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The conservative Wall Street Journal is all in a tizzy.  The WSJ found a psychiatrist who has objected to every edition of the DSM starting with DSM-III, so it is no surprise that he repeated his complaints for the WSJ:  "He opposes the symptom-only system of classification presented in the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders (editions III, III-R, IV, and IV-TR) on the grounds that it classifies mental disorders according to observation of signs and symptoms while not addressing underlying causes" Paul R. McHugh - Wikipedia, the free encyclopedia http://en.wikipedia.org/wiki/Paul_R._McHugh

Here is an excerpt from Dr. McHugh's WSJ piece: 

" . . . Today the public complains that psychiatrists seem ready to call every state of mental distress an illness. They see that any restless boy can receive a diagnosis of attention deficit disorder, that troubled veterans—whether exposed to combat or not—are routinely said to suffer from post-traumatic stress disorder, and that enormous numbers of discouraged, demoralized people are labeled victims of depression and have medications pressed upon them.

The public is not far wrong. A recent nationwide diagnostic census based on DSM claimed that the majority of Americans have or have had a mental disorder. As a result, an appalling number of young adults in schools and colleges are on one form or another of psychiatric medication.

The problem, though, is not only that psychiatrists have gone too far in naming mental states—they surely have—but that they have gone on too long with their field-guide checklists. They seem unable to do better. DSM-5 will be more of the same—a way to "know of" disorders without "knowing about" them, to draw a distinction made by William James.

With its new manual, the APA might instead have started taking steps toward a system of classification that, as in medicine, organizes disorders according to what we know about their natures and causes. Such knowledge, rather than checklists of symptoms, would then direct treatment and research.

Psychiatrists know, for instance, that depression and anxiety can derive from a number of different sources: cerebral diseases such as schizophrenia and bipolar disorder; alcoholism or drug addiction; experiences of loss, deprivation or trauma; and, more generally, a vulnerable temperament, characterized by introversion, shyness and emotional intensity.

Deciding which of these sources, alone or in combination, applies to a particular patient requires hours of evaluation. Prescribing an appropriate treatment involves not checking symptoms but determining who the patient is and what he or she has experienced and done.

DSM-5 displays none of this thinking. It remains a field guide organized by symptoms, clustered in categories that can expand without limit. Official, APA-approved psychiatry seems to lack the will to change. It justifies its stagnation not only by reminding its members of the chaos of the 1970s but by claiming that the U.S. health system would not pay psychiatrists if they tried to know their patients the way that they could and should.

DSM-5 is a missed opportunity to advance the discipline, instruct the public and encourage financial support for needed psychiatric services. Its editors seem willing to waste another decade before dispersing the mysteries of psychiatry and bringing practitioners and patients together in understanding what they are doing and why."

DSM-5: A Manual Run Amok - WSJ.com http://online.wsj.com/article/SB10001424127887324216004578483391664789414.html?mod=googlenews_wsj

Up to 20 percent of children in the United States suffer from a mental disorder, and the number of kids diagnosed with one has been rising for more than a decade, according to a report released on Thursday by the U.S. Center for Disease Control and Prevention.

In the agency's first-ever study of mental disorders among children aged 3 to 17, researchers found childhood mental illnesses affect up to one in five kids and cost $247 billion per year in medical bills, special education and juvenile justice.

Children with mental disorders - defined as "serious deviations from expected cognitive, social, and emotional development" - often have trouble learning in school, making friends, and building relationships later in life, the report said.

They are more likely to have other chronic health problems, such as asthma and diabetes, and are at risk for developing mental illnesses as adults.

. . .

http://www.reuters.com/article/2013/05/16/us-usa-health-children-idUSBRE94F11N20130516

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"Next week the American Psychiatric Association is publishing its fifth take on the classification of psychiatric disorders, the DSM-5. Judging by the sound and fury, you might be forgiven for thinking that this is something radical – a great breakthrough in our struggle to better understand mental disorders, or alternatively a dastardly plot to extend the boundaries of psychiatry into everyday life and emotions at the behest of greedy drug companies. Or, if the position statement from the Division of Clinical Psychology (DCP) is to be believed, an attempt to emphasise the biological causes of mental disorders over the social and psychological.

In fact, it is none of the above. . .

So why the fuss about DSM-5? After all, it's hardly a good read – not the kind of book anyone will take on holiday – and it isn't the system of classification that we use over here in any case. In practice, most UK mental health professionals will barely notice much difference. Some diagnostic criteria will have improved, others less so, and no doubt there will be some "only in America" stories about the inevitable daft new category. But most of those in the business of helping those with mental disorders will be less concerned with what is in and what is out than with the reality of underfunded and overstretched services. The idea that we are part of a conspiracy to medicalise normality will seem frankly laughable as we struggle to protect services for those whose disorders are all too evident under any classification system."

Do we need to change the way we are thinking about mental illness? | Science | The Observer http://www.guardian.co.uk/science/2013/may/12/dsm-5-conspiracy-laughable

"There's just no incentive to accept changes from outside your own team. You can always find a reason to say "no", and you have very little incentive to say 'yes'."

Sometimes when I'm reading about computers, I stumble across something that explains volumes about culture. 

Here is an example about stagnation and the culture of "no" at Microsoft.  Do you see equivalents in conservative cliques within SSA?  It certainly nails the mentality of the ALJ union.  But sadly, I've also seen these forces at work in the community of representatives and attorneys who represent the disabled at SSA.  It is not necessary to understand the technical points to get the important point.

"Windows is indeed slower than other operating systems in many scenarios, and the gap is worsening. The cause of the problem is social. There's almost none of the improvement for its own sake, for the sake of glory, that you see in the Linux world.

Granted, occasionally one sees naive people try to make things better. These people almost always fail. We can and do improve performance for specific scenarios that people with the ability to allocate resources believe impact business goals, but this work is Sisyphean. There's no formal or informal program of systemic performance improvement. We started caring about security because pre-SP3 Windows XP was an existential threat to the business. Our low performance is not an existential threat to the business.

See, component owners are generally openly hostile to outside patches: if you're a dev, accepting an outside patch makes your lead angry (due to the need to maintain this patch and to justify in in shiproom the unplanned design change), makes test angry (because test is on the hook for making sure the change doesn't break anything, and you just made work for them), and PM is angry (due to the schedule implications of code churn). There's just no incentive to accept changes from outside your own team. You can always find a reason to say "no", and you have very little incentive to say "yes".

There's also little incentive to create changes in the first place. On linux-kernel, if you improve the performance of directory traversal by a consistent 5%, you're praised and thanked. Here, if you do that and you're not on the object manager team, then even if you do get your code past the Ob owners and into the tree, your own management doesn't care. Yes, making a massive improvement will get you noticed by senior people and could be a boon for your career, but the improvement has to be very large to attract that kind of attention. Incremental improvements just annoy people and are, at best, neutral for your career. If you're unlucky and you tell your lead about how you improved performance of some other component on the system, he'll just ask you whether you can accelerate your bug glide . .  "

I Contribute to the Windows Kernel. We Are Slower Than Other Operating Systems. Here Is Why. - Zorinaq http://blog.zorinaq.com/?e=74