Values and psychiatric diagnosis:
Saved in:
| Main Author: | |
|---|---|
| Format: | Book |
| Language: | English |
| Published: |
Oxford [u.a.]
Oxford Univ. Press
2005
|
| Series: | International perspectives in philosophy and psychiatry
|
| Online Access: | Inhaltsverzeichnis |
| Item Description: | Includes bibliographical references (p. [477]-523) and indexes |
| Physical Description: | XVII, 540 S. 24 cm |
| ISBN: | 9780198526377 |
Staff View
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| 245 | 1 | 0 | |a Values and psychiatric diagnosis |c John Z. Sadler |
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| 300 | |a XVII, 540 S. |c 24 cm | ||
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| 490 | 0 | |a International perspectives in philosophy and psychiatry | |
| 500 | |a Includes bibliographical references (p. [477]-523) and indexes | ||
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Record in the Search Index
| _version_ | 1804152805903040512 |
|---|---|
| adam_text | Contents
1 Introduction 1
1.1 Background 2
1.2 Why psychiatric diagnosis and classification? 5
1.3 A brief personal history of nosological controversy 6
1.4 Defining values 8
1.5 Overview of the book 11
2 Methods 21
2.1 Background 22
2.2 Kuhn on scientific theory change 25
2.3 Values, value-terms, and value-semantics 28
2.3.1 Values and context 28
2.3.2 Values and false statements 29
2.3.3 Value-terms 30
2.3.4 Value-semantics 32
2.3.5 Value-commitments, entailments, and consequences 32
2.4 Five heuristic types of value 34
2.4.1 Aesthetic values 38
2.4.2 Epistemic values 40
2.4.3 Ethical values 41
2.4.4 Ontological values 41
2.4.5 Pragmatic values 41
2.5 Unraveling the dense fabric of values 42
3 Science 55
3.1 Background: relations between medicine and science 56
3.2 Basics of classification 59
3.2.1 Classification and taxonomy 60
3.2.2 Tradeoffs in scientific taxonomies 61
3.2.3 Typology and syndrome 63
3.2.4 From numerical taxonomy to taxometrics 64
3.2.5 Monothetic and polythetic psychiatric nosology 65
3.3 Science and psychiatric nosology 67
3.3.1 Epistemological and conceptual concerns 68
3.3.1.1 Scientific-epistemic values in the DSM manuals
proper 69
3.3.1.2 Epistemic values and philosophy of science-based
commentators 73
3.3.2 Bootstrapping 83
3.3.2.1 Validation procedure 85
3.3.2.2 Competing values in construct development 91
xii Contents
3.3.3 Critiques of rigor 95
3.3.3.1 Scientific rigor in DSM-III through IV 95
3.3.3.2 Scientific rigor in ICD-9 and ICD-10 109
3.3.3.3 Critiques of rigor in the larger community 116
4 Patients, profession, and guild 141
4.1 Background 142
4.2 Patient 142
4.2.1 Patients, clients, and consumers 142
4.2.2 Outside-in and inside-out views of mental illness 144
4.2.3 Stigma and psychiatric classification 146
4.3 Profession 147
4.3.1 The seeking and using of scientific or scholarly knowledge 148
4.3.2 Service orientation 148
4.3.3 Extended education 148
4.3.4 Formal ethics 149
4.3.5 Autonomy and self-regulation 149
4.3.6 Association 150
4.4 Guild interests and classification 151
4.4.1 What is a guild? 151
4.4.2 Turf: psychiatric classification and other mental health
professionals 151
4.4.3 Mental health political advocacy and the DSMs 155
4.5 Potential professional conflicts of interest in the DSMs 156
4.6 Weighing patient, professional, and guild interests in the DSMs 161
5 Space, time, and being 167
5.1 Background 168
5.2 Defining mental disorder 169
5.3 World-views, assumptions, and ontological values 175
5.3.1 Empiricism 176
5.3.2 Hyponarrativity 176
5.3.3 Individualism 178
5.3.4 Naturalism 178
5.3.5 Pragmatism 179
5.3.6 Traditionalism 180
5.4 The constraint of ontological space — the transpersonal psychiatry
critique 180
5.5 The constraint of ontological time — the developmentalist
critique 184
5.6 Space and time recast — existential-phenomenological and social
constructionist critiques 186
5.6.1 The situated perspective 186
5.6.2 Social constructionism and the DSMs 188
5.6.3 The DSMs and existential-phenomenological
perspectives 191
5.7 Three contrast-cases for ontological values in psychiatry 194
Contents xiii
6 Sex and gender 203
6.1 Background: the declassification of homosexuality 204
6.2 Mad versus bad in the bedroom 210
6.2.1 Disorder status as a case of public ethics 211
6.2.2 What kind of a bad is mental disorder? 213
6.2.3 Moral wrongfulness in putative mental disorders 217
6.2.4 Mental disorders should harbor mostly nonmorally bad
evaluations 224
