Spinning on its axes: DSM and the social construction of psychiatric diagnosis

Abstract

Through a critical examination of the psychiatric profession's heavy reliance on the Diagnostic and Statistical Manual of Mental Disorders, the authors explore the central role of diagnosis in the theory and practice of psychiatry. The set of beliefs that have guided the psychiatric profession since the creation of DSM-III are viewed as being tied to the new extension of the biopsychiatric medical model. From a sociological perspective, the authors address the issue of psychiatric nosology with reference to practice styles and professional dominance, and consider the impact of DSM's intrinsic social biases both within and outside psychiatry's traditionally drawn boundaries. They conclude that working soley within the confines of a medical framework of diagnosis, with little attention to the wider social and cultural contexts that should surround diagnostic practice, psychiatry will be unable to understand and explain the changing needs of its clientele.