Many scholars believe that psychiatric nosology is undergoing a crisis of confidence. Some of the issues up for debate hark back to the introduction of the natural history approach to classification in the seventeenth century. Natural histories map sameness and difference rather than speculate about causes. In contrast, the natural classification approach aspires to carve nature at the joints by demarcating classifications by causes. Natural classifications are more ideal scientifically, but speculation about causality has had a poor track record in psychiatric nosology. A natural classification of psychiatric disorders may have the added burden of requiring normative assumptions in addition to the discovery of fact. In the natural classification tradition, the epistemic iteration perspective, the Research Domain Criteria (RDoC) initiative, and dimensional models offer different views about the criteria of naturalness (or validity). Also in this tradition, some thinkers believe that causes can be empirically indexed by latent variable models, especially if the latent variables are moderately heritable, but these assumptions may be neither statistically nor genetically warranted.


Article metrics loading...

Loading full text...

Full text loading...


Literature Cited

  1. Ackerknecht EH. 1982. A Short History of Medicine Baltimore, MD: Johns Hopkins Univ. Press
  2. Am. Psychiatr. Assoc. 1968. Diagnostic and Statistical Manual of Mental Disorders. Washington, DC: Am. Psychiatr. Publ, 2nd ed.. [Google Scholar]
  3. Am. Psychiatr. Assoc. 1980. Diagnostic and Statistical Manual of Mental Disorders Washington, DC: Am. Psychiatr. Publ, 3rd ed..
  4. Am. Psychiatr. Assoc. 2000. Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) Washington, DC: Am. Psychiatr. Publ, 4th ed..
  5. Am. Psychiatr. Assoc. 2013. Diagnostic and Statistical Manual of Mental Disorders, 5th Edition: DSM-5 Washington, DC: Am. Psychiatr. Publ, 5th ed..
  6. Andreasen NC. 1984. The Broken Brain: The Biological Revolution in Psychiatry New York: Harper & Row
  7. Anstey PR. 2011. John Locke and Natural Philosophy Oxford, UK: Oxford Univ. Press
  8. Aragona M. 2009. The role of comorbidity in the crisis of the current psychiatric classification system. Philos. Psychiatry Psychol. 16:1–11 [Google Scholar]
  9. Bayer R. 1981. Homosexuality and American Psychiatry: The Politics of Diagnosis New York: Basic Books
  10. Bolton D. 2013. What is mental illness?. The Oxford Handbook of Philosophy and Psychiatry KWM Fulford, M Davies, RGT Gipps, G Graham, JZ Sadler et al.434–50 New York: Oxford Univ. Press [Google Scholar]
  11. Boorse C. 1975. On the distinction between disease and illness. Philos. Public Aff. 5:49–68 [Google Scholar]
  12. Boorse C. 1977. Health as a theoretical concept. Philos. Sci. 44:542–73 [Google Scholar]
  13. Boorse C. 2014. A second rebuttal on health. J. Med. Philos 39:683–724 [Google Scholar]
  14. Borsboom D, Cramer AOJ. 2013. Network analysis: an integrative approach to the structure of psychopathology. Annu. Rev. Clin. Psychol. 9:91–121 [Google Scholar]
  15. Borsboom D, Cramer AOJ, Schmittmann VD, Epskamp S, Lourens W. 2011. The small world of psychopathology. PLOS ONE 6:e27407 [Google Scholar]
  16. Boyd R. 1989. What realism implies and what it does not. Dialectica 43:5–29 [Google Scholar]
  17. Boyd R. 1991. Realism, anti-foundationalism and the enthusiasm for natural kinds. Philos. Stud. 61:127–48 [Google Scholar]
