching consensus on many controversial diagnostic categories and a definition of mental disorder, the provision of diagnostic criteria and a multiaxial evaluation system, and the demonstration of improved diagnostic reliability. In the second part of the article the authors present an overview of DSM-III in which they describe its departures from DSM-II and the reasons for these changes. They conclude that in the next few years there should be systematic study of DSM-III in use, so that information about its strengths and limitations can be made available to those responsible for developing DSM-IV.
In 1977 the American Psychiatric Association called for a critical examination of the clinical effectiveness of meditation. The author provides a review of the literature bearing on clinical and physiological comparisons of meditation with other self-control strategies. He begins by providing a definition of mediation and then cites the literature comparing mediation with such self-regulation strategies as biofeedback, hypnosis, and progressive relaxation. He pays particular attention to the "uniqueness" of mediation as a clinical intervention strategy a well as the adverse effects of meditation. Finally, he offers suggestions and guidelines for future research.
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The randomly selected charts of 50 discharged psychiatric inpatients were reviewed for documentation of medical illness and DSM-III axis III diagnoses. Twenty-eight percent of the patients had had medical symptoms, 56% had had medical findings, 36% had had laboratory findings, and 60% had been given axis III diagnoses. In at least seven cases, the medical findings were poorly reflected in the final axis III diagnosis. In no case did the record indicate that medical factors were viewed as the cause of a patient's immediate psychiatric syndrome.
As future manned space missions become longer, and as crews become more heterogeneous, psychological and interpersonal factors will take on increasing importance in assuring mission success. On the basis of a review of more than 60 American and Soviet space simulation studies on Earth, along with reports from U.S. and Soviet space missions, the author identifies nine psychological and seven interpersonal issues, which are discussed along with pertinent research findings and examples from manned spaceflights. He concludes that more psychological and interpersonal research should be done under actual spaceflight conditions and offers suggestions.
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