Reaction Paper
Introduction
The removal of the exclusionary criterion has generated a great debate. The exclusionary criterion allows clinicians to avoid diagnosing people in grief with a major depressive disorder. The exclusion of such people allows them to experience grief normally until recovery. Those who support the removal of the criterion argue that many people whose bereavement depression becomes clinical may fail to receive treatment on the basis of their grief. The issue is controversial because on one side, treating a normal grieving person with a psychiatric disorder is traumatic. On the other hand, heavy reliance on the exclusionary criterion may deny people with clinical depression access to treatment because they are simply grieving.
Previously, I did not think that there was any need for an exclusionary criterion when treating depressive disorders. My views were based on the assumption that it would be better to treat all depressive disorders than fail to treat some on the basis of grief. However, after reading the articles, it has become clear that treating a grief-related depression as a major depression is erroneous and may traumatize patients.
Supporters of the exclusionary criterion removal assert that the criterion was absent in DSM-III, which was the basis upon which DSM-IV was formed (Comer, 2010). The criterion was added by a task force that was involved in a study of grief. This argument does not provide enough reasons to support the removal of the criterion because its absence in DSM-III does not mean it is irrelevant.
The second argument advanced by those who support the removal of the exclusionary criterion is that diagnostic systems around the world for psychiatric disorders have no exclusionary criterion for grief (Kendler, 2010). The argument is fallacious because the absence of a grief exclusionary criterion in the world does not mean it cannot be added when necessary.
Those who oppose the removal of the exclusionary criterion argue that its removal would encourage health practitioners to diagnose major depression in people experiencing grief. Consequently, the clinicians may treat people with a psychiatric disorder. There is no reason to treat a normal grief process that can end on its own. The extra amount of money used to treat grief-related depression can be used to treat other fatal illnesses instead of being used to treat a condition that can end naturally. In addition, the exclusionary criterion prevents normal people from experiencing the trauma associated with psychiatric treatment (Kring and Johnson, 2013).
The second assertion by those who oppose the removal of the exclusionary criterion is that studies indicate differences between major depression and grief-related depression (Friedman, 2012). Those advocating for the criterion removal have argued that the criterion is not required because both types of depression are not different. The existence of the differences, therefore, legitimizes the argument supporting the exclusionary criterion.
It is clear that the DSM-5 committee decision to remove the exclusionary criterion is not justified. The existence of the criterion will allow people to go through the grief process without the dangers of being treated for major depression.
Conclusion
The opponents of the removal have the strongest arguments because they clearly substantiated claims. The readings changed my perception about the exclusionary criterion. I have gained knowledge on the importance of the criterion in protecting those grieving from the stigma that results from major depression treatment.
References
Comer, R.J. (2010). Fundamentals of Abnormal Psychology. Richmond: Worth Publishers.
Friedman, R.A. (2012). Grief, Depression, and the DSM-5. The New England Journal of Medicine, 1855-1857.
Kendler, K. (2010). DSM-5 Mood Disorders Workgroup Response. Washington, DC: American Psychiatric Association.
Kring, A., & Johnson, S.L. (2013). Abnormal Psychology: DSM-5 Update (12th Ed.). New York: Wiley.
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