Patricia Williams writes:
Well, not exactly. The DSMs mention that the etiology or
pathophysiologic
> processes for some mental disorders are known, but not for
others.
Yes, exactly. The DSM labels a lot of behaviours "mental
disorders" -- including, injuries to the brain, neurological disorders.
The behaviours we (most physicians, society) associate with
"mental illness" -- schizophrenia, OCD, manic depression, clinical
depression, ect -- all fall under the rubric in the DSM of
"disorders/illnesess of unknown causes".
<<<<Diagnostic criteria need not include
> etiological information. >>>>
But it usually does, whereas the discussion of "mental disorders"
in the DSM is entirely descriptive. The first thing the authors warns
physicians before making a diagnosis is to rule "out all possible
physical causes". Why? Obviously because they are not definiing
illnesses in the traditional sense , but what they deem to be
problematic behaviour.
There are no clearly defined boundaries for diagnosis in the DSM.
They states stuff like: disorder blah has 8 known symptoms. A, B,
C, D, E, F, etc. If 3 out of the 5 symptoms are present, then the
physician may rule out diagnosis of blah.
For the symptoms of OCD, they make such moral statements as:
OCD sufferers do no engage in "normal routines, occupational
functions, or the usual social activities or relationship with others"
.p 419 DSM-IV). They state that OCD symptoms are behaviours
considered "inappropriate by others of the culture...with social role
functioning (p.420) and that for OCD to be present, sufferers need
to express "guilt" and a "pathological sense of responsibility" (419).
They state that OCD is, in contrast to "normal"
obsessive/compulsive "tendencies" , is "clearly excessive (p.245)
The DSM II provides a ridiculous provision that allows psychicians
to "loosen" diagnostic criterion because, in the words of the
authors, disorders are not applicable "in all those situations and in
every country and for all time". ????!
I can just imagine what the reaction would be were a doctor to
make a similar pronouncement about cancer.
Just to show how idiotic some of the diagnoses are in the DSM,
they use to include homosexuality. Then through pressure from
gay rights activitists the APA eventually "voted" it out of the
manual, despite many APA members objecting to this.
There is also a "controversial" diagnosis called "Mauchensen by
Proxy Syndrome". This is supposedly when women deliberately
hurt their babies in order seek attention from their physicians.
Yet they have still to "discover" the disease-nature of spousal
abuse.
>>> The purpose is to provide a common language for
> clinicians, not to provide in one volume the entirety of knowledge
> regarding all recognized mental disorders. >>>>
Geez...How many "volumes" would you surmise would be enough
space to provide a consise description of the causes of each
"illness"? For example, The DSM-IV (1994) was 886 pages! Don't
you think they could have fit in at least a line or two about the
causes of each of the "disorders"???
<<<It seems to be a bit of a leap
> to conclude that since you can't find the cause of a disorder in
the DSM IV,
> there is no physiological basis to it.>>>>
There is a phsiological basis to all behaviour, no? Obviously what
I'm meant by "physiological" is the supposed biological or genetic
source/cause of the "pathology".
Psyhiatry has been saying for years that they will "locate" the
biological cause of this and that disorder. Yet despite this claim,
they persist with statements, in each of the DSMs, to the effect of:
prior to making a diagnosis, physicians should *first* rule out all
possible physical causes, or the cause of mental disorders are
unknown.
For example, in the DSM III and III-R (which were incidentally
published 7 years apart!), there is the following passage:
"Undoubtedly [?!], with time, some of the disorders of unknown
etiology will be found to have specific biological etiology, others will
have specific psychiological causes, and still others to result
mainlyu from a particular interplay of physiological, social and
biological factors" (DSM III. p.7; DSM III-R p. xxiii).
Undboutedly with time???
They make similar pronouncements in the DSM IV. I am not aware
of any major "discoveries" mentioned in the most recent editions.
All this beggars the question -- what if they, the DSM authors,
don't "discover the biological source of these behaviours". Will they
persisits in calling them llnesses? Or will finally admit they are
quacks and resort to more credible explanations for these
behaviours -- namely, that they are judging "symptoms" on the
basis of societal rules/norms.
Why the need to pin down a physiological cause in order to
consider a
> condition an illness anyway? Was AIDS an illness before its
cause was
> determined?
I don't know. But how many years did it take before they figured out
what caused aids?
The behaviours associated with OCD, for example, was discussed
as far as the 16th century. Obviously you can probably say the
same thing about a lot of diseases we now know the cause to. Yet
we've come a long way with technology which explains why it
probably didn't take that long to discover the cause of AIDs. Yet
despite all the brain scan mechanisms available there is still no
consenses on what causes most mental disorders. And there is
certainly little to show for any of these so-called diseases in terms
of the discovering lesions of some sort or another in the brain that
would distiguish the various mental "illnesses'" from each other.
DOQ
Date sent: Fri, 31 Dec 2004 12:46:48 -0800
Send reply to: Patricia Williams <[log in to unmask]>
From: Patricia Williams <[log in to unmask]>
Subject: Re: Invisible disabilities and the disability card
To: [log in to unmask]
> Well, not exactly. The DSMs mention that the etiology or pathophysiologic
> processes for some mental disorders are known, but not for others. However,
> I would not consult the DSM to learn about these issues, since it is not
> intended for that purpose. It takes a descriptive approach, providing
> standard criteria for diagnosis. Diagnostic criteria need not include
> etiological information. The purpose is to provide a common language for
> clinicians, not to provide in one volume the entirety of knowledge
> regarding all recognized mental disorders. It seems to be a bit of a leap
> to conclude that since you can't find the cause of a disorder in the DSM IV,
> there is no physiological basis to it.
>
> Why the need to pin down a physiological cause in order to consider a
> condition an illness anyway? Was AIDS an illness before its cause was
> determined?
>
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