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The Paradox of Atheoretical Classification
Birger Hjørland
University of Copenhagen, Royal School of Library and Information Science,
6 Birketinget, DK-2300 Copenhagen S, Denmark, <birger.hjorland@hum.ku.dk>
Birger Hjørland holds an MA in psychology and PhD in library and information science. He is Professor in
knowledge organization at the Royal School of Library and Information Science in Copenhagen since 2001
and at the University College in Borås 2000-2001. He was research librarian at the Royal Library in Copenhagen
1978-1990, and taught information science at the Department of Mathematical and Applied Linguistics at
the University of Copenhagen 1983-1986. He is chair of ISKO’s Scientific Advisory Council and a member of
the editorial boards of Knowledge Organization, Journal of the Association for Information Science and Technology and
Journal of Documentation. His H-index is 37 in Google Scholar and 21 in Web of Science.
Hjørland, Birger. 2016. “The Paradox of Atheoretical Classification.” Knowledge Organization 43: 313-323. 68 ref-
erences.
Abstract: A distinction can be made between “artificial classifications” and “natural classifications,” where artificial
classifications may adequately serve some limited purposes, but natural classifications are overall most fruitful by allowing inference and
thus many different purposes. There is strong support for the view that a natural classification should be based on a theory (and, of course,
that the most fruitful theory provides the most fruitful classification). Nevertheless, atheoretical (or “descriptive”) classifications are often
produced. Paradoxically, atheoretical classifications may be very successful. The best example of a successful “atheoretical” classification is
probably the prestigious Diagnostic and Statistical Manual of Mental Disorders (DSM) since its third edition from 1980. Based on such successes
one may ask: Should the claim that classifications ideally are natural and theory-based be reconsidered? This paper argues that the seemingly
success of atheoretical classifications hides deeper problems and that the ideal of theory-based classification should be maintained.
Received: 4 August 2015; Revised 3 March 2016; Accepted 14 March 2016
Keywords: classification, atheoretical, DSM, theories, knowledge
1.0 Introduction
Hope Olson realized that information science and
knowledge organization should be based on theory. Two
examples from her rich production are: 1) Olson (2001)
describes how the dichotomous principles of western
philosophical heritage create classification systems, which
privilege the mainstream, majority view; and 2) Olson
(2002) brings a critical feminist perspective to key issues
in knowledge organization. The title of her book, The
Power to Name, is in itself a powerful expression of an extremely
important theoretical principle: the assignment
of a subject to a document is not a neutral act but is a
policy act contributing to facilitate certain uses of that
document at the expense of other uses. The importance
of this theoretical principle—and of theory in general—
cannot be overestimated. (See more about Olson’s production
and its relation to theory in Fox 2015). Many philosophers
have recognized the importance of theory for
classification; David Hull (1998), for example, wrote:
“The fundamental elements of any classification are its
theoretical commitments, basic units and the criteria for
ordering these basic units into a classification.”
Also in my own writings, this view has often been
highlighted (e.g., Hjørland 2008 and 2013). For example, I
wrote (2008, 335):
In every domain different theories, approaches, interests
and “paradigms” exist, which also tend to describe
and classify the objects according to their
views and goals. For example, psychoanalysis and
biological psychiatry disagree on how mental illness
should be classified and they disagree about the
value of a particular classification scheme such as
the DSMIV.
The claim here is that we have many approaches and theories
of knowledge organization and among them some
claim that they are not theories: they claim that classification
can be or should be atheoretical. This is, of course, a
view that should be examined as should any other view or
theory. If we want to defend any theory (and the teaching
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of theories), we have first of all to defend ourselves against
atheoretical research and atheoretical classification. In this
paper, the focus is atheoretical classification. This is however,
related to the broader issue of atheoretical research
(and atheoretical practice, including atheoretical library and
information practices—the generic concept being atheoretical
activities). Our task can also be understood as “to
uncover the hidden theoretical assumptions in activities,
which claim to be atheoretical” (cf., Slife and Williams
1995). Some researchers do recommend atheoretical research
(e.g. Cole 1996), while others consider it a false
category. Economist Michael P. Keane (2010), for example,
wrote: “All econometric work relies heavily on a priori assumptions.
The main difference between structural and
experimental (or ‘atheoretic’) approaches is not in the
number of assumptions but the extent to which they are
made explicit.”
Windschitl (2004) considered atheoretical research as a
kind of “folk theories of ‘inquiry.’” In this paper, I shall
not go into this broader discussion but will focus on atheoretical
classification, while the broader issues concerning
other forms of atheoretical activity are only superfluously
covered and reserved for a future paper.
