The absent body in psychiatric diagnosis, treatment, and research
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Discussions of psychiatric nosology focus on a few popular examples of disorders, and on the validity of diagnostic criteria. Looking at Anorexia Nervosa, an example rarely mentioned in this literature, reveals a new problem: the DSM has a strict taxonomic structure, which assumes that disorders can only be located on one branch. This taxonomic assumption fails to fit the domain of psychopathology, resulting in obfuscation of cross-category connections. Poor outcomes for treatment of Anorexia may be due to it being pigeonholed as an Eating Disorder, when a disturbance of body perception may be a more central symptom than food restriction. This paper explores the possibility of restructuring the DSM taxonomy to allow for a pluralist classification of disorders. This change could improve treatment and research without requiring any changes to diagnostic criteria.
KeywordsPsychiatric nosology DSM Anorexia nervosa Body perception Taxonomy RDoC
This research was supported in part by Deutsche Forschungsgemeinschaft Excellence Cluster Grant CIN2011-16, at the Centre for Integrative Neuroscience, Universität Tübingen. Many thanks to the anonymous reviewers whose suggestions greatly improved the paper. I acknowledge the Ancestral Traditional Territories of the Ojibway, the Anishnabe, and the Mississaugas of the New Credit, where I live and work, and I am grateful to the people living with Anorexia Nervosa whose stories inspired this paper.
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