Nevertheless, document review is a bit different from direct observation, participant-observation or testing. This focus on Triangulation leads us to a final critical question: are all three sources and methods being deployed when a DSM diagnosis is being made? We will be returning to this question repeatedly in this essay and the next essay as we address the opportunities and challenges associated with use of the Diagnostic and Statistical Manual of Mental Disorders (DSM).
I would suggest, in summary, that the distinction to be drawn between diagnosis and assessment can be captured in the artistic analogy that (as we have already mentioned) defines the purpose of this essay and the next essay in this series. Diagnoses are essentially intimate portraits that are rendered to help us capture the unique features of one person’s pathologies. An intimate rendering is also being offered in our next essay on the assumptive worlds of psychopathy that focuses on the actual experiences of senior clinicians in using DSM.
By contrast, assessments are broader landscape renderings that help us capture the way(s) in which a specific pathology fits into (and is often at least in part induced by) the environment in which the person being diagnosed must operate. This essay is itself a landscape rending, with DSM being placed in a broader societal context. Now, with this brief foray into the fundamentals of both diagnosis and assessment, we are ready to focus specifically on DSM.
Diagnostic and Statistical Manual of Mental Disorders: Current Status
At the present time – and for the foreseeable future, DSM is the official diagnostic classification system in the United States. It is likely to go through future revisions—but will continue to be the “bible” of mental health. We purposefully use the term “bible”, for in many ways this document is treated with a great deal of reverence and is considered to be the definitive word from “on high” (in this case, its publisher, the American Psychiatric Association.
