Book Review - Strengthening the DSM: Incorporating Resilience and Cultural Competence

Strengthening the DSM: Incorporating Resilience and Cultural Competence (2nd Edition), by Anne Petrovich and Betty Garcia, New York, Springer Publishing Company, ISBN 978-0-8261-2662-7, 2016, 368 pages, $75.

    In 2017, the Diagnostic and Statistical Manual of Mental Disorders will celebrate its 65th anniversary. Collectively, from the first edition in which nomenclature and psychodynamic theory ruled (Clegg, 2012) to the most recent one (DSM-5, 2013), there have been significant shifts. The DSM-5 marks one of these with the elimination of the multiaxial diagnostic system.

    In Strengthening the DSM: Incorporating Resilience and Cultural Competence, Petrovich and Garcia (2016) argue that the elimination of the multiaxial system essentially decontextualizes the diagnostic process. In response, their second edition puts context back into the process. Indeed, this alone makes this book a necessary companion to the DSM-5 for all practitioners. Moreover, their crucial reminder that cultural competence is a process, and not an outcome in and of itself, signals the book’s promise early in the opening chapter. They continue by outlining the book’s conceptual framework and highlighting salient concepts (i.e., microaggressions, intersectionality) that set the stage for more comprehensive assessments and contextual diagnoses.

    Against this backdrop, the authors suggest the use of a diversity/resilience formulation for each DSM-5 diagnosis. This contextual formulation (including five domains: intrapersonal, interpersonal, community, spiritual, and diversity) is akin to a bio-psycho-social-spiritual assessment. In fact, their formulation is a more comprehensive Axis IV per the now defunct DSM-IV-TR)—something the authors point out is amiss in the newest incarnation of the Diagnostic and Statistical Manual of Mental Disorders.

    Additional strengths of the book include the following: numerous case studies (with accompanying diversity/resilience formulations), summarized key points throughout the book, discussion questions, evidence-based/practice-model discussions, and attention to etiology and research. Taken together, these user-friendly features invite social work faculty to adopt the text for any diagnosis course.

    Of course, the book is not without its drawbacks. One is that the chapters themselves are not consistent with the new developmental order of the chapters presented in the DSM-5. Instead, the authors take a hybrid approach (DSM-IV-TR and DSM-5). For instance, some chapters (mood and anxiety disorders) are consistent with the DSM-IV-TR, and others are consistent with the DSM-5 (traumatic- and stressor-related disorders). In their next edition, the authors should consider organizing the chapters developmentally—the DSM-5 lifespan chapter organization is a strength. Additionally, the authors should consider including a rationale for the disorders included. No doubt, a third edition that mirrored the DSM-5 chapters may be unwieldy, but if the authors provided a clear rationale for the disorders included (backed by epidemiological research), this notable book would shine even brighter.

Reviewed by Bibiana D. Koh, Ph.D., LICSW, Assistant Professor and BSW Program Director, Augsburg College, Department of Social Work.