The Philosophy Behind the DSM-5

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PURPOSES OF PSYCHIATRIC CLASSIFICATIONS List of psychiatric illnesses that is concise and clear Has concepts and criteria creating reliable communication Should be equally useful for clinicians, researchers, administrators Has widely accepted validity (McHugh and Slavney) Too much acceptance may mean political power (Kuhn) Cannot avoid interpretation (Spitzer) Has guiding hypotheses and theories (Popper) Wiggins and Schwartz in Sadler et. al., 1994 39
WHEN CAN DIAGNOSTIC CRITERIA BE CHANGED Change is confusing to clinicians Medical records and treatment algorithms rely on DSMs Change impairs cumulative research using meta-analysis Longitudinal research is threatened Change requires new structured interviews Changes may not reflect real differences Frequent changes discredit the revision process Small changes may have small benefits Bias and politics always, even with safeguards, affect the process Rounsaville et. al. in Kupfer, 2002 40
Page 1 and 2: THE PHILOSOPHY BEHIND DSM-5 Arthur
Page 3 and 4: NOSOLOGY IN THE U.S. 19 th Century
Page 5 and 6: DIAGNOSES “Do some work in the wo
Page 7 and 8: IDEAL TYPES Do they facilitate unif
Page 9 and 10: PHILOSOPHICAL FRAMEWORK FOR PSYCHIA
Page 11 and 12: JASPER’S GROUPS OF MENTAL ILLNESS
Page 13 and 14: ADOLF MEYER (continued) Anti-catego
Page 15 and 16: HEMPEL’S REQUIREMENTS FOR A SCIEN
Page 17 and 18: LIMITATIONS OF CLASSIFACTORY MANUAL
Page 19 and 20: MENTAL DISORDERS Conditions with di
Page 21 and 22: DEFINING MENTAL Ignore the problem
Page 23 and 24: SPITZER AND DSM-III Interater relia
Page 25 and 26: ISSUES SINCE DSM-III Etiology remai
Page 27 and 28: GOALS FOR DSM-5 Stimulate research
Page 29 and 30: Continual advances in basic and cli
Page 31 and 32: APPROACHES TO VALIDATION Conservati
Page 33 and 34: PSYCHIATRIC CLASSIFICATION Descript
Page 35 and 36: SSRIs are efficacious for: NO ACCUR
Page 37 and 38: KENDLER-VALIDITY Premorbid personal
Page 39 and 40: RATING VALIDITY OF DIAGNOSES IN PSY
Page 41: TOPICS FOR REVISION OF Define menta
Page 45 and 46: PARADOX Can we adopt new diagnoses
Page 47 and 48: HYMAN’S CRITIQUE OF DSM Stifles r
Page 49 and 50: Values and Psychiatric Science Valu

The Philosophy Behind the DSM-5

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