The Increasing Role of Biology in the DSMs of Tomorrow

How Genetics Shape Psychopathology

Rich Simon


Rather than continuing to lament the deficiencies of DSM-5, forensic psychiatrist David Mays, who’s also the author of the Major Mental Illness Pocket Guides, wants to focus on what's ahead for the psychotherapy field. In his view, some of the most important advances in years to come will be finding objective, biological markers for many psychological disorders. This will lead to more focus on developing high-tech approaches incorporating methodologies like genetic scans, brain scans, and biochemical interventions.

In this video clip, Mays talks about the importance of looking at genetics. “Twin studies and adoption studies are fairly clear that for most human behaviors that can be measured by testing, there’s some genetic component. In fact, geneticists estimate that around 50 percent of our character, our personality, has some sort of genetic influence.” As we develop more accurate genetic scans, he believes, the mental health treatment of the future will focus increasingly on behavioral, biological and dietary prevention strategies.

Accordingly, posits Mays, in the years ahead, psychotherapists will become ever more specialized depending on whether they concentrate on working with clients with “normal brains that are unhappy vs. abnormal brains that don’t function properly.” Says Mays, “Some people will focus on doing therapy and teasing out the story that explains why people are the way they are. Others, like me, will maintain a strong biological bent. These practitioners will be more inclined to do biological interventions and treat folks in the abnormal brain category.”

“I think the big conflict is going to be over what’s considered reimbursable treatment,” Mays goes on to say. “The biologically-inclined practitioners are going to have an advantage because they’re going to have a objective markers they can point to. There’s going to be increasing demand for proof that something’s happening in treatment.”

In the Networker Webcast series The Uproar Over DSM-5, Mays delves into what biological interventions might look like in the future.

The Uproar Over DSM-5
How to Use the New Standards with Confidence

Click here for full course details

Topic: Business of Therapy

Tags: brain scan | David Mays | Diagnostic and Statistical Manual | DSM | dsm-5 | future of psychotherapy | genetic scans | mental health | mental health treatment | mental illness | psychiatrist | psychotherapists | psychotherapy | psychotherapy field | therapy

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4 Comments

Friday, June 6, 2014 1:20:23 PM | posted by Derek Roemer
Where does neuroplasticity come in?

Wednesday, June 4, 2014 2:12:32 PM | posted by Charlotte Santa
I've just been enlightened about the so-called "MTHFT Genetic marker/mutation". If what I understand is true, this IS/could be highly significant in the diagnosis and treatment of (some presentations of) "mental illnesses" (hopefully PRIOR to another mass murder--the final aftermath which FINALLY confirms that the perpetrator is "Mentally Ill"---verifiably! Mutation of this gene is said to be responsible for or contributes problematically to the production of neurotransmitters AMONG OTHER VERY IMPORTANT MEDICAL AND MENTAL HEALTH COMPLICATIONS, this mutation is correlated with depression, drug/alcohol/tobacco addiction, complication with pregnancy outcomes (not to mention post-partum/miscarriage depression??). Or, is this one of the possible 'solutions' to some mental health challenges that we will sit on, and allow this population to suffer needlessly because it's development might threaten our own professional and financial security? Consider the concept of PREVENTION. It could be big business, were it not for....well....the big business of pathology.

Tuesday, June 3, 2014 5:15:55 PM | posted by Clifford Ray Fagan
I agree with your premise, but having worked in the mental health field for so lang, I see that trends move heavily toward treating as much as possible with medications to the exclusion of anything more than relatively brief counseling. As such, biological markers are likely to be seen as additional evidence that someone needs more focus on medication management than counseling or coping skills or CBT training. Also any type of suggestion that such skills training would help may meet with efforts to produce lower level clinicians trained for just that one, reimbursable skills set, instead of broadly trained psychological counselors, or alternatively, patients will be told by their insurance to buy self help books to learn CBT, since what they really have is a biological condition treated only by medications rather than counseling. I am not saying this will happen, but having split my career between facilities, outpatient, and insurance managed care, I expect this is the direction this is likely to go. It reminds me of treatment for Autistic spectrum Disorder which is consistently being moved to unreimbursable treatment by unlicensed clinicians working as skills trainers in the outpatient setting.

Tuesday, June 3, 2014 4:49:54 PM | posted by howard mordin
I think that everyone has a genetic predisposition to become mentally ill (for lack of a better term) usually as a result of some unexpected traumatic event sometime during in their lives. This perhaps occurs more during the formative years when the brain is still developing and only shows up later when another event acts as a trigger for emotional problems induced by the original trauma.