Changes in the research stream by standardization: A content analysis of the Archives of General Psychiatry during the establishment of operational diagnostic criteria

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Abstract

Universality through standardization is at the heart of scientific and medical practices. In this study we dealt with the meaning, significance, and implications of standardization through “operationalization” in psychiatric diagnostic criteria by focusing on the effects of the DSM (Diagnostic Statistical Manual) III. What does “operational” mean?* The discussion of “operationalization” in psychiatric diagnosis poses quite a challenge. Given the importance of semantics and the word networks of everyday life in forming descriptions of symptoms and reaching clinical judgments, cultural differences in these semantics inevitably have strong impacts on psychiatric diagnosis. The link between sensitivity and semantics in words enhances this effect. In spite of the difficulties in approaching operationalization in psychiatric diagnosis, several attempts have been made to standardize diagnostic criteria. Prominent examples include the DSM of the American Psychiatric Association and the ICD (International Disease Classification) of the WHO. In this paper we analyzed the effects of standardized diagnostic criteria by performing a content analysis of papers published in the Archives of General Psychiatry from 1978 to 1990. Our results clearly show changes in the research questions, research designs, methodologies, target diseases, and selections of independent and dependent variables.

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