Show Summary Details

Page of

PRINTED FROM OXFORD HANDBOOKS ONLINE (www.oxfordhandbooks.com). © Oxford University Press, 2018. All Rights Reserved. Under the terms of the licence agreement, an individual user may print out a PDF of a single chapter of a title in Oxford Handbooks Online for personal use (for details see Privacy Policy and Legal Notice).

date: 14 November 2019

Abstract and Keywords

The concepts of reliability and validity are fundamental for evaluating psychiatric diagnosis, including the "operationalist" approach pioneered in DSM-III. This chapter explores the complexity of these psychometric concepts and their interrelations. Although reliability constrains validity it does not guarantee it, and pursuing reliability in diagnosis can reduce validity. It is widely believed that the operationalist emphasis on diagnostic reliability has compromised the validity of recent psychiatric classifications. In particular, writers have argued that the drive for atheoretical diagnostic criteria has come at the cost of phenomenological richness and psychodynamic complexity. This chapter argues that although the operationalist turn may have impaired the validity of psychiatric diagnosis in some respects, these criticisms must be balanced by an appreciation of its benefits. In addition, it is suggested that some criticisms rest on a misunderstanding of the goals of operational descriptions. They should be evaluated primarily on pragmatic grounds as identification procedures and judged on their success in serving epistemic and communicative functions. Operational descriptions should not be viewed as comprehensive definitions of clinical phenomena or judged on their failure to encompass the richness and complexity of mental disorders. A diagnostic system is best understood as an intentionally delimited instrument for enabling clinical inference and communication. In essence, it is a simplified pidgin with which clinicians who speak different first languages (theoretical orientations) can conduct their shared business.

Keywords: assessment, diagnosis, DSM, operationalism, psychometrics, reliability, validity

Access to the complete content on Oxford Handbooks Online requires a subscription or purchase. Public users are able to search the site and view the abstracts and keywords for each book and chapter without a subscription.

Please subscribe or login to access full text content.

If you have purchased a print title that contains an access token, please see the token for information about how to register your code.

For questions on access or troubleshooting, please check our FAQs, and if you can''t find the answer there, please contact us.