CoChat
Sign Up
Cited by 580Mental Health and PsychiatryHistorical Psychiatry and Medical PracticesAcademic and Historical Perspectives in Psychology

DSM and the Death of Phenomenology in America: An Example of Unintended Consequences

Open access
Andreasen, N. C.·2006·Schizophrenia Bulletin
DOI 10.1093/schbul/sbl054PMC PMC2632284
Open this paper in CoChat — free accountOpen PDF

Abstract

During the 19th century and early 20th century, American psychiatry shared many intellectual traditions and values with Great Britain and Europe. These include principles derived from the Enlightenment concerning the dignity of the individual and the value of careful observation. During the 20th century, however, American psychiatry began to diverge, initially due to a much stronger emphasis on psychoanalytic principles, particularly in comparison with Great Britain. By the 1960s and 1970s, studies such as the US-UK study and the International Pilot Study of Schizophrenia demonstrated that the psychodynamic emphasis had gone too far, leading to diagnostic imprecision and inadequate evaluation of traditional evaluations of signs and symptoms of psychopathology. Diagnostic and Statistical Manual of Mental Disorders, Third Edition (DSM-III) was developed in this context, under the leadership of representatives from institutions that had retained the more traditional British-European approaches (eg, Washington University, Iowa). The goal of DSM-III was to create a comprehensive system for diagnosing and evaluating psychiatric patients that would be more reliable, more valid, and more consistent with international approaches. This goal was realized in many respects, but unfortunately it also had many unintended consequences. Although the original creators realized that DSM represented a "best effort" rather than a definitive "ground truth," DSM began to be given total authority in training programs and health care delivery systems. Since the publication of DSM-III in 1980, there has been a steady decline in the teaching of careful clinical evaluation that is targeted to the individual person's problems and social context and that is enriched by a good general knowledge of psychopathology. Students are taught to memorize DSM rather than to learn complexities from the great psychopathologists of the past. By 2005, the decline has become so severe that it could be referred to as "the death of phenomenology in the United States."

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Integrity signals

Registry

Crossref · 10.1093/schbul/sbl054

Cites

19 of 19 references verified0 citation errors · 0 not checkable

Statistics

Claims the paper makes

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

The self-check needs the paper’s full text.

Cites

Flagged first, then by citations

Research works printed but not linked: 1

  1. [14]14. Wing JK. A standard form of psychiatric Present State Ex- aminations (PSE) and a method for standardizing the classifica- tion of symptoms. In: Hare EH, Wing JK, eds. Psychiatric Epidemiology. London, UK: Oxford University Press; 1970.

Cited by

Sorted by citations

Related

Authors
Andreasen, N. C.
Affiliations
University of Iowa (US)
Corresponding author
Andreasen, N. C.
ORCID
Andreasen, N. C.
Venue
Schizophrenia Bulletin
Publisher
Oxford University Press (OUP)
Published
2006-12-07
Volume
33
Issue
1
Pages
108-112
ISSN
  • 0586-7614 (ISSN-L)
  • 1745-1701
DOI
10.1093/schbul/sbl054
PMC
PMC2632284
OpenAlex
W2134569588
Cited by
580
References
19
Citations by year
2026: 12 · 2025: 24 · 2024: 33 · 2023: 45 · 2022: 36 · 2021: 23 · 2020: 26 · 2019: 31 · 2018: 44 · 2017: 29 · 2016: 28 · 2015: 32 · 2014: 32 · 2013: 40 · 2012: 28
FWCI
152.30
Type
journal article
Language
en
Open access
Locations
  • Schizophrenia Bulletin (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Social Sciences › Arts and Humanities › Philosophy › Mental Health and Psychiatry
  • Social Sciences › Psychology › Clinical Psychology › Historical Psychiatry and Medical Practices
  • Social Sciences › Psychology › General Psychology › Academic and Historical Perspectives in Psychology
Keywords
DSM-III, American psychiatry
MeSH terms
Brain, Europe, Humans, Interview, Psychological, Psychoanalytic Theory, Schizophrenia, Schizophrenic Psychology, United States, Reproducibility of Results, Internationality, Diagnostic and Statistical Manual of Mental Disorders

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review