Resilience theory and the diagnostic and statistical manual: incompatible bed fellows?
As in any scientific undertaking, theoretical orientation and the classification schemas underlying those theories are important to test hypotheses about optimal conditions for fostering positive growth and adaptation. This article explores what conceptual factors prevent the integration of resilience theory and practice into the Diagnostic and Statistical Manual (DSM). We argue that the DSM was a necessary first step toward a general theory of classification because diagnoses in psychiatry needed to be operationalized but that the DSM's inability to evolve as a classification system and to incorporate developmentally sensitive interactional and transactional factors make the DSM categorical approach inadequate for developmental science. Developmental research, based on firm evidence from context-sensitive longitudinal studies analyzing risk and resilience factors, suggests a reconceptualization based on multiple developmental pathways operating dimensionally across the lifespan and intergenerationally.
Carrey
Normand
N
Maritime Psychiatry, IWK Health Centre, 5850/5950 University Avenue, P.O. Box 9700, Halifax, Nova Scotia, Canada B3K 6R8. normand.carrey@iwk.nshealth.ca
Ungar
Michael
M
D000223:Adaptation, Psychological; D039721:Diagnostic and Statistical Manual of Mental Disorders; D006801:Humans; D008370:Manuals as Topic; D001523:Mental Disorders / Q000175:diagnosis* / Q000523:psychology*; D011582:Psychological Theory