Hindsight, foresight, and having it both ways: a rejoinder to R. L. Spitzer.

Abstract

Using the methods of philosophical analysis, we provide a rejoinder to R. L. Spitzer's (2001) response to our own consideration of the DSMs first published in 1994. Then as now, our major contention has been that the DSM contents and process have been insufficiently explicit in their various value commitments, choices, and decisions. Spitzer raises four major points in his commentary, concerning our claims about the "value naivete" of past DSMs, his contention that the goals of DSM-III and III-R were not "inherently" in conflict, about our allegations of the DSM architects preferring reliability over validity, and various DSM critics' failure to offer a viable alternative to the DSMs. We address each of Spitzer's main points in turn, appealing to Spitzer's own work while acknowledging his leadership role in addressing value issues in mental disorder classification.