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B4U-ACT Representatives Attend APA Annual Meeting

Three representatives of B4U-ACT recently returned from attending the Annual Meeting of the American Psychiatric Association in New Orleans. The APA recognized B4U-ACT as a patient advocacy group at the meeting. There were about 11,000 attendees at the conference, of whom about 8000 were psychiatrists (the rest were students, psychiatric nurses, chaplains, and others). The three B4U-ACT representatives were among only about 20 representatives of advocacy groups. The APA displayed 1000 copies of a flier about B4U-ACT prominently on their “Important Annual Meeting Information” booth in the registration area.

The B4U-ACT representatives attended three sessions related to DSM 5. The first one was entitled “DSM 5: Progress in Research and Development” and presented by Drs. Kupfer and Regier, chair and vice chair of the DSM 5 Task Force, respectively. During the question and answer period, B4U-ACT asked how stakeholder groups are involved in the DSM revision process, and how the Task Force would insure that pedohebephilia field trials (to test the DSM) would involve minor-attracted people who are not under the control of the criminal justice system in order to give unbiased results. Dr. Regier answered both questions, but his answer to the second question was evasive, saying limited funding would prevent such field trials for “low prevalence disorders.” However, he did say, in front of the assembled group of about 200 people, that the Task Force was in the process of initiating communication with a “consumer group” regarding pedohebehilia, meaning B4U-ACT. Afterwards, the B4U-ACT representatives introduced themselves to Dr. Regier and spoke with him about the need for a face-to-face meeting and about their policy for meeting with patient groups.

The second DSM 5 session consisted of reports from the chairs of 5 of the 13 DSM workgroups. One of them was Dr. Zucker, head of the sexual and gender identity disorders workgroup. During the question and answer period after he presented, B4U-ACT asked him why the literature review supporting the proposal for pedohebephilia was so narrowly focused on sex offender literature, ignoring the literature from psychology and other relevant fields, and ignoring the DSM research agenda. He responded by saying a literature review must be delimited, but he also mentioned that Archives of Sexual Behavior (which he edits) was going to publish a long article by Bruce Rind which would draw from some of these fields.

The third session about DSM 5 was entitled “Feedback on Criteria and Terminology in DSM 5,” moderated by Drs. Kupfer and Regier. It consisted of a series of multiple choice questions presented by the moderators, to which attendees were to reply using remote control devices. They then tallied the answers for everyone to see. The questions were about whether particular newly proposed disorders should be added to the DSM, or about whether certain disorder names were clinically useful and/or stigmatizing. There were no questions about pedohebephilia.

In addition to the DSM sessions, B4U-ACT representatives attended a few other sessions that were relevant: on suicide risk assessment, ethical dilemmas in psychiatry, and stigma. At each of these, during the question and answer period, the B4U-ACT representatives mentioned mentioned the organization’s work and raised relevant questions involving people attracted to minors. The answers were generally not satisfying, but resondents were respectful. After the session on ethical dilemmas, two psychiatrists from the audience approached the B4U-ACT representatives to say they were impressed by B4U-ACT’s work and courage. They were given B4U-ACT’s flier.

On Tuesday, B4U-ACT representatives spent some time walking through the exhibit hall and chatted with representatives of a half dozen behavioral health institutions, telling them about B4U-ACT and giving them the flier. Most seemed interested in B4U-ACT’s work.

B4U-ACT representatives also circulated among five evening receptions held by various groups, including two from Maryland. Again, they talked face to face about B4U-ACT and the situation faced by minor-attracted people, especially adolescents. They talked with chairs of the psychiatry departments at two major universities and with a person who heads two major mental health policy programs. They also spoke with the chair of one of the DSM workgroups (but unrelated to sexual disorders).

Overall, attendance at the APA meeting was quite productive. By simply speaking up at sessions they attended, B4U-ACT representatives exposed a total of a few hundred psychiatrists to the organization’s work and to one or two issues facing minor-attracted people. They had more in-depth, one-on-one conversations with two dozen or so individuals, including some important people in psychiatry or DSM development.

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