"Pluralism in Psychiatric Classification" Anke Bueter (University of Hannover)

Psychiatric classification is considered by many to be in a state of crisis, and the controversial status of the Diagnostic and Statistical Manual of Mental Disorders (DSM) has only been amplified by its latest revision. A central concern in these controversies is that the DSM lacks validity, which is often attributed to its atheoretical, syndromal approach. Shortly before the release of the DSM-5, the NIMH has therefore announced to replace the DSM with a theory-driven alternative, the Research Domain Criteria project (RDoC). RDoC presents a change in heuristic strategy that is well justified by the history of DSM-led research. However, it does not by itself end the classification crisis and leads to the important question of the DSM’s future. I argue that to enhance the trustworthiness of psychiatric classification, a combination of strategies is needed. These revolve around different kinds of pluralism: theoretical pluralism (1), nosological pluralism (2), and participatory pluralism (3).