Misdiagnosing normality: psychiatry’s failure to address the problem of false positive diagnoses of mental disorder in a changing professional environment
Journal title PSICOTERAPIA E SCIENZE UMANE
Author/s Jerome C. Wakefield
Publishing Year 2010 Issue 2010/3 Language Italian
Pages 20 P. 295-314 File size 418 KB
DOI 10.3280/PU2010-003001
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In psychiatry’s transformation from an asylum- based to a community-oriented profession, false positive diagnoses became a major challenge to the validity of the diagnostic system. The shift to descriptive, symptom-based operationalized diagnostic criteria of DSM-III further exacerbated this difficulty because of the contextually based nature of the distinction between normal distress and mental disorder. Through selected examples, the degree of success with which DSM-III and DSM-IV have attended to the challenge of avoiding false positive diagnoses is examined. Conceptual analysis of selected criteria sets, with a focus on counterexamples to the claim that DSM criteria imply disorder, is performed. Psychiatry has so far failed to systematically confront the problem of false positives. Flaws in criteria, which can be recognized even by lay people, remain unaddressed, despite the fact that the issue is purely conceptual and is not sensitive to any new research information.
Keywords: Diagnosis in psychiatry, false positives, validity of diagnostic criteria, philosophy of psychiatry, clinical significance
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Jerome C. Wakefield, Patologizzare la normalità: l’incapacità della psichiatria di individuare i falsi positivi nelle diagnosi dei disturbi mentali in "PSICOTERAPIA E SCIENZE UMANE" 3/2010, pp 295-314, DOI: 10.3280/PU2010-003001