  18. Casey BJ, Craddock N, Cuthbert BN, Hyman SE, Lee FS. et al. 2013. DSM-5 and RDoC: progress in psychiatry research?. Nat. Rev. Neurosci. 14:810–14 [Google Scholar]
  19. Chang H. 2004. Inventing Temperature: Measurement and Scientific Progress New York: Oxford Univ. Press
  20. Chaplin WF. 2005. Factor analysis of personality measures. Encyclopedia of Statistics in Behavioral Science BS Everitt, DC Howell 628–36 Chichester, UK: Wiley [Google Scholar]
  21. Charland LC. 2015. Pinel, Phillipe (1745–1826). The Encyclopedia of Clinical Psychology RL Cautin, SO Lilienfeld 2138–43 Hoboken, NJ: Wiley [Google Scholar]
  22. Clark LA. 2005. Temperament as a unifying basis for personality and psychopathology. J. Abnorm. Psychol. 114:505–21 [Google Scholar]
  23. Collins H. 1992. Changing Order: Replication and Induction in Scientific Practice Chicago: Chicago Univ. Press
  24. Conrad LI, Neve M, Nutton R, Porter R, Wear A. 1995. The Western Medical Tradition: 800 BC to AD 1800 Cambridge, UK: Cambridge Univ. Press
  25. Cooper R. 2013. Natural kinds. The Oxford Handbook of Philosophy and Psychiatry KWM Fulford, M Davies, R Gipps, G Graham, JZ Sadler et al.960–65 Oxford, UK: Oxford Univ. Press [Google Scholar]
  26. Cramer AOJ, Waldrop LJ, van der Mass HLJ, Borsboom D. 2010. Comorbidity: a network perspective. Behav. Brain Sci. 33:137–50 [Google Scholar]
  27. Craver CF, Darden L. 2013. In Search of Mechanisms: Discoveries Across the Life Sciences Chicago: Chicago Univ. Press
  28. Crombie AC. 1994. Styles of Scientific Thinking in the European Tradition 3 London: Duckworth
  29. Cunningham A. 1989. Thomas Sydenham and ‘the good old cause.’. The Medical Revolution of the Seventeenth Century R French, A Wear 164–90 Cambridge, UK: Cambridge Univ. Press [Google Scholar]
  30. Cuthbert BN, Kozak MJ. 2013. Constructing constructs for psychopathology: the NIMH research domain criteria. J. Abnorm. Psychol. 122:928–37 [Google Scholar]
  31. Decker HS. 2013. The Making of DSM-III: A Diagnostic Manual's Conquest of American Psychiatry New York: Oxford Univ. Press
  32. Desmond AJ, Moore JR. 1991. Darwin: The Life of a Tormented Evolutionist New York: Warner Books
  33. Ellenberger HF. 1974. Psychiatry from ancient to modern times. American Handbook of Psychiatry S Arieti 3–27 New York: Basic Books [Google Scholar]
  34. Engelhardt HT Jr.. 1974. The disease of masturbation: values and the concept of disease. Bull. Hist. Med. 48:234–48 [Google Scholar]
  35. Engstrom EJ, Kendler KS. 2015. Emil Kraepelin: icon and reality. Am. J. Psychiatry 172:1190–96 [Google Scholar]
  36. Feighner JP, Robins E, Guze SB, Woodruff RA, Winokur G. et al. 1972. Diagnostic criteria for use in psychiatric research. Arch. Gen. Psychiatry 26:57–63 [Google Scholar]
  37. Gaukroger S. 2010. The Collapse of Mechanism and the Rise of Sensibility Oxford, UK: Oxford Univ. Press
  38. Goodman N. 1978. Ways of Worldmaking Indianapolis, IN: Hackett
  39. Guze SB. 1992. Why Psychiatry is a Branch of Medicine New York: Oxford Univ. Press
  40. Hacking I. 1999. The Social Construction of What? Cambridge, MA: Harvard Univ. Press
  41. Haslam N. 2002. Kinds of kinds: a conceptual taxonomy of psychiatric categories. Philos. Psychiatry Psychol. 9:203–17 [Google Scholar]
  42. Helzer JE, Kraemer HC, Krueger RF, Wittchen H-U, Sirovatka PJ, Regier DA. 2008. Dimensional Approaches in Diagnostic Classification: Refining the Research Agenda for DSM-V Arlington, VA: Am. Psychiatr. Assoc.
