Psychiatric Biomarkers: Reliability, Reductionism, and Epistemic (In)Justice in the DSM-6
Abstract
The Biomarkers and Biological Factors Subcommittee of the Future DSM Strategic Committee has proposed introducing psychiatric diagnostic biomarkers (measurable biological indicators of a psychiatric condition) into the DSM-6. We review this proposal considering the questionable reliability and validity of psychiatric diagnoses and the low sensitivity and specificity of their purported biomarkers. These concerns have underappreciated consequences for epistemic justice, particularly regarding how biomarker information will be privileged or weighted against other sources of information, including patient testimony. We argue that introducing diagnostic biomarkers is premature and potentially harmful, risking further disenfranchisement and minoritisation of already vulnerable and marginalised groups. Future work establishing reliable and valid diagnostic phenotypes may assist in converging on biomarkers with the sensitivity and specificity required for clinical utility. We further argue the need for adequate and equitable representation of diverse groups in the identification and validation of psychiatric biomarkers.
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BibTeX
@misc{constable2026psychiatric,
title = {{Psychiatric Biomarkers: Reliability, Reductionism, and Epistemic (In)Justice in the DSM-6}},
author = {Toby Constable and Jacob Thomas and Beth Johnson and Jeggan Tiego},
howpublished = {PsyArXiv},
year = {2026},
month = oct,
doi = {10.31234/osf.io/wj263_v1},
url = {https://osf.io/preprints/psyarxiv/wj263_v1/},
note = {CC BY 4.0},
}
RIS
TY - UNPB
TI - Psychiatric Biomarkers: Reliability, Reductionism, and Epistemic (In)Justice in the DSM-6
AU - Toby Constable
AU - Jacob Thomas
AU - Beth Johnson
AU - Jeggan Tiego
PY - 2026
DA - 2026/10/20
PB - PsyArXiv
DO - 10.31234/osf.io/wj263_v1
UR - https://osf.io/preprints/psyarxiv/wj263_v1/
AB - The Biomarkers and Biological Factors Subcommittee of the Future DSM Strategic Committee has proposed introducing psychiatric diagnostic biomarkers (measurable biological indicators of a psychiatric condition) into the DSM-6. We review this proposal considering the questionable reliability and validity of psychiatric diagnoses and the low sensitivity and specificity of their purported biomarkers. These concerns have underappreciated consequences for epistemic justice, particularly regarding how biomarker information will be privileged or weighted against other sources of information, including patient testimony. We argue that introducing diagnostic biomarkers is premature and potentially harmful, risking further disenfranchisement and minoritisation of already vulnerable and marginalised groups. Future work establishing reliable and valid diagnostic phenotypes may assist in converging on biomarkers with the sensitivity and specificity required for clinical utility. We further argue the need for adequate and equitable representation of diverse groups in the identification and validation of psychiatric biomarkers.
ER -