L3: Categorical Taxonomy (DSM-5) Flashcards
how do we define symptoms?
many different discourses (social, medical, scientific, etc for ex: earlier homosexuality was thought to be a disorder)
-> expectation & norms -> our definitions of deviations, problems, our theories etc -> our definition of a symptom as seen in the DSM
who were the 3 most influential figures in categorical taxonomy in the 19th century and where did they think symptoms arose from?
Kraepelin: thought that symptoms arose from a psychiatric syndrome (psychiatry)
Freud: thought that symptoms arose from unconscious conflicts, fantasy, defens mechanisms (formations of the unconscious)
Skinner: thought that symptoms arose from behaviours learned through conditioning of stimuli (behaviourism)
which way of categorizing mental disorders was dominant immediately post WW2? which after this?
right after WW2: psychoanalysis
50s onwards: humanistic & existentialist approaches (rogers, gestalt, client centered approach etc)
60s & 70s: anti psychiatry
Neo-Kraepelian Revolution
80s & 90s: DSM III, rise of psychofarmacology & biopsychiatry, RCTs, and DSM-CBT treatment model
what was the anti psychiatry movement characterized by?
critique on reliability of diagnosis, quality of research and the authority of psychiatrists
What was the Neo-Kreaepelian revolution?
response to the anti-psychiatry movement of the 60s & 70s
made more reliable diagnostic criteria:
1972: ‘The Feighner criteria’ for syndromes
1972-1974: Research Diagnostic Criteria (RDC)
1980: DSM-III
defined syndromes as the covariance of problems
what are the 5 parts of the 5 part framework of Ian Hacking? what is this framework about?
- a classification (like multiple personaliy disorder)
- the people: those that exhibit the symptoms (like those unhappy ppl that started showing MP symptoms more and more after diagnosis was “discovered”)
- the institutions (includes clinics, talkshows, programmes for therapists etc)
- the knowledge: supposed “facts” that are spread around about a certain classification (ex: that MPD is caused by early sexual abuse)
- the experts/professionals who generate 4. the knowledge, judge its validity, and use it in their practice. they work in 3. the institutions that guarantee their legitimacy, authenticity, and status as experts. they study, try to help, or advise on the control of b. the people who are a. classified as of a given kind.
its about how these 5 factors interact to change the likelihood of a diagnosis being given and the meaning that diagnoses have
how the person turns out all depends on all of these factors (ex; someone with a 5. expert that doesnt believe in an MPD diagnosis will turn our very differently than if treated by an 5. expert that believes in MPD)
what are the core ideas of ian hacking’s making up people?
- making up people
- moving targets
- looping effects
- transient mental illness
- engines of discovery are also engines of making up ppl
what is Hacking’s “making up people” idea?
Our sciences create kinds of ppl that in a certain sense did not exist before our study of them
we make up disorders, we select certain criteria and make it a disorder
What is Hacking’s “moving targets” idea?
by diagnosing someone we change their symptoms and view of self,so they are constantly changing
our investigations interact with them and change them
What is Hacking’s transient mental illness idea?
if you name a disorder then more ppl will identify with it which then makes more ppl mentally ill, more and more ppl are diagnosed w mental illness
specific mental illness diagnoses exist only at a certain time and place, in certain circumstances that allow them to thrive
-> the fact that diagnoses defintions and terms come and go makes it easy for transcience believers to say that these illnesses are not really real
What is Hacking’s “engines of discovery are also engines of making up people” idea?
engines by which we try to find out the facts about mental disorders inevitabely (us trying to medicalise, geneticize etc influences those who its done to) produce effects on the kind of ppl to whom they are applied, they change the boundaries & characteristics
fortunately there is competition, different groups/organisations say different things about the causes/characteristics/defintiions etc of each disorder
what are the 10 engines of discovery (and by proxy, engines of making up ppl)
in chronoligcal order from when they became effective:
1. count: how many ppl have disorder x
2. quantify: to what extent does person y have disorder x
3. create norms: person y is deviant from the norm
4. correlate: what does disorder x correlate with
5. medicalise: mental disorder x is a psychiatric disorder and hence a medical disorder
6. biologize: mental disorder x has biological cause z, relieving the person from any personal responsibility
7. geneticise: mental disorder x has genetic causes
engine of practice:
8. normalize: we try to make the unfavourable deviants of disorder x as close to normal as possible (in therapy, w medicine etc)
engine of administration:
9. bureaucratise: there are systems in place to pick out ppl w disorder x from society and help them
engine of resistance to the knowers:
10. resistance: ppl diagnosed w disorder x try to reclaim their identity
how does our “counting” engine of discovery contribute to the making up of people?
for some mental disorders, the definitions have broadened, which has led to a seeming increase in their prevalence (since more ppl fall under the definition, so its doubtful whether for ex autism rates have actually increased)
how does our “quantity” engine of discovery ontribute to the making up of people?
its hard to quantify deficits involved in mental disorders (like for obesity there is BMI but there is not real way of quantifying how autistic someone is)
how does our “bureaucracy” engine of discovery ontribute to the making up of people?
systems seek out who has mental disorder x so they can see who needs help
but the criteria in place to find the ppl w the disorder are influenced by what is seen and vice versa
feedback effect
