The Diagnostic and Statistical Manual of Mental Disorders–IV (DSM–IV) has long been considered the Bible of diagnosis and treatment, and is the foundation of treatment decisions made by managed care companies. Yet many mental health professionals are expressing increasing, and voluble, discontent with the DSM as a diagnostic tool. Among the criticisms they direct at the DSM include its reliance on a medical model and its excessive focus on reliability at the expense of validity.

The contributors to this volume explore these and many other concerns about the DSM system and propose new ways of looking at the diagnostic and treatment activities of therapists. This thought-provoking collection of diverse professional viewpoints, edited by James W. Barron, contributes to the ongoing dialogue about diagnosis and how it can be meaningfully related to what clinicians do in their actual work with patients.

Table of Contents




I. Examining the Strengths and Weaknesses of Syndromal Approaches to Diagnosis

  1. The DSM–IV and Its Antecedents: Enhancing Syndromal Diagnosis
    —Peter E. Nathan
  2. Meaning and Melancholia: Why the DSM–IV Cannot (Entirely) Ignore the Patient's Intentional System
    —Jerome C. Wakefield
  3. A Psychodynamic Approach to the Diagnosis of Psychopathology
    —Sidney J. Blatt and Kenneth N. Levy
  4. Case Formulation and Personality Diagnosis: Two Processes or One?
    —Drew Westen
  5. The Role of Ego Mechanisms of Defense in the Diagnosis of Personality Disorders
    —George E. Vaillant and Leigh McCullough

II. Widening the Scope: Moving From Diagnosis to Assessment

  1. Assessment in Transitional Family Therapy: The Importance of Context
    —William H. Watson and Susan H. McDaniel
  2. Relationship, Subjectivity, and Inference in Diagnosis
    —Nancy McWilliams
  3. Psychological Testing, Psychodiagnosis, and Psychotherapy
    —Bruce L. Smith
  4. An Experiential Psychoanalytic Approach to the Assessment Process
    —Paul J. Lerner and Howard D. Lerner
  5. Depression: Intervention as Assessment
    —Enrico E. Jones
  6. Assessment of the Patient With Borderline Personality Disorder for Psychodynamic Treatment
    —John F. Clarkin, Otto F. Kernberg, and Javiera Somavia
  7. Reassessing a Person With Schizophrenia and Developing a New Treatment Plan
    —Courtenay M. Harding

Author Index

Subject Index

About the Editor