It take years for the American Psychiatric Association to publish a new Diagnositic and Statistical Manual (DSM). The first was published in 1952 and the most recent, number 5, in 2013.

The DSM is often referred to as “the bible of psychiatry” as you can see by looking the term up in Google here and reading any of the articles.

With each edition not only are diagnostic categories added and removed and changed, but so are the statistics of their prevalence. During the era of Trump we have seen that there are numerous people from government officials to media personalities to the general public with manifestions of mental illnesses or linked combinations of illnesses that haven’t been categorized previously.

The numbers of people with these conditions either has changed upwards or wasn”t previously known to be as high as it seems to be.

For a current example, the defense witness Costello who lost control in court yesterday is a very minor example of someone who probably has a psychiatric diagnosis, his involving bad judgement, narcissism, and impulse control.

Malignant narcissism, which Trump has, as a diagnosis never was in a DSM but it includes listed severe diagnoses combined in one person. Enough people may meet the criteria that perhaps it should be in DSM-6.

I am not sure what names would be used for the constellations of thoughts, beliefs, and behaviors for the new disorders. There could be enough people manifesting symptoms to have disorders called gullibilty disorder, self-defeating behavior disorder, lack of insight into self disorder, easily led by others disorder, worshipping a leader disorder, and perhaps the most significant, confirmation bias disorder.

All of these disorders have, to varying degrees, impaired reality testing. People with these disorders generally do not think there’s anything wrong with them. Some , or all, members of their peer group have the same disorder and this reinforces their belief that far from wondering whether they have an impairment themselves they are superior to those who don’t share their beliefs.

Some disorders would remain in the DSM but the manifestions would change as would the statistics. The one that comes to mind is narcissistic personality disorder. As current described it is as follows (from Wikipedia):

Narcissistic personality disorder (NPD) is a personality disordercharacterized by a life-long pattern of exaggerated feelings of self-importance, an excessive need for admiration, and a diminished ability to empathize with other people’s feelings. 

If you look at the signs and symptoms you will see from personal experience and observation that those with NPD fall into two basic categories: those who experience feelings like fear and shame and those who don’t. You can judge for yourself which public figures with NPD actually feel fear and shame.

Like with all DSM’s there would be a list of symptoms and to meet the criteria for being diagnosed with the disorder one would have to have a certain number of the symptoms. If they don’t have enough of them but have a few they could be described as having traits of a particular disorder.

I am not about to attempt to elaborate on this. Hundreds of experts work for years on the DSM. I am only saying that the next edition will probably be very different than the current one.

I also expect the book itself will be thicker than the current edition…

Here’s the 136 page version, the DSM-2, which I used when I began working as a psychotherapist:

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