“Why is the Diagnostic and Statistical Manual of Mental Disorders so hard to revise? Path-dependence and “lock-in” in classification,” by Rachel Cooper. The abstract reads,
The latest edition of the Diagnostic and Statistical Manual of Mental Disorders, the D.S.M.-5, was published in May 2013. In the lead up to publication, radical changes to the classification were anticipated; there was widespread dissatisfaction with the previous edition and it was accepted that a “paradigm shift” might be required. In the end, however, and despite huge efforts at revision, the published D.S.M.-5 differs far less than originally envisaged from its predecessor. This paper considers why it is that revising the D.S.M. has become so difficult. The D.S.M. is such an important classification that this question is worth asking in its own right. The case of the D.S.M. can also serve as a study for considering stasis in classification more broadly; why and how can classifications become resistant to change? I suggest that classifications like the D.S.M. can be thought of as forming part of the infrastructure of science, and have much in common with material infrastructure. In particular, as with material technologies, it is possible for “path dependent” development to cause a sub-optimal classification to become “locked in” and hard to replace.
The December 2013 issue of History of Psychiatry is now online. Included in this issue are articles that explore the magazines produced in Irish psychiatric hospitals, the nature of DSM classification, and the history of autism. Full titles, authors, and abstracts follow below.
“Søren Kierkegaard (1813–55): a bicentennial pathographical review,” by Johan Schioldann and Ib Søgaard. The abstract reads,
Researchers in the fields of psychology, psychiatry, medicine and theology have made exhaustive efforts to shed light on the elusive biography/pathography of the great Danish philosopher Søren Kierkegaard (1813–55). This ‘bicentennial’ article reviews his main pathographical diagnoses of, respectively, possible manic-depressive [bipolar] disease, epilepsy, complex partial seizure disorder, Landry-Guillain-Barré’s acute ascending paralysis, acute intermittent porphyria with possible psychiatric manifestations, and syphilidophobia.
BackStory with the American History Guys is a podcast series hosted by U.S. historians Ed Ayers, Peter Onuf, and Brian Balogh. In each episode Ayers, Onuf, and Balogh, along with their guests, explore the historical roots of a topic of current relevance. Two recent podcasts explore issues of interest to historians of psychology. In “States of Mind: Mental Illness in America,” the American history guys use the recent release of the DSM-5 as a springboard for discussion of the history of mental illness in the United States,
…exploring how the diagnostic line between mental health and madness has shifted over time, and how we’ve treated those on both sides of it. We’ll hear how the desire of slaves to escape bondage was once interpreted as a psychological disorder, how a woman’s sleepwalking landed her in the state asylum, and how perspectives on depression altered in the 1970s. Plus, the Guys walk us through a mid-20th century quiz that promised to identify a new kind of mental “disorder” – our susceptibility to fascism.
“Bridge for Sale: Deception in America,” features an interview with psychologist Geoff Bunn on the history of the lie detector and its connection to Wonder Woman, which is also detailed in his recent book The Truth Machine: A Social History of the Lie Detector. In this episode, the American history guys,
…dig into the long story of confidence men and counterfeiters. We discover a time when fake money jump-started the economy, and take a look at the long, strange history of “the truth compelling machine.” And, oh yeah… we try to sell the Brooklyn Bridge.
The June 2013 issue of History of Psychiatry is now online. Included in this issue are articles on diagnostic categories in the DSM, erogtism in Norway, and relationship between Japanese and German psychiatry before World War II. Full titles, authors, and abstracts follow below.
“Ergotism in Norway. Part 2: The symptoms and their interpretation from the eighteenth century onwards,” by Torbjørn Alm and Brita Elvevåg. The abstract reads,
Ergotism, the disease caused by consuming Claviceps purpurea, a highly poisonous, grain-infecting fungus, occurred at various places scattered throughout Norway during the eighteenth and nineteenth centuries. By focusing on these cases we chart the changing interpretations of the peculiar disease, frequently understood within a religious context or considered as a supernatural (e.g. ghostly) experience. However, there was a growing awareness of the disease ergotism, and from the late eighteenth century onwards it was often correctly interpreted as being due to a fungus consumed via bread or porridge. Also, nineteenth-century fairy-tales and regional legends reveal that people were increasingly aware and fearful of the effects of consuming infected grain.
The meeting got off to a great start with a keynote address by Martyn Pickersgill on the DSM as technology, particularly in relation to various uses and understandings of anti-social personality disorder. Other papers thus far have looked at an array of conceptual and historical issues related to the DSM, new and old. This has included a symposium on sexual disorders, discussion of efforts to classify mental disorders prior to the construction of the DSM, and papers on the ways in which the Rorschach has been used to investigate both homosexuality and homophobia.
Another full day of programming taking place as we speak and the conference will close today with a keynote address from Ian Parker.
The November 2012 issue of History of Psychology is now online. Included in this issue are articles on the history of psychology in Columbia, the neurological status of Little Albert, and the work of Alfred Binet in his Sorbonne laboratory (above). Also included in this issue is a piece on how the history of the DSM can be used to teach students about the complexities of conceptions of mental health and illness, as well as a description of an archive for the history of psychology in Spain and an author’s reflection on the process of writing a recent book on William Stern. Full titles, authors, and abstracts follow below.
