Dynamics of Decision-Making: The Issue of Reliability in Diagnosis

  • Stijn Vanheule


In this chapter Stijn Vanheule examines the reliability of the DSM. In the early days of psychiatry, diagnosis started from elaborate prototypical descriptions of diverse types of psychopathology. These were replaced by classification systems such as the DSM, due to a crisis in psychiatric practice during the 1960s and 1970s: several academic researchers demonstrated that diagnoses were unreliable, critical scholars pointed to weak points in the overall ethos of psychiatry, and societal changes challenged the actual practice of psychiatry itself. A group of so-called neo-Kraepelinian psychiatrists responded to this malaise by defining psychiatry as a strictly medical discipline, thus switching to a criteria-based method of diagnosis. However, Vanheule demonstrates that with the DSM, psychiatric diagnosis did not become more reliable. Moreover, the key problems that critical researchers had been addressing in the 1970s, such as the issue of hasty decision-making and the problem of reification, stigma, and power, still remain unresolved.


Attention Deficit Hyperactivity Disorder Personality Disorder Psychiatric Diagnosis Diagnostic Category Kappa Coefficient 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Other References

  1. Angermeyer, M. C., Holzinger, A., Carta, M. G., & Schomerus, G. (2011). Biogenetic explanations and public acceptance of mental illness: Systematic review of population studies. The British Journal of Psychiatry, 199, 367–372.PubMedCrossRefGoogle Scholar
  2. Angst, J. (2002). Historical aspects of the dichotomy between manic-depressive disorders and schizophrenia. Schizophrenia Research, 57, 5–13.PubMedCrossRefGoogle Scholar
  3. Baer, L., & Blais, M. A. (2010). Handbook of clinical rating scales and assessment in psychiatry and mental health. New York: Humana Press.CrossRefGoogle Scholar
  4. Batstra, L., & Thoutenhoofd, E. D. (2012). The risk that DSM-5 will further inflate the diagnostic bubble. Current Psychiatry Reviews, 8, 260–263.CrossRefGoogle Scholar
  5. Beck, A. T., Ward, C. H., Mendelson, M., Mock, J. E., & Erbaugh, J. K. (1962). Reliability of psychiatric diagnoses: 2. A study of consistency of clinical judgments and ratings. American Journal of Psychiatry, 119, 351–357.PubMedCrossRefGoogle Scholar
  6. Ben-Zeev, D., Young, M. A., & Corrigan, P. W. (2010). DSM-V and the stigma of mental illness. Journal of Mental Health, 19, 318–327.PubMedCrossRefGoogle Scholar
  7. Bergmann, J. R. (1992). Veiled morality: Notes on discretion in psychiatry. In P. Drew & J. Heritage (Eds.), Talk at work: Interaction in institutional settings (pp. 137–162). Cambridge: Cambridge University Press.Google Scholar
  8. Berrios, G. E., & Hauser, R. (1988). The early development of Kraepelin’s ideas on classification: A conceptual history. Psychological Medicine, 18, 813–821.PubMedCrossRefGoogle Scholar
  9. Bleuler, E. (1934). Textbook of psychiatry. New York: Macmillan.Google Scholar
  10. Carey, B. (2008, December 17). Psychiatrists revise the book of human troubles. New York Times.Google Scholar
  11. Chmielewski, M., Bagby, R. M., Clark, L. A., & Watson, D. (2015). Method matters: Understanding diagnostic reliability in DSM-IV and DSM-5. Journal of Abnormal Psychology, 124, 764–769.PubMedPubMedCentralCrossRefGoogle Scholar
  12. Clarke, D. E., Narrow, W. E., Regier, D. A., et al. (2013). DSM-5 field trials in the United States and Canada, part I: Study design, sampling strategy, implementation, and analytic approaches. American Journal of Psychiatry, 170, 43–58.PubMedCrossRefGoogle Scholar
  13. Compton, W. M., & Guze, S. B. (1995). The neo-Kraepelinian revolution in psychiatric diagnosis. European Archives of Psychiatry and Clinical Neuroscience, 245, 196–201.PubMedCrossRefGoogle Scholar
