Gender differences in the diagnosis of mental disorders: Conclusions and controversies of the DSM-IV

One of the more controversial issues in terms of mental disorder diagnoses has been their differential sex prevalence. The conclusions provided in the 4th edition of the American Psychiatric Association's {1994) Diagnostic and Statistical Manual of Mental Disorders were derived from systematic reviews of the research literature. However, this research is perhaps complicated by common sources of error. Two sources, in particular, are emphasized here: biases in sampling and biases within the diagnostic criteria themselves. The potential for such biases is illustrated for a wide variety of mental disorder diagnoses, and suggestions for research to address them are provided. One of the more controversial issues for mental disorder diag-noses has been their differential sex prevalence. The diagnoses that generated the most controversy in the development of the recent editions of the American Psychiatric Association's (APA's) influential Diagnostic and Statistical Manual of Mental Disorders (DSM; APA, 1980, 1987, 1994) were controversial largely because of their questionable application to one sex relative to the other (Ross, Frances, & Widiger, 1995). The critiques of decisions made for the third (DSM-III), revised third (DSM-III-R), and fourth (DSM-IV) editions of the DSM have often focused on issues concerning a purported se