6.3 Mental disorder diagnosis and women: what are the issues? 227
6.4 Discrimination and stigma as negative value-consequences 230
6.5 Gender concepts as entailed ontological values 234
6.6 Medicalization and eudaimonia 238
7 Culture 251
7.1 The cultural challenge to mental disorder classification 254
7.1.1 Ethnocentrism 255
7.1.2 Practical and ethical difficulties with ethnocentric
categories 258
7.2 DSM-IV approaches to the problems of culture 264
7.2.1 Too little too late 264
7.2.2 Cultural detail versus cultural perspective 265
7.3 Ten weird things about Western psychiatry 267
7.3.1 Individuals have illnesses 270
7.3.2 The tightly bounded self 270
7.3.3 Egalitarian doctor-patient relationships 271
7.3.4 Mental illness distinct from physical illness 271
7.3.5 Illness is secular 271
7.3.6 Meaning is distinct from nature 272
7.3.7 The whole is the sum of the parts 273
7.3.8 Perception (empiricism) is the best evidence 273
7.3.9 Diagnosis is distinct from morality 274
7.3.10 Particular cultural ideals 274
7.3.11 A bonus: the economy of text pragmatic-aesthetic
value 275
7.4 Relativism, absolutism, and cross-cultural DSMs 276
7.5 Toward an ethics of cross-cultural psychiatric diagnosis 277
7.5.1 Cross-cultural validation 278
7.5.2 The ethics of using nonvalidated cross-cultural diagnostic
categories 281
7.5.2.1 Informed consent 282
7.5.2.2 Diagnosis and social justice 284
7.5.2.3 Balancing individual and collective interests 284
8 Genetic nosology 291
8.1 Background 292
8.2 Barest essentials of psychiatric genetics 293
8.2.1 Genotype and phenotype 293
xiv Contents
8.2.2 Psychiatric geneticists dissatisfactions with clinical
nosology 295
8.2.3 What is the phenotype in psychiatric genetics? 295
8.3 Psychiatric genetic nosology 297
8.3.1 Why psychiatric genetic nosology? 297
8.3.2 Use of conventional clinical diagnoses 299
8.3.3 Revising clinical diagnosis I: spectrum disorders 300
8.3.4 Revising clinical diagnosis II: concordance ratios and diagnostic
schemes 302
8.3.5 Revising clinical diagnosis III: diagnostic accuracy assessments
and caseness approaches 303
8.3.6 Alternative phenotypes and endophenotypes 304
8.4 Value-structure of genetic versus clinical nosology 304
8.4.1 Relative reversals of value priorities 304
8.4.2 Ontological domains and ontological reductions 306
8.4.3 Ontological reference properties 307
8.4.4 Summarizing the ontological value-structures 311
8.5 Implications of a rising psychiatric genetic nosology 312
8.5.1 The promise of psychiatric genetics research 313
8.5.2 Value-consequences of a genetic primary nosology 314
8.5.3 Value-consequences of genetic nosological contributions to
clinical nosology 316
8.5.4 Value-consequences of any nosology that is ontologically remote
and phenomenologically ambiguous 319
8.5.5 Conclusions 321
9 Technology 327
9.1 Background: Heidegger, Dreyfus, and technology 328
9.2 Insights from the philosophy of technology 330
9.2.1 Use of technology involves a conventionalized
hermeneutic 331
9.2.2 Disappearance phenomenon 332
9.2.3 Magnification-reduction 332
9.2.4 Depth 333
9.2.5 Ambivalence about technology 334
9.3 Psychiatric classification as technological 336
9.3.1 Psychiatric classification: artifact, material, praxis 336
9.3.2 The depth of psychiatric classification 337
9.3.3 Magnification-reduction and the conventionalized
hermeneutic 337
9.4. Poietic versus technological diagnostic practice 339
9.4.1 The existentialist encounter 339
9.4.2 Care ethics and the poietic 341
9.5 Toward a balanced poietic-technological practice 344
9.5.1 Reform of diagnostic technology by individual initiative 344
9.5.1.1 Awareness of the technological mode of diagnostic
practice 347
Contents j xv
9.5.1.2 Clinical ultimate concerns, focal things and practices,
and engagement 347
9.5.2 Technological reform of classification from the
DSM-ICD side 349
9.5.2.1 Involvement of those with the most interest in the
outcome of classification 350
9.5.2.2 Redirecting the manual s content to reflect the goal of
patient care 350
10 Politics 359
10.1 Political meanings 360
10.1.1 Politicsj 361
10.1.2 Politics2 361
10.1.3 Politics3 362
10.1.4 Polirics4 362
10.1.5 Just plain politics 363
10.2 The politics-science dichotomy syndrome 363
10.2.1 Schacht on DSM-III politics and science 364
10.2.2 Spitzer on PSDS 366
10.2.3 A reconsideration of PSDS, Schacht, and Spitzer 368
10.3 Externalist political landscapes and classification 371
10.3.1 The libertarian critique 372
10.3.2 Social-centered political critiques 375
