Paul T. Wilson

Bio: Paul T. Wilson is an academic researcher. The author has contributed to research in topics: Mental health & Epidemiology of child psychiatric disorders. The author has an hindex of 3, co-authored 4 publications receiving 48 citations.

A guide to the American Psychiatric Association's new diagnostic nomenclature.

Abstract: The new diagnostic nomenclature, which will become official on July 1, represents a significant advance toward the use of a standard international classification system to facilitate the exchange of ideas among psychiatrists of all countries. The ways in which the new manual (DSM-II) differs both from the original (DSM-I) and from the current World Health Organization International Classification of Diseases (ICD-8) are discussed to aid psychiatrists in making the transition.

Continuing education for psychiatrists: programs and techniques.

Abstract: Of 1,847 institutions responding to a survey by the Task Force on Continuing Education for Psychiatrists, 51 sponsored courses meeting the questionnaire's criteria. Sponsors were distributed geographically in the same relative density as psychiatrists. Universities, state and county institutions for the mentally ill, and psychoanalytic institutes were most active. Courses varied widely. Increasing interest in continuing education suggests that these data reflect a situation that will soon change dramatically.

An introduction to the American Psychiatric Association's new diagnostic nomenclature for New York State Department of Mental Hygiene personnel.

Abstract: For many years the New York State Department of Mental Hygiene has used two nomenclatures to record psychiatric diagnoses. The state hospitals used the 1942 “Revised Classification,” a revision of the American Medical Association's 1934 classification, and all other mental health facilities used the first edition of theDiagnostic and Statistical Manual of the American Psychiatric Association.

DSM-III and the transformation of American psychiatry: a history

Abstract: The author traces the history of the development of DSM-III within the larger context--intellectual, economic, scientific, and ideological--of the development of American psychiatry since World War II. Data were obtained through a literature review, investigation of archival material from the DSM-III task force and APA, and interviews with key participants. This research indicates that from the end of World War II until the mid-1970s, a broadly conceived biopsychosocial model, informed by psychoanalysis, sociological thinking, and biological knowledge, was the organizing model for American psychiatry. However, the biopsychosocial model did not clearly demarcate the mentally well from the mentally ill, and this failure led to a crisis in the legitimacy of psychiatry by the 1970s. The publication of DSM-III in 1980 represented an answer to this crisis, as the essential focus of psychiatric knowledge shifted from the clinically-based biopsychosocial model to a research-based medical model. The author concludes that while DSM-III, and the return to descriptive psychiatry which it inaugurated, has had positive consequences for the profession, at the same time it represents a significant narrowing of psychiatry's clinical gaze.

Alzheimer’s Disease: Past, Present, and Future

Abstract: Although dementia has been described in ancient texts over many centuries (e.g., "Be kind to your father, even if his mind fail him." - Old Testament: Sirach 3:12), our knowledge of its underlying causes is little more than a century old. Alzheimer published his now famous case study only 110 years ago, and our modern understanding of the disease that bears his name, and its neuropsychological consequences, really only began to accelerate in the 1980s. Since then we have witnessed an explosion of basic and translational research into the causes, characterizations, and possible treatments for Alzheimer's disease (AD) and other dementias. We review this lineage of work beginning with Alzheimer's own writings and drawings, then jump to the modern era beginning in the 1970s and early 1980s and provide a sampling of neuropsychological and other contextual work from each ensuing decade. During the 1980s our field began its foundational studies of profiling the neuropsychological deficits associated with AD and its differentiation from other dementias (e.g., cortical vs. subcortical dementias). The 1990s continued these efforts and began to identify the specific cognitive mechanisms affected by various neuropathologic substrates. The 2000s ushered in a focus on the study of prodromal stages of neurodegenerative disease before the full-blown dementia syndrome (i.e., mild cognitive impairment). The current decade has seen the rise of imaging and other biomarkers to characterize preclinical disease before the development of significant cognitive decline. Finally, we suggest future directions and predictions for dementia-related research and potential therapeutic interventions. (JINS, 2017, 23, 818-831).

