And then there was the field trial idiocy.
To see whether or not new diagnoses and new diagnostic criteria really work, whether they are useful, whether they create unforeseen consequences like too-high rates of diagnosis, they are field tested. Mental health workers in hospitals and private offices use the new criteria and report back on how they worked, and based on their experience the criteria are tweaked.
Field trials were supposed to begin in May 2010. But the criteria weren’t ready by then, which gave the dissenters more ammunition, as one of their criticisms was that the process was hopelessly inefficient and behind schedule. Over the summer, little was heard of the field trials, but every time I asked a question about the vagueness of various criteria or the complexity of the process by which the APA wants to start specifying the severity of mental disorders, the answer was, Wait until the field trials. In the meantime, certain deadlines loomed that were out of th APA’s control, especially the deadline for the update of the World Health Organization’s International Classficiation of Diseases (too complicated to go into here, but trust me, if the APA doesn’t get their DSM shit together before the ICD goes to press, they’re gonnna be one sorry bunch). So the pressure was on to get the field trials under way.
Finally, in October, the APA announced in a press release that the field trials had begun. I emailed to get some details and quickly discovered that the trials had not begun at all, except for one–the pilot study, which had been under way for months and whose results would determine the final shape of the field trials. Near as I could make out, the real start date was at least two months away.
You can’t blame the APA for not wanting this information out there. But why in the world would they announce that the trials had started when they had not? Did they really think no one would ask? I can only think of two possibilities, besides the obvious, which is that they’re too arrogant to think anyone will notice or care. First possibility: it could have been a Freudian slip–an unconscious revelation of something that they did not want in the light of day, truth coming to light in the form of a lie. Second, it could have been an Orwellian assault on language, you know, when an institution has so much power that it thinks it can control the meaning of words, as in War is Peace.
Of course, there’s a third possibility: rank incompetence. That’s the explanation I think dissenters would go with, but it just seems too simplistic to me.