Diagnostic Reliability

Abstract

A major area of research concerning classification has focused on the reliability of conventional psychiatric systems. The neo-Kraepelinians have emphasized this research because they have been promoting a scientific approach to psychopathology. They have come to believe that if a psychiatric classification is not reliable, the development of a science about mental disorders will not be possible:

Classification systems such as diagnosis have two primary properties, reliability and validity. Reliability refers to the consistency with which subjects are classified; validity, to the utility of the system for its various purposes. In the case of psychiatric diagnosis, the purposes of the classification system are communication about clinical features, aetiology, course of illness and treatment. A necessary constraint on the validity of a system is its reliability. There is no guarantee that a reliable system is valid, but assuredly an unreliable system must be invalid. (Spitzer & Fleiss, 1974, p. 341)

A preoccupation with description and classification is itself portrayed as a symptom, an abnormal psychological phenomenon whereby psychiatrists defend themselves against their own inadequacy and fear by emphasizing the “objectivity” inherent in their arid statistical and classificatory approaches and by hiding behind a smokescreen of measurements and “scientific” jargon.

Anthony Clare, 1976, p. 83