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The American Psychiatric Association's (APA) recent publications about the Sixth Edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM‐6) exhibit an emerging concept of culture. This article reviews the contributions of clinically applied medical anthropology to prior DSM revisions, showing how anthropologists and psychiatrists have transformed the culture concept from belonging to minority patients to an interactive exchange among all patients and clinicians. Regrettably, the APA's articles about DSM‐6 exhibit a theory of practice that I call reflexive areflexivity in lacking examination into how psychiatrists are positioned in relation to patients and their research. DSM‐6 treats culture as secondary to biology, important mostly for minoritized patients, and as a static variable, not an interactional process. To reverse course, the APA can publicize scientific debates about DSM‐6, include experts on culture and diagnosis, and revise definitions for diagnoses based on the ethnographic record.
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Neil Krishan Aggarwal (2026) studied this question.
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