From Bibles to Biomarkers: the Future of the Dsm and Forensic Psychiatric Diagnosis

The Diagnostic and Statistical Manual on Mental Disorders (DSM) represents the current thinking on the symptomology of mental illness, from the perspective of the American Psychiatric Association. The most recent version, DSM-5, was published in May 2013 after nearly two decades of research and a highly politicized revision process.1 Intended primarily as an aid in the diagnosis and treatment of mental illness, the uses of the DSM have spilled over into research. The DSM has also become the de facto guide for forensic psychiatry.2 Despite the strong language in the introduction to the DSM that advises otherwise, “the DSM is now regularly used unadulterated in forensic contexts . . . .”3 Having researched how judges sentence psychopaths in the past, it was curious to me that some judges would ignore any evidence of psychopathy, whether presented by the defense or the prosecution, because the diagnosis of psychopathy is not in the DSM.4 Despite the fact there is a validated diagnostic tool for