The title is an understatement: Heterogeneity in psychiatric diagnostic classification. This is a paper in Psychiatry Research by Kate Allsopp, John Read, Rhiannon Corcoran, and Peter Kinderman.
Abstract (to which I added paragraphifications):
The theory and practice of psychiatric diagnosis are central yet contentious. This paper examines the heterogeneous nature of categories within the DSM-5, how this heterogeneity is expressed across diagnostic criteria, and its consequences for clinicians, clients, and the diagnostic model. Selected chapters of the DSM-5 were thematically analysed: schizophrenia spectrum and other psychotic disorders; bipolar and related disorders; depressive disorders; anxiety disorders; and trauma- and stressor-related disorders.
Themes identified heterogeneity in specific diagnostic criteria, including symptom comparators, duration of difficulties, indicators of severity, and perspective used to assess difficulties.
Wider variations across diagnostic categories examined symptom overlap across categories, and the role of trauma. Pragmatic criteria and difficulties that recur across multiple diagnostic categories offer flexibility for the clinician, but undermine the model of discrete categories of disorder.
This nevertheless has implications for the way cause is conceptualised, such as implying that trauma affects only a limited number of diagnoses despite increasing evidence to the contrary. Individual experiences and specific causal pathways within diagnostic categories may also be obscured. A pragmatic approach to psychiatric assessment, allowing for recognition of individual experience, may therefore be a more effective way of understanding distress than maintaining commitment to a disingenuous categorical system
Notice that they skipped the politically controversial subject of gender dysphoria. Had they tackled that, “activists” would have had a volcanic fit, and four professors would be out looking for a job. (Is there such a diagnosis of volcanic fit frenzy? I ask in earnestness.)
Now, that we all know this is true is also proof that psychiatric diagnoses, at least in politically controversial subjects, can be rank nonsense. If a psychiatrist fears to make a diagnosis which he believes is correct, then it is proof that outside motivating forces which should play no role in diagnosis do in fact influence decisions. Thus we don’t know what to believe—or who to trust.
This is particularly important in Tranny Madness situations, where young children are being physically and permanently mutilated by fee-charging surgeons. Surgeons who ply their dull knives using psychiatric diagnoses as their justification for getting rich. (See Saturday’s The Week In Doom, where this subject is tackled.)
It’s not only politics. It’s the the inherent uncertainty in mapping outward behavior with inward states.
…there are almost 24,000 possible symptom combinations for panic disorder in DSM-5, compared with just one possible combination for social phobia (Galatzer-Levy and Bryant, 2013). Olbert and colleagues (2014) also report considerable heterogeneity within the criteria of individual diagnoses, showing that in the majority of diagnoses in both DSM-IV-TR and DSM-5 (64% and 58.3% respectively), two people could receive the same diagnosis without sharing any common symptoms. Such ‘disjunctive’ categories have been described as scientifically meaningless. [My emphasis.]
Since science is what can be measured, a psychiatric illness that can’t be measured (reliably) isn’t science.
And, indeed, not all about our mental states is science. Read Introduction to the Science of Mental Health by Fr. Chad A. Ripperger for much insight. (Those men needing to get in shape can also use this book for a weight-lifting substitute.)
A scientist or psychiatrist who makes a judgment in an area which is not scientific, but which he thinks is, means he is substituting a prejudice. Now this prejudice may even be a good or true one, but that a scientist holds the prejudice doesn’t make it science. For instance, it is metaphysically impossible for a man to “transition into” a woman. This is a true proposition not known (exclusively) scientifically. A scientist or psychiatrist who thinks this impossibility can be accomplished is thus substituting a prejudice.
The limitations of madness are not fully limned. This paper proves it, but in only a handful of areas. Yet, somehow, “Mental health disorders on the rise globally” (original source).
What that headline means is that mental health diagnoses are on the rise. Whether people are truly becoming crazier has to be tackled on a malady-by-malady basis. People are certainly losing grasp on Reality in sexual matters, but that is not (for almost all) because of psychiatric disorders.
