Читать книгу Understanding Mental Health and Counselling - Группа авторов - Страница 55

DSM-IV was published in 1994 (APA, 1994). Its goals, as described by its chair, psychiatrist Allen Frances, were modest: they were ‘to introduce rigour, objectivity, and transparency in how decisions were made’ (Frances, 2013, p. 70). Conceptually and structurally, DSM-IV largely followed DSM-III, though it attempted to address the issue of cultural variation in mental health problems. Although the DSM is a US system, it is used in many countries and, of course, the US population itself is culturally varied. Culture researchers therefore argued that the manual needed to acknowledge that its construction of mental health was culturally shaped, but DSM-IV took a more minimalist approach. It included an appendix with an outline of a cultural formulation and a glossary of so-called ‘culture-bound syndromes’. These could refer to the way in which a DSM disorder was expressed differently in different cultures, or to an indigenous ‘folk’ category of distress. An example given by DSM-IV was ‘amok’, which referred to ‘a dissociative episode characterized by a period of brooding followed by an outburst of violent, aggressive, or homicidal behavior directed at people and objects’ (APA, 1994, p. 845). This had apparently been reported primarily (although not exclusively) in Southeast Asia.

A further edition (DSM-IV-TR) was published six years later, in 2000, though the revisions were primarily textual rather than conceptual.