document_title: Teak

question_text: in india where does teak grow most abundantly

text: Teak

text: Description[edit]

text: Teak is a large, long, deciduous tree up to 40 m (131 ft) tall with gray to grayish brown branches. These are mostly known for their finest quality wood. Leaves are ovate-elliptic to ovate, 15–45 cm (5.9–17.7 in) long by 8–23 cm (3.1–9.1 in) wide, and are held on robust petioles which are 2–4 cm (0.8–1.6 in) long. Leaf margins are entire.[8]

text: Fragrant white flowers are borne on 25–40 cm (10–16 in) long by 30 cm (12 in) wide panicles from June to August. The corolla tube is 2.5–3 mm long with 2 mm wide obtuse lobes. Tectona grandis sets fruit from September to December; fruits are globose and 1.2-1.8 cm in diameter.[8] Flowers are weakly protandrous in that the anthers precede the stigma in maturity and pollen is shed within a few hours of the flower opening.[9] The flowers are primarily entomophilous (insect-pollinated), but can occasionally be anemophilous (wind-pollinated).[10] A 1996 study found that in its native range in Thailand, the major pollinator were species in the bee genus Ceratina.[9]

text: Wood[edit]

text:
Heartwood is yellowish in colour. It darkens as it ages.[citation needed] Sometimes there are dark patches on it. There is a leather-like scent in newly cut wood.
Sapwood is whitish to pale yellowish brown in colour. It can easily separate from heartwood.[citation needed]
Wood texture is hard and ring porous.
Density is 720 kg/m3.

text: Botanical history[edit]

text: Tectona grandis was first formally described by Carl Linnaeus the Younger in his 1782 work Supplementum Plantarum.[11] In 1975, Harold Norman Moldenke published new descriptions of four forms of this species in the journal Phytologia. Moldenke described each form as varying slightly from the type specimen: T. grandis f. canescens is distinguished from the type material by being densely canescent, or covered in hairs, on the underside of the leaf, T. grandis f. pilosula is distinct from the type material in the varying morphology of the leaf veins, T. grandis f. punctata is only hairy on the larger veins on the underside of the leaf, and T. grandis f. tomentella is noted for its dense yellowish tomentose hairs on the lower surface of the leaf.[12]

text: Distribution and habitat[edit]

text: Tectona grandis is one of three species in the genus Tectona. The other two species, T. hamiltoniana and T. philippinensis, are endemics with relatively small native distributions in Myanmar and the Philippines, respectively.[13] Tectona grandis is native to India, Sri Lanka, Indonesia, Myanmar, northern Thailand, and northwestern Laos.[8][9]

text: Tectona grandis is found in a variety of habitats and climatic conditions from arid areas with only 500 mm of rain per year to very moist forests with up to 5,000 mm of rain per year. Typically, though, the annual rainfall in areas where teak grows averages 1,250-1,650 mm with a 3-5 month dry season.[14]

text: Cultivation[edit]

text: Teak's natural oils make it useful in exposed locations, and make the timber termite and pest resistant. Teak is durable even when not treated with oil or varnish. Timber cut from old teak trees was once believed to be more durable and harder than plantation grown teak. Studies have shown that plantation teak performs on par with old-growth teak in erosion rate, dimensional stability, warping, and surface checking, but is more susceptible to color change from UV exposure.[15]

text: The vast majority of commercially harvested teak is grown on teak plantations found in Indonesia and controlled by Perum Perhutani (a state owned forest enterprise) that manages the country's forests. The primary use of teak harvested in Indonesia is in the production of outdoor teak furniture for export. Nilambur in Kerala, India is also a major producer of Teak of fine quality, holds the world's oldest Teak plantation.[16]

text: Teak consumption raises a number of environmental concerns, such as the disappearance of rare old-growth teak. However, its popularity has led to growth in sustainable plantation teak production throughout the seasonally dry tropics in forestry plantations. The Forest Stewardship Council offers certification of sustainably grown and harvested teak products. Propagation of teak via tissue culture for plantation purposes is commercially viable.[17]

text: Teak plantations were widely established in Equatorial Africa during the Colonial era. These timber resources, as well as the oil reserves, are at the heart of the current (2014) South Sudanese conflict.[18][19]

text: Much of the world's teak is exported by Indonesia and Myanmar. There is also a rapidly growing plantation grown market in Central America (Costa Rica) and South America. With a depletion of remaining natural hectares of teak forests, a growth in plantations in Latin America is expected to rise.[20]

text: Hyblaea puera, commonly known as the teak defoliator, is a moth native to southeast Asia. It is a teak pest whose caterpillar feeds on teak and other species of trees common in the region of southeast Asia.[21]

text: Uses[edit]

text: Teak's high oil content, high tensile strength and tight grain make it particularly suitable where weather resistance is desired. It is used in the manufacture of outdoor furniture and boat decks. It is also used for cutting boards, indoor flooring, countertops and as a veneer for indoor furnishings. Although easily worked, it can cause severe blunting on edged tools because of the presence of silica in the wood. Over time teak can weather to a silvery-grey finish, especially when exposed to sunlight.[22]

text: Teak is used extensively in India to make doors and window frames, furniture, and columns and beams in old type houses. It is resistant to termite attacks and damage caused by other insects. Mature teak fetches a very good price. It is grown extensively by forest departments of different states in forest areas.

text: Leaves of the teak wood tree are used in making Pellakai gatti (jackfruit dumpling), where batter is poured into a teak leaf and is steamed.[23] This type of usage is found in the coastal district of Udupi in the Tulunadu region in South India. The leaves are also used in gudeg, a dish of young jackfruit made in Central Java, Indonesia, and give the dish its dark brown color.

text: Teak is used as a food plant by the larvae of moths of the genus Endoclita including E. aroura, E. chalybeatus, E. damor, E. gmelina, E. malabaricus, E. sericeus and E. signifer and other Lepidoptera including Turnip Moth.

text:
Teak table

Teak garden armchairs

text: Uses in boatbuilding[edit]

text: Teak has been used as a boatbuilding material for over 2000 years (it was found in an archaeological dig in Berenice Panchrysos, a port on the Indian Roman trade).[24] In addition to relatively high strength, teak is also highly resistant to rot,[25] fungi and mildew. In addition, teak has a relatively low shrinkage ratio,[26] which makes it excellent for applications where it undergoes periodic changes in moisture. Teak has the unusual properties of being both an excellent structural timber for framing, planking, etc., while at the same time being easily worked, unlike some other similar woods such as purpleheart,[27] and finished to a high degree.[28] For this reason, it is also prized for the trim work on boat interiors. Due to the oily nature of the wood, care must be taken to properly prepare the wood before gluing.[29]

text: When used on boats, teak is also very flexible in the finishes that may be applied. One option is to use no finish at all, in which case the wood will naturally weather to a pleasing silver-grey.[30] The wood may also be oiled with a finishing agent such as linseed or tung oil.[31] This results in a pleasant, somewhat dull finish.[citation needed] Finally, teak may also be varnished for a deep, lustrous glow.[citation needed]

text: Teak is also used extensively in boat decks, as it is extremely durable and requires very little maintenance. The teak tends to wear in to the softer 'summer' growth bands first, forming a natural 'non-slip' surface.[30] Any sanding is therefore only damaging. Use of modern cleaning compounds, oils or preservatives will shorten the life of the teak, as it contains natural teak-oil a very small distance below the white surface. Wooden boat experts will only wash the teak with salt water, and re-caulk when needed. This cleans the deck, and prevents it from drying out and the wood shrinking. The salt helps it absorb and retain moisture, and prevents any mildew and algal growth. Over-maintenance, such as cleaning teak with harsh chemicals, can shorten its usable lifespan as decking.[25]

text: Alternatives to teak[edit]

text: Due to the increasing cost of teak, various alternatives have been employed. These include purpleheart, iroko, and angelique.

text: Propagation[edit]

text: Teak is propagated mainly from seeds. Germination of the seeds involves pretreatment to remove dormancy arising from the thick pericarp. Pretreatment involves alternate wetting and drying of the seed. The seeds are soaked in water for 12 hours and then spread to dry in the sun for 12 hours. This is repeated for 10–14 days and then the seeds are sown in shallow germination beds of coarse peat covered by sand. The seeds then germinate after 15 to 30 days.[32][33]

text: Clonal propagation of teak has been successfully done through grafting, rooted stem cuttings and micro propagation. While bud grafting on to seedling root stock has been the method used for establishing clonal seed orchards that enables assemblage of clones of the superior trees to encourage crossing, rooted stem cuttings and micro propagated plants are being increasingly used around the world for raising clonal plantations.[34]

text: World's largest living teak tree[edit]

text: Ministry of Environmental Conservation and Forestry (Myanmar) found out two world biggest living teak on 28 August 2017 in Homalin Township, Sagaing Region, Myanmar. The biggest one, named Homemalynn 1, is 27.5 feet (8.4 m) in girth and 110 feet (34 m) tall. The second biggest one, named Homemalynn 2, is 27 feet (8.2 m) in girth.[35]

text: Previously, the world's biggest recorded teak tree was located within the Parambikulam Wildlife Sanctuary in the Palakkad District of Kerala in India, named Kannimara. The tree is approximately 47.5 metres (156 ft) tall.

text: In 2017, a tree was discovered in the Ottakallan area of Thundathil range of Malayattoor Forest Division in Kerala with a girth of 7.65 metres (25.1 ft) and height of 40 metres (130 ft).[citation needed] A teak tree in Kappayam, Edamalayar, Kerala which used to considered as the biggest, has a diameter of only 7.23 meters.[citation needed]

text: TEAKNET[edit]

text: The International Teak Information Network (Teaknet) supported by the Food and Agriculture Organization (FAO) Regional office for Asia-Pacific, Bangkok, currently has its offices at the Kerala Forest Research Institute, Peechi, Thrissur, Kerala State in India. Teaknet is an international network of institutions and individuals interested in teak. Teaknet addresses the interests of all the categories of stakeholders related to teak, whether they are growers, traders, researchers or other groups with a profound interest or concerned with teak. From time to time, the organisation formulates action plans focusing on the short term and long term needs of the global teak sector. The TEAKNET website[36] provides information to all those concerned with research, conservation, growing, management and utilisation of teak.


