Rethinking psychiatric symptoms
The role of measurement heterogeneity in diagnostic validity
Bibliographic Data
| ID | 12028822 |
|---|---|
| Authors | Daniel Montero-Espinoza (0009-0009-8064-0799, Leibniz University Hannover, corresponding author) |
| Year | 2025 |
| Volume | 47 |
| Issue | 2 |
| Pages | 20-20 |
| Publication date | 2025-03-19 |
| Open Access | Yes |
| Type | ARTICLE |
| Venue | History & Philosophy of the Life Sciences (JOURNAL) |
| Journal identifiers | ISSN: 0391-9714 • E-ISSN: 1742-6316 |
| Publisher | Springer Nature (PUBLISHER • SG) |
| DOI | 10.1007/s40656-025-00659-5 |
| PMID | 40106198 |
| OpenAlex | W4408591714 |
| Language | EN |
| Citations received | 2 |
| References cited | 42 |
The current research environment in psychiatry is marked by the discredit of the main psychiatric classifications. The common narrative about the DSM holds that the current diagnostic categories lack diagnostic validity. This claim is supported by the high degrees of diagnostic heterogeneity and comorbidity among diagnosed patients. Current attempts to overcome these problems emphasize the need to develop alternative ways of investigating psychopathology that no longer rely on the DSM categories. In this line, transdiagnostic research initiatives such as RDoC promote the abandonment of the DSM categories while still relying on traditional psychiatric symptoms. This reliance assumes that symptoms do not pose similar problems to the ones commonly ascribed to the DSM categories. In this article, I challenge what I call the "received view of symptoms" and argue that a closer look at symptom measurement reveals that different measurements of purportedly the same symptom differ from each other in ways that have an impact on both psychiatric research and clinical practice. Furthermore, I show that psychiatric symptoms are not "neutral" vis-à-vis the DSM categories. To illustrate my points, I use a case study from the history of the measurement of anhedonia. Based on this case study, I argue that in addition to diagnostic heterogeneity, there is also symptom measurement heterogeneity. Finally, I suggest a reassessment of the common narrative about the DSM's lack of diagnostic validity in light of my case study and argue that closer attention should be given to symptoms
Abandonment (legal · Anhedonia · Comorbidity · Narrative · Psychiatry · Psychopathology · Psychotherapist · Schizophrenia (object-oriented programming · Clinical Psychology · Mental Health and Psychiatry · Mental Health Research Topics · Psychology · Treatment of Major Depression
The History of Mental Symptoms
The Diagnosis of Mental Disorders
The RDoC framework: facilitating transition from ICD/DSM to dimensional approaches that integrate neuroscience and psychopathology
A Scale for the Assessment of Hedonic Tone the Snaith–Hamilton Pleasure Scale
Toward the future of psychiatric diagnosis
The 52 symptoms of major depression
Establishment of Diagnostic Validity in Psychiatric Illness
Depression is not a consistent syndrome
Transdiagnostic approaches to mental health problems
Well-Being and Pluralism
The hermeneutics of symptoms
What is Wrong with the DSM
The anhedonias
How autism shows that symptoms, like psychiatric diagnoses, are 'constructed
Data, Phenomena, and Reliability
Saving the Phenomena
A Philosophy for the Science of Well-Being
| Citations per year | 2 |
|---|---|
| Citation span | 2025 - 2026 (2) |
| Highly cited | No |