  43. Hoffman GA, Zachar P. 2017. RDoC's metaphysical assumptions: problems and promises. Extraordinary Science and Psychiatry J Poland, Ş Tekin 59–86 Cambridge, MA: MIT Press [Google Scholar]
  44. Hyman SE. 2010. The diagnosis of mental disorders: the problem of reification. Annu. Rev. Clin. Psychol. 6:155–79 [Google Scholar]
  45. Insel T. 2013. Transforming diagnosis. NIMH Director's Message April 28 Bethesda, MD: NIMH (Natl. Instit. Mental Health) https://www.nimh.nih.gov/about/directors/thomas-insel/blog/2013/transforming-diagnosis.shtml [Google Scholar]
  46. Jaspers K. 1963 (1923). General psychopathology Chicago: Univ. Chicago Press
  47. Jones E, Wessely S. 2001. Psychiatric battle casualties: an intra- and interwar comparison. Br. J. Psychiatry 178:242–47 [Google Scholar]
  48. Kendell RE. 1975. The concept of disease and its implications for psychiatry. Br. J. Psychiatry 127:305–15 [Google Scholar]
  49. Kendler KS. 1990. Toward a scientific psychiatric nosology. Arch. Gen. Psychiatry 47:969–73 [Google Scholar]
  50. Kendler KS. 2009. An historical framework for psychiatric nosology. Psychol. Med. 39:1935–41 [Google Scholar]
  51. Kendler KS. 2012. Epistemic iteration as a historical model for psychiatric nosology: promises and limitations. Philosophical Issues in Psychiatry II: Nosology KS Kendler, J Parnas 305–22 Oxford, UK: Oxford Univ. Press [Google Scholar]
  52. Kendler KS. 2016a. The nature of psychiatric disorders. World Psychiatry 15:5–12 [Google Scholar]
  53. Kendler KS. 2016b. The phenomenology of major depression and the representativeness and nature of DSM criteria. Am. J. Psychiatry 173:771–80 [Google Scholar]
  54. Kendler KS, Jablensky A. 2011. Kraepelin's concept of psychiatric illness. Psychol. Med. 41:1119–26 [Google Scholar]
  55. Kendler KS, Muñoz RA, Murphy G. 2010. The development of the Feighner criteria: a historical perspective. Am. J. Psychiatry 167:134–42 [Google Scholar]
  56. Kraepelin E. 1904. Lectures on clincial psychiatry New York: William Wood
  57. Krueger RF, Watson D, Barlow DH. 2005. Toward a dimensionally based taxonomy of psychopathology. J. Abnorm. Psychol. 114:491–93 [Google Scholar]
  58. Kuhn TS. 1962. The Structure of Scientific Revolutions Chicago: Chicago Univ. Press
  59. Latour B, Woolgar S. 1979. Laboratory Life: The Social Construction of Scientific Facts London/Los Angeles, CA: Sage
  60. Lifton RJ. 1973. Home From the War. Vietnam Veterans: Neither Victims nor Executioners. Oxford, UK: Simon & Schuster
  61. Livesley WJ. 2012. Tradition versus empiricism in the current DSM-5 proposal for revising the classification of personality disorders. Criminal Behav. Mental Health 22:81–91 [Google Scholar]
  62. Livesley WJ, Jang KL. 2008. The behavioral genetics of personality disorder. Annu. Rev. Clin. Psychol. 4:247–74 [Google Scholar]
  63. Livesley WJ, Jang KL, Vernon PA. 1998. Phenotypic and genetic structure of traits delineating personality disorder. Arch. Gen. Psychiatry 55:941–48 [Google Scholar]
  64. Locke J. 1689 (1997). An Essay Concerning Human Understanding London: Penguin Books
  65. Magner LN. 2002. A History of the Life Sciences New York: CRC Press
  66. Markon KE. 2013. Epistemological pluralism and scientific development: an argument against authoritative nosologies. J. Personal. Disord. 27:554–79 [Google Scholar]
