Second problem – the design of the DSM 5 field trial had a byzantine complexity that could be dreamed up only by people with no experience in real life field testing. One look made clear that there would be serious implementation problems and that it would be impossible to complete within the time allotted. The first stage of the field trial limped in eighteen months late, having taken twice as long as was scheduled. APA then had to choose between delaying the publication of DSM 5 or canceling its planned second stage of field testing that was meant to provide for desperately needed quality control. APA decided to cancel the trial and instead is rushing ahead with the premature publication of DSM 5 next May – publishing profits clearly trumped concern for the quality and integrity of the product. Fiduciary responsibility was thrown out the window.
Major Depressive Disorder and Generalized Anxiety Disorder were among those that achieved the unacceptable kappas in 0.20–0.39 range. This makes sense for GAD because its DSM 5 definition was so very poorly done. But how to explain the ridiculously low levels of agreement for MDD. DSM 5 had made no changes from the MDD definition whose reliability has been studied hundreds of times in the past 30 years and has always achieved rates about twice as high. The only possible explanation for the egregiously poor MDD result is amateur incompetence in how the DSM 5 field trials were conducted- and this throws in doubt all of the other results (and all of DSM 5).