One of the main challenges for clinicians and researchers is proving that a disorder exists. In this module, you will explore the concept of research and its influence on defining psychological disorders.

For your initial post, begin by reviewing the Research Changes and Practices Excerpts PDF document for information about the history of homosexuality and PTSD in the DSM. In addition, review the four excerpts about homosexuality and PTSD. Then address the following:

• How have changes in the DSM impacted clinical diagnosis for homosexuality and PTSD?
• How has the field of mental health changed as a result of the current concepts of homosexuality and PTSD?
• What is the impact on clinical practice because of these changes?
• How does the concept of research trends in the DSM apply to any of the following programmatic themes? You may want to review the Programmatic Themes PDF document.
  • Self-care
  • Social justice
  • Emotional intelligence
  • Career connections
  • Ethics

REFERENCE: This article addresses how homosexuality was pathologized in the DSM. "A good example is the pathologisation of homosexuality. Until 1980, homosexuality was classified as a mental illness on the DSM (Diagnostic and Statistical Manual of Mental Disorderssee below). Following a show of hands by the writers of the DSM in 1973, it was removed at the next revision. However, it is still classified as a mental illness in the latest edition of the Chinese diagnostic system (CCMD-3), is illegal in many countries and carries the death penalty in several African countries." (Humphreys, 2011, "The Human and Cultural/Historical Construction of Abnormality" section, para. 3) Excerpt 2 This article outlines the history of homosexuality in the DSM. "The American Psychiatric Association (APA) recently completed a several year process of revising the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). During that time, there were objections raised to retaining DSM's gender identity disorder diagnoses and calls to remove them, just as homosexuality had been removed from DSM-II in 1973. At the conclusion of the DSM-5 revision process, the gender diagnoses were retained, albeit in altered form and bearing the new name of 'gender dysphoria.' The author of this paper was a member of the DSM-5 Workgroup on Sexual and Gender Identity Disorders and presently serves on the WHO Working Group on Sexual Disorders and Sexual Health. Both groups faced similar tasks: reconciling patients' needs for access to care with the stigma of being given a psychiatric diagnosis. The differing nature of the two diagnostic manuals led to two different outcomes. As background, this paper updates the history of homosexuality and the gender diagnoses in the DSM and in the International Statistical Classification of Diseases and Related Health Problems (ICD) as well as what is expected to happen to the homosexuality and gender diagnoses following the current ICD-11 revision process." (Drescher, 2015b) Excerpt 3: This article outlines theoretical views on homosexuality and addresses destigmatization. "APA's 1973 diagnostic revision was the beginning of the end of organized medicine's official participation in the social stigmatization of homosexuality. Similar shifts gradually took place in the international mental health community as well. In 1990, the World Health Organization removed homosexuality per se from the International Classification of Diseases (ICD-10) [64]. As a consequence, debates about homosexuality gradually shifted away from medicine and psychiatry and into the moral and political realms as religious, governmental, military, media, and educational institutions were deprived of medical or scientific rationalization for discrimination. As a result, cultural attitudes about homosexuality changed in the U.S. and other countries as those who accepted scientific authority on such matters gradually came to accept the normalizing view. For if homosexuality was no longer considered an illness, and if one did not literally accept biblical prohibitions against it, and if gay people are able and prepared to function as productive citizens, then what is wrong with being gay? Additionally, if there is nothing wrong with being gay, what moral and legal principles should the larger society endorse in helping gay people openly live their lives?" (Drescher, 2015a, 571-572) 1 Excerpt 4: This article gives an overview and outlines the history of the PTSD diagnosis. "The risk of exposure to trauma has been a part of the human condition since we evolved as a species. Attacks by saber tooth tigers or twenty-first century terrorists have probably produced similar psychological sequelae in the survivors of such violence. Shakespeare's Henry IV appears to meet many, if not all, of the diagnostic criteria for Posttraumatic Stress Disorder (PTSD), as have other heroes and heroines throughout the world's literature. The history of the development of the PTSD concept is described by Trimble (1). In 1980, the American Psychiatric Association (APA) added PTSD to the third edition of its Diagnostic and Statistical Manual of Mental Disorders (DSM-III) nosologic classification scheme (2). Although controversial when first introduced, the PTSD diagnosis has filled an important gap in psychiatric theory and practice. From an historical perspective, the significant change ushered in by the PTSD concept was the stipulation that the etiological agent was outside the individual (i.e., a traumatic event) rather than an inherent individual weakness (i.e., a traumatic neurosis). The key to understanding the scientific basis and clinical expression of PTSD is the concept of 'trauma.'" (Friedman, n.d., "A Brief History of the PTSD Diagnosis" section, paras. 1-2) References Drescher, J. (2015a). Out of DSM: Depathologizing Homosexuality. Behavioral Sciences, 5(4), 565-575. https://doi-org.ezproxy.snhu.edu/10.3390/bs5040565 Drescher, J. (2015b). Queer diagnoses revisited: The past and future of homosexuality and gender diagnoses in DSM and ICD [Abstract]. International Review of Psychiatry, 27(5), 386-395. https://doi-org.ezproxy.snhu.edu/10.3109/09540261.2015.1053847 Friedman, M. J. (n.d.). PTSD history and overview. PTSD: National Center for PTSD. U.S. Department of Veterans Affairs. https://www.ptsd.va.gov/professional/treat/essentials/history_ptsd.asp#:~:text=In%201980%2 C%20the%20American%20Psychiatric,in%20psychiatric%20theory%20and%20practice Humphreys, P. (2011, April). Psychopathologies: Paul Humphreys explores definitions and diagnoses of 'abnormality,' from historical perspectives to the present day. Psychology Review, 16(4), 2+.

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PLEASE READ THE ARTICLE THAT IS REFERENCED