document_title: History of the automobile

question_text: when was the first car invented in the united states

question_tokens: when was the first car invented in the united states

root

text: History of the automobile

text: Power sources[edit]

text: The early history of the automobile was concentrated on the search for a reliable portable power unit to propel the vehicle.

tag: p

text: Steam-powered wheeled vehicles[edit]

text: 17th and 18th centuries[edit]

text: Ferdinand Verbiest, a member of a Jesuit mission in China, built a steam-powered vehicle around 1672 as a toy for the Chinese Emperor. It was small scale and could not carry a driver but it was, quite possibly, the first working steam-powered vehicle ('auto-mobile').[2][3]

text: Steam-powered self-propelled vehicles large enough to transport people and cargo were first devised in the late 18th century. Nicolas-Joseph Cugnot demonstrated his fardier à vapeur ("steam dray"), an experimental steam-driven artillery tractor, in 1770 and 1771. As Cugnot's design proved to be impractical, his invention was not developed in his native France. The center of innovation shifted to Great Britain. By 1784, William Murdoch had built a working model of a steam carriage in Redruth [4] and in 1801 Richard Trevithick was running a full-sized vehicle on the roads in Camborne. The first automobile patent in the United States was granted to Oliver Evans in 1789.

text: 19th century[edit]

text: During the 19th century attempts were made to introduce practical steam powered vehicles. Innovations such as hand brakes, multi-speed transmissions and better steering developed. Some commercially successful vehicles provided mass transit until a backlash against these large vehicles resulted in the passage of legislation such as the United Kingdom Locomotive Act (1865), which required many self-propelled vehicles on public roads to be preceded by a man on foot waving a red flag and blowing a horn. This effectively halted road auto development in the UK for most of the rest of the 19th century; inventors and engineers shifted their efforts to improvements in railway locomotives. The law was not repealed until 1896, although the need for the red flag was removed in 1878.

text: In 1816, a professor at Prague Polytechnic, Josef Bozek, built an oil-fired steam car.[5]:p.27 Walter Hancock, builder and operator of London steam buses, in 1838 built a 2 seated car phaeton.[5]:p27

text: In 1867, Canadian jeweller Henry Seth Taylor demonstrated his 4-wheeled "steam buggy" at the Stanstead Fair in Stanstead, Quebec and again the following year.[6] The basis of the buggy, which he began building in 1865, was a high-wheeled carriage with bracing to support a two-cylinder steam engine mounted on the floor.[7]

text: One of the first "real" automobiles was produced by Frenchman Amédée Bollée in 1873, who built a self-propelled steam road vehicles to transport groups of passengers.

text: The first carriage-sized automobile suitable for use on existing wagon roads in the United States was a steam-powered vehicle invented in 1871 by Dr. J.W. Carhart, a minister of the Methodist Episcopal Church, in Racine, Wisconsin.[8][self-published source] It induced the State of Wisconsin in 1875 to offer a $10,000 award to the first to produce a practical substitute for the use of horses and other animals. They stipulated that the vehicle would have to maintain an average speed of more than 5 miles per hour (8.0 km/h) over a 200-mile (320 km) course. The offer led to the first city to city automobile race in the United States, starting on 16 July 1878 in Green Bay, Wisconsin, and ending in Madison, via Appleton, Oshkosh, Waupun, Watertown, Fort Atkinson, and Janesville. While seven vehicles were registered, only two started to compete: the entries from Green Bay and Oshkosh. The vehicle from Green Bay was faster, but broke down before completing the race. The Oshkosh finished the 201-mile (323 km) course in 33 hours and 27 minutes, and posted an average speed of six miles per hour. In 1879, the legislature awarded half the prize.[9][10][11]

text: 20th century[edit]

text: Steam-powered road vehicles, both cars and wagons, reached the peak of their development in the early 1930s with fast-steaming lightweight boilers and efficient engine designs. Internal combustion engines also developed greatly during WWI, becoming simpler to operate and more reliable. The development of the high-speed diesel engine from 1930 began to replace them for wagons, accelerated in the UK by tax changes making steam wagons uneconomic overnight. Although a few designers continued to advocate steam power, no significant developments in production steam cars took place after Doble in 1931.

text: Whether steam cars will ever be reborn in later technological eras remains to be seen. Magazines such as Light Steam Power continued to describe them into the 1980s. The 1950s saw interest in steam-turbine cars powered by small nuclear reactors[citation needed] (this was also true of aircraft), but the dangers inherent in nuclear fission technology soon killed these ideas.

text: Electric automobiles[edit]

text: In 1828, Ányos Jedlik, a Hungarian who invented an early type of electric motor, created a tiny model car powered by his new motor.[13] In 1834, Vermont blacksmith Thomas Davenport, the inventor of the first American DC electrical motor, installed his motor in a small model car, which he operated on a short circular electrified track.[14] In 1835, Professor Sibrandus Stratingh of Groningen, the Netherlands and his assistant Christopher Becker created a small-scale electrical car, powered by non-rechargeable primary cells.[15] In 1838, Scotsman Robert Davidson built an electric locomotive that attained a speed of 4 miles per hour (6 km/h). In England, a patent was granted in 1840 for the use of rail tracks as conductors of electric current, and similar American patents were issued to Lilley and Colten in 1847. Between 1832 and 1839 (the exact year is uncertain) Robert Anderson of Scotland invented the first crude electric carriage, powered by non-rechargeable primary cells.

text: The Flocken Elektrowagen of 1888 by German inventor Andreas Flocken is regarded as the first real electric car of the world.[12]

text: Electric cars enjoyed popularity between the late 19th century and early 20th century, when electricity was among the preferred methods for automobile propulsion, providing a level of comfort and ease of operation that could not be achieved by the gasoline cars of the time. Advances in internal combustion technology, especially the electric starter, soon rendered this advantage moot; the greater range of gasoline cars, quicker refueling times, and growing petroleum infrastructure, along with the mass production of gasoline vehicles by companies such as the Ford Motor Company, which reduced prices of gasoline cars to less than half that of equivalent electric cars, led to a decline in the use of electric propulsion, effectively removing it from important markets such as the United States by the 1930s. However, in recent years, increased concerns over the environmental impact of gasoline cars, higher gasoline prices, improvements in battery technology, and the prospect of peak oil, have brought about renewed interest in electric cars, which are perceived to be more environmentally friendly and cheaper to maintain and run, despite high initial costs, after a failed reappearance in the late-1990s.

text: Internal combustion engines[edit]

text: Early attempts at making and using internal combustion engines were hampered by the lack of suitable fuels, particularly liquids, therefore the earliest engines used gas mixtures.

text: Early experimenters used gases. In 1806, Swiss engineer François Isaac de Rivaz built an engine powered by internal combustion of a hydrogen and oxygen mixture. In 1826, Englishman Samuel Brown tested his hydrogen-fuelled internal combustion engine by using it to propel a vehicle up Shooter's Hill in south-east London. Belgian-born Etienne Lenoir's Hippomobile with a hydrogen-gas-fuelled one-cylinder internal combustion engine made a test drive from Paris to Joinville-le-Pont in 1860, covering some nine kilometres in about three hours.[16] A later version was propelled by coal gas. A Delamare-Deboutteville vehicle was patented and trialled in 1884.

text: About 1870, in Vienna, Austria (then the Austro-Hungarian Empire), inventor Siegfried Marcus put a liquid-fuelled internal combustion engine on a simple handcart which made him the first man to propel a vehicle by means of gasoline. Today, this car is known as "the first Marcus car". In 1883, Marcus secured a German patent for a low-voltage ignition system of the magneto type; this was his only automotive patent. This design was used for all further engines, and the four-seat "second Marcus car" of 1888/89. This ignition, in conjunction with the "rotating-brush carburetor", made the second car's design very innovative. His second car is on display at the Technical Museum in Vienna. During his lifetime he was honored as the originator of the motorcar but his place in history was all but erased by the Nazis during World War II. Because Marcus was of Jewish descent, the Nazi propaganda office ordered his work to be destroyed, his name expunged from future textbooks, and his public memorials removed, giving credit instead to Karl Benz.[17]

text: It is generally acknowledged[according to whom?] that the first really practical automobiles with petrol/gasoline-powered internal combustion engines were completed almost simultaneously by several German inventors working independently: Karl Benz built his first automobile in 1885 in Mannheim. Benz was granted a patent for his automobile on 29 January 1886,[18] and began the first production of automobiles in 1888, after Bertha Benz, his wife, had proved – with the first long-distance trip in August 1888, from Mannheim to Pforzheim and back – that the horseless coach was absolutely suitable for daily use. Since 2008 a Bertha Benz Memorial Route commemorates this event.[19]

text: Soon after, Gottlieb Daimler and Wilhelm Maybach in Stuttgart in 1889 designed a vehicle from scratch to be an automobile, rather than a horse-drawn carriage fitted with an engine. They also are usually credited with invention of the first motorcycle in 1886, but Italy's Enrico Bernardi of the University of Padua, in 1882, patented a 0.024 horsepower (17.9 W) 122 cc (7.4 cu in) one-cylinder petrol motor, fitting it into his son's tricycle, making it at least a candidate for the first automobile and first motorcycle;.[5]:p.26 Bernardi enlarged the tricycle in 1892 to carry two adults.[5]:p.26

text: One of the first four-wheeled petrol-driven automobiles in Britain was built in Birmingham in 1895 by Frederick William Lanchester, who also patented the disc brake and the first electric starter was installed on an Arnold, an adaptation of the Benz Velo, built in Kent between 1895 and 1898.[5]:p.25

text: George F. Foss of Sherbrooke, Quebec built a single-cylinder gasoline car in 1896 which he drove for 4 years, ignoring city officials' warnings of arrest for his "mad antics."[6]

text: In all the turmoil, many early pioneers are nearly forgotten. In 1891, John William Lambert built a three-wheeler in Ohio City, Ohio, which was destroyed in a fire the same year, while Henry Nadig constructed a four-wheeler in Allentown, Pennsylvania. It is likely they were not the only ones.[5]:p.25

text: Eras of invention[edit]

text: Veteran era[edit]

text: The first production of automobiles was by Karl Benz in 1888 in Germany and, under license from Benz, in France by Emile Roger. There were numerous others, including tricycle builders Rudolf Egg, Edward Butler, and Léon Bollée.[5]:p.20–23 Bollée, using a 650 cc (40 cu in) engine of his own design, enabled his driver, Jamin, to average 45 kilometres per hour (28.0 mph) in the 1897 Paris-Tourville rally.[5]:p.23 By 1900, mass production of automobiles had begun in France and the United States.