  14. Cosgrove, L., & Krimsky, S. (2012). A comparison of DSM-IV and DSM-5 panel members’ financial associations with industry: A pernicious problem persists. Plos Medicine, 9, e1001190.PubMedPubMedCentralCrossRefGoogle Scholar
  15. Cosgrove, L., Krimsky, S., Vijayaraghavan, M., & Schneider, L. (2006). Financial ties between DSM-IV panel members and the pharmaceutical industry. Psychotherapy and Psychosomatics, 75, 154–180.PubMedCrossRefGoogle Scholar
  16. Cosgrove, L., Krimsky, S., Wheeler, E. E., et al. (2014). Tripartite conflicts of interest and high stakes patent extensions in the DSM-5. Psychotherapy and Psychosomatics, 83, 106–113.PubMedCrossRefGoogle Scholar
  17. Croskerry, P. (2003). The importance of cognitive errors in diagnosis and strategies to minimize them. Academic Medicine, 78, 775–780.PubMedCrossRefGoogle Scholar
  18. Dar-Nimrod, I., & Heine, S. J. (2011). Genetic essentialism: On the deceptive determinism of DNA. Psychological Bulletin, 137, 800–818.PubMedPubMedCentralCrossRefGoogle Scholar
  19. Decker, H. (2007). How Kraepelinian was Kraepelin? How Kraepelinian are the neo-Kraepelinians? – from Emil Kraepelin to DSM-III. History of Psychiatry, 18, 337–360.PubMedCrossRefGoogle Scholar
  20. Decker, H. (2013). The making of DSM-III. New York: Oxford University Press.Google Scholar
  21. DeFife, J. A., Peart, J., Bradley, B., et al. (2013). Validity of prototype diagnosis for mood and anxiety disorders. JAMA Psychiatry, 70, 140–148.PubMedCrossRefGoogle Scholar
  22. Dehue, T. (2008). De depressie-epidemie. Over de plicht het lot in eigen hand te nemen [The depression epidemic. On the duty to control your own destiny]. Amsterdam: Augustus.Google Scholar
  23. Dowrick, C. (2009). Beyond depression: A new approach to understanding and management. Oxford: Oxford University Press.CrossRefGoogle Scholar
  24. Feighner, J. P., Woodruff, R. A., Winokur, G., Munoz, R., Robins, E., & Guze, S. B. (1972). Diagnostic criteria for use in psychiatric research. Archives of General Psychiatry, 26, 57–63.PubMedCrossRefGoogle Scholar
  25. First, M. B., Spitzer, R. L., Gibbon, M., et al. (1995). The structured clinical interview for DSM-III-R personality disorders (SCID-II). Part II: Multi-site test-retest reliability study. Journal of Personality Disorders, 9, 92–104.CrossRefGoogle Scholar
  26. First, M. B., Williams, J. B. W., Karg, R. S., & Spitzer, R. L. (2016). Structured clinical interview for DSM-5 disorders – Clinican version (SCID-5-CV). Washington, DC: American Psychiatric Association.Google Scholar
  27. Fleiss, J. L., & Cohen, J. (1973). The equivalence of weighted kappa and the intraclass correlation coefficient as measures of reliability. Educational and Psychological Measurement, 33, 613–619.CrossRefGoogle Scholar
  28. Fleiss, J. L., Levin, B., & Paik, M. (1981). The measurement of interrater agreement. In J. L. Fleiss, B. Levin, & M. C. Paik (Eds.), Statistical methods for rates and proportions – Third edition (pp. 598–626). New York: Wiley.Google Scholar
  29. Foucault, M. (1965). Madness and civilization: A history of insanity in the age of reason. New York: Random House.Google Scholar
  30. Foucault, M. (2006 [1973–1974]). Psychiatric power – Lectures at the Collège de France. New York: Picador.Google Scholar
  31. Frances, A. (2012, May 8). Newsflash from APA meeting: DSM-5 has flunked its reliability tests. Retrieved May 19, 2013, from
  32. Frances, A. (2013). Saving normal – An insider’s revolt against out-of-control psychiatric diagnosis, DSM-5, big pharma, and the medicalization of ordinary life. New York: William Morrow & Harper Collins Publishers.Google Scholar
  33. Freedman, R., Lewis, D. A., Michels, R., et al. (2013). The initial field trials of DSM-5: New blooms and old thorns. American Journal of Psychiatry, 170, 1–5.PubMedCrossRefGoogle Scholar
