The DSM 6 and Federal Rule of EVidence 407 ---Subsequent remedial Measures

​Val's Take

• By and large, mental health patients and/or Defendants are not interacting directly with the American Psychiatric Association (APA).
  • ​They are interacting with a Clinician and/or Forensic Evaluator.

When people complain to me of the medical model --- I say what medical model --- It's a Sham Medical Model at Best

The Need for a new Integrated DSM

​In 2013, the National Institute of Mental Health (NIMH) said the DSM 5 ----- "lacked validity."

The DSM 6 is expected to be out by 2028 --- and there seem to be some highly significant REFORMS.

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​Transforming DSM-6 Development: A Call for Integrated Approaches and Cautious Innovation (2025)

By Dr. Steven E.  Hyler
Professor Emeritus of Psychiatry at Columbia University Medical Center

Key Takeaways

• AI and digital platforms can revolutionize DSM-6 development, enabling real-time updates and broader participation through a Wiki-D platform.
• AI integration can bridge DSM and RDoC frameworks, supporting personalized medicine and continuous updates, enhancing diagnostic accuracy.

​This article argues for greater use of technology in the DSM 6.  

Part of the problem in previous DSMs has been that the APA didn't have the technology to keep up with the research --- and it's been EXPLODING the past several years --- BUT not necessarily getting to the clinicians or the patients.

NIMH Delivers a kill shot to the DSM 5

Burden of Proof

​But this is NOT just about TECHNOLOGY.

This is about a medical professional organization struggling with major re-conceptualizations of "Mental Disorders" based on newer scientific discoveries and research.

• ​A lot of this struggle is political.

Perfectionism and an out-of-date DSM -- We need Interim Procedures

The DSM Criminal Justice Wheel of Fortune

Conceptualization Matters --- It Matters a lot in the Criminal Justice System

Hair Analysis, Psychological Analysis

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​Law Professor Wes Porter at Golden Gate University Law School, former US Dept. of Justice Attorney

Federal Rules of Evidence (FRE) Rule 407 - Subsequent Remedial Measures

Harvard Law Review Sounds the Alarm on the "Anti-Social Personality Disorder" Diagnosis

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​The Evolution of Psychiatric Diagnosis: From DSM-5 to DSM-6 (2024)
 
By Emily Thatcher
Department of Psychiatry, Harvard University

​"Advancements in neuroscience and genetics have profound implications for psychiatric diagnosis.

The DSM-5 began to incorporate findings from these fields, although it was constrained by the limits of contemporary research.  [Val's Note:  That was not the only problem.]

"As scientific understanding continues to evolve, the DSM-6 is poised to integrate more robust neurobiological data, enhancing the precision and reliability of diagnoses.

"This integration may involve the inclusion of biomarkers and genetic information, providing a more detailed picture of mental health disorders.
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[Val's Note:  Metabolomic Biomarker Signatures for   Bipolar Disorder and Unipolar Depression --- JAMA Psychiatry (2024)]

"For example, genetic predispositions and neuroimaging findings could become part of diagnostic criteria, offering objective measures alongside clinical assessments.

​Such developments promise to refine diagnoses, enable personalized treatment plans, and improve outcomes for patients.

"The categorical nature of the DSM has often been criticized for its limitations in capturing the complexity of mental health disorders, which frequently exist along spectrums rather than within discrete categories.

"The DSM-5 made some progress towards dimensional approaches, particularly with the introduction of severity specifiers for various disorders.

​"The DSM-6 is likely to further this dimensional approach, recognizing that many psychiatric conditions are not binary but exist on a continuum."