text: The first motor car in Central Europe was produced by the Austro-Hungarian company Nesselsdorfer Wagenbau (later renamed to Tatra in today's Czech Republic) in 1897, the Präsident automobil.[20]

text: The first company formed exclusively to build automobiles was Panhard et Levassor in France, which also introduced the first four-cylinder engine.[5]:p.22 Formed in 1889, Panhard was quickly followed by Peugeot two years later. By the start of the 20th century, the automobile industry was beginning to take off in Western Europe, especially in France, where 30,204 were produced in 1903, representing 48.8% of world automobile production that year.[21]

text: The American George B. Selden filed for a patent on 8 May 1879. His application included not only the engine but its use in a 4-wheeled car. Selden filed a series of amendments to his application which stretched out the legal process, resulting in a delay of 16 years before the patent [22] was granted on 5 November 1895. This patent did more to hinder than encourage development of autos in the United States. Selden licensed his patent to most major American automakers, collecting a fee on every car they produced.

text: In the United States, brothers Charles and Frank Duryea founded the Duryea Motor Wagon Company in 1893, becoming the first American automobile manufacturing company. The Autocar Company, founded in 1897, established a number of innovations still in use[23] and remains the oldest operating motor vehicle manufacturer in the United States However, it was Ransom E. Olds and his Olds Motor Vehicle Company (later known as Oldsmobile) who would dominate this era of automobile production. Its production line was running in 1901. The Thomas B. Jeffery Company developed the world's second mass-produced automobile, and 1,500 Ramblers were built and sold in its first year, representing one-sixth of all existing motorcars in the United States at the time.[24] Within a year, Cadillac (formed from the Henry Ford Company), Winton, and Ford were also producing cars in the thousands.

text: Within a few years, a dizzying assortment of technologies were being used by hundreds of producers all over the western world. Steam, electricity, and petrol/gasoline-powered automobiles competed for decades, with petrol/gasoline internal combustion engines achieving dominance in the 1910s. Dual- and even quad-engine cars were designed, and engine displacement ranged to more than a dozen litres. Many modern advances, including gas/electric hybrids, multi-valve engines, overhead camshafts, and four-wheel drive, were attempted, and discarded at this time.

text: In 1898, Louis Renault had a De Dion-Bouton modified, with fixed drive shaft and differential, making "perhaps the first hot rod in history" and bringing Renault and his brothers into the car industry.[25] Innovation was rapid and rampant, with no clear standards for basic vehicle architectures, body styles, construction materials, or controls, for example many veteran cars use a tiller, rather than a wheel for steering. During 1903, Rambler standardized on the steering wheel[26] and moved the driver's position to the left-hand side of the vehicle.[27] Chain drive was dominant over the drive shaft, and closed bodies were extremely rare. Drum brakes were introduced by Renault in 1902.[28] The next year, Dutch designer Jacobus Spijker built the first four-wheel drive racing car;[29] it never competed and it would be 1965 and the Jensen FF before four-wheel drive was used on a production car.[30]

text: Innovation was not limited to the vehicles themselves, either. Increasing numbers of cars propelled the growth of the petroleum industry,[31] as well as the development of technology to produce gasoline (replacing kerosene and coal oil) and of improvements in heat-tolerant mineral oil lubricants (replacing vegetable and animal oils).[32]

text: There were social effects, also. Music would be made about cars, such as "In My Merry Oldsmobile" (a tradition that continues) while, in 1896, William Jennings Bryan would be the first presidential candidate to campaign in a car (a donated Mueller), in Decatur, Illinois.[33] Three years later, Jacob German would start a tradition for New York City cabdrivers when he sped down Lexington Avenue, at the "reckless" speed of 12 mph (19 km/h).[34] Also in 1899, Akron, Ohio, adopted the first self-propelled paddy wagon.[34]

text: By 1900, the early centers of national automotive industry developed in many countries, including Belgium (home to Vincke, which copied Benz; Germain, a pseudo-Panhard; and Linon and Nagant, both based on the Gobron-Brillié),[5]:p,25 Switzerland (led by Fritz Henriod, Rudolf Egg, Saurer, Johann Weber, and Lorenz Popp),[5]:p.25 Vagnfabrik AB in Sweden, Hammel (by A. F. Hammel and H. U. Johansen at Copenhagen, in Denmark, which only built one car, ca. 1886[5]:p.25), Irgens (starting in Bergen, Norway, in 1883, but without success),[5]:p.25–26 Italy (where FIAT started in 1899), and as far afield as Australia (where Pioneer set up shop in 1898, with an already archaic paraffin-fuelled centre-pivot-steered wagon).[5] Meanwhile, the export trade had begun, with Koch exporting cars and trucks from Paris to Tunisia, Egypt, Iran, and the Dutch East Indies.[5]:p25 The Studebaker brothers, having become the world's leading manufacturers of horse-drawn vehicles, made a transition to electric automobiles in 1902, and gasoline engines in 1904, but also continued to build horse-drawn vehicles until 1919.[35]:p.90

text: In 1908, the first South American automobile was built in Peru, the Grieve.[36] Motor cars were also exported very early to British colonies and the first motor car was exported to India in 1897.

text: Throughout the veteran car era, however, the automobile was seen more as a novelty than as a genuinely useful device. Breakdowns were frequent, fuel was difficult to obtain, roads suitable for traveling were scarce, and rapid innovation meant that a year-old car was nearly worthless. Major breakthroughs in proving the usefulness of the automobile came with the historic long-distance drive of Bertha Benz in 1888, when she traveled more than 80 kilometres (50 mi) from Mannheim to Pforzheim, to make people aware of the potential of the vehicles her husband, Karl Benz, manufactured, and after Horatio Nelson Jackson's successful transcontinental drive across the United States in 1903.

text: The 1908 New York to Paris Race was the first circumnavigation of the world by automobile. German, French, Italian and American teams began in New York City 12 February 1908 with three of the competitors ultimately reaching Paris. The US built Thomas Flyer with George Schuster (driver) won the race covering 22,000 miles in 169 days. While other automakers provided motorists with tire repair kits, Rambler was first in 1909 to equip its cars with a spare tire that was mounted on a fifth wheel.[37]

text: Brass or Edwardian era[edit]

text: This period lasted from roughly 1905 through to 1914 and the beginning of World War I. It is generally referred to as the Edwardian era, but in the United States is often known as the Brass era from the widespread use of brass in vehicles during this time.

text: Within the 15 years that make up this era, the various experimental designs and alternate power systems would be marginalised. Although the modern touring car had been invented earlier, it was not until Panhard et Levassor's Système Panhard was widely licensed and adopted that recognisable and standardised automobiles were created. This system specified front-engined, rear-wheel drive internal combustion engined cars with a sliding gear transmission. Traditional coach-style vehicles were rapidly abandoned, and buckboard runabouts lost favour with the introduction of tonneaus and other less-expensive touring bodies.

text: By 1906, steam car development had advanced, and they were among the fastest road vehicles in that period.[citation needed]

text: Throughout this era, development of automotive technology was rapid, due in part to hundreds of small manufacturers competing to gain the world's attention. Key developments included the electric ignition system (by dynamotor on the Arnold in 1898,[38] though Robert Bosch, 1903, tends to get the credit), independent suspension (actually conceived by Bollée in 1873),[38] and four-wheel brakes (by the Arrol-Johnston Company of Scotland in 1909).[5]:p27 Leaf springs were widely used for suspension, though many other systems were still in use, with angle steel taking over from armored wood as the frame material of choice. Transmissions and throttle controls were widely adopted, allowing a variety of cruising speeds, though vehicles generally still had discrete speed settings, rather than the infinitely variable system familiar in cars of later eras. Safety glass also made its debut, patented by John Wood in England in 1905.[28] (It would not become standard equipment until 1926, on a Rickenbacker.)[28]

text: Between 1907 and 1912 in the United States, the high-wheel motor buggy (resembling the horse buggy of before 1900) was in its heyday, with over seventy-five makers including Holsman (Chicago), IHC (Chicago), and Sears (which sold via catalog); the high-wheeler would be killed by the Model T.[5]:p.65 In 1912, Hupp (in the United States, supplied by Hale & Irwin) and BSA (in the UK) pioneered the use of all-steel bodies,[39] joined in 1914 by Dodge (who produced Model T bodies).[28] While it would be another two decades before all-steel bodies would be standard, the change would mean improved supplies of superior-quality wood for furniture makers.[5]

text: Some examples of cars of the period included:[citation needed]

text:
1907 In Japan, the Hatsudoki Seizo Co. Ltd. is formed, which was later renamed in 1951 as Daihatsu Kōgyō Kabushiki-gaisha. Also in April 1907, the aforementioned Komanosuke Uchiyama produced the Takuri, the first entirely Japanese-made gasoline engine car.[40]
1908–1927 Ford Model T — the most widely produced and available 4-seater car of the era. It used a planetary transmission, and had a pedal-based control system. Ford T was proclaimed as the most influential car of the 20th century in the international Car of the Century awards.
1909 Morgan Runabout – a very popular cyclecar, cyclecars were sold in far greater quantities than 4-seater cars in this period[41]
1910 Mercer Raceabout — regarded as one of the first sports cars, the Raceabout expressed the exuberance of the driving public, as did the similarly conceived American Underslung and Hispano-Suiza Alphonso.
1910–1920 Bugatti Type 13 — a notable racing and touring model with advanced engineering and design. Similar models were the Types 15, 17, 22, and 23.
1914–1917, the Kaishinsha Motor Works operated by Masujiro Hashimoto in Tokyo, while importing, assembling and selling British cars, also manufactured seven units of a two-cylinder, 10-horsepower “all-Japanese” car called Dattogo. Kaishinsha was the first automobile manufacturing business in Japan.[40]
1917 Japanese company Mitsubishi builds the Mitsubishi Model A, all hand built in limited numbers for Japanese executives.