2.0 The paradox of atheoretical positions
In Hjørland (2015) I defined the concept “theory” as a
statement or a conception, which is considered open to
questioning and which is connected with background assumptions
(i.e., theory is the way something is considered).
Theories form interconnected systems of grand, middle
rank and micro theories and actions; concepts, observations,
practices and artifacts are theory-laden.
The idea of atheoretical research, practice and classification
is related to the positivist dichotomy between observational
and theoretical statements: What we can see (e.g., a
hammer or a blackbird) are here considered “given,” not
theory or theory-laden. Wilfrid Sellars (1956), among many
others, criticized the view that perceptions of sense data
give immediate knowledge that can serve as the foundation
of empirical knowledge. He called this “the myth of the
given.” The opposite of this myth is known from many
philosophical positions such as historicism, pragmatism,
paradigm theory, hermeneutics and activity theory, which
all claim that human perception is “mediated” by language
and other culturally developed sign systems. The positivist
dichotomy between observational and theoretical statements
came into crisis (see Putnam 1962) as did the logical
positivist program in general in the aftermath of Kuhn’s
(1962) The Structure of Scientific Revolutions. When a clear distinction
between observations and theories cannot be obtained,
it follows that all human actions are theoretically
laden and the very idea of atheoretical action becomes an
oxymoron (as does the concept of “raw data,” cf., Gitelman
2013). According to Novick (1988), historical science
considered itself objective from its positivist foundation
about 1880 until, for example, black people and women
entered scholarship and put forward alternative views on
history. This example may demonstrate a general principle:
the only way something can be revealed as theoretically
laden is by developing an alternative view or theory (e.g., by
introducing people with other cultural perspectives or
other disciplinary backgrounds, or engaged in broader philosophical
studies). Very often, things look for a very long
time as “given” or “atheoretical” until a new understanding
reveals their theoretical nature.
There is, however, an important difference between an
abstract claim that something is theoretically loaded and a
specific analysis of “how” this thing is theoretically loaded.
It is problematic, for example, to claim that all research
done by men is wrong just because it is done by men.
Some men have contributed to feminist theory or to
knowledge acknowledged by feminist epistemology. Therefore,
claims of theoretical “bias” should be specified, not
just held as a generalized principle.
The methodological implications should be obvious: researchers
who possess broad background knowledge and
know alternative views should be better equipped to evaluate
those theories and to do better research and to better
classify things. They are less vulnerable to the mistake of
“naïve realism” or choosing a problematic theoretical basis.
Based on such knowledge of different perspectives, researchers
and classifiers may negotiate different theoretical
views and choose the optimal solution or the best compromise.
From this perspective, atheoretical positions must
be considered less advanced. However, as we shall see in
the following section, atheoretical positions may be extremely
successful. It is a paradox that solutions that are
more primitive are more successful compared to more advanced
solutions. How can this be the case? For answering
this question, it is important to consider the extraordinary
success of an “atheoretical” classification. Here the DSMIII
will be used as an example, but it is certainly not an exception.
(DSM has formerly been investigated in knowledge
organization and information science, by, e.g. Bowker
and Star 1999; Fujigaki 2006; and Spasser 1998).
3.0 The DSM classification
Diagnostic and Statistical Manual of Mental Disorders (DSM) is
a classification system for mental disorders published by
the American Psychiatric Association (APA). Today, it is
extremely influential—also internationally—and by far the
most important diagnostic tool in its domain. This was,
however, not the case with the first edition, which was
published in 1952 (APA 1952). The following editions are
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the second edition, DSM-II (APA 1968), the third edition,
DSM-III (APA 1980), the fourth edition, DSM-IV-TR
(APA 2000) and the fifth edition, DSM-5 (APA 2013). The
first two editions were relatively theoretically based, but
with DSM-III, the atheoretical principle took over, which
seems particularly paradoxical because American psychiatry
at that time was strongly influenced by biologically oriented
theory (Demazeux and Singy 2015, xiv-xv):
Given this general evolution of American psychiatry,
the history of the DSM is paradoxical. The third edition
(DSM-III), published in 1980, constitutes according
to historians a true nosological revolution.
But this revolution did not consist in having fully
embraced neurological or genetic factors, as we
might have expected given the general evolution of
psychiatry, and especially of American psychiatry.
Rather, it consisted in remaining, or trying to remain,
atheoretical. The DSM-III offered a classification
that voluntarily ignored the etiological models of
mental disorders, in order to focus instead on the
task of providing unambiguous descriptions of these
disorders by means of precise and exhaustive diagnostic
criteria. It is often said that the DSM-III broke
with psychoanalysis, which was dominant in large
American cities. It is less often said that it also broke
with the essentially biological direction of its predecessors
(while the influence of psychoanalysis on the
DSM-I and DSM-II is regularly stressed by historians,
we should not forget that the first two editions
of the DSM gave an important role to biology, as illustrated
by the key category of “Organic Brain syn-
drome”).
