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February 27th, 2008

When different is crazy

  • Feb. 27th, 2008 at 2:52 PM
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A word about the politics of diagnosis-making is in order. Over the years, DSM task forces have had to contend with bids, pro and con, for diagnoses such as masochistic personality disorder, sadistic personality disorder, pathological (racial) bias, and premenstrual dysphoric disorder (a.k.a. PMS). Soon, planners of the next edition, the DSM-V, tentatively scheduled for publication in 2012, will hear appeals to create categories for shopping and food addictions. Internet addiction will surely come up too -- as it did this summer at a meeting of the American Medical Association. Pro-life advocates hope to get the DSM to adopt "post-abortion syndrome" (indicating pathological regret after terminating a pregnancy). Meanwhile, there is a battle over gender identity disorder, with some members of the transsexual community wanting it evicted, while others wanting it to stay in so that insurance companies will pay for sex-reassignment surgery.
-- Sally Satel, a review of Allan V. Horwitz 'The Loss of Sadness: How Psychiatry Transformed Normal Sorrow Into Depressive Disorder'

Psychology has long had a hang-up about being seen as a 'science'. It's all about statistics and categories, measurable 'this' and quantifiable 'that'. It tends to twist someone up, that need to count and label. It tends to twist up an entire industry when it's enshrined into one definitive book -- psychiatry's Diagnostic & Statistical Manual.

I still love psychology, though. Probably because it's got -- pardon yet another pun -- personality. It craves respect -- but only on the terms psychology itself defines. I remember being taught to test for statistical significance across a group of subjects in a psychology experiment. If you test a hundred people, at least 5 should show the 'effect' in order for it to be considered real. Less than five, not significant.

In discussing this with my lecturer in The Philosophy of Psychology (my favourite subject), my lecturer said, 'If even one person feels the effect, surely that's significant? Isn't it significant for that one person?'

That contrast between the significance of one life, and the life of a group, has always stuck with me.

Which is entirely tangential to the above article on a book that investigates psychiatric categorisation.

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