tag: ul

text: Vintage era[edit]

text: The vintage era lasted from the end of World War I (1918), through to the Wall Street Crash at the end of 1929. During this period the front-engined car came to dominate with closed bodies and standardised controls becoming the norm. In 1919, 90% of cars sold were open; by 1929, 90% were closed.[5]:p.7 Development of the internal combustion engine continued at a rapid pace, with multi-valve and overhead camshaft engines produced at the high end, and V8, V12, and even V16 engines conceived for the ultra-rich. Also in 1919, hydraulic brakes were invented by Malcolm Loughead (co-founder of Lockheed); they were adopted by Duesenberg for their 1921 Model A.[28] Three years later, Hermann Rieseler of Vulcan Motor invented the first automatic transmission, which had two-speed planetary gearbox, torque converter, and lockup clutch; it never entered production.[28] (Its like would only become an available option in 1940.)[28] Just at the end of the vintage era, tempered glass (now standard equipment in side windows) was invented in France.[28] In this era the revolutionary ponton design of cars without fully articulated fenders, running boards and other non-compact ledge elements was introduced in small series but mass production of such cars was started much later (after WWII).

text: American auto companies in the 1920s expected they would soon sell six million cars a year, but did not do so until 1955. Numerous companies disappeared.[42] Between 1922 and 1925, the number of U.S. passenger car builders decreased from 175 to 70. H. A. Tarantous, managing editor of MoToR Member Society of Automotive Engineers, in a New York Times article from 1925, suggested many were unable to raise production and cope with falling prices (due to assembly line production), especially for low-priced cars. The new pyroxylin-based paints, eight cylinder engine, four wheel brakes, and balloon tires as the biggest trends for 1925.[43]

text: Examples of period vehicles:[citation needed]

text:
1922–1939 Austin 7 — one of the most widely copied vehicles ever, serving as a template for cars around the world, from BMW to Nissan.
1922–1931 Lancia Lambda — very advanced car for the time, first car to feature a load-bearing monocoque and independent front suspension.[citation needed]
1924–1929 Bugatti Type 35 — one of the most successful racing cars of all time, with over 1,000 victories in five years.[citation needed]
1925–1928 Hanomag 2 / 10 PS — early example of ponton styling.
1927–1931 Ford Model A (1927-1931) — after keeping the brass era Model T in production for too long, Ford broke from the past by restarting its model series with the 1927 Model A. More than 4 million were produced, making it the best-selling model of the era. The Ford Model A was a prototype for the beginning of Soviet mass car production (GAZ A).
1930 Cadillac V-16 — developed at the height of the vintage era, the V16-powered Cadillac would join Bugatti's Royale as the most legendary ultra-luxury cars of the era.

text: Pre-war era[edit]

text: The pre-war part of the classic era began with the Great Depression in 1930, and ended with the recovery after World War II, commonly placed at 1946. It was in this period that integrated fenders and fully closed bodies began to dominate sales, with the new saloon/sedan body style even incorporating a trunk or boot at the rear for storage. The old open-top runabouts, phaetons, and touring cars were largely phased out by the end of the classic era as wings, running boards, and headlights were gradually integrated with the body of the car.

text: By the 1930s, most of the mechanical technology used in today's automobiles had been invented, although some things were later "re-invented", and credited to someone else. For example, front-wheel drive was re-introduced by André Citroën with the launch of the Traction Avant in 1934, though it had appeared several years earlier in road cars made by Alvis and Cord, and in racing cars by Miller (and may have appeared as early as 1897). In the same vein, independent suspension was originally conceived by Amédée Bollée in 1873, but not put in production until appearing on the low-volume Mercedes-Benz 380 in 1933, which prodded American makers to use it more widely.[38] In 1930, the number of auto manufacturers declined sharply as the industry consolidated and matured, thanks in part to the effects of the Great Depression.

text: Exemplary pre-war automobiles:[citation needed]

text:
1932–1939 Alvis Speed 20 — the first with all-synchromesh gearbox[citation needed]
1932–1948 Ford V-8 (Model B) — introduction of the flathead V8 in mainstream vehicles
1934–1938 Tatra 77 — first serial-produced car with aerodynamical design
1934–1940 Bugatti Type 57 — a singular refined automobile for the wealthy
1934–1956 Citroën Traction Avant — the first mass-produced front-wheel drive car, built with monocoque chassis
1936–1955 MG T series — sports cars
1938–2003 Volkswagen Beetle — a design that was produced for over 60 years with over 20 million units assembled in several counties
1936–1939 Rolls-Royce Phantom III — V12 engine

text: Post-war era[edit]

text: A major change in automobile design since World War II was the popularity of ponton style, in which running boards were eliminated and fenders were incorporated into the body. Among the first representatives of the style were the Soviet GAZ-M20 Pobeda (1946), British Standard Vanguard (1947), United States Studebaker Champion and Kaiser (1946), as well as the low-production Czech luxury Tatra T600 Tatraplan (1946) and the Italian Cisitalia 220 sports car (1947).

text: Automobile design and production finally emerged from the military orientation and other shadow of war in 1949, the year that in the United States saw the introduction of high-compression V8 engines and modern bodies from General Motors' Oldsmobile and Cadillac brands. Hudson introduced the "step-down" design with the 1948 Commodore, which placed the passenger compartment down inside the perimeter of the frame, that was one of the first new-design postwar cars made and featured trend-setting slab-side styling.[44] The unibody/strut-suspended 1951 Ford Consul joined the 1948 Morris Minor and 1949 Rover P4 in the automobile market in the United Kingdom. In Italy, Enzo Ferrari was beginning his 250 series, just as Lancia introduced the revolutionary V6-powered Aurelia.

text: Throughout the 1950s, engine power and vehicle speeds rose, designs became more integrated and artful, and automobiles were marketed internationally. Alec Issigonis' Mini and Fiat's 500 diminutive cars were introduced in Europe, while the similar kei car class became popular in Japan. The Volkswagen Beetle continued production after Hitler and began exports to other nations, including the United States. At the same time, Nash introduced the Nash Rambler, the first successful modern compact car made in the United States,[45] while the standard models produced by the "Big Three" domestic automakers grew ever larger in size, featuring increasing amounts of chrome trim, and luxury was exemplified by the Cadillac Eldorado Brougham. The markets in Europe expanded with new small-sized automobiles, as well as expensive grand tourers (GT), like the Ferrari America.

text: The market changed in the 1960s, as the United States "Big Three" automakers began facing competition from imported cars, the European makers adopted advanced technologies and Japan emerged as a car-producing nation. Japanese companies began to export some of their more popular selling cars in Japan internationally, such as the Toyota Corolla, Toyota Corona, Nissan Sunny, and Nissan Bluebird in the mid-1960s. The success of American Motors' compact-sized Rambler models spurred GM and Ford to introduce their own downsized cars in 1960. Performance engines became a focus of marketing by United States automakers, exemplified by the era's muscle cars. In 1964, the Ford Mustang developed a new market segment, the pony car. New models to compete with the Mustang included the Chevrolet Camaro, AMC Javelin, and Plymouth Barracuda. Captive imports and badge engineering increased in the United States and the UK as amalgamated groups such as the British Motor Corporation consolidated the market. BMC's space-saving Mini, which first appeared in 1959, was marketed under the Austin and Morris names, until Mini became a marque in its own right in 1969.[46] Competition increased, with Studebaker, a pioneering automaker, shutting down, and the trend for consolidation reached Italy where niche makers like Maserati, Ferrari, and Lancia were acquired by larger companies. By the end of the decade, the number of automobile marques had been greatly reduced.

text: Technology developments included the widespread use of independent suspensions, wider application of fuel injection, and an increasing focus on safety in automotive design. Innovations during the 1960s included NSU's Wankel engine, the gas turbine, and the turbocharger. Of these, only the last endured, pioneered by General Motors, and adopted by BMW and Saab, later seeing mass-market use during the 1980s by Chrysler. Mazda continued developing its Wankel engine, in spite of problems in longevity, emissions, and fuel economy. Other Wankel licensees, including Mercedes-Benz and GM, never put their designs into production because of engineering and manufacturing problems, as well as the lessons from the 1973 oil crisis.

text: The 1970s were turbulent years for automakers and buyers with major events reshaping the industry such as the 1973 oil crisis, stricter automobile emissions control and safety requirements, increasing exports by the Japanese and European automakers, as well as growth in inflation and the stagnant economic conditions in many nations. Smaller-sized grew in popularity. The United States saw the establishment of the subcompact segment with the introduction of the AMC Gremlin, followed by the Chevrolet Vega and Ford Pinto. The station wagons (estate, break, kombi, universal) body design was popular, as well as increasing sales of non-commercial all-wheel drive off-road vehicles.

text: To the end of the 20th century, the United States Big Three (GM, Ford, and Chrysler) partially lost their leading position, Japan became for a while the world's leader of car production and cars began to be mass manufactured in new Asian, East European, and other countries.

