Philosophical Perspectives on Psychiatric Diagnostic Classification edited by John Z. Sadler, Osborne P. Wiggins, and Michael A. Schwartz Baltimore, MD:  Johns Hopkins University Press, 1994,  xiv + 399 pp., $69.50; $29.95 paper

A chapter in the book under review contains the following statement: “In DSM-III-R post-traumatic stress disorder is ‘more severe and long lasting when the stressor is of human design…,’ an acknowledgment that the meaning of the stressor is critical for the course of the disorder” (p. 145). Most of the chapters in this excellent collection show that a) the philosophical assumptions embodied in DSM-III-R attempt to subvert every effort to include the meanings human beings find in experience as a factor in diagnosing mental disorders; b) DSM-III-R does not exclude meaning, nor can it be excluded when psychic phenomena are considered; and c) the attempt to exclude meaning has had disastrous consequences for psychiatry.

Except for the initial, “historico-philosophical' overview of “Psychiatry and Its Nosology,” by Edwin R. Wallace, IV, the chapters fall into four categories: Methods, Psychopathology, Values, and Future Prospects and Alternatives. Each chapter is well written, original, and challenging. In this review, I aim both to provide an overview and to suggest a direction to enable philosophical critique of DSM-III-R to move into a constructive phase.