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Vice and Psychiatric Diagnosis outlines the implications of vice concepts being incorporated into psychiatric diagnosis and clinical practice, leading to some of the vexing problems in mental health and social care.
In this work, John Z. Sadler examines the nature and significance for practice of the value-content of psychiatric diagnostic classification.
Vice and Psychiatric Diagnosis begins with the simple question of why some categories of mental disorder include immoral or criminal conduct as diagnostic features, while most mental disorders in the DSM and ICD do not involve such "vice-laden" concepts. While this initial puzzle seems to concern only the limited domain of psychiatric nosology, Sadler's expansive scholarship reveals that this simple question leads inexorably to complex questions about the role of "madness and morality" in intellectual history, and to today's many conflicts and contradictions in the policy and culture of mental health, criminal justice, and related social welfare efforts. The book outlines the implications of vice concepts being incorporated into psychiatric diagnosis and clinical practice, leading to some of the vexing problems in mental health and social care. These issues include the fragmentation of care in social welfare efforts involving mentally ill people, criminal offenders, intellectually disabled individuals, and juvenile offenders. The analysis extends to cultural attitudes and policies as well: the insanity defense, managing the mentally ill criminal offender, the value of punishment in criminal justice, and derivative issues such as the ethics of forensic psychiatry, the growing problem of mass shootings, stigma, health literacy, and the difficulties in pursuing rigorous and consistent approaches to psychiatric diagnostic classification. In the pursuit of untangling these threads of vice and psychiatric diagnosis, Sadler provides a brief history of ideas about madness and morality, beginning in prehistory and extending into the late 20th century. The lessons from this history are applied in subsequent chapters, examining the "vice-mental disorder relationship" from the perspectives of philosophical/conceptual issues, the perspectives of criminal law and the criminal justice system, and the perspectives of public interest and public opinion. The concluding chapters formulate an alternative way of thinking about the vice-mental disorder relationship in clinical practice and public policy, culminating in "Forty Theses" which present the detailed conclusions and social implications for this monumental work.
Blurred boundaries between the normal and the pathological are a recurrent theme in almost every publication concerned with the classification of mental disorders. Yet, systematic approaches that take into account discussions about vagueness are rare. This volume is the first in the psychiatry/philosophy literature to tackle this problem.
Though mental health recommendations for the elderly is rapidly evolving, the few current textbooks on this subject are either too voluminous or complex for regular review by clinicians, and most do not contain the latest information available in the field. Written by experts in geriatric psychiatry, this book provides a comprehensive yet concise review of the subject.The text covers topics that include the social aspect of aging, treatment and diagnosis options unique to the elderly in need of psychiatric care, policy and ethics, and particular geriatric health concerns that may influence psychiatric considerations. Psychiatric Disorders Late in Life is the ultimate resource for practicing psychiatrists, physicians, geriatricians, and medical students concerned with the mental healthcare of the elderly.
Diagnosis in psychiatry -- DSM and its discontents -- Over-diagnosis and overtreatment -- Science, philosophy and diagnosis -- How "major" is major depression? -- The boundaries of bipolarity -- PTSD and trauma -- ADHD and attention -- Personality and personality disorder -- Other disorders in which over-diagnosis is a risk -- Transdiagnostic approaches -- The rise of aggressive psychopharmacology -- How do we know what is normal? -- Where do we go from here?
