DSM-III controversies with two illustrative cases

Due to the continued presence of criticisms levied against the current official psychiatric diagnostic nomenclature (DSMIII and its revision) and the continued requirements of its use by insurance companies and the federal government, the controversies surrounding the DSMIII are explored. This was done in an effort to understand the uses and misuses of the system. (i) A history of the development of the DSMIII-R is given, along with statements of purposes and goals. (ii) The major diagnostic controversies are discussed. These include issues of the philosophical approaches inherent within the manual, research considerations, treatment connections, views of normality and bias, and the labeling of deviance. (iii) Two examples of recent diagnostic controversies, those of homosexuality and the self-defeating personality disorder, are discussed. Views regarding homosexuality and masochism are discussed, the controversies regarding the specific diagnoses are traced, and these controversies are used to illustrate the major controversial issues surrounding the DSMIII. (iv) It is concluded that, although the DSMIII clearly has flaws, it also has strengths that would make the abandonment of the system premature.