  67. Mayr E. 1982. The Growth of Biological Thought Cambridge, MA: Belknap
  68. McNally RJ. 2003. Remembering Trauma Cambridge, MA: Belknap
  69. McNally RJ, Robinaugh D, Wu GWY, Wang L, Deserno MK. et al. 2015. Mental disorders as causal systems: a network approach to posttraumatic stress disorder. Clin. Psychol. Sci. 3:836–49 [Google Scholar]
  70. Mill JS. 1843 (1973). A System of Logic Toronto: Univ. Toronto Press
  71. Murphy D. 2006. Psychiatry in the Scientific Image Cambridge, MA: MIT Press
  72. Nutton V. 1995. Medicine in the Greek world, 800–50 BC. See Conrad et al. 1995 11–38
  73. Porter R. 1995. The eighteenth century. See Conrad et al. 1995 371–475
  74. Porter R. 2006. Medical science. The Cambridge History of Medicine R Porter 136–75 New York: Cambridge Univ. Press [Google Scholar]
  75. Quine WVO. 1960. Word and Object Cambridge, MA: MIT Press
  76. Regier DA, Narrow WE, Kuhl EA, Kupfer DJ. 2009. The conceptual development of DSM-V. Am. J. Psychiatry 166:645–50 [Google Scholar]
  77. Reznek L. 1987. The Nature of Disease London: Routledge & Kegan Paul
  78. Richardson RC. 2007. Evolutionary Psychology as Maladapted Psychology Cambridge, MA: MIT Press
  79. Richters JE, Hinshaw SP. 1999. The abduction of disorder in psychiatry. J. Abnorm. Psychol. 108:438–45 [Google Scholar]
  80. Robins E, Guze SB. 1970. Establishment of diagnostic validity in psychiatric illness: its application to schizophrenia. Am. J. Psychiatry 126:983–86 [Google Scholar]
  81. Rounsaville BJ, Alarcon RD, Andrews G, Jackson JS, Kendell RE. et al. 2002. Basic nomenclature issues for DSM-V. A Research Agenda for DSM–V1–29 Washington, DC: Am. Psychiatr. Assoc. [Google Scholar]
  82. Schneider K. 1959 (1946). Clinical psychopathology New York: Grune & Stratton
  83. Scott WJ. 1990. PTSD in DSM-III: a case in the politics of diagnosis and disease. Soc. Probl. 37:294–310 [Google Scholar]
  84. Shatan CF. 1973. The grief of soldiers: Vietnam combat veterans' self-help movement. Am. J. Orthopsychiatry 43:640–53 [Google Scholar]
  85. Shorter E. 2015. The history of nosology and the rise of the Diagnostic and Statistical Manual of Mental Disorders. Dialogues Clin. Neurosci. 17:59–67 [Google Scholar]
  86. Simms LJ, Watson D, Doebbelling BN. 2002. Confirmatory factor analyses of posttraumatic stress symptoms in deployed and nondeployed veterans of the Gulf War. J. Abnorm. Psychol. 111:637–47 [Google Scholar]
  87. Sloan PR. 1972. John Locke, John Ray, and the problem of the natural system. J. Hist. Biol. 5:1–53 [Google Scholar]
  88. Smith GT, Combs J. 2010. Issues of construct validity in psychiatric diagnosis. Contemporary Directions in Psychopathology T Millon, RF Krueger, E Simonsen 205–22 New York: Guilford [Google Scholar]
  89. Spitzer RL. 1999. Harmful dysfunction and the DSM definition of mental disorder. J. Abnorm. Psychol. 108:430–32 [Google Scholar]
  90. Spitzer RL, Endicott J, Robins E. 1975. Clinical criteria for psychiatric diagnosis and DSM-III. Am. J. Psychiatry 132:1187–92 [Google Scholar]
  91. Spitzer RL, Endicott J, Robins E. 1978. Research diagnostic criteria: rationale and reliability. Arch. Gen. Psychiatry 35:773–82 [Google Scholar]
  92. Sydenham T. 1676 (1981). Preface to the third edition: observations medicae. Concepts of Health and Disease: Interdisciplinary Perspectives AL Caplan, HT Engelhardt Jr., JJ McCartney 145–55 Reading, MA: Addison-Wesley [Google Scholar]
