The DSM validation method and its decision points: value judgments, metaphysical presuppositions, and validators

Area of Science:

• Philosophy of Science
• Psychiatry
• Medical Classification Systems

Background:

• The Diagnostic and Statistical Manual of Mental Disorders (DSM) validation method was intended to base mental disorder classification on empirical evidence.
• Historical development reveals the DSM validation method incorporated non-empirical factors despite its empirical aims.
• This reliance on extra-empirical considerations presents a tension within the DSM's methodological framework.

Purpose of the Study:

• To analyze the role of non-empirical factors in the DSM validation method.
• To explore how value judgments and metaphysical presuppositions influence diagnostic category development and application.
• To understand how these factors resolve indeterminacy in classification beyond empirical evidence.

Main Methods:

• Reconstruction of the historical development and institutionalization of the DSM validation method.
• Application of the 'decision point' concept from science and values literature.
• Identification of decision points in the application and design of the DSM validation method.

Main Results:

• The DSM validation method, in its design and application, relies on crucial extra-empirical considerations.
• Value judgments and metaphysical presuppositions are identified as necessary components at key decision points.
• These non-empirical elements enable the validation method to achieve determinate conclusions for diagnostic categories.

Conclusions:

• Non-empirical factors are integral and epistemically pertinent to the DSM validation method.
• The incorporation of values and metaphysical presuppositions is essential for the method's formation and application.
• The DSM validation process necessitates these elements to move beyond initial stages and reach definitive classifications.