All we know for sure is that it is becoming easier to be diagnosed as nuts, and therefore to be in need of the paid services of doctors and pharmaceutical companies. To blame this only on doctors would be wrong. But it wouldn’t be very wrong.
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“Is there such a diagnosis of volcanic fit frenzy? I ask in earnestness.” No, but there most certainly should be. Unfortunately, too many psychiatrists would suffer from it and vote it out, like homosexuality.
The problem here is people do not understand (partially because both patients and psychiatrists/psychologists LIE about the situation) that psychiatry is NOT and never has been science. The drugging of people is also not science, but rather a marketing guessing game of what we can get people to take and shut up about their problems they don’t want to face (or stop hallucinating, which is a nobel cause, unlike fixing compainers). “Mental illness” is politics and philosophy. There a has NEVER been any science in it. None. Drugging is relatively new and a chemical straightjacket is so much more acceptable than a real one. It does NOT mean science is involved. Plus, drugging a population controls it, which is what totalitarian governments, including ours, do. (Okay, technically we are still an inch from totalitarian…..Give Zuckerberg time. He’s trying.)
People are very easily duped and psychiatrists and psychologists have made utter fools of the population.
Off topic, but speaking of meaningless (and statistics, of course), life expectancy is “down” again in the USA by .1 years—barely a month. There should be a psychiatric disorder for the insane belief that .1 years is in any way significant, yet alone can be calculated, for life expectancy. This certainly must be a mental illness and very, very widespread it seems.
In a not unrelated headline, 1 in 5 British school children have diagnosed mental or emotional health disorders.
About one in three boys in the USA have been prescribed Ritalin (better known on the streets as “speed”).
Psychologists and psychiatrists go into the profession because they are crazy. That’s not just my opinion (and common sense), that’s the result of an actual study.
Are not mental disorders now defined by political correctness? We should look forward to the time when belief in God is defined as such. Or being a conservative. Or insisting that 2 X 2 is not 5.
The Four Horsemen of the Apocalypse:
Marx
Darwin
Freud
Keynes
All created fake “sciences” focused on destruction of Normal culture and institutions.
They continue to rampage through our culture, leaving chaos and mayhem in their wake.
Freud’s fake “science” was exposed and rejected. But it’s just been replaced by worse (equally bad?) fake “science.”
Scientism. A destructive adoration of charismatic fake “authorities.”
Heaven help us.
I suspect that if the truth were known to us, as it is to God, there is a x:x-1 relationship between the exact way the human mind is fallen and broken and the number of humans who have been created (there is one notable exception). This does not depridate all attempts to help one another, but that in excluding the genuine nature of the root spiritual problem, there can be no universal answer, complete solution or actual renewing.
There is a good reason for disjunctive categories in some cases, and that is when a condition with a single cause expresses itself in different ways. I think there are various medical conditions that work this way. The disjunctive diagnosis is acceptable in this case because it can lead to a treatment–or at least to a prognosis.
I speculate that the purpose of disjunctive categories in psychology is for treatment rather than cause (since they have no idea of causes). It is basically a “they need this kind of drug” category.
Seems kind of lazy, though; if that’s your purpose, why not call it a “Ritalin disorder” if all you mean is that they show symptoms of the sort that are often alleviated by Ritalin*. And have the drug companies openly write the manuals. It would at least be more honest.
* Nothing I said should be taken as an implicit assumption that there really are conditions that are suitably treated with Ritalin.
Dear Sheri,
Your off-topic observation is interesting in that “life expectancy” is not even a real statistic, let alone measurable.
Lifetimes of people, light bulbs, shoes, and atomic nuclei are better evaluated using Survival Analysis (a statistics thingy), and it is more correcter to speak of “half lives” given a set of conditionals.
As in half the people my age and in my condition are expected to croak within a couple or three years, but half are expected to still be kicking past that date. Or something to that effect…
More on-topic, is dumbass a bona fide mental illness? If not why not?