text: Notable exemplary post-war cars:[citation needed]

text:
1946–1958 GAZ-M20 Pobeda — Soviet car with full ponton design
1947–1958 Standard Vanguard — British mass-market car with full ponton design
1948–1971 Morris Minor – an early post-war car exported around the world
1953–1971 Chevrolet Bel Air and 1953–2002 Cadillac Eldorado Brougham – first generations were representative of tailfin design
1955–1976 Citroën DS — aerodynamic design and innovative technology, awarded third place as Car of the 20th Century
1959–2000 Mini — a radical and innovative small car that was manufactured for four decades; awarded second place as Car of the 20th Century
1960-1990 Volkswagen Brasília
1961–1975 Jaguar E-type — a classic sports car design
1963–1989 Porsche 911 – a sports car was awarded fifth place as Car of the 20th Century
1964–present Ford Mustang — the pony car that became one of the best-selling cars of the era
1966–end of the 20th century Fiat 124 — an Italian car that was produced under license in many other counties including the Soviet Union
1966–1971 Subaru 1000 – one of the first Japanese built sedans using a boxer engine, front wheel drive and introducing the "double offset joint" drive shaft to the front wheels
1967 NSU Ro 80 — the basic wedge profile of this design was emulated in subsequent decades,[47] unlike its Wankel engine
late 1960s-early 1980s Gurgel BR-800
late 1960s-early 1980s Gurgel Supermini
1969 Datsun 240Z — Japanese sports car[48]
1980–1988 AMC Eagle — the first mass-produced full-time all-wheel drive car[49]

text: Modern era[edit]

text: This section needs additional citations for verification. Please help improve this article by adding citations to reliable sources. Unsourced material may be challenged and removed. (June 2014) (Learn how and when to remove this template message)

tag: table

text: The modern era is normally defined as the 25 years preceding the current year.[citation needed] The modern era has been one of increasing standardisation, platform sharing, computer-aided design, to reduce costs and development time and increasing use of electronic for both engine management and entertainment systems.

text: Some particular contemporary developments are the proliferation of front- and all-wheel drive, the adoption of the diesel engine, and the ubiquity of fuel injection. Most modern passenger cars are front-wheel-drive monocoque/unibody designs, with transversely mounted engines.

text: Body styles have changed as well in the modern era. Three types, the hatchback, sedan, and sport utility vehicle, dominate today's market.[citation needed] All originally emphasised practicality, but have mutated into today's high-powered luxury crossover SUV, sports wagon and two-volume Large MPV. The rise of pickup trucks in the United States and SUVs worldwide has changed the face of motoring with these "trucks" coming to command more than half of the world automobile market.[citation needed] There was also the introduction of the MPV class (smaller non-commercial passenger minivans), among the first of which were the French Renault Espace and the Chrysler minivan versions in the United States

text: The modern era has also seen rapidly improving fuel efficiency and engine output. The automobile emissions concerns have been eased with computerised engine management systems.

text: The economic crisis of 2008 cut almost a third of light vehicle sales from Chrysler, Toyota, Ford, and Nissan. It also subtracted about a fourth of Honda's sales and about a seventh of sales from General Motors.[50]

text: Since 2009, China has become the world's largest car manufacturer with production greater than Japan, the United States, and all of Europe. Besides large growth of car production in Asian and other countries, there has been growth in transnational corporate groups, with the production of transnational automobiles sharing the same platforms as well as badge engineering or re-badging to suit different markets and consumer segments.

text: Since the end of the 20th century, several award competitions for cars and trucks have become widely known, such as European Car of the Year, Car of the Year Japan, North American Car of the Year, World Car of the Year, Truck of the Year, and International Car of the Year. Also, a Car of the Century award was held in which in the US the Ford Model T was named as most influential car of the 20th century.[citation needed]

text: Exemplary modern cars:[citation needed]

text:
1966–present Toyota Corolla – a Japanese saloon/sedan that has become the best-selling nameplate of all time, with over 40 million sold across 11 generations through July 2013.[51]
1966–1992 Oldsmobile Toronado – Introduced electronic anti-lock braking system,[52] and airbag [53] First modern-era American car with front wheel drive.
1973–present Mercedes-Benz S-Class – Seat belt pretensioner, and electronic traction control system
1975–present BMW 3 Series – the 3 Series has been on Car and Driver magazine's annual Ten Best list 17 times
1977–present Honda Accord saloon/sedan — a Japanese sedan that became popular in the United States
1983–present Chrysler minivans – the two-box minivan design nearly pushed the station wagon out of the market
1984–present Renault Espace — first mass one-volume car of non-commercial MPV class
1986–present Ford Taurus — this mid-sized front-wheel drive sedan dominated the United States market in the late-1980s
1997–present Toyota Prius, launched in the Japanese market and became the best known hybrid electric vehicle and also the world's top selling hybrid.[54]
1998–present Ford Focus — one of the most popular hatchbacks and Ford's best selling world car
2008–present Tata Nano — an inexpensive (₹100,000, ≈ $2200), rear-engined, four-passenger city car aimed primarily at the Indian domestic market
2008–2012 Tesla Roadster — first highway-capable all-electric vehicle in serial production for sale in the United States in the modern era. Sold about 2,500 units worldwide.
2008–2013 BYD F3DM – first highway-capable series production plug-in hybrid, launched in China in December 2008, sold over 2,300 units.[55][56]
2009–present, Mitsubishi i-MiEV – first highway-capable series production all-electric car, launched in Japan in July 2009 for fleet customers, and in April 2010 for retail customers. Rebadged versions of the i MiEV are sold in Europe by PSA Peugeot Citroën (PSA) as the Peugeot iOn and Citroën C-Zero.[57][58]
2010–present, Nissan Leaf and Chevrolet Volt — all-electric car and plug-in hybrid correspondingly, launched in December 2010, are the world's top selling mass production vehicles of their kind.[59] As of early December 2015, global Leaf sales totaled 200,000 units and Volt sales over 100,000.[60]
2012–present, Tesla Model S – Introduced in 2012, the Model S quickly climbed up sales. It was ranked as the world's best selling plug-in electric vehicle in 2015.[61] It was also named car of the century by Car and Driver.[62]


document_title: All Is Fair in Love and War

question_text: who wrote everything is fair in love and war

text: All Is Fair in Love and War

text: All Is Fair in Love and War may refer to:

text:
All Is Fair in Love and War (album), an album by Blessed by a Broken Heart
"All Is Fair in Love and War" (song), a song by Ronnie Milsap
"All is fair in love and war", a proverb attributed to John Lyly's Euphues

text:
This disambiguation page lists articles associated with the title All Is Fair in Love and War.
If an internal link led you here, you may wish to change the link to point directly to the intended article.

text: Disambiguation pages

text: All article disambiguation pagesAll disambiguation pages


question_text: he diagnostic and statistical manual for diagnosing psychiatric disorders was first published in

text: Uses and definition[edit]

text: Many mental health professionals use the manual to determine and help communicate a patient's diagnosis after an evaluation; hospitals, clinics, and insurance companies in the US also generally require a DSM diagnosis for all patients treated. The DSM can be used clinically in this way, and also to categorize patients using diagnostic criteria for research purposes. Studies done on specific disorders often recruit patients whose symptoms match the criteria listed in the DSM for that disorder. An international survey of psychiatrists in 66 countries compared the use of the ICD-10 and DSM-IV; it found the former was more often used for clinical diagnosis while the latter was more valued for research.[11]

text: DSM-5, and the abbreviations for all previous editions, are registered trademarks owned by the APA.[6][12]

text: History[edit]

text: This section needs additional citations for verification. Please help improve this article by adding citations to reliable sources. Unsourced material may be challenged and removed. (December 2017) (Learn how and when to remove this template message)

text: The initial impetus for developing a classification of mental disorders in the United States was the need to collect statistical information. The first official attempt was the 1840 census, which used a single category: "idiocy/insanity". Three years later, the American Statistical Association made an official protest to the U.S. House of Representatives, stating that "the most glaring and remarkable errors are found in the statements respecting nosology, prevalence of insanity, blindness, deafness, and dumbness, among the people of this nation", pointing out that in many towns African-Americans were all marked as insane, and calling the statistics essentially useless.

text: The Association of Medical Superintendents of American Institutions for the Insane was formed in 1844, changing its name in 1892 to the American Medico-Psychological Association, and in 1921 to the present American Psychiatric Association (APA).

text: Edward Jarvis and later Francis Amasa Walker helped expand the census, from 2 volumes in 1870 to 25 volumes in 1880. Frederick H. Wines was appointed to write a 582-page volume called Report on the Defective, Dependent, and Delinquent Classes of the Population of the United States, As Returned at the Tenth Census (June 1, 1880) (published 1888). Wines used seven categories of mental illness: dementia, dipsomania (uncontrollable craving for alcohol), epilepsy, mania, melancholia, monomania and paresis. These categories were also adopted by the Association.[13]

text: In 1917, together with the National Commission on Mental Hygiene (now Mental Health America), the APA developed a new guide for mental hospitals called the Statistical Manual for the Use of Institutions for the Insane. This included 22 diagnoses and would be revised several times by the APA over the years.[14] Along with the New York Academy of Medicine, the APA also provided the psychiatric nomenclature subsection of the US general medical guide, the Standard Classified Nomenclature of Disease, referred to as the Standard.[15]

text: DSM-I (1952)[edit]

text: World War II saw the large-scale involvement of US psychiatrists in the selection, processing, assessment, and treatment of soldiers. This moved the focus away from mental institutions and traditional clinical perspectives. A committee headed by psychiatrist Brigadier General William C. Menninger developed a new classification scheme called Medical 203, that was issued in 1943 as a War Department Technical Bulletin under the auspices of the Office of the Surgeon General.[16] The foreword to the DSM-I states the US Navy had itself made some minor revisions but "the Army established a much more sweeping revision, abandoning the basic outline of the Standard and attempting to express present day concepts of mental disturbance. This nomenclature eventually was adopted by all Armed Forces", and "assorted modifications of the Armed Forces nomenclature [were] introduced into many clinics and hospitals by psychiatrists returning from military duty." The Veterans Administration also adopted a slightly modified version of Medical 203.[citation needed]