  34. Gagnon, M. A., & Lexchin, J. (2008). The cost of pushing pills: A new estimate of pharmaceutical promotion expenditures in the United States. PLoS Med, 5(1), e1.PubMedPubMedCentralCrossRefGoogle Scholar
  35. Grandin, T. (2013). The autistic brain – Thinking across the spectrum. Boston: Houghton, Mifflin Harcourt.Google Scholar
  36. Grob, G. N. (1987). The forging of mental health policy in America: World War II to new frontier. Journal of the History of Medicine and Allied Sciences, 42, 410–446.PubMedCrossRefGoogle Scholar
  37. Grob, G. N. (1991). Origins of DSM-I: A study in appearance and reality. American Journal of Psychiatry, 148, 421–431.PubMedCrossRefGoogle Scholar
  38. Guze, S. B. (1992). Why psychiatry is a branch of medicine. New York: Oxford University Press.Google Scholar
  39. Haggerty, G., Zodan, J., Zubair, A., et al. (2016). Reliability and validity of prototype diagnosis for adolescent psychopathology. The Journal of Nervous and Mental Disease, 204, 287–290.Google Scholar
  40. Harper, D. (2011). Online etymological dictionary. Retrieved September 7, 2011, from
  41. Harwood, V. (2010). Mobile asylums: Psychopathologisation as a personal, portable psychiatric prison. Discourse: Studies in the Cultural Politics of Education, 31, 437–451.Google Scholar
  42. Haslam, N. (2011). Genetic essentialism, neuroessentialism, and stigma: Commentary on Dar-Nimrod and Heine (2011). Psychological Bulletin, 137, 819–824.PubMedCrossRefGoogle Scholar
  43. Healy, D. (2008). Historical overview: Kraepelin’s impact on psychiatry. European Archives of Psychiatry and Clinical Neuroscience, 248(Suppl 2), 18–24.CrossRefGoogle Scholar
  44. Hiller, W., Dichtl, G., Hecht, H., et al. (1993). An empirical comparison of diagnoses and reliabilities in ICD-10 and DSM-III-R. European Archives of Psychiatry and Clinical Neuroscience, 242, 209–217.PubMedCrossRefGoogle Scholar
  45. Hyman, S. E. (2010). The diagnosis of mental disorders: The problem of reification. Annual Review of Clinical Psychology, 6, 155–179.PubMedCrossRefGoogle Scholar
  46. Kahneman, D. (2011). Thinking, fast and slow. New York: Farra, Strauss & Giroux.Google Scholar
  47. Kant, E. (1764/2011). Essay on the maladies of the head. In P. Frierson & P. Cuyer (Eds.), Emmanuel Kant: Observations on the feeling of the beautiful and sublime and other writings. Cambridge: Cambridge University Press.Google Scholar
  48. Keller, M. B., Hanks, D. L., & Klein, D. N. (1996). Summary of the DSM-IV mood disorders field trial and issue overview. The Psychiatric Clinics of North America, 19, 1–28.PubMedCrossRefGoogle Scholar
  49. Kirk, S. A., & Hsieh, D. K. (2004). Diagnostic consistency in assessing conduct disorder: An experiment on the effect of social context. American Journal of Orthopsychiatry, 74, 43–55.PubMedCrossRefGoogle Scholar
  50. Kirk, S. A., & Hsieh, D. K. (2009). Do perceptions of dysfunction and normality mediate clinicians judgments of adolescent antisocial behavior? Social Service Review, 83, 245–266.CrossRefGoogle Scholar
  51. Kirshner, L. (2009). Biopolitics and the transformation of the psychiatric subject. In S. Binkley & J. Capetillo (Eds.), A Foucault for the 21st century: Governmentality, biopolitics and discipline in the new millennium (pp. 92–104). Newcastle upon Tyne: Cambridge Scholars Publishing.Google Scholar
  52. Klerman, G. L. (1978). The evolution of a scientific nosology. In J. C. Shershow (Ed.), Schizophrenia: Science and practice (pp. 99–121). New York/London: Guilford.Google Scholar
  53. Kraemer, H. C., Periyakoil, V. S., & Noda, A. (2002). Tutorial in biostatistics: Kappa coefficients in medical research. Statistical Medicine, 21, 2109–2129.CrossRefGoogle Scholar
  54. Kraepelin, E. (1907). Clinical psychiatry (p. 1981). Delmar: Scholars’ facsimiles and reprints.Google Scholar
  55. Kraepelin, E. (1921). Manic-depressive insanity and paranoia. Edinburgh: Livingstone.Google Scholar
