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What is wrong with the DSM?

Research output: Contribution to journalJournal article

Published

Journal publication date2004
JournalHistory of Psychiatry
Journal number1
Volume15
Number of pages21
Pages5-25
Original languageEnglish

Abstract

The DSM is the main classification of mental disorders used by psychiatrists in the United States and, increasingly, around the world. Although widely used, the DSM has come in for fierce criticism, with many commentators believing it to be conceptually flawed in a variety of ways. This paper assesses some of these philosophical worries. The first half of the paper asks whether the project of constructing a classification of mental disorders that �cuts nature at the joints� makes sense. What is mental disorder? Are types of mental disorder natural kinds (that is, are the distinctions between them objective and of fundamental theoretical importance, as are, say, the distinctions between the chemical elements)? The second half of the paper addresses epistemic worries. Even if types of mental disorder are natural kinds there may be reason to doubt that the DSM will come to reflect their natural structure. In particular, I examine the extent to which the DSM is theory-laden, and look at how it has been shaped by social and financial factors. Ultimately, I conclude that although the DSM is of immense practical importance it is not likely to become the best possible classification of mental disorders.

Bibliographic note

This article is a short version of an argument presented at book length in Rachel Cooper (2005) Classifying madness. Springer. The final, definitive version of this article has been published in the Journal, History of Psychiatry, 15 (1), 2004, © SAGE Publications Ltd, 2004 by SAGE Publications Ltd at the History of Psychiatry page: http://hpy.sagepub.com/ on SAGE Journals Online: http://online.sagepub.com/