“Colombian approaches to psychology in the 19th century,” by Gilberto Leonardo Oviedo. The abstract reads,
Colombian intellectuals of the 19th century widely consulted scientific psychology in regard to their political, religious, and educational interests. Colombian independence from Spain (1810) introduced the necessity of transforming the former subjects into illustrious citizens and members of a modern state. After independence, political liberals embraced Bentham’s thesis of utilitarianism and the theories of sensibility, with a teaching style based in induction. Conservatives defended the Catholic tradition about the divine origin of the soul and used scholasticism as a model of teaching. A bipartisan coalition, the Regeneration, incorporated the ideas of modern psychology based on the principles of Thomistic thought (Neo-Thomism). The Neo-Thomists considered psychology as a science of the soul and debated physiological explanations of the mind. The conceptual advances of the period have been trivialized in historical accounts of psychology in Colombia, due to the emphasis on the institutionalization processes of the discipline in 1947.
A new issue of History of the Human Sciences has just been released online. Included in this issue are articles on the history of Female Sexual Dyfunction as a diagnostic category, Freud’s social theory, the role of the brain in dementia, and more. Full titles, authors, and abstracts follow below.
“Contested psychiatric ontology and feminist critique: ‘Female Sexual Dysfunction’ and the Diagnostic and Statistical Manual,” by Katherine Angel (above left). The abstract reads,
In this article I discuss the emergence of Female Sexual Dysfunction (FSD) within American psychiatry and beyond in the postwar period, setting out what I believe to be important and suggestive questions neglected in existing scholarship. Tracing the nomenclature within successive editions of the American Psychiatric Association’s Diagnostic and Statistical Manual (DSM), I consider the reification of the term ‘FSD’, and the activism and scholarship that the rise of the category has occasioned. I suggest that analysis of FSD benefits from scrutiny of a wider range of sources (especially since the popular and scientific cross-pollinate). I explore the multiplicity of FSD that emerges when one examines this wider range, but I also underscore a reinscribing of anxieties about psychogenic aetiologies. I then argue that what makes the FSD case additionally interesting, over and above other conditions with a contested status, is the historically complex relationship between psychiatry and feminism that is at work in contemporary debates. I suggest that existing literature on FSD has not yet posed some of the most important and salient questions at stake in writing about women’s sexual problems in this period, and can only do this when the relationship between ‘second-wave’ feminism, ‘post-feminism’, psychiatry and psychoanalysis becomes part of the terrain to be analysed, rather than the medium through which analysis is conducted. Continue reading New Issue! History of the Human Sciences→
The January issue of the widely read e-zine Wired has published an article about Allen Frances’ (pictured left) vocal opposition to the process by which the 5th edition of the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disroders (DSM-5) is being written. There are, or course, many people who are discontented with the ways in which psychiatry goes about its professional business. What makes Frances’ critique so notable is not only that he is himself a psychiatrist, but that he was one of the editors of the last edition of the selfsame book, DSM-IV.
But Frances’ doubts go far beyond the 5th edition. They appear to extend to all of psychiatry, including his own participation in writing its most important and influential reference work. “There is no definition of a mental disorder. It’s bullshit,” he declares at one point. “We made mistakes that had terrible consequences,” he concedes at another. Continue reading DSM-IV Editor Says Psychiatry “Going Off a Cliff”→
There has been so much controversy over the process by which the American Psychiatric Association’s Diagnostic and Statistical Manual (DSM) is being revised, that relatively little attention has been paid to the changes to the diagnostic categories that are being proposed.
A new piece by Stephanie Pappas in Live Science fills that gap, however. She notes that, under the proposals of the DSM revision committee, Asperger’s Syndrome would be dropped, and the condition folded into Autisim Spectrum Disorder as a high functioning type. A new diagnosis of “temper dysregulation with dysphoria” would be created for children who are highly irritable and have extreme temper tantrums. A number of “behavioral” addictions (such as gambling) would be introduced as well. There is also continuing controversy over how to handle anomalies of gender identity. Some advocacy groups for the transgendered want “gender identity disorder” to be dropped entirely because it stigmatizes unconventional expression of gender as an illness. Some psychiatrists point out, however, that without a diagnosis in the DSM, insurance companies will not cover the hormone treatments and surgery that these people sometimes require. Continue reading Summary of Proposed DSM Catergories→
University of Toronto historian of psychiatry Edward Shorter has written a fascinating article in the Wall Street Journal on the history of the Diagnostic and Statistical Manual (DSM) of the American Psychiatric Association (APA). The article comes in the wake of controversy over the forthcoming 5th edition of the book, which is used by psychiatrists and many psychologists to diagnose the particular kinds of disorders from which their patients and clients suffer.
Shorter declares at the start of the article that “Psychiatry seems to have lost its way in a forest of poorly verified diagnoses and ineffectual medications.” In the 1950s, the diagnostics terms used by psychiatrists were often the same as those used colloquially by their patients — “a case of the nerves,” or “nervous breakdown.” Now, Shorter says, “A patient with the same symptoms today might be told he has “social anxiety disorder” or “seasonal affective disorder.” The increased specificity is spurious. There is little risk of misdiagnosis, because the new disorders all respond to the same drugs, so in terms of treatment, the differentiation is meaningless.” Continue reading Edward Shorter on the History of DSM→