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On February 10, the world of psychiatry will be asked, metaphorically, to lie on the couch and answer questions about the state it thinks it is in. For that is the day the American Psychiatric Association (APA) plans to release a draft of the fifth version of its Diagnostic and Statistical Manual of Mental Disorders (DSM-V). Mental illness carrying such stigma (~) as it does, and the brain being as little-understood as it is, revising the DSM is always a controversial undertaking. This time, however, some of the questions asked of the process are likely to be particularly probing.
The DSM, the first version of which was published in 1952, lists recognized psychological disorders and the symptoms used to diagnose them. In the United States, what is in it influences whether someone will be diagnosed with an illness at all, how he will be treated if he is so diagnosed, and whether his insurance company will pay for that treatment. Researchers in other countries generally defer to the DSM, too, making the manual’s definitions a lingua franca for the science of medical psychology. And, perhaps most profoundly, the DSM, then, is an important document. The APA has been working on the latest revision since 1999, and will not release the final version until May 2013. But some people are already accusing it of excessive secrecy and being too ambitious about the changes it proposes. Those critics will be picking over the draft next week to see if their fears have been realized.
The original DSM reflected the "psychodynamic" view of mental illness, in which problems were thought to result from an interplay between personality and life history. (Think Freud, Jung and long hours recounting your childhood and dreams.) The third version, which was published in 1980, took a more medical approach. Mental illnesses were seen as distinct and classifiable, like physical diseases. DSM-Ⅲ came with checklists of symptoms that allowed straightforward, unambiguous diagnosis. Psychiatry began to seem less like an art form and more like a science.
DSM-Ⅲ also introduced many more diagnoses than had appeared before. These included attention-deficit disorder, post-traumatic stress disorder and social phobia. In fact, the number of specific diagnoses more than doubled between DSM-Ⅰ and DSM-Ⅲ, from 106 to 265. DSM-IV, published in 1994, increased the number to 267, but left the underlying model alone.
Since its first publication in 1952, the DSM has been influential in that______

A. it has caused little problem in the actual diagnosis of the illness
B. its stipulation gives exact instructions on the treatment of the illness
C. its principles are adhered to by not only doctors but also patients
D. it is widely recognized as an important part of medical psychology
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