The six most essential questions in psychiatric diagnosis: A pluralogue part 2: Issues of conservatism and pragmatism in psychiatric diagnosis [Book Review]

Abstract

In face of the multiple controversies surrounding the DSM process in general and the development of DSM-5 in particular, we have organized a discussion around what we consider six essential questions in further work on the DSM. The six questions involve: 1) the nature of a mental disorder; 2) the definition of mental disorder; 3) the issue of whether, in the current state of psychiatric science, DSM-5 should assume a cautious, conservative posture or an assertive, transformative posture; 4) the role of pragmatic considerations in the construction of DSM-5; 5) the issue of utility of the DSM - whether DSM-III and IV have been designed more for clinicians or researchers, and how this conflict should be dealt with in the new manual; and 6) the possibility and advisability, given all the problems with DSM-III and IV, of designing a different diagnostic system. Part I of this article took up the first two questions. Part II will take up the second two questions. Question 3 deals with the question as to whether DSM-V should assume a conservative or assertive posture in making changes from DSM-IV. That question in turn breaks down into discussion of diagnoses that depend on, and aim toward, empirical, scientific validation, and diagnoses that are more value-laden and less amenable to scientific validation. Question 4 takes up the role of pragmatic consideration in a psychiatric nosology, whether the purely empirical considerations need to be tempered by considerations of practical consequence. As in Part 1 of this article, the general introduction, as well as the introductions and conclusions for the specific questions, are written by James Phillips, and the responses to commentaries are written by Allen Frances

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References found in this work

The Structure of Scientific Revolutions.Thomas S. Kuhn - 1962 - University of Chicago Press.
The Structure of Scientific Revolutions.Thomas Samuel Kuhn - 1962 - Chicago: University of Chicago Press.
The Concepts of Health and Illness Revisited.Lennart Nordenfelt - 2006 - Medicine, Health Care and Philosophy 10 (1):5-10.
Neuroethics: The Practical and the Philosophical.Martha J. Farah - 2005 - Trends in Cognitive Sciences 9 (1):34-40.
Defining Mental Disorder. Exploring the 'Natural Function' Approach.Somogy Varga - 2011 - Philosophy, Ethics, and Humanities in Medicine 6:1-.

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