@article{c8c2d31598704c1f9cfc8f5ef81562f4,
title = "DSM III as a systemic culture pattern: Studying intracultural variation among psychiatrists",
abstract = "DSM III is viewed as embodying a pool of information pertaining to a systemic culture pattern of psychiatry and attempts are made to describe how psychiatrists understand and apply it using ideas from cognitive anthropology. Each of seven psychiatrists evaluated a group of patients in an intake setting. Seven broad categories of Axis I diagnoses were formed and the frequencies with which psychiatrists used these categories were computed. In addition, twelve arithmetical measures pertaining to the five axes of DSM III and a current functioning axis and the decision regarding disposition were also computed. Using these dependent variables, the study analyzes the similarities and differences among psychiatrists in the way they formulate intake evaluations. Psychiatrists' selection of Axis I diagnoses were highly intercorrelated but they differed greatly among themselves in the way they coded many of the axes of DSM III. Group correlations among diagnostic measures indicated a patterning among diagnostic measures and the nature of this patterning is discussed. Each psychiatrists' set of correlations among the twelve diagnostic measures was itself correlated with that of others and this showed a very high level of interpsychiatrist agreement. Deductions drawn from the cultural consensus model suggest that psychiatrists share an underlying 'grammar' that references the pool of information pertaining to DSM III.",
author = "Horacio Fabrega and Ahn, {Chul W.} and James Boster and Mezzich, {Juan E.}",
note = "Funding Information: The study was conducted at the Western Psychiatric Institute and Clinic (WPIC) of the University of Pittsburgh, a large, comprehensive, urban-based university psychiatric facility that also servesa s a community mental health center. Details of the Institute and the setting where the study was conducted, the Diagnostic and Evaluation Center, have been presented in previous publications (MEZZICH, Dow, & RICH, 1981). Individuals presenting for evaluation were asked to participate in a longitudinal research project involving the study of diagnosis supported by the National Institutes of Health. Initial evaluations were conducted by study clinicians (either a psychologist, advanced Ph.D. psychology trainee or an experienced nurse clinician specially trained in psychiatric assessment) and a supervising faculty psychiatrist. The interviewersr eviewed all pertinent records and material furnished by the patient and accompanying persons. Information from these records and from the evaluation itself was coded according to the Initial Evaluation Form (I.E.F.), a semi-structured assessment procedure having a mutual complementary narrative and standardizedc omponents (MEZZICH et a/., 1981;M EZZICH, CO~FMAN&, GOODPASTOR1, 982). The process of evaluation culminated in a multi-axial diagnostic formulation along lines stipulated in DSM III and a decision regarding disposition jointly reached by members of the evaluation team.",
year = "1990",
doi = "10.1016/0022-3956(90)90054-T",
language = "English (US)",
volume = "24",
pages = "139--154",
journal = "Journal of Psychiatric Research",
issn = "0022-3956",
publisher = "Elsevier Limited",
number = "2",
}