  93. Szasz T. 1960 (2004). The myth of mental illness. Health, Disease, and Illness AL Caplan, JJ McCartney, DA Sisti 43–50 Washington, DC: Georgetown Univ. Press [Google Scholar]
  94. Tabb K. 2015. Mad errors: associated ideas, enthusiasm, and personal identity in Locke PhD thesis, Univ Pittsburgh:
  95. Turkheimer E. 2015. The nature of nature. Philosophical Issues in Psychiatry III: The Nature and Sources of Historical Change KS Kendler, J Parnas 227–44 Oxford, UK: Oxford Univ. Press [Google Scholar]
  96. Turkheimer E. 2017. The hard question in psychiatric nosology. Philosophical Issues in Psychiatry IV: Psychiatric Nosology KS Kendler, J Parnas 27–44 Oxford, UK: Oxford Univ. Press In press [Google Scholar]
  97. Turkheimer E, Ford DC, Oltmanns TF. 2008. Regional analysis of self-reported personality disorder criteria. J. Pers. 76:1587–622 [Google Scholar]
  98. Turkheimer E, Horn EE, Pettersson E. 2014. A phenotypic null hypothesis for the genetics of personality. Annu. Rev. Psychol. 65:515–40 [Google Scholar]
  99. Vaidyanathan U. 2016. Facts and myths about RDoC Presented at Philos. Issues Sci. Psychiatry: RDoC, DSM, Mechanisms, And More Atlanta, GA:
  100. Wakefield JC. 1992a. The concept of mental disorder: on the boundary between biological facts and social values. Am. Psychol. 47:373–88 [Google Scholar]
  101. Wakefield JC. 1992b. Disorder as harmful dysfunction: a conceptual critique of DSM-III-R’s definition of mental disorder. Psychol. Rev. 99:232–47 [Google Scholar]
  102. Wakefield JC. 1999. Evolutionary versus prototype analyses of the concept of disorder. J. Abnorm. Psychol. 108:374–99 [Google Scholar]
  103. Walmsley J. 2004. Locke's natural philosophy in Draft A of the Essay. J. Hist. Ideas 65:15–37 [Google Scholar]
  104. Wear A. 1995. Medicine in early modern Europe, 1500–1700. See Conrad et al. 1995 215–361
  105. Whewell W. 1858. Novum Organon Renovatum London: Parker
  106. Widiger TA, Samuel DB. 2005. Diagnostic categories or dimensions? A question for the Diagnostic and Statistical Manual of Mental Disorders–Fifth Edition. J. Abnorm. Psychol. 114:494–504 [Google Scholar]
  107. Wilson EO. 1998. Consilience: The Unity of Knowledge New York: Knopf
  108. Woolhouse RS. 1988. The Empiricists Oxford, UK: Oxford Univ. Press
  109. Yamagata S, Suzuki A, Ando J, Ono Y, Kijima N. et al. 2006. Is the genetic structure of human personality universal? A cross-cultural twin study from North America, Europe, and Asia. J. Pers. Soc. Psychol. 90:987–98 [Google Scholar]
  110. Zachar P. 2000. Folk taxonomies should not have essences either: a response to the commentary. Philos. Psychiatry Psychol. 7:191–94 [Google Scholar]
  111. Zachar P. 2014. A Metaphysics of Psychopathology Cambridge, MA: MIT Press
  112. Zachar P, Krueger RF, Kendler KS. 2016. Personality disorder in the DSM-5: an oral history. Psychol. Med. 46:1–10 [Google Scholar]
  113. Zachar P, McNally RJ. 2017. Psychiatric classification and the sorites problem: the case of PTSD. Gradualist Approaches to Health and Disease G Keil, L Keuck, R Hauswald 169–88 Oxford, UK: Oxford Univ. Press [Google Scholar]
  • Article Type: Review Article
This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error