Rhetorical Analysis of the Introduction to DSM IV-R

The introduction to the “Diagnostic and Statistical Manual of Mental Disorders IV- Revision” was published by the American Psychiatric Association.  According to the APA’s website, the DSM “is the standard classification of mental disorders used by mental health professions in the United States…” (1) The American Psychiatric Association released other editions prior to this version such as the DSM I, DSM II, and DSM III. The first part of the introduction provides the reader of the historical background behind the DSM, which consists of a recount of important events leading up to the creation of the DSM III. The historic part of this introduction can be seen as an educational tool, but is also acting as a form of ethos by providing the reader for a reason why they are authoritative in the subject. The second part of the introduction, the APA presents an argument that goes against their own writing, but they give reason to why they must act against their ideals. Their main argument states that the definition of “Mental Disorder” is a too complex of a concept to assign a strict definition or term to. To support this argument, they use direct appeal to the reader’s logos through the use of logical ideas. However, they do provide a definition they consider to be “useful”.

                The first part of the excerpt is headed “Historical Background”.  History and background information are used in rhetoric so that the reader can have a better understanding of the subject and the origin of the ideas and facts presented. The introductory paragraph begins by providing some generalizations that can be made about the overall history of the DSM. One states that there has been a need for a classification of mental disorders and much argument has been centralized on “which disorders should be included and the optimal method for their organization”. (1)  The other is that many other systems of mental disorder classification have been developed in past 2000 years. He finally goes on to state that they will only focus on the events leading to the DSM. (1)

                The historical portion begins with what is considered to be the first “official attempt to gather information about mental illness in the United States.” (APA, 2)  In the 1840 census, data concerning the frequency of “idiocy/insanity” was collected. (APA, 2) Later events are then mentioned and depict how the collection of mental illness statistics evolved and how psychiatric nomenclature such as the ICD-6 and the DSM I emerged. The first edition of the DSMI-I was developed by the APA Committee on Nomenclature in 1952. (APA, 4) According to the APA, “DSM-I contained a glossary of descriptions of the diagnostic categories and was the first official manual of mental disorders to focus on clinical utility.”(4)

                The authors then explain the impact different psychiatric professionals had on subsequent revisions and changes made to the DSM and ICD. For example, the DSM-III, published in 1980, “introduced a number of important methodological innovations, including explicit diagnostic criteria, a multiaxial system, and a descriptive approach that attempted to be neutral with respect to theories etiology. This effort was facilitated by the extensive empirical work then under way in the construction and validation of explicit diagnostic criteria and the development of semi structured interviews. (APA, 6)

                The second part of the essay is headed “Definition of Mental Disorder”, it includes an overview and discussion about the term mental disorder and its definition. The APA starts this section by arguing that the term itself is not very appropriate for the subject behind it. The APA then cites an unknown source and states that “there is much “physical” in “mental” disorders and much me “mental” in “physical” disorders. (8) This means that, even though, the term “Mental Disorder” implies a difference between “mental” disorders and “physical” disorders, they are really interconnected terms.  (APA, 8) Even though the term “Mental Disorders” is a problem, the APA reasons that the term is still used in the title of the DSM because they “have not found an appropriate substitute.” (8)

                A second argument is made that “no definition adequately specifies precise boundaries for the concept of “mental disorder”.”(APA, 9) They support this argument by using logical comparisons to examples of “various levels of abstraction” in medical conditions. It is then stated that even though these levels of abstraction or concepts can be indicators of a medical condition or mental disorder, none are “…equivalent to the concept, and different situations call for different definitions.” (APA, 9) After the argument is made, the APA offers a definition from past DSMs (DSM-III and DSM-IIIR). Even though they know that the definition cannot completely cover all situations, they believe it can help guide “…decisions regarding which conditions on the boundary between normality and pathology…”(APA, 9)

In this introduction, the APA primarily appeals to ethos and logos. For ethos, they use their own history of the development of the DSM to show how much time and authority they have in their field.  However, their entire introduction also comes off as restrained, sincere, and fair minded. Their arguments are even generated so they formally acknowledge that there are some issues with their DSM and offer explanations to these issues. The language, grammar, and level of writing used are appropriate for the subject and audience of clinical professionals, students, and policy makers. As for logos, they appeal to of logic through citing “compelling literature”, drawing comparisons, and using definitions. One of the most noticeable devices used in this excerpt is repetition. In paragraph 9, the APA makes their argument on how there cannot be an adequate definition for “mental disorders”. The commoratio form of repetition is used as the authors repeat their main argument about three times in paragraph. Using these tools of rhetoric, the APA effectively informs the reader about the history of the DSM, and supports their argument to why the definition of “Mental Disorder” is too complex of a concept to assign a term and definition to.

                

Works Cited

American Psychiatric Association. “ Diagnostic and Statistical Manual of Mental Disorders.”  4^th ed. Rev. 2 Introduction Washington, D.C: American Psychological Association, Print.

DSM-5 Development 2012. American Pschological Association. 19 Feb. 2012

<www.dsm5.org/about/Pages/DSMVoverview.aspx>