Despite the atheoretical nature of DSM-III and following
editions (or because of it?) it became an extreme success
(Demazeux and Singy 2015, xv-xvi):
There is another paradox in the history of the DSM:
its [DSM-III’s] extraordinary success. While the
DSM-III did not offer any theoretical innovation,
but only a stupendous methodological audacity, its
impact on contemporary psychiatric discourse and
practice has been considerable. The first printing of
the DSM-III, in 1980, was quickly sold out. It was
soon translated into many languages…The successive
editions, the DSM-III-R (1987), the DSM-IV
(1994), and the DSM-IV-TR (2000), only reinforced
the world domination of the DSM. The DSM
quickly supplanted most national classifications,
wiped them from memory, and contributed to an
unprecedented homogenization and universalization
in the practice of psychiatry. It even influenced the
WHO’s ICD [International Classification of Diseases],
which, from 1992 on, came to adopt a structure
and methodological principles that are very similar
to the DSM’s .… Without a doubt, today no psychiatrist
in the world is unaware of the meaning of
the acronym “DSM,” even when many clinicians
continue to resist the imperative to use this manual.
Most certainly, all scientifically ambitious researchers
in psychiatry must refer to the DSM, however unsatisfied
they might be with the manual. Today, with the
publication of the DSM-5 in 2013, and despite all
the criticisms and complaints directed against this
new edition even before it was published (and often
formulated by American psychiatrists themselves),
the hegemony of the American system remains in-
tact.
How can this success be explained? It seems also paradoxically
because, as Poland’s (2015) analysis demonstrates,
overall DSM-based research has not yielded any
solid result and DSM provides researchers with decontextualized
diagnoses that are symptom-based, atheoretical,
polytheist, and not associated with well-confirmed
tests and models. Rather, DSM has a flawed epistemological
structure and categories provide “artificial groupings”
of individuals experiencing mental illness.
What is stated here is that the success of DSM-III is
not based on solid research and that the classes in this system
are not associated with research-based diagnostic tests
or procedures. Therefore, its success seems paradoxical.
Demazeux and Singy (2015) also write, however, that
much criticism was raised against the new DSM-5. Thus,
its success was perhaps temporary, and psychiatric diagnosis—and
thus psychiatry as a whole—seems to be in a serious
crisis, very different from the general pattern of
progress in other subfields of medicine (see, e.g., Frances
2013; Greenberg 2013; Maj 2015; Paris and Phillips 2013;
and Zachar et al. 2014). Nonetheless, the atheoretical
principle of DSM-III was considered extremely successful,
even a revolution (at least for a period), which is a fact that
calls for an explanation.
If atheoretical action is an oxymoron, as argued above,
it follows that DSM-III cannot be atheoretical, that there
must be hidden theoretical assumptions in this system in
spite of its claim of the opposite. The two following
quotes provides an analysis of this issue (Whooley and
Horwitz 2013, 79):
The revisions to the DSM-III sought to increase reliability
through moving psychiatry away from the
fluid psychoanalytic understanding of mental illness
toward a standardized nosology of fixed disease
categories. They overthrew the broad, continuous,
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and vague concepts of dynamic psychiatry and replaced
them with a discrete system of classification
that treated mental disorders as discrete diseases.
This nosology rigorously segregated the pathological
from the normal, in a way that the previous
psychodynamic model never did.
While the DSM-III revisions were advertised as agnostic
toward different theoretical schools of psychiatry
[APA 1980], the entire endeavor—
delineating discrete disease categories to facilitate diagnostic
consistency—implied an endorsement of
the biomedical model. The revisions were sold as
ways to improve treatment through empirically
based research programs and targeted diagnoses.
The new paradigm of diagnostic psychiatry organized
symptoms into discrete disease entities with the
expectation that the organic bases of these entities
would soon be discovered [Horwitz 2002]. In other
words, the revisions to the DSM were a strategy to
attain a biomedical model by understanding illnesses
as stable entities that can be explained in terms of
specific causal mechanisms located in the brain. The
hope was that the identification of the elusive biological
or genetic markers for mental disorders
would follow from the standardized classification
system. DSM-III promised a future when specific
etiologies were discovered for specific disorders and,
in turn, specific treatments would emerge.
