Showing posts with label Psychopathology. Show all posts
Showing posts with label Psychopathology. Show all posts

Monday, May 6, 2013

Controversy over the New Psychiatric Diagnostic and Statistical Manual

Since 1952, the American Psychiatric Association has published the Diagnostic and Statistical Manual of Mental Disorders (DSM for short) which has spelled out the criteria for diagnosing all of the known psychiatric disorders.  It has undergone four editions and two revisions with the fifth one due out this year.  In the past there were controversies such as whether or not homosexuality should be included in the manual and it was dropped from the DSM in the 1970s.  New changes are made to the manual as new information is brought to light and cultural views of what is and what is not a disorder change.

This year the fifth edition of the DSM proposes changes to 13 current diagnoses.  The most controversial of these is Asperger's Syndrome which is being eliminated as a separate diagnosis and is being placed under the  Autism spectrum of disorders.  Unlike the gay community in the 1970s, has deletion been met with resistance by those who have been previously diagnosed with Aspergers.  Other changes have been made to dyslexia, ADHD and other diagnoses.  At least 10 new diagnoses are included in the DSM such as post-traumatic embitterment disorder, skin picking disorder, and compulsive hoarding (maybe the American Psychiatric Association all watches TLC). 

Previously the DSM has been accepted as the Bible of psychiatric diagnosis but, right before the DSM-V comes out the National Institutes of Mental Health (NIMH) has announced that it will not use it as a standard for diagnosis in their research.  This means that they will not be funding studies that use the DSM-V as a diagnostic criteria.   The reason given by the NIMH is that Unlike our definitions of ischemic heart disease, lymphoma, or AIDS, the DSM diagnoses are based on a consensus about clusters of clinical symptoms, not any objective laboratory measure."  This suggests a desire for exactness which the behavioral sciences have lacked relative to the physical sciences sometime termed physics envy.

There have been advances in neuroscience and genetics which shed light on many of these disorders and made many pharmacological treatments possible but the main reliance for diagnosis is still on behavioral symptoms.  The NIMH is creating a Research Domain Criteria for Diagnoses (RDoC) based on biological criteria which it believes are more objective.  The behavioral symptoms are often subject to interpretation and often still not enough is known about the brain and genetics to differentiate between pathologies.  Consider the figure at left.  Is this a rabbit with its head held high or a duck?  This image is subject to interpretation just as all behaviors and incomplete scientific data are.  Science is fundamentally a human endeavor where politics often plays a role.  
  

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The Need for Exactness

Friday, December 14, 2012

'The Secret' Gets the CSI w/o Dead Bodies Treatment

In 2006 Australian author Rhonda Byrne published a self improvement book which became an international best seller followed by a movie.  A friend suggested I read her book called The Secret.  I've had similar suggestions before from friends who want to improve my life who have all meant well. 

The book presents a pretty simple law of self improvement called the Law of Attraction which Byrne says has been suppressed for over 3,000 years and is only known by the wealthy 1% and great men throughout history such as "Plato, Newton, Carnegie, Beethoven, Shakespeare, and Einstein."  It says that believing that positive things will happen will make it happen for you with wealth, health, and relationships and believing negative things will happen will make the opposite happen.  It goes on to present that secret in DaVinci Code/Scientology fashion with lots of testimonials and graphics but little hard data to show how the law of attraction always works.  The experts in the film even say that "the anti-war movement creates more war."  Here is trailer for the film.  The author is seen very little in the film.


 
The book has it's critics such as Barbara Ehrenreich who discusses her own struggle with cancer and how not being positive all the time helps her.  The problem with relying on testimonial evidence alone is that it's always possible to find one contradicting your theory.  The film presents no evidence of how this secret was suppressed all these years.

 

A closer look at the historical figures presented in the film and book shows that few of then had full happy lives.  The one who comes closest is Plato and that is only because he lived thousands of years ago and we know so little about his relationships and what sort of man he was.  Ludwig van Beethoven had a miserable life with many relationship, money, and health problemsIsaac Newton was "not a pleasant man" as described by Stephen Hawking (he holds the same professorship that Newton did) who never married and took pleasure in crushing his rivals.  Andrew Carnegie may have been a good husband and father and did lots of charity work but he also ruthlessly crushed the Homestead Steel Strike and was negligent in the Johnstown Flood with crony Henry Clay Frick.  William Shakespeare is another about whom there is little known and some controversy so I will not address.  Albert Einstein like the others did excel at what they were good at but you would not want to be married to him.

There is always a risk of disaster and the chance of success.  You can take steps to minimize the risk and maximize the chance but can never eliminate either.  The passengers and crew on the Titanic had lots of positive energy and optimism but were oblivious to the risks that icebergs posed and we all know how that turned out (see my post Titanic Perspective if you don't for a review of this and Andrew Carnegie's role in the Johnstown Flood). I'm all for having success but at who's expense?  Solutions can be found to the world's porblems but by realistically thinking through the risks and chances.  It gives the secret as the reason for "the richest 1% controlling 96% of the world's wealth" when Ehrenreich and other social critics would give very different reasons.  The Secret has definitely made Rhonda Byrne very wealthy.


