Psychiatrists must run field trials for each new set of diagnostic criteria to prevent unpleasant surprises

The DSM has to prioritize reliability when defining mental disorders to prevent disagreement, which sacrifices validity. But then there is the problem of knowing which criteria to choose and pretesting for their safety. Before they go prime time with a criteria set, the safe play is to audition it in a field trial. A test drive reduces uncertainty about how it will eventually perform, reducing the risk of unpleasant surprises and the dangers of unwanted fads. The idea is to have clinicians try out the new definition under conditions that approximate real-life circumstances. If the proposal performs well, it becomes official; if poorly, it is revised or scrapped. But again there is a catch. Really several different catches:

• Field trails for new diagnostic criteria for mental disorders are unreliable for predicting future rates
• Field trials for diagnostic criteria for mental disorders are tested on samples of people chosen by researchers, generating better results than in real psychiatric settings
• It is much easier for psychiatrists to diagnose in a field study than in everyday practice

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References

• Frances, Allen. (2013). Saving Normal CHAPTER 1. What’s Normal and What’s Not? (p. 4). New York, NY: HarperCollins.

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Type:🔴 Tags: Psychiatry Status:☀️