Whooley and Horwitz (2013) thus argue that DSM-III was
indeed based on a (meta)theoretical view, the view of biological
psychiatry as opposed to, among others, psychodynamic
and cultural views. A narrow biological view of
mental illness is opposed to a rather broadly recognized
view that mental illness should be understood from a
combined biological, psychological and social perspective.
For those, who believe that a form of biopsychosocial
model provides the best scientific explanation of mental
illness, the adaption of the strict biological view underlying
DSM-III does not provide scientific advance, but on
the contrary: it represents a reductionist scientific ideology.
This ideology was extremely successful by strengthening
the professional powers of psychiatrists at the expense
of other professions involved in mental health, in
standardizing psychiatry and gaining support from powerful
institutions such as health assurance and the pharmacological
industry. This is the basic explanation of the
success of DSM-III as described by Whooley and Horwitz
(2013). However, because this ideology is not scientifically
based—but based on anticipation, the expectation that the
organic bases of these entities would soon be discovered—the
system fails because the expected findings did
not turn up and thus it has severe problems reflecting a
natural classification of mental illness. Therefore, the system
is today in a serious validity crisis as revealed by a
growing critical literature. The issue about the biological
basis of mental diseases has not been settled but remains
highly controversial. The point here is that different theories
should be developed, brought into a dialogue and negotiated.
The disregarding of other theories without
proper basis in research is ideological rather than scientific.
The atheroretical attitude contributes to such an ideology.
Also Foerstl and Hoff (2009, 57) argued against
atheoretical classification of psychiatric disorders and
wrote:
Wir sollten auf dem Boden einer aufgewerteten Psychopathologie
die unfruchtbare Polarisierung „theoriereich“
vs. „theoriearm“/„theoriefrei“ hinter uns
lassen .... Was wir brauchen in der Psychiatrie, ist keine
„Theoriephobie, “ sondern reflektierte und damit
undogmatische Theorie.
Thus, our analysis so far has shown that the success of the
“atheoretical” DSM-III was based on:
1) That it was not atheoretical as it claimed to be. Rather, it
was supporting a reductionist biomedical theory of
mental illness (although only in a very general way).
This is the hidden theoretical assumption that Whooley
and Horwitz (2013) uncovered.
2) Its contribution to the homogenization and universalization
of the practice of psychiatry and to the power of
the psychiatric profession. This was obtained by the
emphasis on reliability at the expense of validity as we
shall consider in a following section.
4.0 Artificial versus natural classification
Poland (2015) characterized DSM’s categories as “artificial
groupings.” The distinction between artificial and natural
classification is important. An artificial classification may
be useful for limited purposes. For example, we often organize
documents and document representation in artificial
ways (e.g. in alphabetical order), which for many purposes
have proven to be very practical. However, in order to retrieve
things of a specific natural kind, those things have to
be identified, named and classified, which presupposes a
subject approach and natural classification.
William Perry and Edward Hacker wrote (1991, 133):
For example, one may divide rocks—or even animals—into
those weighing less than ten grams,
those weighing at least ten but less than twenty
grams, and so on; but this is likely to be of little
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use, except perhaps for knowing what it would cost
to mail them.
And later:
[A classification] is fruitful to the extent that it suggests
new hypothesis, explanations, and theories
concerning its subject matter. For example, the periodic
table—the classification of the elements—
proved extremely fruitful, since it suggested the existence
of hitherto unknown elements and even
suggested what physical properties they would
have. It should be noted that natural classifications,
by definition, are more fruitful than artificial ones.
To make an extreme case, one could classify all mental
patients according to their weight, which would be “an
artificial grouping” that would not be helpful for treatment
decisions (but it would be highly objective and reliable!).
“A natural classification” of mental patients, on the
other hand, would be one that could be helpful predicting
which patients would benefit from a particular treatment.
Such a natural classification should be based on theory
and knowledge of mental diseases. This example is extreme,
of course, but theoretical clarity is often obtained
by considering such “pure” examples. This clarity can
thereafter also be applied to less extreme examples.
5.0 Reliability versus validity of classifications
The issue concerning artificial versus natural classification
is related to the problem of “reliability” versus “validity”
of classifications. “Reliability” means that different persons
report the same result, (i.e., obtain consistency), corresponding
to the concept known as “inter-indexer consistency”
in knowledge organization (see Lancaster 2003, 68-
82). “Validity,” on the other hand, means that a description,
a measurement or a representation is adequate in relation
to its purpose. Often there is a high prestige for professionals
connected to reliability (the same is also, of course,
expected for validity, but professionals in disagreement are
easily revealed, and low reliability is in itself a sign of low
validity, therefore there is a tendency to make priority to reliability).