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Probability

 

My N Word

 

Bullying & Society

Monday, October 8, 2012

The Psychopathology and Incidence of Bullying

Here is the second guest post from guest post U for CSI Without Dead Bodies.
Bullying is any form of aggressive behavior that seeks to force or coerce others, usually by force. Typically bullying presents itself in the context of an imbalance of power and as a habitual behavior by the aggressor. Bullies, especially young ones, may target the religion, sexuality, ability, or race of the recipient of their bullying aggression. There are many types and formats of bullying, and just as many ways to combat bullying from persisting or arising in the first place.

Types of Bullying
Social scientists have identified three main forms of bullying - emotional bullying, verbal bullying, and physical bullying. Emotional and verbal bullying usually come saddled with attempts at coercion and intimidation. Coercion almost explains intimidation in that coercion is defined as forcing another party to behave in an involuntary way via use of bellicose threats and intimidation. Intimidation is defined as an aggressor party presenting injury or harm to another person for some type of benefit, usually social or financial.

Emotional bullying, also known as psychological abuse, may involve coercion and intimidation as well as subjecting another party to any event or treatment that will result in the other party experiencing psychology trauma, such as anxiety or depression. Emotionally bullying is predictably associated with an exploitation of a power imbalance. For this reason, emotional bullying and psychological abuse is prevalent on the schoolyard, the home, and in the workplace.

One form of emotional bullying is verbal aggression. Verbal aggression is colloquially defined as something that intentionally upsets, annoys, or disturbs another person. There are other forms of emotional bullying like dominant and jealous behaviors but those forms of emotionally bullying are unimportant for this conversation. At any rate, the US Department of Justice recently concluded that emotionally abusive characteristics are those which cause fear by intimidation or threaten the physical harm of one's family members, classmates, or fellow employers. Another interesting finding coming out of Health Canada found that emotional abuse is motivated by power and facilitated within social arenas in which power was imbalanced and exploited by the aggressor.

Conventional Yet Harmful
Perhaps the most well-known form of bullying is physical bullying. Physical bullying is defined as an aggressor party deliberately seeking to instill bodily harm or injury onto another party. Popular forms of physical abuse or physical bullying are: striking, kicking, kneeing, drowning, cutting, slapping, and burning. Partly because physical bullying is so openly and inclusively defined, physical bullying is also prevalent in the home, schools, and workplaces all around the United States. Physical abuse is even popular on college campuses in the form of sorority hazing. In the home, physical abuse presents itself as child abuse, sometimes negligence, or domestic violence.

Standup and Fight! 
There has been an increasingly large swell of celebrities and activities seeking to combat bullying. Considering some of the dire outcomes of bullying, like suicide, bullying in the classroom is no laughing matter. Canada actually conceived the National Bullying Prevention Week in 2000. In the United States, the It Gets Better campaign was created in 2010 to tell young, gay teens that bullying doesn't usually persist into later life and that they are apt to feel better in the future. Lady Gaga, in fact, started the Born This Way campaign soon after the unveiling of the It Gets Better campaign, which both directly combat homosexual bullying and indirectly fight teen suicides.

Needs to Stop
After understanding more about the three main types of bullying and the severity of its outcomes, bullying is clearly a problem endemic to many social institutions and peoples that needs to sputter to a stop soon.

Becki Alvarez writes about parenting, education & family finance at www.grouphealthinsurance.org.
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Guest Post U
The University of Great Content

Monday, September 5, 2011

We Need Slightly Unstable Leaders?

The Colbert ReportMon - Thurs 11:30pm / 10:30c
Nassir Ghaemi
www.colbertnation.com
Colbert Report Full EpisodesPolitical Humor & Satire BlogVideo Archive

Last month Stephen Colbert had Dr. Nasir Ghaemi on his show who wrote a book titled A First Rate Madness leaders saying that America's more successful Presidents such as Lincoln or Franklin Roosevelt have had a predisposition to bipolar disorder (it used to be called manic depression) or depression while most of our less successful one's were more normal like Jimmy Carter, Herbert Hoover, or George HW Bush I.  These mood disorders are genetic according to Ghaemi and other psychiatrists.

Colbert uses the example of Ronald Reagan of someone who was normal and was a successful President and Ghaemi sort of agreed about him being normal but not really about his leadership.  I must point out that Reagan did have an alcoholic father growing up (which can be inherited but Reagan apparently wasn't an alcoholic himself) and his family disagrees about whether he suffered from Alzheimer's while President.  If one looks through other leader's backgrounds it's possible to find other abnormalities in their psyche. Some mental health struggles should not disqualify a person from elective office.

Another problem with Dr. Ghaemi's theory is that we often place too much emphasis on the characteristics of leaders to understand how things happen and too little on the circumstances that surround them.  This is called the Great Man Theory of history.  It may be irrelevant in the long run whether Barack Obama is too normal or not to handle our current crisis if the movements around him do not motivate him to do what is necessary as he prepares his jobs address.  Roosevelt and Lincoln were pushed to do great things like create social security and end slavery by popular movements which had been working for years to make these things happen.  This doesn't mean that leaders do not matter.  No one wants leaders like Nero or Caligula.


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