text: In 1949, the World Health Organization published the sixth revision of the International Statistical Classification of Diseases (ICD), which included a section on mental disorders for the first time. The foreword to DSM-1 states this "categorized mental disorders in rubrics similar to those of the Armed Forces nomenclature." An APA Committee on Nomenclature and Statistics was empowered to develop a version specifically for use in the United States, to standardize the diverse and confused usage of different documents. In 1950, the APA committee undertook a review and consultation. It circulated an adaptation of Medical 203, the VA system, and the Standard's Nomenclature to approximately 10% of APA members. 46% replied, of which 93% approved, and after some further revisions (resulting in its being called DSM-I), the Diagnostic and Statistical Manual of Mental Disorders was approved in 1951 and published in 1952. The structure and conceptual framework were the same as in Medical 203, and many passages of text were identical.[16] The manual was 130 pages long and listed 106 mental disorders.[17] These included several categories of "personality disturbance", generally distinguished from "neurosis" (nervousness, egodystonic).[18]

text: In 1952, the APA listed homosexuality in the DSM as a sociopathic personality disturbance. Homosexuality: A Psychoanalytic Study of Male Homosexuals, a large-scale 1962 study of homosexuality by Irving Bieber and other authors, was used to justify inclusion of the disorder as a supposed pathological hidden fear of the opposite sex caused by traumatic parent–child relationships. This view was widely influential in the medical profession.[19][full citation needed] In 1956, however, the psychologist Evelyn Hooker performed a study that compared the happiness and well-adjusted nature of self-identified homosexual men with heterosexual men and found no difference.[20][full citation needed] Her study stunned the medical community and made her a heroine to many gay men and lesbians,[21][full citation needed] but homosexuality remained in the DSM until May 1974.[22]

text: DSM-II (1968)[edit]

text: In the 1960s, there were many challenges to the concept of mental illness itself. These challenges came from psychiatrists like Thomas Szasz, who argued that mental illness was a myth used to disguise moral conflicts; from sociologists such as Erving Goffman, who said mental illness was merely another example of how society labels and controls non-conformists; from behavioural psychologists who challenged psychiatry's fundamental reliance on unobservable phenomena; and from gay rights activists who criticised the APA's listing of homosexuality as a mental disorder. A study published in Science by Rosenhan received much publicity and was viewed as an attack on the efficacy of psychiatric diagnosis.[23]

text: Although the APA was closely involved in the next significant revision of the mental disorder section of the ICD (version 8 in 1968), it decided to go ahead with a revision of the DSM. It was published in 1968, listed 182 disorders, and was 134 pages long. It was quite similar to the DSM-I. The term "reaction" was dropped, but the term "neurosis" was retained. Both the DSM-I and the DSM-II reflected the predominant psychodynamic psychiatry,[24] although they also included biological perspectives and concepts from Kraepelin's system of classification. Symptoms were not specified in detail for specific disorders. Many were seen as reflections of broad underlying conflicts or maladaptive reactions to life problems, rooted in a distinction between neurosis and psychosis (roughly, anxiety/depression broadly in touch with reality, or hallucinations/delusions appearing disconnected from reality). Sociological and biological knowledge was incorporated, in a model that did not emphasize a clear boundary between normality and abnormality.[25] The idea that personality disorders did not involve emotional distress was discarded.[18]

text: An influential 1974 paper by Robert Spitzer and Joseph L. Fleiss demonstrated that the second edition of the DSM (DSM-II) was an unreliable diagnostic tool.[26] They found that different practitioners using the DSM-II were rarely in agreement when diagnosing patients with similar problems. In reviewing previous studies of 18 major diagnostic categories, Fleiss and Spitzer concluded that "there are no diagnostic categories for which reliability is uniformly high. Reliability appears to be only satisfactory for three categories: mental deficiency, organic brain syndrome (but not its subtypes), and alcoholism. The level of reliability is no better than fair for psychosis and schizophrenia and is poor for the remaining categories".[27]

text: Sixth printing of the DSM-II, 1974[edit]

text: As described by Ronald Bayer, a psychiatrist and gay rights activist, specific protests by gay rights activists against the APA began in 1970, when the organization held its convention in San Francisco. The activists disrupted the conference by interrupting speakers and shouting down and ridiculing psychiatrists who viewed homosexuality as a mental disorder. In 1971, gay rights activist Frank Kameny worked with the Gay Liberation Front collective to demonstrate against the APA's convention. At the 1971 conference, Kameny grabbed the microphone and yelled: "Psychiatry is the enemy incarnate. Psychiatry has waged a relentless war of extermination against us. You may take this as a declaration of war against you."[28]

text: This activism occurred in the context of a broader anti-psychiatry movement that had come to the fore in the 1960s and was challenging the legitimacy of psychiatric diagnosis. Anti-psychiatry activists protested at the same APA conventions, with some shared slogans and intellectual foundations.[29][30]

text: Presented with data from researchers such as Alfred Kinsey and Evelyn Hooker, the sixth printing of the DSM-II, in 1974, no longer listed homosexuality as a category of disorder. After a vote by the APA trustees in 1973, and confirmed by the wider APA membership in 1974, the diagnosis was replaced with the category of "sexual orientation disturbance".[31]

text: DSM-III (1980)[edit]

text: In 1974, the decision to create a new revision of the DSM was made, and Robert Spitzer was selected as chairman of the task force. The initial impetus was to make the DSM nomenclature consistent with the International Statistical Classification of Diseases and Related Health Problems (ICD), published by the World Health Organization. The revision took on a far wider mandate under the influence and control of Spitzer and his chosen committee members.[32] One goal was to improve the uniformity and validity of psychiatric diagnosis in the wake of a number of critiques, including the famous Rosenhan experiment. There was also a need to standardize diagnostic practices within the US and with other countries after research showed that psychiatric diagnoses differed markedly between Europe and the US.[33] The establishment of these criteria was an attempt to facilitate the pharmaceutical regulatory process.

text: The criteria adopted for many of the mental disorders were taken from the Research Diagnostic Criteria (RDC) and Feighner Criteria, which had just been developed by a group of research-orientated psychiatrists based primarily at Washington University in St. Louis and the New York State Psychiatric Institute. Other criteria, and potential new categories of disorder, were established by consensus during meetings of the committee, as chaired by Spitzer. A key aim was to base categorization on colloquial English descriptive language (which would be easier to use by federal administrative offices), rather than assumptions of cause, although its categorical approach assumed each particular pattern of symptoms in a category reflected a particular underlying pathology (an approach described as "neo-Kraepelinian"). The psychodynamic or physiologic view was abandoned, in favor of a regulatory or legislative model. A new "multiaxial" system attempted to yield a picture more amenable to a statistical population census, rather than just a simple diagnosis. Spitzer argued that "mental disorders are a subset of medical disorders" but the task force decided on the DSM statement: "Each of the mental disorders is conceptualized as a clinically significant behavioral or psychological syndrome."[24] The personality disorders were placed on axis II along with mental retardation.[18]

text: The first draft of the DSM-III was prepared within a year. Many new categories of disorder were introduced, while some were deleted or changed. A number of the unpublished documents discussing and justifying the changes have recently come to light.[34] Field trials sponsored by the U.S. National Institute of Mental Health (NIMH) were conducted between 1977 and 1979 to test the reliability of the new diagnoses. A controversy emerged regarding deletion of the concept of neurosis, a mainstream of psychoanalytic theory and therapy but seen as vague and unscientific by the DSM task force. Faced with enormous political opposition, the DSM-III was in serious danger of not being approved by the APA Board of Trustees unless "neurosis" was included in some capacity; a political compromise reinserted the term in parentheses after the word "disorder" in some cases. Additionally, the diagnosis of ego-dystonic homosexuality replaced the DSM-II category of "sexual orientation disturbance".

text: Finally published in 1980, the DSM-III was 494 pages and listed 265 diagnostic categories. It rapidly came into widespread international use and has been termed a revolution or transformation in psychiatry.[24][25] However, Robert Spitzer later criticized his own work on it in an interview with Adam Curtis, saying it led to the medicalization of 20-30 percent of the population who may not have had any serious mental problems.

text: When DSM-III was published, the developers made extensive claims about the reliability of the radically new diagnostic system they had devised, which relied on data from special field trials. However, according to a 1994 article by Stuart A. Kirk:

text: Twenty years after the reliability problem became the central focus of DSM-III, there is still not a single multi-site study showing that DSM (any version) is routinely used with high reliably by regular mental health clinicians. Nor is there any credible evidence that any version of the manual has greatly increased its reliability beyond the previous version. There are important methodological problems that limit the generalisability of most reliability studies. Each reliability study is constrained by the training and supervision of the interviewers, their motivation and commitment to diagnostic accuracy, their prior skill, the homogeneity of the clinical setting in regard to patient mix and base rates, and the methodological rigor achieved by the investigator…[23]

text: DSM-III-R (1987)[edit]

text: In 1987, the DSM-III-R was published as a revision of the DSM-III, under the direction of Spitzer. Categories were renamed and reorganized, and significant changes in criteria were made. Six categories were deleted while others were added. Controversial diagnoses, such as pre-menstrual dysphoric disorder and masochistic personality disorder, were considered and discarded. "Ego-dystonic homosexuality" was also removed and was largely subsumed under "sexual disorder not otherwise specified", which can include "persistent and marked distress about one's sexual orientation."[24][35] Altogether, the DSM-III-R contained 292 diagnoses and was 567 pages long. Further efforts were made for the diagnoses to be purely descriptive, although the introductory text stated that for at least some disorders, "particularly the Personality Disorders, the criteria require much more inference on the part of the observer" (p. xxiii).[18]

text: DSM-IV (1994)[edit]

text: In 1994, DSM-IV was published, listing 297 disorders in 886 pages. The task force was chaired by Allen Frances. A steering committee of 27 people was introduced, including four psychologists. The steering committee created 13 work groups of five to 16 members. Each work group had about 20 advisers. The work groups conducted a three-step process: first, each group conducted an extensive literature review of their diagnoses; then, they requested data from researchers, conducting analyses to determine which criteria required change, with instructions to be conservative; finally, they conducted multicenter field trials relating diagnoses to clinical practice.[36][37] A major change from previous versions was the inclusion of a clinical significance criterion to almost half of all the categories, which required that symptoms cause "clinically significant distress or impairment in social, occupational, or other important areas of functioning". Some personality disorder diagnoses were deleted or moved to the appendix.[18]

text: DSM-IV-TR (2000)[edit]

text: A "text revision" of the DSM-IV, known as the DSM-IV-TR, was published in 2000. The diagnostic categories and the vast majority of the specific criteria for diagnosis were unchanged.[38] The text sections giving extra information on each diagnosis were updated, as were some of the diagnostic codes to maintain consistency with the ICD. The DSM-IV-TR was organized into a five-part axial system. The first axis incorporated clinical disorders. The second axis covered personality disorders and intellectual disabilities. The remaining axes covered medical, psychosocial, environmental, and childhood factors functionally necessary to provide diagnostic criteria for health care assessments.