Probably the most important issue in the success
of DSM-III was that it made psychiatric diagnosis much
more reliable—thereby increasing the status of psychiatrists
(this has been the overall opinion, but Kirk and
Kutchins (1992) nonetheless found DSM-III to be highly
unreliable). High reliability was the top priority for the designers
of that system and this importance is reinforced by
the demand from, in particular, (American) insurance
companies to make medical diagnoses reliable. Philips
(2014, 164) states:
The quest for this Holy Grail began back in 1980
with DSM-III (American Psychiatric Association
1980). The immediate goal of that manual was to
achieve the first step in a scientific nosology—
diagnostic reliability—with the use of operational
definitions and diagnostic criteria. With DSM-III we
could be confident that clinicians and researchers in
different countries would be talking about the same
phenomenon when they discussed, for instance,
schizophrenia. Built into the DSM-III process, however,
was the understanding that reliable diagnoses
could not yet claim to be valid; we could not feel
comfortable that the diagnostic concept in question
represented a distinct, real entity in the world. How
did we know, for instance, whether the diagnostic entity
called schizophrenia described one distinct illness
or several? In that way, the accomplishment of
DSM-III immediately unleashed a new anxiety and a
new goal—securing diagnostic validity.
In prioritizing reliability over validity, the architects
of DSM-III assumed that ongoing research would
lead to valid diagnostic constructs.
However, let us return to the previous thought experiment:
if psychiatrists classify their patients according to, for example,
their weight, they would be able to provide extremely
reliable groupings, but would not create categories
that would be helpful in determining treatments and predicting
recovery. DSM-III of course, used more valid criteria
than the patients’ weight, but the question of lack of
validity of psychiatric diagnosis is today very pressing and
the word “crisis” is probably not too strong a term to
characterize the situation. A given mental disorder may be
defined by a combination of symptoms. “Schizophrenia,”
for example, is mostly characterized (Zielasek and Gaebel
2015, 9) by a combination of symptoms including delusions,
hallucinations and disorganized thinking with disease
onset in early adulthood. Any such set of symptoms may
be labeled schizophrenia as an artificial definition and classification.
However, the claim that these symptoms correspond
to one and only one natural kind is a scientific hypothesis
that has to be proven. Some scientific classifications
(e.g., bird classifications) have today a solid scientific
basis (about the recent progress in classification of birds,
see Fjeldså 2013). No corresponding solid scientific basis
supports our present classification of psychiatric diagnoses
and the important point is that the categories in a system
like DSM have to be considered scientific hypotheses.
Their revision should therefore be based on considering
the supporting evidence as well as the evidence supporting
alternative categories. Again, we may conclude that it is
paradoxical not to consider these categories as theories.
What kind of decision has produced these categories? Of
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course many years of psychiatric research, practice and experience
has gone into this. But how are the specific decisions
in a given edition of the DSM made? The DSM-III
Task Force wrote (APA 1980, 3):
In attempting to resolve various diagnostic issues,
the Task Force relied, as much as possible, on research
evidence relevant to various kinds of diagnostic
validity. For example, when discussing a
problematic diagnostic category, the Task Force
considered how the disorder, if defined as proposed,
provided information relevant to treatment
planning, course, and familial pattern. It should
come as no surprise to the reader that even when
data were available from relevant research studies,
Task Force members often differed in their interpretations
of the findings.
This general method has comically been summarized as
the BOGSAT method: “A bunch of guys sitting around a
table” (Kendler and Parnas 2012, 141). It should be considered
that in evidence based medicine (EBM), evidence
from expert committee reports or opinions and/or clinical
experience of respected authorities is considered a
very low criterion of evidence, (cf. Hjørland 2011, 1302).
There is much criticism about the DSM system and its
emphasis on reliability and a quote from the book Philosophical
Issues in Psychiatry (Parnas and Sass 2008, 271) reads:
“Excessive and, in our view, epistemologically naïve focus
on the issues of reliability created serious problems concerning
the more fundamental level of validity.”
Such an excessive focus on reliability at the expense of
validity is connected to positivist currents and naïve realism.
While consistency has normally been regarded as an
ideal also in knowledge organization, Cooper (1969) provided
some important reservations in relation to this
ideal. He demonstrates that indexers that are most consistent
with each other do not necessarily produce the best
work and that indexing “can be consistently bad.” While
this might seem strange, it is understandable if, for example,
indexers have been taught bad principles. Superficial
indexing may, for example, rely too much on titles of the
documents being indexed, which tends to produce consistent
but bad indexing. The same is of course the case
about “indexing” psychiatric patients into diagnostic
classes. The principle “reliability before validity” is thus a
problematic principle connected to the ideal of atheoretical
classification.
