Chapter

Progress and the calibration of scientific constructs: the role of comparative validity

Peter Zachar

in Philosophical Issues in Psychiatry II

Published on behalf of Oxford University Press

Published in print April 2012 | ISBN: 9780199642205
Published online February 2013 | e-ISBN: 9780191754777 | DOI: http://dx.doi.org/10.1093/med/9780199642205.003.0005

Series: International Perspectives in Philosophy & Psychiatry

Progress and the calibration of scientific constructs: the role of comparative validity

Show Summary Details

Preview

Has psychiatry made progress in the classification of psychiatric disorders? This is an important question, because if it has not done so then the scientific legitimacy of psychiatric taxonomy would be called into doubt.

In the early 20th century it was claimed that the greatest scientific achievements regarding our understanding of humanity were made by Copernicus, Darwin and Freud. In the latter part of that century, however, the DSM-III abandoned the Freudian metapsychology for what was argued to be a more scientifically legitimate approach based on operationalized diagnostic criteria. With each new edition of the manual come similar claims. The authors of the DSM-IV asserted that psychiatric diagnostic categories, developed on the basis of professional opinions rather than research results, could be improved upon if all changes were “evidence-based” (Widiger et al. 1991). Some architects of the DSM-5 contend that the categorical approach to classification is scientifically inadequate. Psychiatric phenomena, they claim, are really dimensional; therefore, many DSM categories should be replaced with a more scientifically valid dimensional approach. (Hyman 2010; Krueger et al. 2005; Smith and Combs 2010; Widiger and Trull 2007).

This raises two questions. First, can such large shifts in emphasis be considered cumulative scientific progress? Second, does every generation of psychiatrists have to denigrate the “illegitimate science” of the past in the name of progress?

Several thinkers (P. J. Caplan 1995; Kirk and Kutchins 1992; Kutchins and Kirk 1997) assert that the much vaunted scientific progress in psychiatry is an illusion. They state that the scientific support behind psychiatric constructs has been manipulated and marketed in the same way that political campaigns promote their candidates. In this view, the denigration of the past is a political strategy. Such critics also claim that many constructs for psychiatric disorders are not real entities, but ad hoc creations of psychiatrists who have been allocated positions of influence.

Such criticisms should not be ignored or dismissed, but taken seriously and carefully explored. The charge that psychiatric classification represents ad hoc pseudoscience is worthy of critical evaluation. Although these thinkers do not seem to be denigrating the validity of psychiatric classification in the manner of the Scientologists, the differences between the two can be subtle. In both cases, scientific validity is the issue.

In what follows, I will explore the questions raised by Kutchins, Kirk, Caplan and other critics by focusing on the relationship between progress and scientific validity. I begin with some general considerations from the history of science before turning to psychiatry proper.

Chapter.  6514 words. 

Subjects: Psychiatry

Full text: subscription required

How to subscribe Recommend to my Librarian

Buy this work at Oxford University Press »

Users without a subscription are not able to see the full content. Please, subscribe or login to access all content.