text: The DSM-IV-TR characterizes a mental disorder as "a clinically significant behavioral or psychological syndrome or pattern that occurs in an individual [which] is associated with present distress… or disability… or with a significant increased risk of suffering." It also notes that "no definition adequately specifies precise boundaries for the concept of 'mental disorder'… different situations call for different definitions". It states that "there is no assumption that each category of mental disorder is a completely discrete entity with absolute boundaries dividing it from other mental disorders or from no mental disorder" (APA, 1994 and 2000).

text: DSM-IV-TR Categorization[edit]

text: The DSM-IV is a categorical classification system. The categories are prototypes, and a patient with a close approximation to the prototype is said to have that disorder. DSM-IV states, "there is no assumption each category of mental disorder is a completely discrete entity with absolute boundaries" but isolated, low-grade and non-criterion (unlisted for a given disorder) symptoms are not given importance.[39] Qualifiers are sometimes used, for example mild, moderate or severe forms of a disorder. For nearly half the disorders, symptoms must be sufficient to cause "clinically significant distress or impairment in social, occupational, or other important areas of functioning", although DSM-IV-TR removed the distress criterion from tic disorders and several of the paraphilias due to their egosyntonic nature. Each category of disorder has a numeric code taken from the ICD coding system, used for health service (including insurance) administrative purposes.

text: DSM-IV-TR Multi-axial system[edit]

text: With the advent of the DSM-5 in 2013, the APA eliminated the longstanding multiaxial system for mental disorders.[40]

text: Previously, the DSM-IV organized each psychiatric diagnosis into five dimensions (axes) relating to different aspects of disorder or disability:

text:
Axis I: All psychological diagnostic categories except mental retardation and personality disorder
Axis II: Personality disorders and mental retardation
Axis III: General medical condition; acute medical conditions and physical disorders
Axis IV: Psychosocial and environmental factors contributing to the disorder
Axis V: Global Assessment of Functioning or Child Global Assessment of Functioning [cGAF]

text: Mental/Psychiatric/Behavioral/Learning conditions include, but are not limited to: depression, anxiety disorders, bipolar disorder, ADHD, autism spectrum disorders, anorexia nervosa, bulimia nervosa, and schizophrenia.

text: Personality Disorders include, but are not limited to: paranoid personality disorder, schizoid personality disorder, schizotypal personality disorder, borderline personality disorder, antisocial personality disorder, narcissistic personality disorder, histrionic personality disorder, avoidant personality disorder, dependent personality disorder, obsessive-compulsive personality disorder; and organic intellectual disabilities.

text: Common medical/physical conditions or diseases that may result in and/or exacerbate some of the aforementioned mental/psychiatric conditions OR that may be aggravated by the aforementioned mental/psychiatric conditions include, but are not limited to: brain injuries, terminal diseases, pregnancy, cancer, epilepsy, idiopathic physiological conditions and virtually any other conditions, ailments and/or injuries which may affect the patient's mental health.. Many Biopsychosocial Assessments incorporate multiple factors that adversely affect the patient's, client's and/or subject's overall well-being and homeostasis.

text: Typical psychosocial influences that are usually listed as having negative impact on life, mentality and health include, but are not limited to: Environmental factors of dysfunction such as those experienced within home, school and work; Social factors such as issues with drug use (not diagnosed), enabling friends and conflicts with coworkers; Family complications such as divorce, social service involvement and court ordered placements; Various stressors such as recent accident, natural disaster and other traumatic occurrences (i.e. assault, death, abuse); Financial problems such as bankruptcy, job loss and debts; and service needs such as lack of medical insurance, inability to find adequate treatment and inaccessibility to necessary state and federal programs.

text: Sourcebooks[edit]

text: The DSM-IV does not specifically cite its sources, but there are four volumes of "sourcebooks" intended to be APA's documentation of the guideline development process and supporting evidence, including literature reviews, data analyses and field trials.[41][42][43][44] The Sourcebooks have been said to provide important insights into the character and quality of the decisions that led to the production of DSM-IV, and hence the scientific credibility of contemporary psychiatric classification.[45][46]

text: DSM-5 (2013)[edit]

text: The fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM), the DSM-5, was approved by the Board of Trustees of the APA on December 1, 2012.[47] Published on May 18, 2013,[48] the DSM-5 contains extensively revised diagnoses and, in some cases, broadens diagnostic definitions while narrowing definitions in other cases.[49] The DSM-5 is the first major edition of the manual in twenty years.[50]

text: A significant change in the fifth edition is the deletion of the subtypes of schizophrenia (paranoid, disorganized, catatonic, undifferentiated and residual).[51]

text: The deletion of the subsets of autistic spectrum disorder (namely, Asperger's syndrome, classic autism, Rett syndrome, childhood disintegrative disorder and pervasive developmental disorder not otherwise specified) was also implemented, with specifiers with regard to intensity (mild, moderate and severe). Severity is based on social communication impairments and restricted, repetitive patterns of behaviour, with three levels: 1 (requiring support), 2 (requiring substantial support) and 3 (requiring very substantial support).

text: During the revision process, the APA website periodically listed several sections of the DSM-5 for review and discussion.[52]

text: Future revisions and updates (2013 and beyond)[edit]

text: Beginning with the fifth edition, it is intended that diagnostic guidelines revisions will be added more frequently to keep up with research in the field.[53] It is notable that the DSM-5 is identified with Hindu rather than Roman numerals. Beginning with DSM-5, the American Psychiatric Association will use decimals to identify incremental updates (e.g., DSM-5.1, DSM-5.2) and whole numbers for new editions (e.g., DSM-5, DSM-6),[54] similar to the scheme used for software versioning.

text: Criticism[edit]

text: Reliability and validity concerns[edit]

text: The revisions of the DSM from the 3rd Edition forward have been mainly concerned with diagnostic reliability—the degree to which different diagnosticians agree on a diagnosis. It was argued{Henrik Walter} that a science of psychiatry can only advance if diagnosis is reliable. If clinicians and researchers frequently disagree about the diagnosis of a patient, then research into the causes and effective treatments of those disorders cannot advance. Hence, diagnostic reliability was a major concern of DSM-III.[citation needed] When the diagnostic reliability problem was thought to be solved, subsequent editions of the DSM were concerned mainly with "tweaking" the diagnostic criteria.[citation needed] Unfortunately, neither the issue of reliability or validity was settled.[55][better source needed] However, most psychiatric education post DSM-III focused on issues of treatment—especially drug treatment—and less on diagnostic concerns.[citation needed] In fact, Thomas R. Insel, M.D., Director of the NIMH, stated in 2013 that the agency would no longer fund research projects that rely exclusively on DSM criteria due to its lack of validity.[56] Field trials of DSM-5 brought the debate of reliability back into the limelight as some disorders showed poor reliability. For example, major depressive disorder, a common mental illness, had a poor reliability kappa statistic of 0.28, indicating that clinicians frequently disagreed on this diagnosis in the same patients. The most reliable diagnosis was major neurocognitive disorder with a kappa of 0.78.[57]

text: Superficial symptoms[edit]

text: By design, the DSM is primarily concerned with the signs and symptoms of mental disorders, rather than the underlying causes. It claims to collect them together based on statistical or clinical patterns. As such, it has been compared to a naturalist's field guide to birds, with similar advantages and disadvantages.[58] The lack of a causative or explanatory basis, however, is not specific to the DSM, but rather reflects a general lack of pathophysiological understanding of psychiatric disorders. As DSM-III chief architect Robert Spitzer and DSM-IV editor Michael First outlined in 2005, "little progress has been made toward understanding the pathophysiological processes and cause of mental disorders. If anything, the research has shown the situation is even more complex than initially imagined, and we believe not enough is known to structure the classification of psychiatric disorders according to etiology."[59]

text: The DSM's focus on superficial symptoms is claimed to be largely a result of necessity (assuming such a manual is nevertheless produced), since there is no agreement on a more explanatory classification system.[citation needed] Reviewers note, however, that this approach is undermining research, including in genetics, because it results in the grouping of individuals who have very little in common except superficial criteria as per DSM or ICD diagnosis.[6]