6.0 “Descriptive” versus “theoretical” classifications
DSM-III and later editions (see Tsou 2015a) are said to be
“descriptive” rather than theoretically committed. However,
as Gregory Bateson wrote (1977, 147), it is problematic
to consider “descriptions” an atheoretical activity:
You can never get away from theories of the nature
of description whenever, wherever you have descriptions.
All descriptions are based on theories of how
to make descriptions. You cannot claim to have no
epistemology. Those who so claim have nothing but
a bad epistemology. And every description is based
upon, and contains implicitly, a theory of how to de-
scribe.
(Unfortunately, this brief but important statement is not
much unfolded in the source from which it is here quoted).
Indeed, since Kuhn’s (1962) Structure of Scientific Revolutions,
the notion of the theory-laden nature of observations
(and by implication the theory-laden nature of descriptions)
has become a fundamental assumption in the
philosophy of science. By implication, the distinction between
“descriptive” and “theoretical” classifications is
problematic—as already indicated with Sellars’ (1956) notion
“the myth of the given” mentioned above. (This
recognition of the theoretical ladenness of descriptions
may have further important implications for the use of
this term in knowledge organization, e.g., in the concepts
“descriptive bibliography” and “descriptive cataloging”).
In order to understand the atheoretical approach in
DSM-III, we shall look at what is here meant by “descriptive”
versus “theory-based” classification. It is well
known that psychology and psychiatry have been split in
many conflicting views or schools, e.g., psychoanalysis,
cultural psychology, behaviorism, cognitivism, neuroscience.
Such views tend to develop their own conceptual
systems and classifications. “Neurosis,” for example, is a
psychoanalytic concept, “organic brain syndrome” is a
concept associated with neuroscience. Although different
theories may have their own domains for which they provide
good explanations, they also tend to provide opposed
views on the same phenomena. Different therapists
tend to subscribe more or less to one or another of
those views (although eclecticism, the subscribing to different,
perhaps conflicting views, is a widely held position,
it is not a position that can avoid the problems of
theoretical commitment, cf. Slife and Williams 1995, 46-
48). The atheoretical nature of DSM is first of all an attempt
to make one classification that can serve all therapists
whatever view they have about the causes of mental
diseases. When etiology is unknown or controversial,
DSM-III found (APA 1980, 7) that the definition of a
disorder must be at the “lowest order of inference necessary
to describe the characteristic features of the disorder.”
Wakefield (1999, 966) suggested that rather than
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speaking about an atheoretical strategy, DSM would have
been more rigorous if it had used the term “theory neutral”
categories or classification criteria with respect to
plausible theories of etiology.
The atheoretical approach in DSM-III aimed at fulfilling
three different goals:
1. It aimed at moving beyond ideological divisions and
towards science;
2. It aimed at temporarily setting aside the etiological issue
in order to focus on acute descriptions of mental
disorders; and,
3. It aimed at reforming the usual clinical vocabulary by
avoiding as much as possible any claims about mental
events.
However, one might ask: is it possible to avoid theory
(“ideology”) in science and scholarship? Melvin Sabshin,
the medical director of the APA during this period, considered
that the success of the DSM-III was a victory of
science over ideology (Sabshin 2008). Steeves Demazeux,
however, commented (2015, 7, note 3):
It is nevertheless interesting to note that the opposition
between science and ideology has different
meanings in Sabshin’s work: in 1964, Sabshin and his
colleagues defined “ideology” as including any
“theoretical models of mental disorders” (see Strauss
et al. 1964, 8). This conciliatory definition tends to
consider that science and ideology are always inextricably
intertwined. But in his 2006 book, Sabshin defines
“ideology” as all “scientifically unsupported
dogmas” (Sabshin 2006, 36). Here, ideology is clearly
set outside the range of science (see Demazeux
2013, 152). With distance and hindsight, it is clear
that, according to Sabshin, the atheoretical perspective
of the DSM-III is scientific in opposition to
ideological in the second sense.
Sabshin (2008) is thus wrong in both senses: first, that theory
(which he associated with ideology) is not opposed to
science. On the contrary, science is based on theoretical
developments; and second, because DSM-III itself is not
sufficiently scientifically supported, this argument cannot
be used against other theories. It is rather Sabshin himself
(and the atheoretical principle of DSM-III) that introduces
a kind of ideological bias, which impedes scientific progress
by subscribing to the principle “reliability before validity”
(Callender 2013, 77, emphasis added):
There are also downsides to what is described in this
book as the “reliability first, validity second” approach.