A compelling and incisive book that questions the overuse of mental health terms to describe universal human emotions Public awareness of mental illness has been transformed in recent years, but our understanding of how to define it has yet to catch up. Too often, psychiatric disorders are confused with the inherent stresses and challenges of human experience. A narrative has taken hold that a mental health crisis has been building among young people. In this profoundly sensitive and constructive book, psychologist Lucy Foulkes argues that the crisis is one of ignorance as much as illness. Have we raised a 'snowflake' generation? Or are today's young people subjected to greater stress, exacerbated by social media, than ever before? Foulkes shows that both perspectives are useful but limited. The real question in need of answering is: how should we distinguish between 'normal' suffering and actual illness? Drawing on her extensive knowledge of the scientific and clinical literature, Foulkes explains what is known about mental health problems—how they arise, why they so often appear during adolescence, the various tools we have to cope with them—but also what remains unclear: distinguishing between normality and disorder is essential if we are to provide the appropriate help, but no clear line between the two exists in nature. Providing necessary clarity and nuance, Losing Our Minds argues that the widespread misunderstanding of this aspect of mental illness might be contributing to its apparent prevalence.
The publication of the Cultural Formulation Outline in the DSM-IV represented a significant event in the history of standard diagnostic systems. It was the first systematic attempt at placing cultural and contextual factors as an integral component of the diagnostic process. The year was 1994 and its coming was ripe since the multicultural explosion due to migration, refugees, and globalization on the ethnic composition of the U.S. population made it compelling to strive for culturally attuned psychiatric care. Understanding the limitations of a dry symptomatological approach in helping clinicians grasp the intricacies of the experience, presentation, and course of mental illness, the NIMH Group on Culture and Diagnosis proposed to appraise, in close collaboration with the patient, the cultural framework of the patient's identity, illness experience, contextual factors, and clinician-patient relationship, and to narrate this along the lines of five major domains. By articulating the patient's experience and the standard symptomatological description of a case, the clinician may be better able to arrive at a more useful understanding of the case for clinical care purposes. Furthermore, attending to the context of the illness and the person of the patient may additionally enhance understanding of the case and enrich the database from which effective treatment can be planned. This reader is a rich collection of chapters relevant to the DSM-IV Cultural Formulation that covers the Cultural Formulation's historical and conceptual background, development, and characteristics. In addition, the reader discusses the prospects of the Cultural Formulation and provides clinical case illustrations of its utility in diagnosis and treatment of mental disorders. Book jacket.
The United States will no longer have a Caucasian majority in the second half of the 21st century. Evidence shows that misdiagnosis of mental disorders occurs more frequently in minority populations. Thus, the domestic and international utility of DSM-IV and its companions will depend on their suitability for use with various cultures. A key feature of this volume is the collaboration of cultural experts, members of the National Institute of Mental Health (NIMH ) Culture and Diagnosis Group, nosologists, and members of the DSM-IV Task Force and Work Groups. The NIMH and the American Psychiatric Association held a conference on Culture and Psychiatric Diagnosis to prepare for DSM-IV. Culture and Psychiatric Diagnosis developed from that meeting to enhance the cultural validity of DSM-IV. If clinicians are to become culturally sensitive, they must understand the criteria that define a disorder and consider the cultural context of the person being examined. They can then ascertain whether the criteria are applicable in the present cultural context of the patient. Culture and Psychiatric Diagnosis will benefit all clinicians treating minority patients because it documents and clarifies how cultural factors influence psychopathology; the manifestations, assessment, and course of mental disorders, and the response to treatment.
This book is a guide for psychiatrists struggling to incorporate transformational strategies into their clinical work. The book begins with an overview of the concept of critical psychiatry before focusing its analytic lens on the DSM diagnostic system, the influence of the pharmaceutical industry, the crucial distinction between drug-centered and disease-centered approaches to pharmacotherapy, the concept of “de-prescribing,” coercion in psychiatric practice, and a range of other issues that constitute the targets of contemporary critiques of psychiatric theory and practice. Written by experts in each topic, this is the first book to explicate what has come to be called critical psychiatry from an unbiased and clinically relevant perspective. Critical Psychiatry is an excellent, practical resource for clinicians seeking a solid foundation in the contemporary controversies within the field. General and forensic psychiatrists; family physicians, internists, and pediatricians who treat psychiatric patients; and mental health clinicians outside of medicine will all benefit from its conceptual insights and concrete advice.