  56. Kutchins, H., & Kirk, S. A. (1997). Making us crazy: DSM – The psychiatric bible and the creation of mental disorders. New York: Free Press.Google Scholar
  57. Kvaale, E. P., & Haslam, N. (2016). Motivational orientations and psychiatric stigma: Social motives influence how causal explanations relate to stigmatizing attitudes. Personality and Individual Differences, 89, 111–116.CrossRefGoogle Scholar
  58. Kvaale, E. P., Haslam, N., & Gottdiener, W. H. (2013). The ‘side effects’ of medicalization: A meta-analytic review of how biogenetic explanations affect stigma. Clinical Psychology Review, 33, 782–794.PubMedCrossRefGoogle Scholar
  59. Lacan, J. (1988 [1953–1954]). The seminar of Jacques Lacan, book I: Freud’s papers on technique. New York/London: W.W. Norton.Google Scholar
  60. Lacan, J. (1988 [1954–1955]). The seminar of Jacques Lacan, book II, the ego in Freud’s theory and in the technique of psychoanalysis. Cambridge: Cambridge University Press.Google Scholar
  61. Lacan, J. (2006 [1949]). The mirror stage as formative of the function of the I. In J. Lacan & J. A. Miller (Eds.), Écrits (pp. 75–81). New York/London: W. W. Norton.Google Scholar
  62. Laing, R. D. (1960). The divided self: An existential study in sanity and madness. Harmondsworth: Penguin.Google Scholar
  63. Landis, J. R., & Koch, G. G. (1977). The measurement of observer agreement for categorical data. Biometrics, 33, 159–174.PubMedCrossRefGoogle Scholar
  64. Lane, C. (2008). Shyness: How normal behavior became sickness. Yale: Yale University Press.Google Scholar
  65. Maj, M. (2012). Validity and clinical utility of the current operational characterization of major depression. International Review of Psychiatry, 24, 530–537.PubMedCrossRefGoogle Scholar
  66. McNally, R. J. (2011). What is mental illness? Cambridge/London: Belknap Harvard.Google Scholar
  67. Meehl, P. E. (1973). Why I do not attend case conferences. In Psychodiagnosis: Selected papers (pp. 225–302). Minneapolis: University of Minnesota Press.Google Scholar
  68. Menninger, K. A. (1959). The psychiatric diagnosis. Bulletin of the Menninger Clinic, 23, 226–243.Google Scholar
  69. Menninger, K., Ellenberger, H., Pruyser, P., & Mayman, M. (1958). The unitary concept of mental illness. Bulletin of the Menninger Clinic, 22, 4–12.PubMedGoogle Scholar
  70. Moskowitz, A., & Heim, G. (2011). Eugen Bleuler’s Dementia praecox or the group of Schizophrenias (1911): A centenary appreciation and reconsideration. Schizophrenia Bulletin, 37, 471–479.PubMedPubMedCentralCrossRefGoogle Scholar
  71. Moynihan, R., Heath, I., & Henry, D. (2002). Selling sickness: The pharmaceutical industry and disease mongering. Commentary: Medicalisation of risk factors. BMJ, 324, 886–891.PubMedPubMedCentralCrossRefGoogle Scholar
  72. Mukolo, A., Heflinger, C. A., & Wallston, K. A. (2010). The stigma of childhood mental disorders: A conceptual framework. Journal of the American Academy of Child and Adolescent Psychiatry, 49, 92–198.PubMedPubMedCentralGoogle Scholar
  73. Nietsche, F. (1887). The gay science. New York: Vintage Books.Google Scholar
  74. Nieweg, E. H. (2005). On reification and natural kinds in psychiatry. Tijdschrift voor Psychiatrie, 47, 687–696.Google Scholar
  75. Parens, E., & Johnston, J. (2011). Troubled children: Diagnosing, treating and attending to context: A hastings center special report. Hastings Center Report, 41(2), 1–32.Google Scholar
  76. Peerenboom, E. (2002). Transparent science. EMBO Reports, 3(1), 9–11.PubMedPubMedCentralCrossRefGoogle Scholar
  77. Philips, C. B. (2006). Medicine goes to school: Teachers as sickness brokers for ADHD. Plos Medicine, 3, e182.CrossRefGoogle Scholar
  78. Pickard, H. (2009). Mental illness is indeed a myth. In L. Bortolotti & M. Broome (Eds.), Psychiatry as cognitive science: Philosophical perspectives (pp. 83–101). London: Open University Press.Google Scholar