One of these is that diagnostic entities become
“self-perpetuating feedback loops.” Although
they may only be rough approximations to “real”
conditions (if such things can be said to exist), they
become the phenotypes that are used in research. A
genetic study of schizophrenia will be a study of
DSM-defined schizophrenia. An antidepressant drug
trial will be carried out on patients with DSMdefined
depression. DSM categories determine what
questions can be asked and therefore risk becoming
a system that impedes rather than advances scientific progress.
Descriptions are not atheoretical, although the persons
doing the descriptions may be unaware of their theoretical
influences and thereby produce “biased” descriptions.
As argued in Hjørland (2016), explicit and considered
subjectivism should be preferred for subjectivity disguised
as objectivity. Further problems in the descriptive
approach to classification are presented in the section below
about epistemological hubs.
7.0 Ontological versus epistemological approaches
to classification
In the community of knowledge organization researchers,
there seem to be two different approaches, the ontological
approach and the epistemological approach, and
some researchers try to combine these two approaches
(Kleineberg 2015, 194): “As pointed out by Gnoli (2008),
the open question remains in which way ontologyoriented
and epistemology-oriented approaches might be
integrated in order to benefit from their possibly complementary
character.”
However, as argued by Sadegh-Zadeh (2015, 759),
“ontology cannot be independent of epistemology. The
quality of an epistemology will influence, via the knowledge
it approves or refutes, the quality of the corresponding
ontology. For instance, compare the world of
an astrologer with that of an astronomer.” In knowledge
organization, a well-informed paper about this question,
Martínez-Ávila and Fox (2015, 16) wrote:
The existence of different categorial schemes and
the disagreements about the “nature” of those categories
highlights the importance of epistemology as
a complement to ontology rather than as a separate
entity. Though one might claim a singular ontological
arrangement of concepts, the philosophical objections
to this ontological arrangement must be understood
in order to justify one’s claims.
I believe the present paper is a further argument for the
necessity of considering epistemological issues in classification,
and I challenge everybody to put forward a classi-
Knowl. Org. 43(2016)No.5
B. Hjørland. The Paradox of Atheoretical Classification
320
fication of mental diseases—or just defend an existing
one—based on “the ontological approach,” ignoring
epistemological issues. When we consider such a specific
example, the necessity for an epistemological approach
seems evident. What has been termed “the ontological
approach” in knowledge organization is in reality an
atheoretical approach. If not, on what basis are the criteria
of semantic relations in the classification decided?
How is it decided that A is a kind of B?
8.0 Classifications as epistemological hubs?
Susan Leigh Star and James R. Griesemer introduced in
1989 the concept of “boundary objects” which since has
become very influential. They explicitly included classifications
and defined it in this way (1989, 393): “Boundary
objects are objects that are both plastic enough to adapt
to local needs and the constraints of the several parties
employing them, yet robust enough to maintain a common
identity across sites.”
Is a classification like DSM a boundary object? Or,
how should it be constructed if we wanted it to serve as a
boundary object? Jonathan Tsou suggested (2015a, 43)
that DSM should be designed to serve as an “epistemological
hub”:
I argue that the DSM should reconceive of its goals
more narrowly such that it functions primarily as an
epistemic hub that mediates among various contexts
of use in which definitions of mental disorders
appear. My analysis emphasizes the importance
of pluralism as a methodological means for avoiding
theoretical dogmatism and ensuring that the
DSM is a reflexive and self-correcting manual.
As far as I understand an “epistemological hub” is equivalent
to a “boundary object” (and it seems to me to be a
better term). Tsou’s suggestion on how to design DSM for
better serving this goal seems to be more clear than the
one provided by Star and Griesemer (and it also seems to
be better related to our discussions of “descriptive” versus
“theoretical” classifications). Tsou (2015a) examined the
goals of DSM-III, which were guiding treatment, facilitating
research, and improving communication. He suggested
that the DSM’s purely descriptive approach is best suited
for improving communication among mental health professionals,
but theoretical approaches would be superior
for purposes of treatment and research. He also outlined
steps required to move the DSM towards a hybrid system
of classification that can accommodate the benefits of descriptive
and theoretical approaches, and discussed how the
DSM’s descriptive categories could be revised to incorporate
theoretical information regarding the causes of disorders.
He argues that the DSM should reconceive of its
goals more narrowly such that it functions primarily as an
epistemic hub that mediates among various contexts.
