suggests to us that the administration of an antipsy-
chotic medication is more likely to be effective than
is a course of psychoanalytic psychotherapy. How-
ever, it is important to note one thing in passing.
Although, in theory, the linkage between diagnosis
and treatment would seem to justify the time
involved in diagnostic assessment, often several
treatments appear to be equally effective for an
individual disorder.
In summary, diagnosis and classification of
psychopathology serve many useful functions.
Whether they are researchers or practitioners, con-
temporary clinical psychologists use some form of
diagnostic system in their work. At this point, we
turn to a brief description of classification systems
that have been used to diagnose mental disorders
over the years, and then we examine in more detail
the features of the diagnostic classification system
used most frequently in the United States, the
DSM-IV-TR.
Early Classification Systems
Classification systems for mental disorders have pro-
liferated for many years. For example, the earliest
reference to a depressive syndrome appeared as far
back as 2600B.C. (Menninger, 1963). Since that
time, both the number and breadth of classification
systems have increased. To bring some measure of
order out of this chaos, the Congress of Mental
Science adopted a single classification system in
1889 in Paris. More recent attempts can be traced
to the World Health Organization and its 1948
International Statistical Classification of Diseases, Inju-
ries, and Causes of Death, which included a classifi-
cation of abnormal behavior.
In 1952, the American Psychiatric Association
published its own classification system in theDiag-
nostic and Statistical Manual, and this manual con-
tained a glossary describing each of the diagnostic
categories that were included. This first edition,
known as DSM-I, was followed by revisions in
1968 (DSM-II), 1980 (DSM-III), 1987 (DSM-
III-R), and 1994 (DSM-IV). Presently, the most
widely used classification system is the text revision
of DSM-IV (DSM-IV-TR, American Psychiatric
Association, 2000), which appeared in 2000. A
new version of theDSM, theDSM-V, is scheduled
for release in 2013. To help classify psychopathol-
ogy among very young children, a similar manual
has been developed for children aged 0–3 years
(i.e.,DC 0–3: Diagnostic Classification System, 0– 3 ,
published in 1994). A revised version, the DC
0 – 3Rwas published in 2005. All of these manuals
are embodiments of Emil Kraepelin’s efforts in the
late 19th century (see Figure 5-2). To illustrate how
things have changed over the past 50 years, com-
pare the British system in use in the late 1940s (see
Table 5-1) with theDSM-IV-TRsystem described
in Table 5-2.
From the 1950s to the early 1960s, the enthusi-
asm for psychiatric diagnosis waned (L. N. Robins &
Helzer, 1986). Diagnosis was said to be dehumaniz-
ing and to ignore individual variation. But diagnosis
in psychiatry and psychology has staged a comeback.
The most revolutionary changes in our diagnostic
system were introduced inDSM-III,publishedinF I G U R E 5-2 Emil Kraepelin is generally regarded as
the father of modern systems of psychiatric diagnosis and
classification.Culver Pictures, Inc.DIAGNOSIS AND CLASSIFICATION OF PSYCHOLOGICAL PROBLEMS 143