Thomas Szasz was famous for the Myth of Mental Illness:
https://en.m.wikipedia.org/wiki/The_Myth_of_Mental_Illness
https://www.thenewatlantis.com/publications/the-myth-of-thomas-szasz
Speculatively assuming this was true, just focusing on violent criminally insane as one possibility, the accused could be mask-wearers, Actors! Human or angelic shapeshifter actors (Heb 13:2 be careful to entertain strangers for some have entertained angels unawares).
The universe is just indestructible energy that changes form. And particle wave collisions and formations and explosions and step-repeat.
And rape-murder (“Its just a shout away” – Rolling Stones ‘Gimee Shelter’ Merry Clayton background vocals).
And police investigations and courtroom adversarial conflicts to discover the truth about the accuser and the accused and render just judgment according to ideology de jour.
And TV and movie dramas play acting same.
It’s all Acting and Entertainment. Hurtling through space.
So IF violent criminally insane were/are Actors at least that would make them responsible for their crimes.
“Forgive them for they know not what they do” is meaningless to the recipient of forgiveness IF they still know not what they do after the fact.
Another possibility is God punishing with insanity. Daniel 4:33 comes to mind. Nebuchadnezzar’s mind temporarily becomes that of an Ox, as do his hygiene and eating habits.
1. DSM 5 is a dog. This is well known to most practising phenomenologists and epidemiologists.
1a. One of the reasons the design of DSM is a dog is that it describes criteria that distinguish A from B but do not describe them.
2. The clinical descriptions of mania, melancholia, panic and psychosis, however are robust and consistent over generations. I suggest people look up Kendler’s papers or read his book.
3. I suggest that this heterogeneity is the result of using a dog of a classification system. This is not a problem of the illnesses — but the classification system
What we need is a more reliable, “lumpy” and reality based way of discussing psychiatric illnesses. The best we have is the ICD system. But the correlation of any system with what a patient is suffering will never be perfect
Matt,
we need your comments to help us realise everything we are told by professionals isn’t a science and there are no such things as experts. DSM-5 has also misdiagnosed ADHD, as I, and others, attempted to show here:
http://www.mayohomeopathy.ie/index.php/adhd-diagnosis-science-scientific/
Dr Samuel Hahnemann was the first to treat humanely the mentally ill (the Duke of Saxony made a wing of his castle available to Hahnemann to treat such patients humanely – 50 years before Pinel turned up in France).
Hahnemann’s approach to psychiatry did not split mind and body: ‘mental’ symptoms are seen as a continuation of physical symptoms; never a separate disease. It’s time Hahnemann’s approach (see his Organon of Rational Healing) was restudied.
Thanks again for giving us the surety not to be duped by professionals’ own baggage!
Stephen Blendell
Frederick Crewes 768 pages book, released less than 2 years ago, gave the death blow to the entire framework of Freud’s work.
“Beginning around 1970, independent scholars such as Henri F Ellenberger, Frank Cioffi, and Paul Roazen began to chip away at the legendary Freud who had been canonised in the 1950s by Anna Freud, Ernest Jones, and others. The process has continued to this day. Freud, we now know, regularly lied about his breakthroughs, double-crossed benefactors, and slandered his rivals, and through ad hoc tinkering with a dubious theory, he created a great jumble of conflicting notions, bordering at times on mysticism.”
Freud: The Making of an Illusion
by Frederick Crews
“An elegant and relentless exposé . . . Impressively well-researched, powerfully written, and definitively damning. Crews wields his razor-sharp scalpel on Freud’s slavish followers, in particular, who did not want to see or who willfully redacted the sloppiness of Freud’s research methods in order to ‘idealize him.’ ”?Kirkus Reviews (Starred Review)
Sophie Freud, granddaughter of the father of modern psychiatry, in the film Neighbours: Freud And Hitler In Vienna, Sophie reminisces about her famous relative. “In my eyes, both Adolf Hitler and my grandfather were false prophets of the 20th century.”