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The article you linked, and Insel's related pronouncements (as detailed in his NIMH blog) do not support your position. His quite reasonable criticisms of the

The article you linked, and Insel's related pronouncements (as detailed in his NIMH blog) do not support your position. His quite reasonable criticisms of the DSM as a framework for categorising and funding mental health research (and suggestion of what may be a more suitable replacement) does not imply that the entire field of psychiatry is unscientific.

lutusp 12y ago
> The article you linked, and Insel's related pronouncements (as detailed in his NIMH blog) do not support your position. Here's my position: "The goal of this new manual, as with all previous editions, is to provide a common language for describing psychopathology. While DSM has been described as a “Bible” for the field, it is, at best, a dictionary, creating a set of labels and defining each. The strength of each of the editions of DSM has been “reliability” – each edition has ensured that clinicians use the same terms in the same ways. The weakness is its lack of validity." "Unlike our definitions of ischemic heart disease, lymphoma, or AIDS, the DSM diagnoses are based on a consensus about clusters of clinical symptoms, not any objective laboratory measure. In the rest of medicine, this would be equivalent to creating diagnostic systems based on the nature of chest pain or the quality of fever. Indeed, symptom-based diagnosis, once common in other areas of medicine, has been largely replaced in the past half century as we have understood that symptoms alone rarely indicate the best choice of treatment. Patients with mental disorders deserve better." Source: http://www.nimh.nih.gov/about/director/2013/transforming-diagnosis.shtml http://www.nimh.nih.gov/about/director/2013/transforming-dia... > ... does not imply that the entire field of psychiatry is unscientific. But I never made that claim anywhere, and certainly not with respect to Insel's views -- I don't need to. It's sufficient to note that there's no science in psychiatry. It's sufficient to say that the DSM, the sum of psychiatric knowledge, is being discarded by the NIMH for the reason that is has no scientific content. It's sufficient to ask for the identity and location of the unifying corpus of theory in psychiatry, a theory that forges a consensus between psychiatrists, that demonstrates its scientific standing, a theory such as exists in every legitimate science without exception. If you will name a science, I will tell you the theory that defines it and legitimizes it as a science. Even though all scientific theories are subject to falsification and many are in fact falsified, at any given time a central corpus of theory guides research and practice in each and every scientific field. But for the sake of argument, let's say the above isn't a requirement for science, see where this takes us. Let's say that we don't need a falsifiable explanation for what we're studying, that descriptions -- the descriptions that Insel complains about with respect to the DSM above -- are all we have. Is it still science? This example may help you over this intellectual hurdle. An imaginary Doctor Dubious invents a new treatment for the common cold. His treatment is to shake a dried gourd over the cold sufferer until the patient gets better. Sometimes the treatment takes a week, but it always works — the cold sufferer always recovers. So, why doesn't Doctor Dubious get a Nobel Prize for his breakthrough? The answer is that the procedure is only a description — shake the gourd, patient recovers — without an explanation, without a basis for actually learning anything or being truthful about the connection between cause and effect. It's the same with psychiatry.

lutusp 12y ago

> The article you linked, and Insel's related pronouncements (as detailed in his NIMH blog) do not support your position. Here's my position: "The goal of this new manual, as with all previous editions, is to provide a common language for describing psychopathology. While DSM has been described as a “Bible” for the field, it is, at best, a dictionary, creating a set of labels and defining each. The strength of each of the editions of DSM has been “reliability” – each edition has ensured that clinicians use the same terms in the same ways. The weakness is its lack of validity." "Unlike our definitions of ischemic heart disease, lymphoma, or AIDS, the DSM diagnoses are based on a consensus about clusters of clinical symptoms, not any objective laboratory measure. In the rest of medicine, this would be equivalent to creating diagnostic systems based on the nature of chest pain or the quality of fever. Indeed, symptom-based diagnosis, once common in other areas of medicine, has been largely replaced in the past half century as we have understood that symptoms alone rarely indicate the best choice of treatment. Patients with mental disorders deserve better." Source: http://www.nimh.nih.gov/about/director/2013/transforming-diagnosis.shtml http://www.nimh.nih.gov/about/director/2013/transforming-dia... > ... does not imply that the entire field of psychiatry is unscientific. But I never made that claim anywhere, and certainly not with respect to Insel's views -- I don't need to. It's sufficient to note that there's no science in psychiatry. It's sufficient to say that the DSM, the sum of psychiatric knowledge, is being discarded by the NIMH for the reason that is has no scientific content. It's sufficient to ask for the identity and location of the unifying corpus of theory in psychiatry, a theory that forges a consensus between psychiatrists, that demonstrates its scientific standing, a theory such as exists in every legitimate science without exception. If you will name a science, I will tell you the theory that defines it and legitimizes it as a science. Even though all scientific theories are subject to falsification and many are in fact falsified, at any given time a central corpus of theory guides research and practice in each and every scientific field. But for the sake of argument, let's say the above isn't a requirement for science, see where this takes us. Let's say that we don't need a falsifiable explanation for what we're studying, that descriptions -- the descriptions that Insel complains about with respect to the DSM above -- are all we have. Is it still science? This example may help you over this intellectual hurdle. An imaginary Doctor Dubious invents a new treatment for the common cold. His treatment is to shake a dried gourd over the cold sufferer until the patient gets better. Sometimes the treatment takes a week, but it always works — the cold sufferer always recovers. So, why doesn't Doctor Dubious get a Nobel Prize for his breakthrough? The answer is that the procedure is only a description — shake the gourd, patient recovers — without an explanation, without a basis for actually learning anything or being truthful about the connection between cause and effect. It's the same with psychiatry.