Psychiatric Progress and the Assumption of Diagnostic Discrimination

Abstract

Psychiatry’s failure to validate its diagnostic constructs is often attributed to the prioritizing of reliability over validity in the Diagnostic and Statistical Manual of Mental Disorders ( DSM ). I argue that a more powerful way in which the DSM has retarded biomedical progress is by encouraging unwarranted optimism about diagnostic discrimination : the assumption that our diagnostic tests group patients together in ways that allow for relevant facts about mental disorder to be discovered. I argue that the Research Domain Criteria (RDoC) framework, a new paradigm for classifying objects of psychiatric research, solves some of the challenges brought on by this assumption.