Overview and analysis of the behaviourist criticism of the<i>Diagnostic and Statistical Manual of Mental Disorders</i>(<i>DSM</i>)

Andersson, Gerhard; Ghaderi, Ata

doi:10.1080/13284200600690461

Cited by 21 publications

(20 citation statements)

References 61 publications

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“…An important question is whether dependence is a discrete, dichotomous state that is either present or absent, or a continuum that can vary quantitatively. Psychiatric diagnosis treats all disorders as dichotomous ( American Psychiatric Association [APA], 2000 ) and has been criticized for ignoring intermediate variations ( Andersson & Ghaderi, 2006 ;Baker, Breslau, Covey, & Shiffman, 2012 ). Similarly, the Hooked on Nicotine Checklist ( HONC ;DiFranza et al, 2002 ) is typically scored dichotomously, considering endorsement of even one symptom as an indication of dependence and has similarly been criticized for classifying almost all smokers (and even some nonsmokers; Dar & Frenk, 2010 ;Hughes & Shiffman, 2008 ) as dependent.…”

Section: Introductionmentioning

confidence: 99%

Tobacco Dependence Among Intermittent Smokers

Shiffman

Ferguson

Dunbar

et al. 2012

Nicotine & Tobacco Research

113

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The study confirmed that DS are more dependent than ITS and that CITS are more dependent than NITS. Importantly, ITS exhibit features of dependence, and there is meaningful variation in dependence within ITS, suggesting that some aspects of dependence may appear with very infrequent smoking. Future work should examine implications for ITS' potential progression to daily smoking and cessation outcome.

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Section: Introductionmentioning

confidence: 99%

Tobacco Dependence Among Intermittent Smokers

Shiffman

Ferguson

Dunbar

et al. 2012

Nicotine & Tobacco Research

113

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“…This ‘nosology of diseases’ [21] based not on empirical evidence, but on clinical authority and historical tradition [22], has been problematic for psychiatry itself [13, 23–26], let alone for clinical psychology. It has been plagued by such major problems as excessive rates of comorbidity [27, 28], which may be an indicator of arbitrary boundaries between its disorders [29, 30], by the broad heterogeneity within its diagnosed groups [21, 31–33], and by the fact that none of the putative underlying disease processes have been uncovered in the 35 years of research since DSM-III was published [25, 34–37]. The search for biological etiology has greatly disappointed [38, 39], suggesting that psychiatric diagnosis has over simplified psychopathology [40].…”

Section: The Need For a New Conception Of Clinical Psychological Probmentioning

confidence: 99%

“…While many medical diagnoses point to underlying biochemical or neurological mechanisms, few psychopathological ones do [23–25]. Neither do they indicate particular psychological-level mechanisms [34, 35]. Hence, clinical psychologists rarely find such diagnoses useful.…”

Section: Seeking the Essence Of Clinical Psychological Problemsmentioning

confidence: 99%

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A new conception and subsequent taxonomy of clinical psychological problems

Bakker

2019

BMC Psychol

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Background A taxonomy of the objects of study, theory, assessment, and intervention is critical to the development of all clinical sciences. Clinical psychology has been conceptually and administratively dominated by the taxonomy of an adjacent discipline – psychiatry’s Diagnostic and statistical manual of mental disorders (DSM). Many have called for a ‘paradigm shift’ away from a medical nosology of diseases toward clinical psychology’s own taxonomy of clinical psychological problems (CPPs), without being able to specify what is to be listed and classified. Main text An examination of DSM’s problems for clinical psychology, especially its lack of clinical utility, and a search for the essence of CPPs in what clinical psychologists actually do, leads to the proposal that: The critical psychological-level phenomenon underlying CPPs is the occurrence of ‘problem-maintaining circles’ (PMCs) of causally related cognitions, emotions, behaviours, and/or stimuli. This concept provides an empirically-derived, theory-based, treatment-relevant, categorical, essentialist, parsimonious, and nonstigmatizing definition of CPPs. It distinguishes psychological problems in which PMCs have not (yet?) formed, and which may respond to ‘counseling’, clinical psychological problems in which active PMCs require clinical intervention, and psychopathological problems which are unlikely to be ‘cured’ by PMC-breaking alone. Conclusion A subsequent classification and coding system of PMCs is proposed, and expected benefits to research, communication, and the quality of case formulation in clinical psychology are described, reliant upon a development effort of some meaningful fraction of that which has been devoted to the DSM.

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“…The relative strengths and weaknesses of DSMtype psychiatric diagnosis versus behavioural functional analysis or cognitive behavioural case formulation have been thoroughly summarised by Andersson and Ghaderi (2006). They concluded that, although the DSM system has failed in providing therapeutic guidelines, functional analysis has thus far failed to provide a functional classification system.…”

Section: Pmc-based Diagnosismentioning

confidence: 99%

Problem-maintaining circles: Case illustrations of formulations that truly guide therapy

Bakker

2008

Clinical Psychologist

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The cognitive behaviour therapy (CBT) emphasis on treatment relevance in assessment, and on evidence‐based intervention, has led to an increasing focus on problem maintenance factors (vs. precipitants) in both its models of psychopathology and in its individual case formulations. This article describes the reasons for this growing focus, and presents a generic CBT model based on the functional analysis of “problem‐maintaining circles” (PMCs) of causes. Some samples of the profuse literature implicating PMCs in many psychological disorders are presented, and the utility of PMC‐based functional analysis, case formulation, or modelling of psychopathology is advanced, not only as a guide to selection of therapeutic interventions, but as an alternative to standard psychiatric diagnosis. A sampling of a taxonomy of such PMCs is presented. And finally, the clinical application of PMC‐based functional analysis, case formulation, and treatment selection is illustrated in five case illustrations drawn from a recent clinical caseload.

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Overview and analysis of the behaviourist criticism of theDiagnostic and Statistical Manual of Mental Disorders(DSM)

Cited by 21 publications

References 61 publications

Tobacco Dependence Among Intermittent Smokers

Tobacco Dependence Among Intermittent Smokers

A new conception and subsequent taxonomy of clinical psychological problems

Problem-maintaining circles: Case illustrations of formulations that truly guide therapy

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