Abstract

When it was published in 1980, the Diagnostic and Statistical Manual of Mental Disorders, third edition - universally known as DSM-III - embodied a new method for identifying psychiatric illness. The manual's authors and their supporters claimed that DSM-III's development was guided by scientific principles and evidence and that its innovative approach to diagnosis greatly ameliorated the problem of the unreliability of psychiatric diagnoses. In this paper we challenge the conventional wisdom about the research data used to support this claim. Specifically, we argue that the rhetoric of science, more than the scientific data, was used convincingly by the developers of DSM-III to promote their new manual. We offer a re-analysis of the data gathered in the original DSM-III field trials in light of the interpretations that had been offered earlier for the reliability studies of others. We demonstrate how the standards for interpreting reliability were dramatically shifted over time in a direction that made it easier to claim success with DSM-III when, in fact, the data were equivocal