‘…[O]ne of the main claimed innovations in the DSM-5 is that it promotes the use of ‘dimensional‘ or quantitative measures of symptoms. Traditionally the DSM has been about all-or-nothing, categorical diagnoses (“He is depressed”, “She has schizophrenia”). The 5th edition, for the first time, also recommends the use of severity scales.
It’s a move away from digital and in the direction of analogue – such is progress in psychiatry.
In fact, what we might call the ‘dimensional turn’ is more of a statement of intent than anything else. The core of DSM-5 remains the categorical diagnoses – 245 of them, by my count. The dimensional stuff is effectively an appendix. Nonetheless, it’s something.
But why is the DSM promoting symptom scales? Or more to the point, why is it suddenly promoting them now, given that dimensional measures have been used in psychiatry for 60 years? This is where it gets interesting.
The head of the APA’s DSM-5 task force, David Kupfer, stands accused of failing to disclose a conflict of interest which – arguably – means that he has a financial stake in the concept of dimensional assessment.’ (Neuroskeptic)