Lifetime criminality among boys with attention deficit hyperactivity disorder: a prospective follow-up study into adulthood using official arrest records.

Abstract: This study investigates the relationship between childhood attention deficit hyperactivity disorder (ADHD) and later criminality. White boys (n = 207, ages 6–12) with ADHD, free of conduct disorder, were assessed at ages 18 and 25 by clinicians who were blind to childhood status. A non-ADHD group served as comparisons. Lifetime arrest records were obtained when subjects were 38 years old for subjects who resided in New York State throughout the follow-up interval (93 probands, 93 comparisons). Significantly more ADHD probands than comparisons had been arrested (47% vs. 24%), convicted (42% vs. 14%), and incarcerated (15% vs. 1%). Rates of felonies and aggressive offenses also were significantly higher among probands. Importantly, the development of an antisocial or substance use disorder in adolescence completely explained the increased risk for subsequent criminality. Results suggest that even in the absence of comorbid conduct disorder in childhood, ADHD increases the risk for developing antisocial and substance use disorders in adolescence, which, in turn, increases the risk for criminal behavior in adolescence and adulthood.

Unipolar and Bipolar Affective Illness: Differences in Clinical Characteristics Accompanying Depression

Abstract: A comparison of the clinical characteristics of the depressive state was made between 25 patients with a diagnosis of depressive psychosis (unipolar) and 25 patients with a diagnosis of manic-depressive psychosis (bipolar). Patients were observed for a 14-day drug-free period in a research ward during which time mania was absent. Higher levels of physical activity, overt expression of anger, and somatic complaints differentiated the depression of the unipolar patients from those of the bipolar patients who tended to be less active and more socially withdrawn. Anxiety and psychotic behavior were not differentiating characteristics, although the former approached significance. Evidence from biological, genetic, and other clinical studies supports the hypothesis that depressive psychosis and manic-depressive psychosis may be distinctly different types of affective disorder.

A brief historicity of the Diagnostic and Statistical Manual of Mental Disorders: Issues and implications for the future of psychiatric canon and practice

Abstract: The Diagnostic and Statistical Manual (DSM) of the American Psychiatric Association, currently in its fourth edition and considered the reference for the characterization and diagnosis of mental disorders, has undergone various developments since its inception in the mid-twentieth century. With the fifth edition of the DSM presently in field trials for release in 2013, there is renewed discussion and debate over the extent of its relative successes - and shortcomings - at iteratively incorporating scientific evidence on the often ambiguous nature and etiology of mental illness. Given the power that the DSM has exerted both within psychiatry and society at large, this essay seeks to analyze variations in content and context of various editions of the DSM, address contributory influences and repercussion of such variations on the evolving landscape of psychiatry as discipline and practice over the past sixty years. Specifically, we document major modifications in the definition, characterization, and classification of mental disorders throughout successive editions of the DSM, in light of shifting trends in the conceptualization of psychopathology within evolving schools of thought in psychiatry, and in the context of progress in behavioral and psychopharmacological therapeutics over time. We touch upon the social, political, and financial environments in which these changes took places, address the significance of these changes with respect to the legitimacy (and legitimization) of what constitutes mental illness and health, and examine the impact and implications of these changes on psychiatric practice, research, and teaching. We argue that problematic issues in psychiatry, arguably reflecting the large-scale adoption of the DSM, may be linked to difficulties in formulating a standardized nosology of psychopathology. In this light, we highlight 1) issues relating to attempts to align the DSM with the medical model, with regard to increasing specificity in the characterization of discrete mental disease entities and the incorporation of neurogenetic, neurochemical and neuroimaging data in its nosological framework; 2) controversies surrounding the medicalization of cognition, emotion, and behavior, and the interpretation of subjective variables as 'normal' or 'abnormal' in the context of society and culture; and 3) what constitutes treatment, enablement, or enhancement - and what metrics, guidelines, and policies may need to be established to clarify such criteria.