At first reading, this suggestion seemed highly persuasive
to me. However, my second thought was: what is the
purpose of communicating “descriptive” classifications if
they are not valid? Because the etiology of mental diseases
is often unknown, their definitions sometimes must—as
also stated by Tsou (2015a, 45) —be based on descriptions
of symptoms and on emphasizing that “the importance of
pluralism as a means to ensure that the DSM is informed
by a multiplicity of, sometimes conflicting, scientific theories
on psychopathology.” We cannot here go deeper into
this problem, but the solution for DSM—or another system
trying to serve as “boundary objects” or “epistemological
hubs” for defining and classifying objects—should
probably be to outline the most important alternative theories,
their conceptions and classifications. Then a conversion
table or “crosswalk” should be established (although
this may turn out to be difficult due to the taxonomic incommensurability
of different theories, cf. Oberheim and
Hoyningen-Huene 2013). Andersen, Barker and Chen
(2006, 42-64) presented a system for representing concepts
by means of dynamic frames, which may also be worth
further examination in the KO-community in relation to
epistemological hubs. The concept “bird,” for example,
may be defined by among other attributes the values of the
attributes “beak,” “neck,” “color,” “size,” foot” and “gait.”
This system is also used to relate concepts in different scientific
theories or paradigms.
9.0 Conclusion
This article has put forward arguments that “atheoretical
classification” is either an artificial classification or an oxymoron
and in both cases unsatisfactory as a basis for scientific
taxonomies. We have considered one important example
of an atheoretical classification, the DSM-III. This system
claims to be based on an atheoretical approach to classification,
but it has been argued that its great success
probably was not due to its lack of theoretical commitment
but rather to two highly attractive ideological underpinnings:
biological reductionism and “reliability before validity.”
These two ideological underpinnings may both have
impeded scientific progress in the field as well as the
treatment of psychiatric patients on a scientific basis. The
apparent success of DSM-III may therefore have been
achieved at great cost.
Only one example has been analyzed in this paper, but
the analysis is related to my analysis of the subjectivity of
bibliometric maps (see Hjørland 2016). The principle
about the theoretical foundation of all knowledge organization
systems (KOSs) should be a considered a general
Knowl. Org. 43(2016)No.5
B. Hjørland. The Paradox of Atheoretical Classification
321
principle in knowledge organization. It seems obvious, that
for all KOSs the most important evaluation criterion is
their theoretical commitments (which are often their hidden
theoretical assumptions). This should therefore also be
emphasized in the principles of how to construe KOSs.
This may not be easy, but something that cannot be neglected
without loss of scientific credibility for knowledge
organization. As claimed by Hjørland (2013), it is difficult
to find other approaches to the field of equal importance:
knowledge organization has to be based on theories of
knowledge.
The idea of atheoretical classification is, as mentioned
above, associated with “positivism.” However, Turner
(1993) realized that the founder of positivism, Auguste
Comte, had been misinterpreted and wrote “Comte would
turn over in his grave” if he was confronted with the present-day
understanding of positivism. He demonstrated
that Comte’s “positive science” clearly and explicitly included
a central role for theory and that Comte dismissed
as unscientific the kind of empirical research that is conducted
in the absence of theory. My use of the term
“positivism” is derived from Kuhn’s (1962) criticism of
logical positivism (although Kuhn was badly informed in
the writings of the logical positivists, see Tsou 2015b).
The opposition between Kuhn and the positivist can perhaps
best be explained in this way: the positivists try to
compare our theories with “reality” but according to
Kuhn, this is not possible because we have no unmediated
access to “reality.” We cannot compare our theories or beliefs
about the world with “reality,” but only with alternative
theories (see also Devlin 2015, 157). In Hjørland
(2016) I also present my understanding of “positivism”
and the Kuhnian alternative. The basic argument is that
researchers who do not reveal their theoretical basis and
claim to be “objective” do in reality act on the basis of a
subjectivity disguised as objectivity. Therefore, we may
conclude with Karl Theodor Jaspers (1913, here quoted
from Maj 2015, 68 ): “if anyone thinks he can exclude
philosophy and leave it aside as useless, he will eventually
be defeated by it in some obscure form or another.”
The atheoretical view of classification seems also to be
related to standardization as an approach for constructing
KOSs (see Fujigaki 2006). Standardization shall not be
discussed further in the present paper, but it has recently
struck me that standardization seems to be a rather widespread
approach in knowledge organization in need for a
deeper examination of its theoretical assumptions.
Olson and Fox (2010) recommend Gayatri Spivak’s
feminist Marxist postcolonial approach as a theoretical
framework for uncovering bias and cultural imperialism in
knowledge organization. At first, it seems paradoxical that
such a view should provide more objectivity in research,
but Harding (2015) puts forward a convincing argument.
There is a lack of research in knowledge organization
based on subject knowledge and on considering the influence
of different theories on concepts and classification.
Hope Olson’s research is an exception from this general
tendency and provides a much-needed contribution to the
field.
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