  79. Pigeaud, J. (2001). Aux portes de la psychiatrie. Pinel, l’ancien et le moderne. Paris: Aubier.Google Scholar
  80. Pinel, P. (1806). A treatise on insanity. Sheffield: Todd.CrossRefGoogle Scholar
  81. Pottick, K. J., Kirk, S. A., Hsieh, D. K., & Tian, X. (2007). Judging mental disorder in youths: Effects of client, clinician and contextual factors. Journal of Consulting and Clinical Psychology, 75, 1–8.PubMedCrossRefGoogle Scholar
  82. Rafalovich, A. (2004). Framing ADHD children: A critical examination of the history, discourse, and everyday experience of attention deficit/hyperactivity disorder. Lanham: Lexington Books.Google Scholar
  83. Regier, D. A., Narrow, W. E., Clarke, D. E., et al. (2013). DSM-5 field trials in the United States and Canada, part II: Test-retest reliability of selected categorical diagnoses. American Journal of Psychiatry, 170, 59–70.PubMedCrossRefGoogle Scholar
  84. Robins, E., & Guze, S. (1970). Establishment of diagnostic validity in psychiatric illness: Its application to schizophrenia. American Journal of Psychiatry, 126, 983–987.PubMedCrossRefGoogle Scholar
  85. Rose, N. (1996). Inventing our selves – Psychology, power and personhood. Cambridge: Cambridge University Press.CrossRefGoogle Scholar
  86. Rose, N. (1999). Governing the soul – The shaping of the private self – Second edition. London/New York: Free Association Books.Google Scholar
  87. Rosen, G. M., & Lilienfeld, S. O. (2008). Posttraumatic stress disorder: An empirical evaluation of core assumptions. Clinical Psychology Review, 28, 837–868.PubMedCrossRefGoogle Scholar
  88. Rosenhan, D. (1973). Being sane in insane places. Science, 179, 250–258.PubMedCrossRefGoogle Scholar
  89. Rosenhan, D. (1975). The contextual nature of psychiatric diagnosis. Journal of Abnormal Psychology, 84, 462–474.PubMedCrossRefGoogle Scholar
  90. Scheff, T. (1966). Being mentally ill – A sociological theory. Chicago: Aldine.Google Scholar
  91. Schomerus, G., Schwahn, C., Holzinger, A., et al. (2012). Evolution of public attitudes about mental illness: A systematic review and meta-analysis. Acta Psychiatrica Scandinavica, 125, 440–452.PubMedCrossRefGoogle Scholar
  92. Skre, I., Onstad, S., Torgensen, S., & Kringlen, E. (1991). High interrater reliability for the structured clinical interview for DSM-III-R Axis I (SCID-I). Acta Psychiatrica Scandinavica, 84, 167–173.PubMedCrossRefGoogle Scholar
  93. Solomon, A. (2012). Far from the tree – Parents, children and the search for identity. London: Vintage books.Google Scholar
  94. Spitzer, R. L. (1975). On pseudoscience in science, logic in remission and psychiatric diagnosis: A critique of Rosenhan’s ‘on being sane in insane places’. Journal of Abnormal Psychology, 84, 442–452.PubMedCrossRefGoogle Scholar
  95. Spitzer, R. L., & Fleiss, J. L. (1974). A re-analysis of the reliability of psychiatric diagnosis. British Journal of Psychiatry, 125, 341–347.PubMedCrossRefGoogle Scholar
  96. Spitzer, R. L., Endicot, J., & Robins, E. (1978). Research diagnostic criteria – Rationale and reliability. Archives of General Psychiatry, 35, 773–782.PubMedCrossRefGoogle Scholar
  97. Spitzer, R. L., Forman, J. B. W., & Nee, J. (1979). DSM-III field trials: I. Initial interrater diagnostic reliability. American Journal of Psychiatry, 136, 815–817.PubMedCrossRefGoogle Scholar
  98. Spitzer, R. L., Williams, J. B., Gibbon, M., & First, M. B. (1984). Structured clinical interview for DSM-III axis I disorders. New York: New York State Psychiatric Institute.Google Scholar
  99. Strand, M. (2011). Where do classifications come from? The DSM-III, the transformation of American psychiatry, and the problem of origins in the sociology of knowledge. Theory and Society, 40, 273–313.CrossRefGoogle Scholar
