The Epistemology of Psychiatric Diagnoses in Lived Experience Research

Authors

Abstract

Abstract: I explore the relationship between psychiatric diagnoses, lived experience, and knowledge in participatory research. It has been claimed that people who have a particular psychiatric diagnosis have unique knowledge about that psychiatric diagnosis which everyone else lacks. Advocates have used critical realism to justify basing lived experience research around psychiatric diagnoses. I suggest there is no straightforward way to think that psychiatric diagnoses relate to knowledge through lived experience. Two challenges need addressing. First, when we link psychiatric diagnoses to lived experience we can understand this as relating to categorical understandings or dimensional understandings of the psychiatric diagnosis. Whether the psychiatric diagnosis is taken as categorical or dimensional has a significant impact upon who should be taken as having lived experience. Second, there are potentially alternative diagnoses which have a better connection to lived experience than currently used psychiatric diagnoses do. Alternative diagnoses which are more homogeneous would result in more commonality of lived experience. I outline my own solution by portraying psychiatric diagnoses as idealized and abstract models. Given that no model fully describes reality, we should use a plurality of approaches. For example, when conducting participatory research on people currently diagnosed as autistic, different participatory studies should use categorical notions of autism, dimensional notions of autism, substantive subtypes of autism and alternatives which completely dispense with autism. Finally, how lived experience research could occur in relation to categorical approaches, dimensional approaches, Research Domain Criteria and Hierarchical Taxonomy of Psychopathology is outlined.

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