DSM Revisions and the 'Western Conundrum'

The Diagnostic and Statistical Manual of Mental Disorders is the most widely used classification system of mental health disorders in the world. Currently in its fifth edition (DSM-5; American Psychiatric Association, Diagnostic and statistical manual of mental disorders, 5th edn. American Psychiatric Publishing, Arlington, 2013), the DSM has been continually revised over the past 60 years as new research is made available to users. There is a robust movement among psychiatric and psychological scholars to upgrade the DSM with each of its revisions to incorporate and modify, when appropriate, findings that enable DSM users to better understand how to accurately serve individuals from diverse countries and diverse cultural, racial, ethnic, language, and immigrant backgrounds. A common template used by many in this movement is to characterize mental health services and nosology as being influenced by “Western” vs. “Non-Western” influences. This chapter argues that the terms “Western” and “Non-Western” do not enjoy a universal consensus in how they are defined. The boundaries between these two terms are fuzzy and permeable, and many groups worldwide share similar and dissimilar Western and Non-Western characteristics simultaneously. The difficult issues inherent in these observations and problems are elucidated, and suggestions are advanced for ways in which cultural supplements to the DSM can appropriately address these issues.