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

James Phillips, Allen Frances, Michael A. Cerullo, John Chardavoyne, Hannah S. Decker, Michael B. First, Nassir Ghaemi, Gary Greenberg, Andrew C. Hinderliter, Warren A. Kinghorn, Steven G. LoBello, Elliott B. Martin, Aaron L. Mishara, Joel Paris, Joseph M. Pierre, Ronald W. Pies, Harold A. Pincus, Douglas Porter, Claire Pouncey, Michael A. SchwartzThomas Szasz, Jerome C. Wakefield, G. S. Waterman, Owen Whooley, Peter Zachar

    Research output: Contribution to journalReview article

    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.

    Original languageEnglish (US)
    Article number8
    JournalPhilosophy, Ethics, and Humanities in Medicine
    Volume7
    Issue number1
    DOIs
    StatePublished - Apr 18 2012

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    Politics
    Mental Disorders
    Diagnostic and Statistical Manual of Mental Disorders
    Posture
    Psychiatry
    France
    Conservatism
    Pragmatism
    Research Personnel

    ASJC Scopus subject areas

    • Issues, ethics and legal aspects
    • Health Policy
    • History and Philosophy of Science

    Cite this

    The six most essential questions in psychiatric diagnosis : A pluralogue part 2: Issues of conservatism and pragmatism in psychiatric diagnosis. / Phillips, James; Frances, Allen; Cerullo, Michael A.; Chardavoyne, John; Decker, Hannah S.; First, Michael B.; Ghaemi, Nassir; Greenberg, Gary; Hinderliter, Andrew C.; Kinghorn, Warren A.; LoBello, Steven G.; Martin, Elliott B.; Mishara, Aaron L.; Paris, Joel; Pierre, Joseph M.; Pies, Ronald W.; Pincus, Harold A.; Porter, Douglas; Pouncey, Claire; Schwartz, Michael A.; Szasz, Thomas; Wakefield, Jerome C.; Waterman, G. S.; Whooley, Owen; Zachar, Peter.

    In: Philosophy, Ethics, and Humanities in Medicine, Vol. 7, No. 1, 8, 18.04.2012.

    Research output: Contribution to journalReview article

    Phillips, J, Frances, A, Cerullo, MA, Chardavoyne, J, Decker, HS, First, MB, Ghaemi, N, Greenberg, G, Hinderliter, AC, Kinghorn, WA, LoBello, SG, Martin, EB, Mishara, AL, Paris, J, Pierre, JM, Pies, RW, Pincus, HA, Porter, D, Pouncey, C, Schwartz, MA, Szasz, T, Wakefield, JC, Waterman, GS, Whooley, O & Zachar, P 2012, 'The six most essential questions in psychiatric diagnosis: A pluralogue part 2: Issues of conservatism and pragmatism in psychiatric diagnosis', Philosophy, Ethics, and Humanities in Medicine, vol. 7, no. 1, 8. https://doi.org/10.1186/1747-5341-7-8
    Phillips, James ; Frances, Allen ; Cerullo, Michael A. ; Chardavoyne, John ; Decker, Hannah S. ; First, Michael B. ; Ghaemi, Nassir ; Greenberg, Gary ; Hinderliter, Andrew C. ; Kinghorn, Warren A. ; LoBello, Steven G. ; Martin, Elliott B. ; Mishara, Aaron L. ; Paris, Joel ; Pierre, Joseph M. ; Pies, Ronald W. ; Pincus, Harold A. ; Porter, Douglas ; Pouncey, Claire ; Schwartz, Michael A. ; Szasz, Thomas ; Wakefield, Jerome C. ; Waterman, G. S. ; Whooley, Owen ; Zachar, Peter. / The six most essential questions in psychiatric diagnosis : A pluralogue part 2: Issues of conservatism and pragmatism in psychiatric diagnosis. In: Philosophy, Ethics, and Humanities in Medicine. 2012 ; Vol. 7, No. 1.
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