Metaphorical analysis of psychiatric classification as a psychological test.

Abstract

In this taxonomic article we explore the metaphor of comparing a psychiatric classification to a psychological test. Structurally, diagnostic criteria are like test items; diagnostic categories are like scales; and classification are like tests. Analytically, the ideas of reliability and validity are the primary concepts invoked in the empirical evaluation of both classifications and tests. However, when the metaphor is explored in more detail, the differences between classifications and tests become clear. These differences are discussed in terms of the structural and analytical relations between tests and classifications. This metaphorical analysis of classifications as tests suggests that certain issues that have been discussed in regard to psychological tests, particularly reliability and validity, may require modification when applied to psychiatric classification.

Explicating the Construct of Psychopathy: Development and Validation of a Conceptual Model, the Comprehensive Assessment of Psychopathic Personality (CAPP)

“…Before we describe these stages in more detail, it is important to discuss six assumptions that guided our work. These assumptions were based on our understanding of the research on the development of concepts and measures generally, as well as personality disorder more specifically (Blashfield & Livesley, 1991;Clark & Watson, 1995;Maraun & Peters, 2005;Smith, Fischer & Fister, 2003).…”

“…The adequacy of any measurement procedure must be judged in terms of-and, importantly, is inherently limited by-the definition of the underlying construct. Put simply, construct explication guides the development and evaluation of all measures, including those for mental disorder (Blashfield & Livesley, 1991; more generally, see Borg & Shye, 1995;Guttman & Greenbaum, 1998;Krauth, 1981;Middendorp, 1991); incomplete or inadequate construct explication leads to incomplete or inadequate measures.…”

Capturing clinical complexity: Towards a personality-oriented measure of psychopathy

“…We derived eight principles from the literature on the development of concepts and measures to guide our attempts to describe the topography of the concept of psychopathy (Blashfield & Livesley, 1991;Clark & Watson, 1995;Maraun & Peters, 2005;Smith, Fischer, & Fister, 2003). First, following Blackburn (1988), the conceptual model should entail symptoms defined in terms of personality pathology -stylistic variations amongst people -not departures from cultural or moral standards, such as specific criminal or antisocial behaviors (Blackburn, 1988;Skeem & Cooke, 2010a,b).…”

“…Psychological science progresses through the successive iteration and refinement of both the construct of interest and putative measures of the construct (Blashfield & Livesley, 1991;Cronbach & Meehl, 1955;Strauss & Smith, 2009).…”

Testing a Relational Model of Psychopathology With the MMPI-2

“…Classifications of psychopathology, still operating on a monadic ideology, are best illustrated by the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV). This manual determines how psychopathology is diagnosed and presented in psychiatric and abnormal psychology textbooks, as if there were relationships between diagnosis and treatment (Acierno, Hersen, & Van Hasselt, 1997;Barlow, 1991;Bellack & Hersen, 1993;Blashfield & Livesley, 1991;Hersen & Last, 1990;Maser, Kaelber, & Weise, 1991;Millon, 1991;Sperry & Carlson, 1996;Turner & Hersen, 1997). These and other treatises, too many to be cited here, seem to accept uncritically a monadic ideology, even though criticisms about the DSM-IV and its predecessors have been frequent (Carson, 1996;Eysenck, 1986;Garfield, 1986;Livesley, 1995), many contained in Millon and Klerman's (1991) seminal work.…”