10.3.3 Psychiatric classification, Connolly and normalization 377
10.4 Toward a political architecture for DSM-IV 380
10.4.1 The DSM-FV procedural flow 381
10.4.2 The DSM-FV process as reflecting democratic values 383
10.4.2.1 Majoritarian versus protection of minority
interests 385
10.4.2.2 The fairness of citizen involvement versus the
efficiency of expertise 391
10.4.2.3 Correct policy versus legitimate policy 395
10.5 Good politics for science and classification 396
10.5.1 What makes science? 398
10.5.2 Toward good politics in science 400
10.5.2.1 Openness 400
10.5.2.2 Equality of opportunity 401
10.5.2.3 Peer review 401
10.5.2.4 Epistemic freedom 402
10.5.2.5 Criticism 403
10.5.3 Against anarchy 403
11 Values and psychiatric diagnosis 415
11.1 What is diagnosis? 416
11.1.1 Diagnosis as characterization 419
11.1.2 Diagnosis as disclosure 420
11.1.3 Diagnosis as embedded observation 421
xvi Contents
11.1.4 Diagnosis as relevance 421
11.1.5 Diagnosis as privilege 421
11.1.6 Diagnosis as rationality 422
11.1.7 Diagnosis as ritual 422
11.1.8 Toward an aesthetics of diagnosis 423
11.1.8.1 Diagnosis should provide a simple
characterization 423
11.1.8.2 Diagnosis should involve ongoing
reinterpretation 424
11.1.8.3 Diagnosis should forge clinical understanding and
moral purpose into therapeutic action 425
11.1.8.4 Diagnosis should respect the patient 426
11.1.8.5 Diagnosis should be faithful 427
11.1.9 Relations between diagnostic practice and classification 428
11.2 A gardener s allegory and the point of mental disorder
classification 432
11.3 Grasping the whole of values in classification 436
11.3.1 How do values guide action? 437
11.3.1.1 Priority aspect 437
11.3.1.2 The ground aspect 440
11.4 Just how did values guide action in the DSM-IV? 444
11.4.1 Clinical utility, comprehensive coverage, atheoreticism, and
user-friendliness 444
11.4.2 Empiricism and traditionalism 445
11.4.3 Four utilities plus pragmatism and scientific rigor 446
11.4.4 Advocacy, aid, democratic, and guild values 446
11.4.5 Eudaimonia and six isms in the OLB 446
11.4.6 Pragmatism, professionalism, and profitability 447
11.5 Just how shouId values guide action in future DSMs? 448
11.5.1 Meta-ethics of classification 448
11.5.2 The foreground and end for the DSM should be to aid the
mentally ill 449
11.5.2.1 From defining disorder to defining health 449
11.5.2.2 From health to eudaimonia 451
11.5.3 Moving the utilities to midground means 452
11.5.3.1 Administrative utility as a midground means 452
11.5.3.2 Clinical utility as a midground means 453
11.5.3.3 Educational utility as a midground means 454
11.5.3.4 Research utility as a midground means 455
11.5.3.5 Can all the DSM utilities live together in
harmony? 455
11.5.4 Subduing the covert operations of metaphysical isms 457
11.5.4.1 The positives of the isms in DSM-IV 458
11.5.4.2 Manipulating the visibility of isms in a future
DSM 459
11.5.4.3 Manipulating the priority of isms in a future
DSM 463
11.5.5 A role for professional, guild, and advocacy interests 466
Contents xvii
11.5.6 Addressing the tension between scientific rigor
and traditionalism 467
11.5.7 A prescription for further democratization 468
11.5.8 Values in the value-structural status quo 469
References 477
Author Index 525
Subject Index 529
|
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| spelling | Sadler, John Z. 1953- Verfasser (DE-588)172710332 aut Values and psychiatric diagnosis John Z. Sadler Oxford [u.a.] Oxford Univ. Press 2005 XVII, 540 S. 24 cm txt rdacontent n rdamedia nc rdacarrier International perspectives in philosophy and psychiatry Includes bibliographical references (p. [477]-523) and indexes HBZ Datenaustausch application/pdf http://bvbr.bib-bvb.de:8991/F?func=service&doc_library=BVB01&local_base=BVB01&doc_number=027693980&sequence=000002&line_number=0001&func_code=DB_RECORDS&service_type=MEDIA Inhaltsverzeichnis |
| spellingShingle | Sadler, John Z. 1953- Values and psychiatric diagnosis |
| title | Values and psychiatric diagnosis |
| title_auth | Values and psychiatric diagnosis |
| title_exact_search | Values and psychiatric diagnosis |
| title_full | Values and psychiatric diagnosis John Z. Sadler |
| title_fullStr | Values and psychiatric diagnosis John Z. Sadler |
| title_full_unstemmed | Values and psychiatric diagnosis John Z. Sadler |
| title_short | Values and psychiatric diagnosis |
| title_sort | values and psychiatric diagnosis |
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