DSM-5: Centripetal Scientific and Centrifugal Antiscientific Forces

The excellent articles in this Special Series underscore the centripetal forces pushing the Diagnostic and Statistical Manual of Mental Disorders (DSM), including DSM-5, toward science, as well as the centrifugal forces pushing the DSM away from science. These articles demonstrate that, some assertions to the contrary, many of the DSM-5 revisions were indeed responsive to data. At the same time, these articles underscore the point that certain assumptions and constraints are impeding the DSM's scientific potential. I highlight three such centrifugal forces here: (a) unwarranted categorical assumptions, (b) unwarranted belief in natural kinds, and (c) the DSM's many masters. Although the DSM is in part a scientific document, it is also in part a pragmatic compromise among multiple competing demands and constituencies. I encourage boosting competition in the marketplace of ideas as a means of enhancing the verisimilitude of the psychiatric classification system.