Chapter

DSM-IV: context, concepts and controversies

Harold Alan Pincus

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/9780199642205.003.0023

Series: International Perspectives in Philosophy & Psychiatry

DSM-IV: context, concepts and controversies

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The intent of this paper is to provide an overview of the circumstances surrounding the development of DSM-IV, the principles and process underlying its development and several especially interesting or controversial issues that were encountered in its development. From the outset, it is worth pointing out that the work on DSM-IV was initiated during a period of burgeoning interest in “evidence-based medicine.” Within the leadership of the American Psychiatric Association (APA), most notably Melvin Sabshin, the Medical Director at that time, there was a strong sense that psychiatry must be part of that movement and this intent was inherent in establishing the APA's Office of Research several years prior to initiating the DSM-IV process. In fact, when I established the Office we were given responsibility for spearheading DSM-III-R through the final phases of its process. As such, it was felt that evidence-based approaches to psychiatric classification are essential to assure the credibility of the field and to conform to current scientific standards. They do, however, have important limitations and are not without their own explicit and implicit set of values. More on this later.

Chapter.  7334 words. 

Subjects: Psychiatry

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