Posted by pseudoname on May 15, 2006, at 23:58:44
In reply to Re: new diagnostic manual, posted by Caedmon on May 15, 2006, at 22:37:43
Chris,
Have I offended you in some way? This is the second post by me in two weeks to which your response has been, “I don't see what the big deal is.”
Last time I bit my tongue. This time I'll make some "I"-statements.
Not everything I post about is a big deal. I'll admit that at least 99% of my posts are NOT a big deal. Virtually anything I post can easily be dismissed by any other human being. Of course, perhaps it's good to have that actually keep happening just to make sure I'm properly oriented.
> I believe that DSM categories were originally designed to help keep research definitions consistent.
Nope. Diagnostic agreement among psychiatrists was running as low as 32% in pre-DSM days. The DSM was created to try to make psychiatric diagnoses consistent clinician to clinician (scientifically “reliable”) because, as an early DSM editor said, “without reliability the system is completely random, and the diagnoses mean almost nothing — maybe worse than nothing, because they’re falsely labelling. You’re better off not having a diagnostic system.”
So they made the DSM to try to prove to the critics that the diagnoses psychiatrists were already making were somehow not false. The DSM thus tried, and only partly succeeded, to fix the “reliability” problems.
The validity problems are an open issue.
Alix Spiegel wrote a history of the DSM in the Jan 3 '05 New Yorker, which was discussed here at the time: http://www.dr-bob.org/babble/psycho/20041218/msgs/434588.html (Note: Also not a big deal.)
> They *weren't* necessarily designed as methods to diagnose disorders
That is exactly what they were explicitly designed to do. Their additional use in research (which was a secondary intention) couldn't possibly change that. How would research using such criteria ever be clinically applicable if practitioners weren't also using them?
And anyway, even had it been otherwise originally, the DSM IS USED THAT WAY NOW. Are you saying it should not be? Welcome to the club. (But be prepared for people to tell you they don't see what the big deal is.)
> let alone the whole spectra of the human condition
I don't know what you mean.
poster:pseudoname
thread:644339
URL: http://www.dr-bob.org/babble/20060515/msgs/644580.html