What we’ve said about Diagnostic validity

“when I speak about validity, I mean, What I'm basically referring to is how well does a diagnosis track or map onto an actual disease or condition existing in reality, in biological or psychological reality”

“It basically said that you needed to see convergence among multiple validators, multiple independent lines of evidence, including symptoms, genetics, or familial aggregation, longitudinal course of illness”

“The categories are social constructions. We've developed these to try to capture real aspects of the real world. And sometimes a patient may meet the criteria for multiple diagnoses, and they really only have one disease”

“we need to go back and we need to restore a focus on validity and prioritize validity over reliability. Reliability is important, but you get reliability when you're studying real things”

“we ought to rate each diagnosis on its empirical validity. How valid is And we develop a sort of hierarchy where the more robustly validated disorders are prioritized in diagnosis, and you sort of move down the hierarchy if the patient doesn't meet the criteria for the more Robustly Validated Disorders”

“I think it's underrated the degree to which our lack of diagnostic reliability and therefore lack of treatment reliability across the field undermines us as a field”

“It becomes extra important, maybe 100 times more important now, to have a diagnostic system that, while existing as a scientific and clinical tool, also teaches at the same time because people use it to learn rather than to learn to use it”

“there's so much emphasis on symptoms and entire systems now being developed around symptoms like HITOP, the hierarchical taxonomy of psychopathology. But that's one, it's only one of the classic validators. Think about in general medicine, how many diseases share symptoms like cough and fever and pain”

“they share a third of their, a third of associated genes. They diverge on two thirds of their associated genes. They share some symptoms, but their courses are different. They have completely different longitudinal courses”

“There's an emphasis on transdiagnostic markers and symptoms, a real skepticism towards the idea that there are natural kinds in psychopathology, that there actually are different diseases or conditions”

“there was a real division during the crafting or the development of DSM-3 between psychiatrists who wanted to prioritize validity and Versus psychiatrists who wanted to prioritize reliability”

“the Feiner paper listed 14 psychiatric disorders. The RDC, the Research Diagnostic Criteria published in 1978, a group led by Robert Spitzer, identified 25 psychiatric conditions. When DSM-3 is published in 1980, just two years after the RDC is published, that paper, it lists 265 distinct psychiatric diagnoses”

“after DSM-3 is published, the idea is to subject these new categories to testing, rigorous validity testing. That really doesn't happen. The little research that is done is sort of ignored”