Textual standardization and the 'common language' of the Diagnostic and Statistical Manual of Mental Disorders

This dissertation analyzes the textual standardization of discursive and pragmatic practices in the American Psychiatric Association’s (APA) Diagnostic and Statistical Manual of Mental Disorders (DSM). Specifically, this study examines psychiatrists’ prescriptive and proscriptive discursive practices in the diagnostic manuals. This study claims psychiatrists’ metadiscourse about the textual standardization of discursive and pragmatic practices in the DSMs as a distinct object of study. This project focuses on the textual standardization of a professional discourse community’s communicative practices by asking about the ways in which the DSMs help to constitute psychiatric knowledge. In order to answer the question, the project examines psychiatrists’ metadiscourse about style, standards, and standardization in the DSMs themselves, in psychiatric journals, and in journalistic coverage of the DSMs. The three chapters of analysis focus on different processes and stages in the textual standardization of the DSMs. The analysis of psychiatrists’ metadiscourse demonstrates that, in an effort to standardize disciplinary knowledge, sometimes the object of scientific inquiry in the DSMs is the discursive practices of psychiatrists. When this happens, the development of a professional style for American psychiatry contributes to knowledge-making because psychiatrists locate the evidence for knowledge claims in discourse structures. In addition to the many other purposes the diagnostic manuals fulfill (e.g., diagnostic, statistical, forensic, actuarial, and so on), the textual standardization of the professional style constitutes a handbook of usage, and in this sense, then, the DSMs are a rhetoric. A central claim of this project is that the professional style facilitates the cultural shareability and portability of the APA's “common language” across a range of rhetorical situations. The study concludes that the development of a professional style and the textual standardization of that style in the APA's diagnostic manuals are central to the discursive construction of the APA as a professional scientific society and to the discursive production of psychiatric knowledge.