  100. Szasz, T. S. (1961). The myth of mental illness – Foundations of the theory of personal conduct. New York: Harper & Row.Google Scholar
  101. Tait, G. (2009). The logic of ADHD: A brief review of fallacious reasoning. Studies in Philosophy and Education, 28, 239–254.CrossRefGoogle Scholar
  102. Temerlin, M. K. (1968). Suggestion effects in psychiatric diagnosis. Journal of Nervous and Mental Disease, 147, 349–353.PubMedCrossRefGoogle Scholar
  103. Temerlin, M. K. (1970). Diagnostic bias in community mental health. Community Mental Health Journal, 6, 110–117.PubMedCrossRefGoogle Scholar
  104. The Psychologist. (2011). Society’s critical response to DSM-5. Retrieved Oktober 17, 2013, from
  105. Timimi, S., & Leo, J. (2009). Rethinking ADHD. London/New York: Palgrave MacMillan.CrossRefGoogle Scholar
  106. Trajkovic, G., Starcevic, V., Latas, M., et al. (2011). Reliability of the Hamilton rating scale for depression: A meta-analysis over a period of 49 years. Psychiatry Research, 189, 1–9.PubMedCrossRefGoogle Scholar
  107. Van Os, J. (2016). “Schizophrenia” does not exist. The British Medical Journal, 352, i375.PubMedGoogle Scholar
  108. Van Os, J., Kenis, G., & Rutten, B. P. (2010). The environment and schizophrenia. Nature, 268, 203–212.CrossRefGoogle Scholar
  109. Van Os, J., Rutten, B. P., Myin-Germeys, I., et al. (2014). Identifying gene-environment interactions in schizophrenia: Contemporary challenges for integrated, large-scale investigations. Schizophrenia Bulletin, 40, 729–736.PubMedCrossRefGoogle Scholar
  110. Vanheule, S., Desmet, M., Meganck, R., et al. (2014). Reliability in psychiatric diagnosis with the DSM: Old wine in new barrels. Psychotherapy and Psychosomatics, 83, 313–314.Google Scholar
  111. Viera, A. J., & Garrett, J. M. (2005). Understanding interobserver agreement: The kappa statistic. Family Medicine, 37, 360–363.PubMedGoogle Scholar
  112. Weber, M. M., & Engstrom, E. J. (1997). Kraepelin’s “diagnostic cards”. The confluence of clinical research and preconceived categories. History of Psychiatry, 8, 375–385.PubMedCrossRefGoogle Scholar
  113. Welner, A., Liss, J. L., & Robins, E. (1974). Systematic approach for making a psychiatric diagnosis. Archives of General Psychiatry, 31, 193–196.PubMedCrossRefGoogle Scholar
  114. Westen, D. (2012). Protoype diagnosis of psychiatric syndromes. World Psychiatry, 11, 16–21.PubMedPubMedCentralCrossRefGoogle Scholar
  115. Westen, D., DeFife, J. A., Bradley, B., & Hilsenroth, M. J. (2010). Prototype personality diagnosis in clinical practice: A viable alternative for DSM-5 and ICD-11. Professional Psychology: Research and Practice, 41, 482–487.CrossRefGoogle Scholar
  116. Williams, J. B. W., & Kobak, K. A. (2008). Development and reliability of a structured interview guide for the montgomery depression rating scale (SIGMA). British Journal of Psychiatry, 192, 52–58.PubMedCrossRefGoogle Scholar
  117. Williams, J. B. W., Gibbon, M., First, M. B., et al. (1992). The structured clinical interview for DSM-III-R (SCID) – II. Multisite test-retest reliability. Archives of General Psychiatry, 49, 630–636.PubMedCrossRefGoogle Scholar
  118. Woodruff, R., Goodwin, D., & Guze, S. (1974). Psychiatric diagnosis. New York: Oxford University Press.Google Scholar
  119. Zanarini, M. C., Skodol, A. E., Bender, D., et al. (2000). The collaborative longitudinal personality disorders study: Reliability of Axis I and II diagnoses. Journal of Personality Disorders, 14, 291–299.PubMedCrossRefGoogle Scholar
  120. Ziółkowska, J. (2012). The objectifying discourse of doctors’ questions. Qualitative analysis of psychiatric interviews. Social Theory & Health, 10, 292–307.CrossRefGoogle Scholar

Copyright information

© The Author(s) 2017

Authors and Affiliations

  • Stijn Vanheule
    • 1
  1. 1.Ghent UniversityGhentBelgium

Personalised recommendations