The DSM 5's over-reliance on the medical model raises questions of its status as being atheoretical.

Answer 1

The DSM-5 (Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition) faces criticism for relying too much on the medical model of mental health, which emphasizes biological factors and symptoms while overlooking psychological and social influences. This raises concerns about whether it lacks a solid theoretical framework, or is “atheoretical.”

Key issues include oversimplification, as the focus on biological dysfunctions can reduce complex mental health issues to simple symptoms, ignoring important psychological and social factors. Diagnostic accuracy is another concern; the symptom-based approach may lead to misdiagnosis by failing to capture the deeper causes of mental disorders. Additionally, limited treatment options arise because emphasizing medication can restrict access to other effective treatments, like therapy. Cultural bias is also a factor, as the DSM-5 may not adequately account for cultural differences in mental health, leading to biases in diagnosis and treatment.

To address these concerns, researchers and clinicians are advocating for a more integrated approach by using biopsychosocial models that consider biological, psychological, and social factors together. Enhancing cultural sensitivity in diagnostic criteria and focusing on evidence-based practices that evaluate the effectiveness of different treatment methods are also important steps.

In summary, while the DSM-5’s reliance on the medical model raises questions about its theoretical foundation. However, ongoing research efforts aim to provide a more comprehensive understanding of mental health disorders considering said factors.

Answer 2

Emily - This is a great question. It goes to the heart of psychology as a scientific discipline, and I applaud you for asking it. My answer is barely a brief outline of the issue, but I hope it makes sense as a beginning sketch. The psychological literature contains far more detailed accounts of this issue that could be referenced.

In the early days of psychology’s development as a scientific discipline, there was significant debate over the theoretical model it should adopt. Some advocated for a holistic approach, taking human beings' lived experience as foundational and developing research methodologies and practices grounded in lived experience. Scientific research methods would take seriously the whole, intentional, relationally embedded nature of human experience and develop methods of study that honored this holistic nature.

Others advocated following the models used in the hard sciences like chemistry and physics that manipulated discrete elements of the physical world to understand causal relationships and propose explanatory models. As advocated for in psychology, these models conceptualized human thought, emotion, and behavior as the result of discrete mechanical processes that could be decomposed in laboratory experiments like the elements of the physical world were in the hard sciences. These processes could be either internal to the person (e.g., brain states), external to the person (e.g., environmental events), or some combination. Either way, the processes could be manipulated, the effects of those manipulations could be observed and measured, and the resulting findings put forward as explanations of human thought and behavior.

The “medical model” in psychology and psychiatry is one result of the victory of the hard science model. Based on the hard science model, medical science views humans as a collection of interrelated physical systems, which can be “fixed” when misbehaving through physical interventions. Psychological and psychiatric models follow suit. As a manifestation of this theoretical view, the DSM relies heavily on the medical model to describe and characterize human functioning and advise treatments. 

The bottom line is that the DSM is not “atheoretical.” At its core, it is based on a specific set of assumptions and beliefs about what counts as the proper, acceptable explanation of human thought, emotion, and behavior. However, this theoretical view has been accepted so widely and for so long that it has become invisible as a theoretical model. It is taken for granted so broadly and has been assumed valid for so long that most people in the discipline are unaware of it as a model.