Misdiagnosing normality: Psychiatry's failure to address the problem of false positive diagnoses of mental disorder in a changing professional environment

Journal of Mental Health
Jerome C Wakefield

Abstract

In psychiatry's transformation from primarily an asylum-based profession to a community-oriented profession, false positive diagnoses that mistakenly classify normal intense reactions to stress as mental disorders became a major challenge to the validity of psychiatric diagnosis. The shift to symptom-based operationalized diagnostic criteria in DSM-III further exacerbated this difficulty because of the contextually based nature of the distinction between normal distress and mental disorder, which often display similar symptoms. The problem has particular urgency because the DSM's symptom-based criteria are often applied in studies and screening instruments outside of the clinical context and by non-mental-health professionals. To consider, through selected examples, the degree of concern, systematicity and thoroughness - and the degree of success - with which recent revisions of the DSM have attended to the challenge of avoiding false positive diagnoses. Conceptual analysis of selected criteria sets, with a focus on possible counterexamples to the claim that DSM criteria imply disorder. Psychiatry has so far failed to systematically adjust its diagnostic practices to confront the problem of false positives. Flaws in criteria, w...Continue Reading

References

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Mar 31, 2000·Nature Genetics·M J van den BoogaardH K van Amstel
Mar 1, 2002·The American Journal of Psychiatry·Jerome C WakefieldStuart A Kirk
Jul 8, 2005·Canadian Journal of Psychiatry. Revue Canadienne De Psychiatrie·Jerome C WakefieldMark F Schmitz
Apr 25, 2006·Canadian Journal of Psychiatry. Revue Canadienne De Psychiatrie·Jerome C WakefieldXin Tian
Apr 25, 2007·The World Journal of Biological Psychiatry : the Official Journal of the World Federation of Societies of Biological Psychiatry·Franco Benazzi

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Citations

Oct 30, 2013·Disease Markers·Daniel Martins-de-Souza
Dec 2, 2011·The British Journal of Psychiatry : the Journal of Mental Science·David P Geaney
Sep 13, 2011·International Journal of Law and Psychiatry·Graham W MellsopDavid B Menkes
Aug 21, 2012·Psychology and Psychotherapy·Stijn Vanheule
Feb 14, 2015·Epidemiology and Psychiatric Sciences·J C Wakefield
Jan 21, 2015·Frontiers in Psychology·Marco Castiglioni, Federico Laudisa
Sep 27, 2016·Biological Psychiatry·Nicholas T Van DamMichael P Milham
Feb 13, 2019·Journal of Attention Disorders·Whitney L M WoodBenjamin J Lovett
Dec 20, 2019·Journal of Computational Biology : a Journal of Computational Molecular Cell Biology·Elİf Pala, Tuba Denkçeken
Sep 7, 2018·Italian Journal of Pediatrics·Laura Reale, Maurizio Bonati
Dec 10, 2019·Progress in Neurobiology·M M J van den BergJ J Briedé

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