The Reliability of Psychiatric, and the Validity of Psychological, Diagnoses

In determining the diagnostic value of psychological tests the usual external criterion is the psychiatric diagnosis. This criterion has suffered a steady decline in prestige among both psychiatrists and psychologists. The following remarks by Noyes (1953) would be endorsed by many psychiatrists: “The principal value of classification is not in the categorizing of a disease entity but in quickly eliminating those considerations which will be least useful in understanding the patient and in directing attention to those which are likely to be relevant. Except in organic disorders a classificatory diagnosis is less important than a psychodynamic study of the personality. The psychiatrist should be interested in processes, not in labels … we should endeavour not so much to fit the symptoms into a classificatory scheme as to understand the sick person in terms of his life experience.”