text: Despite the lack of consensus on underlying causation, advocates for specific psychopathological paradigms have nonetheless faulted the current diagnostic scheme for not incorporating evidence-based models or findings from other areas of science. A recent example is evolutionary psychologists' criticism that the DSM does not differentiate between genuine cognitive malfunctions and those induced by psychological adaptations, a key distinction within evolutionary psychology but one that is widely challenged within general psychology.[60][61][62] Another example is the strong operationalist viewpoint, which contends that reliance on operational definitions, as purported by the DSM, necessitates that intuitive concepts like depression be replaced by specific measurable concepts before they are scientifically meaningful. One critic states of psychologists that "Instead of replacing 'metaphysical' terms such as 'desire' and 'purpose', they used it to legitimize them by giving them operational definitions…the initial, quite radical operationalist ideas eventually came to serve as little more than a 'reassurance fetish' (Koch 1992) for mainstream methodological practice."[63]

text: A 2013 review published in the European Archives of Psychiatry and Clinical Neuroscience states "that psychiatry targets the phenomena of consciousness, which, unlike somatic symptoms and signs, cannot be grasped on the analogy with material thing-like objects." As an example of the problem of the superficial characterization of psychiatric signs and symptoms, the authors gave the example of a patient saying they "feel depressed, sad, or down", showing that such a statement could indicate various underlying experiences: "not only depressed mood but also, for instance, irritation, anger, loss of meaning, varieties of fatigue, ambivalence, ruminations of different kinds, hyper-reflectivity, thought pressure, psychological anxiety, varieties of depersonalization, and even voices with negative content, and so forth." The structured interview comes with "danger of over confidence in the face value of the answers, as if a simple 'yes' or 'no' truly confirmed or denied the diagnostic criterion at issue." The authors gave an example: A patient who was being administered the Structured Clinical Interview for the DSM-IV Axis I Disorders denied thought insertion, but during a "conversational, phenomenological interview", a semi-structured interview tailored to the patient, the same patient admitted to experiencing thought insertion, along with a delusional elaboration. The authors suggested 2 reasons for this discrepancy: either the patient did not "recognize his own experience in the rather blunt, implicitly either/or formulation of the structured-interview question", or the experience did not "fully articulate itself" until the patient started talking about his experiences.[64]

text: Dividing lines[edit]

text: Despite caveats in the introduction to the DSM, it has long been argued that its system of classification makes unjustified categorical distinctions between disorders and uses arbitrary cut-offs between normal and abnormal. A 2009 psychiatric review noted that attempts to demonstrate natural boundaries between related DSM syndromes, or between a common DSM syndrome and normality, have failed.[6] Some argue that rather than a categorical approach, a fully dimensional, spectrum or complaint-oriented approach would better reflect the evidence.[65][66][67][68]

text: In addition, it is argued that the current approach based on exceeding a threshold of symptoms does not adequately take into account the context in which a person is living, and to what extent there is internal disorder of an individual versus a psychological response to adverse situations.[69][70] The DSM does include a step ("Axis IV") for outlining "Psychosocial and environmental factors contributing to the disorder" once someone is diagnosed with that particular disorder.

text: Because an individual's degree of impairment is often not correlated with symptom counts and can stem from various individual and social factors, the DSM's standard of distress or disability can often produce false positives.[71] On the other hand, individuals who do not meet symptom counts may nevertheless experience comparable distress or disability in their life.

text: Cultural bias[edit]

text: Some psychiatrists argue that current diagnostic standards rely on an exaggerated interpretation of neurophysiological findings and so understate the scientific importance of social-psychological variables.[72] Advocating a more culturally sensitive approach to psychology, critics such as Carl Bell and Marcello Maviglia contend that the cultural and ethnic diversity of individuals is often discounted by researchers and service providers.[73] In addition, current diagnostic guidelines have been criticized as having a fundamentally Euro-American outlook. Although these guidelines have been widely implemented, opponents argue that even when a diagnostic criterion set is accepted across different cultures, it does not necessarily indicate that the underlying constructs have any validity within those cultures; even reliable application can only demonstrate consistency, not legitimacy.[72] Cross-cultural psychiatrist Arthur Kleinman contends that the Western bias is ironically illustrated in the introduction of cultural factors to the DSM-IV: the fact that disorders or concepts from non-Western or non-mainstream cultures are described as "culture-bound", whereas standard psychiatric diagnoses are given no cultural qualification whatsoever, is to Kleinman revelatory of an underlying assumption that Western cultural phenomena are universal.[74] Kleinman's negative view toward the culture-bound syndrome is largely shared by other cross-cultural critics, common responses included both disappointment over the large number of documented non-Western mental disorders still left out, and frustration that even those included were often misinterpreted or misrepresented.[75][page needed] Many mainstream psychiatrists have also been dissatisfied with these new culture-bound diagnoses, although not for the same reasons. Robert Spitzer, a lead architect of the DSM-III, has held the opinion that the addition of cultural formulations was an attempt to placate cultural critics, and that they lack any scientific motivation or support. Spitzer also posits that the new culture-bound diagnoses are rarely used in practice, maintaining that the standard diagnoses apply regardless of the culture involved. In general, the mainstream psychiatric opinion remains that if a diagnostic category is valid, cross-cultural factors are either irrelevant or are only significant to specific symptom presentations.[72] One of the results was the development of the Azibo Nosology by Daudi Ajani Ya Azibo as an alternative to the DSM to treat African and African American patients.[76][77][78]

text: Medicalization and financial conflicts of interest[edit]

text: It has also been alleged that the way the categories of the DSM are structured, as well as the substantial expansion of the number of categories, are representative of an increasing medicalization of human nature, which may be attributed to disease mongering by psychiatrists and pharmaceutical companies, the power and influence of the latter having grown dramatically in recent decades.[79] Of the authors who selected and defined the DSM-IV psychiatric disorders, roughly half have had financial relationships with the pharmaceutical industry at one time, raising the prospect of a direct conflict of interest.[80] The same article concludes that the connections between panel members and the drug companies were particularly strong in those diagnoses where drugs are the first line of treatment, such as schizophrenia and mood disorders, where 100% of the panel members had financial ties with the pharmaceutical industry.[80] In 2005, then APA President Steven Sharfstein released a statement in which he conceded that psychiatrists had "allowed the biopsychosocial model to become the bio-bio-bio model".[81]

text: However, although the number of identified diagnoses has increased by more than 300% (from 106 in DSM-I to 365 in DSM-IV-TR), psychiatrists such as Zimmerman and Spitzer argue it almost entirely represents greater specification of the forms of pathology, thereby allowing better grouping of more similar patients.[6] However, William Glasser refers to the DSM as "phony diagnostic categories", arguing that "it was developed to help psychiatrists – to help them make money".[82] In addition, the publishing of the DSM, with tightly guarded copyrights, has in itself earned over $100 million for the APA.[10]

text: Clients, survivors, and consumer[edit]

text: A client is a person who accesses psychiatric services and may have been given a diagnosis from the DSM, while a survivor self-identifies as a person who has endured a psychiatric intervention and the mental health system (which may have involved involuntary commitment and involuntary treatment).[citation needed] A term adopted by many users of psychiatric services is "consumer." This term was chosen to eliminate the "patient" label and restore the person to an active role as a user or consumer of services.[83] Some individuals[who?] are relieved to find that they have a recognized condition that they can apply a name to and this has led to many people self-diagnosing.[citation needed] Others, however, question the accuracy of the diagnosis, or feel they have been given a "label" that invites social stigma and discrimination (the terms "mentalism" and "sanism" have been used to describe such discriminatory treatment).[84]

text: Diagnoses can become internalized and affect an individual's self-identity, and some psychotherapists have found that the healing process can be inhibited and symptoms can worsen as a result.[85] Some members of the psychiatric survivors movement (more broadly the consumer/survivor/ex-patient movement)[who?] actively campaign against their diagnoses, or the assumed implications, and/or against the DSM system in general. Additionally, it has been noted that the DSM often uses definitions and terminology that are inconsistent with a recovery model, and such content can erroneously imply excess psychopathology (e.g. multiple "comorbid" diagnoses) or chronicity.[86]

text: DSM-5 critiques[edit]

text: This section may lend undue weight to certain ideas, incidents, or controversies. Please help to create a more balanced presentation. Discuss and resolve this issue before removing this message. (March 2017)

text: Psychiatrist Allen Frances has been critical of proposed revisions to the DSM-5. In a 2012 New York Times editorial, Frances warned that if this DSM version is issued unamended by the APA, "it will medicalize normality and result in a glut of unnecessary and harmful drug prescription."[87] In a December 2, 2012 blog post in Psychology Today, Frances provides his "…list of DSM 5's ten most potentially harmful changes":[88][unreliable medical source?]

text:
Disruptive Mood Dysregulation Disorder, for temper tantrums
Major Depressive Disorder, includes normal grief
Minor Neurocognitive Disorder, for normal forgetting in old age
Adult Attention Deficit Disorder, encouraging psychiatric prescriptions of stimulants
Binge Eating Disorder, for excessive eating
Autism, defining the disorder more specifically, possibly leading to decreased rates of diagnosis and the disruption of school services
First time drug users will be lumped in with addicts
Behavioral Addictions, making a "…mental disorder of everything we like to do a lot."[88][unreliable medical source?]
Generalized Anxiety Disorder, includes everyday worries
Post-traumatic stress disorder, changes "…opened the gate even further to the already existing problem of misdiagnosis of PTSD in forensic settings."[88][unreliable medical source?]

text: Frances and others have published debates on what they see as the six most essential questions in psychiatric diagnosis:[89]

text:
are they more like theoretical constructs or more like diseases
how to reach an agreed definition
whether the DSM-5 should take a cautious or conservative approach
the role of practical rather than scientific considerations
the issue of use by clinicians or researchers
whether an entirely different diagnostic system is required.

text: In 2011, psychologist Brent Robbins co-authored a national letter for the Society for Humanistic Psychology that has brought thousands into the public debate about the DSM. Over 15,000 individuals and mental health professionals have signed a petition in support of the letter.[90] Thirteen other American Psychological Association divisions have endorsed the petition.[91] Robbins has noted that under the new guidelines, certain responses to grief could be labeled as pathological disorders, instead of being recognized as being normal human experiences.[92]