Abstract

The modern editions of the Diagnostic and Statistical Manual of Mental Disorders (DSM), beginning with DSM-III in 1980, emerged in response to notable challenges to psychiatry’s practices and ways of knowing in the early 1970s. Because these challenges threatened psychiatry’s scientific self-understanding and moral authority, they exemplify what Alasdair MacIntyre has termed “epistemological crisis.” As a response to crisis, the modern DSM has been a stunning political achievement, providing the central diagnostic constructs around which psychiatric research, practice, and reimbursement has been organized for four decades. Indeed, the DSM’s authority survives in the face of ongoing trenchant scientific and philosophical critique. But if psychiatry is to be healthy, it must be epistemologically humble, reckoning honestly with the limits of the DSM before a future epistemological crisis destabilizes it entirely.

中文翻译：

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精神病诊断危机？DSM时代的认识论谦卑

摘要

精神疾病诊断和统计手册（DSM）的现代版本，从DSM-III开始在1980年代，它应运而生，以应对1970年代初期对精神病学实践和认知方式的重大挑战。因为这些挑战威胁着精神病学的科学自我理解和道德权威，所以它们可以例证阿拉斯戴尔·麦金太尔所说的“认识论危机”。作为对危机的回应，现代DSM取得了令人瞩目的政治成就，它提供了围绕精神病学研究，实践和报销的中央诊断体系，已经进行了40年。的确，面对持续不断的科学和哲学批评，DSM的权威仍然存在。但是，如果要使精神病学变得健康，就必须在认识论上保持谦逊，诚实地考虑到DSM的局限性，然后再在未来的认识论危机中彻底破坏它的稳定。