The myth of DSM's invention of new categories of disorder: Houts's diagnostic discontinuity thesis disconfirmed

Jerome C. Wakefield

    Research output: Contribution to journalArticle

    Abstract

    Houts (2001) argues that increases in DSM diagnostic categories are due to the invention of new disorders that are discontinuous with old conceptions of disorder and would not have been previously diagnosed. He maintains that DSM category increases are not comparable in nature to ICD category increases, which are mainly refinements of recognized disorders. I survey categories of disorder introduced after DSM-II and assess whether they are discontinuous with old concepts and categories of disorder. Candidate categories are identified from: Houts and Follette (1998), Mentalism, mechanisms, and medical analogues: Reply to Wakefield. Journal of Consulting and Clinical Psychology; Kutchins and Kirk (1997) Making us crazy: DSM: The psychiatric bible and the creation of mental disorders. New York: Free Press; and my own list. The result is that virtually none of the candidate categories are invented, discontinuous categories. In almost every case, the newly labeled conditions were considered disorders at the time of DSM-II and would have been diagnosed under DSM-II categories. I also reexamine DSM-IV sleep disorder categories, which Houts claims are discontinuous with past diagnostic conceptions. The result is that all DSM-IV sleep disorders were recognized as disorders at the time of DSM-II, and most were recognized as mental disorders. I conclude that DSM category increases are comparable in nature to ICD category increases, and that the invention-of-disorder account cannot explain the vast majority of such increases.

    Original languageEnglish (US)
    Pages (from-to)575-624
    Number of pages50
    JournalBehaviour Research and Therapy
    Volume39
    Issue number5
    DOIs
    StatePublished - Apr 5 2001

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    Diagnostic and Statistical Manual of Mental Disorders
    Mental Disorders
    Bible
    Clinical Psychology
    Psychiatry
    Sleep Wake Disorders

    Keywords

    • Diagnosis
    • DSM-IV
    • Dysfunction
    • Function
    • History of psychiatry
    • Mental disorder
    • Sleep disorders

    ASJC Scopus subject areas

    • Experimental and Cognitive Psychology
    • Clinical Psychology
    • Psychiatry and Mental health

    Cite this

    The myth of DSM's invention of new categories of disorder : Houts's diagnostic discontinuity thesis disconfirmed. / Wakefield, Jerome C.

    In: Behaviour Research and Therapy, Vol. 39, No. 5, 05.04.2001, p. 575-624.

    Research output: Contribution to journalArticle

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