Psychiatric Nosology, The DSM, and International Criminal Justice

Abstract

The American system of psychiatric diagnosis, embodied in the Diagnostic and Statistical Manual of Mental Disorders (DSM), and the modern project of International Criminal Justice may be regarded as twin progeny of the cataclysmic violence which marked the twentieth century. Both emerged as institutionalised, taxonomic responses to the trauma of World War II, each was reconfigured by the Cold War's ideological pressures and the specific moral crises of the Vietnam War, and these classificatory infrastructures converged in the 1990s with the establishment of ad hoc international tribunals. The article traces how these parallel systems of categorisation – one nosological, one juridical—developed distinct yet interrelated epistemic frameworks for addressing core international crimes. It focusses on the critical asymmetry that signifies their application: whilst psychiatric categories, particularly Post-Traumatic Stress Disorder (PTSD), have been expansively adopted by the international criminal courts and tribunals, to validate victim testimony, the same classificatory systems have been largely restricted from addressing perpetrator culpability. This selective adoption reveals the situated and contingent dimensions of classificatory infrastructures: indeed, categorisation stands not a neutral technical exercise but as a socio-political process, where the exigencies of legal accountability, epistemic rigour, and normative clarity are mobilised to negotiate and circumscribe the potentially disruptive psychological continuum between victim and perpetrator.