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Science, Rhetoric, and the DSM: A Comparative Text Review and Conceptual Critique of Changes to the DSM-5-TR Prefatory Material.

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Title: Science, Rhetoric, and the DSM: A Comparative Text Review and Conceptual Critique of Changes to the DSM-5-TR Prefatory Material.
Authors: Wojdak, Christopher, Timmermans, Hannah, Skinner, Brendan, Dirickson, Madison, Schroeder, Jordan, Sederlund, Allison, Thompson, Connor, Joseph, Judeline, Airo, Abigale, Hodge, Kristen, Solares, Leslie, Del Rio, Mariana, Zeaiter, Hidaya, Gaynor, Scott T.
Source: Ethical Human Psychology & Psychiatry; 2026, Vol. 28 Issue 1, p81-93, 13p
Subject Terms: Rhetoric, Classification of mental disorders, Sociocultural factors, Psychiatric diagnosis, Test validity, Sexual diversity, Classification
Reviews & Products: Diagnostic & Statistical Manual of Mental Disorders (Book)
Abstract: Rhetoric has long played an important role in legitimizing the "Bible" of American psychiatry, the Diagnostic and Statistical Manual of Mental Disorders (DSM), particularly since its third edition. Critics have consistently alleged that the confident scientific rhetoric of DSM's authors and advocates has often outpaced the science. In a welcome change of tone, the authors of the text's fifth edition (DSM-5) provided a more honest and sober acknowledgment of the limitations of DSM in the document's prefatory material. In the Introduction and Use of the Manual sections, the authors explicitly drew the reader's attention to a host of conceptual and empirical challenges faced by the DSM classification system. Many of these statements have been removed from the DSM-5-Text Revision (2022) prefatory material. The most notable are the removal of explicit statements concerning validity (and its definition), the concerns about reification, problems with comorbidity, and conceptual and empirical issues with a categorical approach to psychiatric diagnosis. We argue these textual omissions serve the rhetorical function of implying that, in the years since DSM-5, the science has caught up to the system and validated the major DSM diagnoses. This is, unfortunately, not the case, and an increasing chorus of critics agrees that the DSM system has a serious validity problem. While recognizing laudable changes, including the expanded coverage of sociocultural variables, systemic inequities, and gender diversity, we raise concerns about the rhetoric of the DSM-5-TR prefatory material. We contend that the textual changes may contribute to readers overestimating the empirical status of DSM disorders and underestimating the classification system's many limitations. Future editions should restore and expand upon DSM-5's more candid discussion of diagnostic limitations. [ABSTRACT FROM AUTHOR]
Copyright of Ethical Human Psychology & Psychiatry is the property of Springer Publishing Company, Inc. and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
Database: Biomedical Index
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  Data: Science, Rhetoric, and the DSM: A Comparative Text Review and Conceptual Critique of Changes to the DSM-5-TR Prefatory Material.
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  Data: <searchLink fieldCode="AR" term="%22Wojdak%2C+Christopher%22">Wojdak, Christopher</searchLink><br /><searchLink fieldCode="AR" term="%22Timmermans%2C+Hannah%22">Timmermans, Hannah</searchLink><br /><searchLink fieldCode="AR" term="%22Skinner%2C+Brendan%22">Skinner, Brendan</searchLink><br /><searchLink fieldCode="AR" term="%22Dirickson%2C+Madison%22">Dirickson, Madison</searchLink><br /><searchLink fieldCode="AR" term="%22Schroeder%2C+Jordan%22">Schroeder, Jordan</searchLink><br /><searchLink fieldCode="AR" term="%22Sederlund%2C+Allison%22">Sederlund, Allison</searchLink><br /><searchLink fieldCode="AR" term="%22Thompson%2C+Connor%22">Thompson, Connor</searchLink><br /><searchLink fieldCode="AR" term="%22Joseph%2C+Judeline%22">Joseph, Judeline</searchLink><br /><searchLink fieldCode="AR" term="%22Airo%2C+Abigale%22">Airo, Abigale</searchLink><br /><searchLink fieldCode="AR" term="%22Hodge%2C+Kristen%22">Hodge, Kristen</searchLink><br /><searchLink fieldCode="AR" term="%22Solares%2C+Leslie%22">Solares, Leslie</searchLink><br /><searchLink fieldCode="AR" term="%22Del+Rio%2C+Mariana%22">Del Rio, Mariana</searchLink><br /><searchLink fieldCode="AR" term="%22Zeaiter%2C+Hidaya%22">Zeaiter, Hidaya</searchLink><br /><searchLink fieldCode="AR" term="%22Gaynor%2C+Scott+T%2E%22">Gaynor, Scott T.</searchLink>
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  Data: Ethical Human Psychology & Psychiatry; 2026, Vol. 28 Issue 1, p81-93, 13p
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  Data: <searchLink fieldCode="DE" term="%22Rhetoric%22">Rhetoric</searchLink><br /><searchLink fieldCode="DE" term="%22Classification+of+mental+disorders%22">Classification of mental disorders</searchLink><br /><searchLink fieldCode="DE" term="%22Sociocultural+factors%22">Sociocultural factors</searchLink><br /><searchLink fieldCode="DE" term="%22Psychiatric+diagnosis%22">Psychiatric diagnosis</searchLink><br /><searchLink fieldCode="DE" term="%22Test+validity%22">Test validity</searchLink><br /><searchLink fieldCode="DE" term="%22Sexual+diversity%22">Sexual diversity</searchLink><br /><searchLink fieldCode="DE" term="%22Classification%22">Classification</searchLink>
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  Data: Rhetoric has long played an important role in legitimizing the "Bible" of American psychiatry, the Diagnostic and Statistical Manual of Mental Disorders (DSM), particularly since its third edition. Critics have consistently alleged that the confident scientific rhetoric of DSM's authors and advocates has often outpaced the science. In a welcome change of tone, the authors of the text's fifth edition (DSM-5) provided a more honest and sober acknowledgment of the limitations of DSM in the document's prefatory material. In the Introduction and Use of the Manual sections, the authors explicitly drew the reader's attention to a host of conceptual and empirical challenges faced by the DSM classification system. Many of these statements have been removed from the DSM-5-Text Revision (2022) prefatory material. The most notable are the removal of explicit statements concerning validity (and its definition), the concerns about reification, problems with comorbidity, and conceptual and empirical issues with a categorical approach to psychiatric diagnosis. We argue these textual omissions serve the rhetorical function of implying that, in the years since DSM-5, the science has caught up to the system and validated the major DSM diagnoses. This is, unfortunately, not the case, and an increasing chorus of critics agrees that the DSM system has a serious validity problem. While recognizing laudable changes, including the expanded coverage of sociocultural variables, systemic inequities, and gender diversity, we raise concerns about the rhetoric of the DSM-5-TR prefatory material. We contend that the textual changes may contribute to readers overestimating the empirical status of DSM disorders and underestimating the classification system's many limitations. Future editions should restore and expand upon DSM-5's more candid discussion of diagnostic limitations. [ABSTRACT FROM AUTHOR]
– Name: Abstract
  Label:
  Group: Ab
  Data: <i>Copyright of Ethical Human Psychology & Psychiatry is the property of Springer Publishing Company, Inc. and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
PLink https://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=edm&AN=193598862
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        Value: 10.1891/EHPP-2025-0025
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        Text: English
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