Diagnostic Issues and Controversies in DSM-5: Return of the False Positives Problem

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Abstract

The fifth revision of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) was the most controversial in the manual's history. This review selectively surveys some of the most important changes in DSM-5, including structural/organizational changes, modifications of diagnostic criteria, and newly introduced categories. It analyzes why these changes led to such heated controversies, which included objections to the revision's process, its goals, and the content of altered criteria and new categories. The central focus is on disputes concerning the false positives problem of setting a valid boundary between disorder and normal variation. Finally, this review highlights key problems and issues that currently remain unresolved and need to be addressed in the future, including systematically identifying false positive weaknesses in criteria, distinguishing risk from disorder, including context in diagnostic criteria, clarifying how to handle fuzzy boundaries, and improving the guidelines for "other specified" diagnosis.

Original languageEnglish (US)
Pages (from-to)105-132
Number of pages28
JournalAnnual Review of Clinical Psychology
Volume12
DOIs
StatePublished - Mar 28 2016

Keywords

  • Diagnosis
  • False positives
  • Harmful dysfunction
  • Mental disorder
  • Validity

ASJC Scopus subject areas

  • Clinical Psychology
  • Psychiatry and Mental health

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