Thirty-two observers and one patient: A study of diagnostic reliability

Nathan, Peter E.; Andberg, Marcia M.; Behan, Peter O.; Patch, Vernon D.

doi:10.1002/1097-4679(196901)25:1<9::aid-jclp2270250103>3.0.co;2-k

Cited by 11 publications

(3 citation statements)

References 5 publications

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“…The vague and brief descriptions of the syndromes resulted in poor diagnostic reliability (Beck, Ward Mendelson, Mock, & Erbaugh, 1962;Nathan, Andberg, Behan, & Patch, 1969) and significant concerns about the boundaries between mental disorders and normal behavior (e.g. Szasz, 1960).…”

Section: Purpose Of Diagnostic Classificationmentioning

confidence: 99%

Toward a Clinically‐Oriented Model of Anxiety Disorders

Norton

2006

Cognitive Behaviour Therapy

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The Diagnostic and Statistical Manual of Mental Disorders (DSM) model of psychopathology has generally been the accepted standard in North America for understanding and diagnosing psychological disorders for over half a century. This classification model, particularly since DSM-III, has been formulated around the goals of aiding diagnosis, enhancing communication among professionals, fostering psychopathology research and informing treatment. However, all classification systems are inherently dependent on the purpose for the classification. In this paper, an argument is made for a clinically-relevant diagnostic system of mental disorders to support a primary goal of informing treatment. Several lines of research are examined, including studies on diagnostic reliability, dimensional vs categorical nature of anxiety disorders, co-morbidity, and psychotherapeutic and pharmacological treatment outcome as they relate to current and proposed diagnostic models of anxiety disorders. Based on the evidence, suggestions are made for revising diagnostic models of anxiety, and key lines of future research are proposed.

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Section: Purpose Of Diagnostic Classificationmentioning

confidence: 99%

Toward a Clinically‐Oriented Model of Anxiety Disorders

Norton

2006

Cognitive Behaviour Therapy

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“…Dissatisfaction with the results of clinical decision making continues to preoccupy many mental health professionals (Beck, Ward, Mendelson, Mock, & Erbaugh, 1962;Goldberg 1968;Gough, 1971). Although responsibility for inadequate clinical decision making has been apportioned both to the clinician (Chapman & Chapman, 1967;Nathan, Andberg, Behan, & Patch, 1969) and the diagnostic instruments and other evaluative procedures he uses (Hunt & Walker, 1966;Vandenberg, Rosenzweig, Moore, & Dukay, 1964), the utility of traditional Kraepelinian diagnostic groupings for this purpose also continues to be hotly debated (Kanfer & Saslow, 1965;Roth, 1967). One result of this latter concern is recent overhaul of the "official" psychiatric classification system (American Psychiatric Association, 1968) in an effort to make it more useful for predictive purposes (Spitzer & Wilson, 1968).…”

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confidence: 99%

Syndromes of psychosis and nonpsychosis: Factor analysis of a systems analysis.

Martorano¹,

Nathan²

1972

Journal of Abnormal Psychology

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The ratings of 924 psychotic and nonpsychotic patients on the Boston City Hospital Behavior Checklist, a 100-item behavior rating scale derived from a recent systems analysis of traditional psychiatric diagnostic procedures, were factor analyzed. Thirteen factors were denned by an oblique rotation. Discussion of results centers on the degree to which the present factors define dimensions of psychopathology similar to those denned by other analyses of symptom data. Discussion also touches on the value of factor analysis as a means of assessing the validity of "traditional" psychiatric syndromes.

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“…One result was that clinicians often failed to agree on DSM-I and DSM-11 diagnoses, even when they were presented with identical sets of diagnostic information (i.e., interclinician agreement; Beck, Ward, Mendelson, Mock, & Erbaugh, 1962;Sandifer, Pettus, & Quade, 1964) or when they saw the same patient across a short time span (i.e., diagnostic consistency over time; Zubin, 1967). My colleagues and I undertook a study of interclinician agreement shortly after the DSM-11 appeared (Nathan, Andberg, Behan, & Patch, 1969) by asking 32 experienced mental health professionals attending a weekly hospital psychiatric service diagnostic conference to diagnose the 40-year-old man who was evaluated at the meeting.…”

Section: The Roots Of the Dsmmentioning

confidence: 99%

The DSM-IV and its antecedents: Enhancing syndromal diagnosis.

Nathan¹

Making Diagnosis Meaningful: Enhancing Evaluation and Treatment of Psychological Disorders.

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Most efforts to classify psychopathology, including the earliest, have focused on phenomenology, on syndromes of psycbputbbgy , the "grouping of signs and symptoms, based on their frequent co-occurrence, that may suggest a common underlying pathogenesis, course, familial pattern, or treatment selection" (American Psychiatric Association [APA], 1994). Hippocrates recognized and labeled the familiar syndromes of mania, melancholia, and paranoia 2,500 years ago; he blamed them on imbalance in the four essential humors: black bile, yellow bile, blood, and phlegm.Hippocrates's threefold syndromal division, endorsed by Plato a century later, held sway in one form or another throughout the Western world until Phillippe Pinel, at about the time of both the French and American revolutions, offered a modestly more complex classification system. Pinel's influential system identified five syndromes: melancholia, mania, mania with delirium, dementia, and idiotism. The development of this nomenclature coincided with the rise of asylums for the insane, for which Pinel was partly responsible; both Pinel's system and the availability of large numbers of patients in asylums paved the way for the marked

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Thirty-two observers and one patient: A study of diagnostic reliability

Cited by 11 publications

References 5 publications

Toward a Clinically‐Oriented Model of Anxiety Disorders

Toward a Clinically‐Oriented Model of Anxiety Disorders

Syndromes of psychosis and nonpsychosis: Factor analysis of a systems analysis.

The DSM-IV and its antecedents: Enhancing syndromal diagnosis.

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