Descriptions and Prescriptions: Values, Mental Disorders, and the DSMs [Hardcover]

John Z. Sadler (Editor)

Book Description

ISBN-10: 0801868408 | ISBN-13: 978-0801868405 | Publication Date: May 22, 2002 | Edition: 1

Most everyone agrees that having pneumonia or a broken leg is always a bad thing, but not everyone agrees that sadness, grief, anxiety, or even hallucinations are always bad things. This fundamental disjunction in how disease and disorders are valued is the basis for the considerations in Descriptions and Prescriptions.

In this book John Z. Sadler, M.D., brings together a distinguished group of contributors to examine how psychiatric diagnostic classifications are influenced by the values held by mental health professionals and the society in which they practice. The aim of the book, according to Sadler, is "to involve psychiatrists, psychologists, philosophers, and scholars in related fields in an intimate exchange about the role of values in shaping past and future classifications of mental disorders."

Contributors: George J. Agich, Ph.D., Cleveland Clinic Foundation; Carol Berkenkotter, Ph.D., Michigan Technological University; Lee Anna Clark, Ph.D., University of Iowa; K.W.M. Fulford, D.Phil., F.R.C.Psych., University of Warwick, Coventry; Irving I. Gottesman, Ph.D., University of Virginia; Laura Lee Hall, Ph.D.; Cathy Leaker, Ph.D., Empire State College; Chris Mace, M.D., M.R.C.Psych., University of Warwick, Coventry; Laurie McQueen, M.S.S.W., American Psychiatric Association, Washington, D.C.; Christian Perring, Ph.D., Dowling College; James Phillips, M.D., Yale University School of Medicine; Harold Alan Pincus, M.D., University of Pittsburgh School of Medicine; Jennifer H. Radden, D.Phil., University of Massachusetts; Doris J. Ravotas, M.A., L.L.P., Michigan Technological University; Patricia A. Ross, Ph.D., University of Minnesota; Kenneth F. Schaffner, M.D., Ph.D., George Washington University; Michael Alan Schwartz, M.D., Case Western Reserve University; Daniel W. Shuman, J.D., Southern Methodist University; Allyson Skene, Ph.D., York University; Jerome C. Wakefield, D.S.W., Rutgers University; Thomas A. Widiger, Ph.D., University of Kentucky; Osborne P. Wiggins, Ph.D., University of Louisville.

Editorial Reviews

From The New England Journal of Medicine

The Diagnostic and Statistical Manual of Mental Disorders (DSM), now in its fourth edition (DSM-IV), has had a profound impact on the practice of psychiatry and has created a level of medical and social interest and debate comparable to that accompanying Freud's introduction of the notion of infantile sexuality, at the turn of the last century. When the third edition of the DSM (DSM-III) was published in 1980, under the leadership of Robert Spitzer, psychiatry changed forever. Because of the compelling need for clinicians to communicate with each other and with researchers, the DSM took a positivistic, disciplined approach to classification in psychiatry. This, in turn, dramatically modified epidemiology and conversations about psychopathology, because psychiatrists and other clinicians could now speak a common language. As psychiatry was revolutionized by DSM-III, ripple effects were felt in philosophy, ethics, sociology, and even the arts. Diagnosis is fundamental to the practice of medicine. It is not hard to recall the era before DSM-III, when psychoanalytic frames of reference dominated psychiatric thinking and practice. I remember well one day during my training at the Massachusetts Mental Health Center in the early 1970s, when I presented a patient to the legendary Dr. Elvin Semrad and asked, "Dr. Semrad, does the patient have manic-depressive illness or schizophrenia?" Dr. Semrad answered, "I would call the patient Mr. Smith." The unique personhood of every patient, including his or her experience with mental illness and the underlying psychodynamic conflicts implying causality, dominated the DSM classification process right up until the publication of DSM-III. Descriptions and Prescriptions, which emanates from a conference on the DSM held at the University of Texas Southwestern Medical Center, is one of the best accounts of the intense debates on the values underlying the DSM, the need for accountability in psychiatric diagnosis, and some of the chief philosophical and political issues in psychiatry. Mental disorders are real, and the suffering they cause is palpable, but it is clear that the diagnostic enterprise in psychiatry is more messy than that in general medicine and is more susceptible to cultural and political biases. An example, mentioned frequently throughout the book, is the vote by the American Psychiatric Association in the mid-1970s to eliminate homosexuality from its diagnostic nomenclature. Even though diagnoses are easily contaminated by cultural or personal biases, the consensus is that DSM-III and now DSM-IV are not only a major scientific advance but also a work in progress. The eclectic authorship of Descriptions and Prescriptions reflects the broad social impact of the DSM, which goes beyond its usefulness in the clinical care of patients with psychiatric disorders. As DSM vocabulary enters the conversation of everyday life, the underlying values that inform the current edition of the DSM and the development of DSM-V are extremely important to understand and make explicit. The chapter on values, politics, and science, by Thomas Widiger, and the contribution by the book's editor, John Sadler, on values in developing psychiatric classifications, are especially noteworthy. Genetic breakthroughs in elucidating the etiology of discrete mental disorders, as well as continuing improvements in pharmacotherapy for serious mental disorders, will be prime movers in the next phase of development of the DSM. Descriptions and Prescriptions will be an important reference as the process gears up for the next, but not final, edition. Steven S. Sharfstein, M.D.
Copyright © 2002 Massachusetts Medical Society. All rights reserved. The New England Journal of Medicine is a registered trademark of the MMS.

Review

Descriptions and Prescriptions is one of the best accounts of the intense debates on the values underlying the DSM, the need for accountability in psychiatric diagnosis, and some of the chief philosophical and political issues in psychiatry.

(Steven S. Sharfstein, M.D. New England Journal of Medicine 2003)

Anyone who believes that developing the best diagnostic manual possible is an important and complicated task, and also wants to contribute to the process in a scholarly and reflective way, is well-advised to study these chapters.

(Peter Zachar Metapsychology )

This is a stimulating book for healthcare professionals interested in the clarity and development of psychiatric diagnoses, and while most appropriate for the seasoned professional, it can be a useful stimulant to the advanced student in psychiatric healthcare professions.

(Doody's Health Sciences Review )

In particular, I believe this volume has explicit value for all who serve on a DSM-V committee, as well as those with an interest in nosology or medical sociology, those with a critical role in psychiatric education, or those who simply have a philosophical bent (a non-DSM character trait).

(Robert J. Van Den Bosch, M.D., Ph.D. American Journal of Psychiatry )

The scholarship is of high quality and the contributors draw deeply on the literature relevant to their methodologies and perspectives. The multiplicity of approaches nicely illustrates the book's major aim: to make the process of devising a psychiatric nosology more democratic and inclusive.

(Dean F. MacKinnon, M.D., The Johns Hopkins University )

See all Editorial Reviews

Product Details

• Hardcover: 418 pages
• Publisher: The Johns Hopkins University Press; 1 edition (May 22, 2002)
• Language: English
• ISBN-10: 0801868408
• ISBN-13: 978-0801868405
• Product Dimensions: 9.2 x 6.3 x 1.3 inches
• Shipping Weight: 1.6 pounds (View shipping rates and policies)
• Amazon Best Sellers Rank: #2,320,579 in Books (See Top 100 in Books)