Generative AI Is Freely Giving Mental Health Advice For DSM-5 Mental Disorders

This exploration uses the widely popular generative AI application, ChatGPT, to examine real-world examples of AI-generated mental health advice for twenty major mental disorders as defined in the DSM-5, the Diagnostic and Statistical Manual of Mental Disorders, fifth edition, published by the American Psychiatric Association (APA). The DSM-5 is a crucial reference for mental health professionals.

Previous work has investigated the intersection of generative AI and mental health (see link). A CBS 60 Minutes segment highlighted key aspects of this developing field (link, including my interview). Further background includes in-depth coverage of AI-powered mental health chatbots (link), the evolving client-therapist dynamic in the age of AI (link), the future of AI-driven mental therapy (link), and the significance of the World Health Organization (WHO) report on global health and generative AI (link).

Let's delve into today's focus.

The DSM-5: Significance and Content

The DSM-5 is essential for clinicians, psychologists, psychiatrists, cognitive scientists, researchers, and other stakeholders. Its primary purpose, as stated in the manual, is to aid trained clinicians in diagnosing mental disorders as part of a comprehensive assessment leading to informed treatment plans.

Importantly, the DSM-5 is intended for trained professionals. Non-professionals should exercise caution when interpreting its content. However, it also serves as a learning tool for aspiring clinicians.

The term "mental disorder" requires clarification. The Encyclopedia Britannica defines it as "any illness with significant psychological or behavioral manifestations associated with a painful or distressing symptom or impairment in one or more important areas of functioning."

The DSM-5 offers a formal definition:

• A syndrome characterized by clinically significant disturbance in cognition, emotion regulation, or behavior reflecting dysfunction in underlying psychological, biological, or developmental processes.
• Usually associated with significant distress or disability in social, occupational, or other important activities.
• An expectable or culturally approved response to common stressors (e.g., bereavement) is not a mental disorder.
• Socially deviant behavior (e.g., political, religious, or sexual) is not a mental disorder unless stemming from individual dysfunction.

The DSM-5 clarifies the scope of "mental disorder," addressing common misconceptions. The casual use of the term in media often oversimplifies its complexity. Careful consideration is necessary when diagnosing a mental disorder.

Defining and categorizing mental disorders is challenging. Overlapping conditions are common. The DSM-5, in its nearly thousand pages, attempts to provide a detailed roadmap, though this is complex material. It details approximately 300 mental illnesses, organized into 20 major categories.

These categories are:

1. Neurodevelopmental Disorders
2. Schizophrenia Spectrum and Other Psychotic Disorders
3. Bipolar and Related Disorders
4. Depressive Disorders
5. Anxiety Disorders
6. Obsessive-Compulsive and Related Disorders
7. Trauma- and Stressor-Related Disorders
8. Dissociative Disorders
9. Somatic Symptoms and Related Disorders
10. Feeding and Eating Disorders
11. Elimination Disorders
12. Sleep-Wake Disorders
13. Sexual Dysfunctions
14. Gender Dysphoria
15. Disruptive, Impulse-Control, and Conduct Disorders
16. Substance-Related and Addictive Disorders
17. Neurocognitive Disorders
18. Personality Disorders
19. Paraphilic Disorders
20. Other Mental Disorders

Generative AI: The Experiment

Can generative AI offer mental health advice across these twenty categories and roughly 300 disorders? Surprisingly, my testing with ChatGPT revealed it readily provides advice for all of them.

This highlights four key points:

1. Versatility: Generative AI offers broad mental health advice.
2. Surface-Level: Its advice is often superficial.
3. Utility: It can be a helpful initial resource.
4. Limitations: It can be inaccurate, produce hallucinations, or offer poor advice.

Generative AI and Each DSM-5 Category

The following sections explore each DSM-5 category through dialogues with ChatGPT. For each, a brief DSM-5 excerpt defines the disorder, followed by a simulated conversation where I pose as someone seeking advice, claiming a diagnosis (to minimize excessive warnings from the AI). Note that I often state a pre-existing diagnosis from a therapist; however, the AI should not assume the validity of this information. The AI responses are excerpted for brevity; full conversations were conducted.

(1) Neurodevelopmental Disorders: (Example dialogue and analysis provided)

(2) Schizophrenia Spectrum and Other Psychotic Disorders: (Example dialogue and analysis provided)

(3) Bipolar and Related Disorders: (Example dialogue and analysis provided)

(4) Depressive Disorders: (Example dialogue and analysis provided)

(5) Anxiety Disorders: (Example dialogue and analysis provided)

(6) Obsessive-Compulsive and Related Disorders: (Example dialogue and analysis provided)

(7) Trauma- and Stressor-Related Disorders: (Example dialogue and analysis provided)

(8) Dissociative Disorders: (Example dialogue and analysis provided)

(9) Somatic Symptoms and Related Disorders: (Example dialogue and analysis provided)

(10) Feeding and Eating Disorders: (Example dialogue and analysis provided)

(11) Elimination Disorders: (Example dialogue and analysis provided)

(12) Sleep-Wake Disorders: (Example dialogue and analysis provided)

(13) Sexual Dysfunctions: (Example dialogue and analysis provided)

(14) Gender Dysphoria: (Example dialogue and analysis provided)

(15) Disruptive, Impulse-Control, and Conduct Disorders: (Example dialogue and analysis provided)

(16) Substance-Related and Addictive Disorders: (Example dialogue and analysis provided)

(17) Neurocognitive Disorders: (Example dialogue and analysis provided)

(18) Personality Disorders: (Example dialogue and analysis provided)

(19) Paraphilic Disorders: (Example dialogue and analysis provided)

(20) Other Mental Disorders: (Example dialogue and analysis provided)

Important Considerations

Generative AI readily provides mental health advice, raising crucial questions about necessary guardrails. Current warnings are often insufficient. Should legal obligations require more prominent cautions and programmatic controls to limit potentially harmful advice? These are complex issues demanding careful consideration. Shakespeare's words, "Canst thou not minister to a mind diseased," highlight the challenge and the potential, but responsible development and use are paramount.

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