2012

The Diagnostic and Statistical Manual of Mental Disorders (4th ed., text rev.; DSM-IV-TR; American Psychiatric Association, 2000) has been criticized for using categorical diagnosis of psychiatric disorders despite considerable clinical evidence to the contrary (First, 2008). Although yes-no categories appear valid when diagnosing some conditions (e.g., Down Syndrome; Alzheimer’s disease), boundaries between mental health disorders (e.g., schizophrenia and bipolar disorder) and between disorders and normality (e.g., depression) more often exist on a continuum (Arnaout & Petrakis, 2008; First, 2008; Saha, Chou, & Grant, 2006). Client defiance of categorical diagnosis supports the idea that psychiatric diagnosis is a form of rhetoric (Kirk & Kutchens, 1992). DSM developers had hoped that empirically-based diagnostic categories would lead to discovering causes and treatments for disorders (cf. Regier, Narrow, Kuhl, & Kupfer, 2009), but research over the past 30 years has not provided the degree of categorical specificity originally hoped for.