What is the DSM? Diagnostic manual, cultural icon, political battleground: an overview with suggestions for a critical research agenda

Abstract

The Diagnostic and Statistical Manual of Mental Disorders of the APA (known as the DSM) is a system for the classification of mental disorders that provides diagnostic criteria used by psychiatrists and experts in related fields. Although classification systems and standards are ubiquitous in social life, they are rarely conspicuous and almost never become an object of public debate. Yet the DSM has attained the status of a ‘cultural icon’ and has been an object of commentary and controversy internationally. This article offers an introduction to the DSM and to the conditions of possibility for its global influence, based on a critical synthesis of historico-sociological approaches to the manual. In the second part of the article, three keywords – polyvalence, ambivalence and participation – are offered to focus on three points for reflection. The first point concerns the reasons for the manual’s continuing prominence and resistance to change since the publication of its third edition in 1980. The second concerns the reasons why, while acknowledging the importance of the DSM, we should neither overestimate it nor take it at face value. The third defines the question of participatory politics as part of a sociological research agenda in relation to the DSM.