Overview

"The public, mental health consumers, as well as mental health practitioners wonder about what kinds of values mental health professionals hold, and what kinds of values influence psychiatric diagnosis. Are mental disorders socio-political, practical, or scientific concepts? Is psychiatric diagnosis value-neutral? What role does the fundamental philosophical question ""How should I live?"" play in mental health care? In his carefully nuanced and exhaustively referenced monograph, psychiatrist and philosopher of psychiatry John Z. Sadler describes the manifold kinds of values and value judgements involved in psychiatric diagnosis and classification systems like the DSM. Professor Sadler takes the reader on a fascinating conceptual tour of the inner workings of psychiatric diagnosis, considering the role of science, culture, sexuality, politics, gender, technology, human nature, patienthood, and professions in building his vision of a more humane psychiatric diagnostic process."

Full Product Details

Author:   John Z. Sadler (, Department of Psychiatry, University of Texas Southwestern, Dallas, USA)
Publisher:   Oxford University Press
Imprint:   Oxford University Press
Volume:   No. 2
Dimensions:   Width: 15.40cm , Height: 3.00cm , Length: 23.20cm
Weight:   0.852kg
ISBN:  

9780198526377

ISBN 10:   0198526377
Pages:   568
Publication Date:   28 October 2004
Audience:   Professional and scholarly ,  Professional & Vocational
Format:   Paperback
Publisher's Status:   Active
Availability:   To order  
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Table of Contents

PART 1: INTRODUCTION ; 1.1 Background ; 1.2 Why psychiatric diagnosis and classification? ; 1.3 A brief personal history of nosological controversy ; 1.4 Defining 'values' ; 1.5 Overview of the book ; PART 2: METHODS ; 2.1 Background ; 2.2 Kuhn on scientific theory change ; 2.3 Values, value terms and value semantics ; 2.4 Five heuristic types of values ; 2.5 Unravelling the dense fabric of values ; PART 3: SCIENCE ; 3.1 Background - relations between medicine and science ; 3.2 Basics of classification ; 3.3 Science and psychiatric nosology ; PART 4: PATIENTS, PROFESSIONS AND GUILD ; 4.1 Background ; 4.2 Patients ; 4.3 Professions ; 4.4 Guild interests and classification ; 4.5 Potential professional conflicts of interest in the DSMs ; 4.6 Weighing patient, professional and guild interests in the DSMs ; PART 5: SPACE, TIME AND BEING ; 5.1 Background ; 5.2 Defining mental disorder ; 5.3 World views, assumptions and ontological values ; 5.4 The constraint of ontological space - the transpersonal psychiatry critique ; 5.5 The constraint of ontological time - the developmentalist critique ; 5.6 Space and time recast - existential-phenomenological and social constructionist critiques ; 5.7 Three contrast cases for ontological values in psychiatry ; PART 6: SEX AND GENDER ; 6.1 Background: the declassification of homosexuality ; 6.2 Mad vs bad in the bedroom ; 6.3 Mental disorder diagnosis and women: what are the issues? ; 6.4 Discrimination and stigma as negative value- consequences ; 6.5 Gender concepts as entailed ontological values ; 6.6 Medicalization and eudaimonia ; PART 7: CULTURE ; 7.1 The cultural challenge to mental disorder classification ; 7.2 DSM-IV approaches to the problem of culture ; 7.3 Ten weird things about Western psychiatry ; 7.4 Relativism, absolutism, and cross-cultural DSMs ; 7.5 Toward an ethics of cross-cultural psychiatric diagnosis ; PART 8: GENETIC NOSOLOGY ; 8.1 Background ; 8.2 Barest essentials of psychiatric genetics ; 8.3 Psychiatric genetic nosology ; 8.4 Value-structure of genetic vs clinical nosology ; 8.5 Implications of a rising psychiatric genetic nosology ; PART 9: TECHNOLOGY ; 9.1 Background: Heidegger, Dreyfus and technology ; 9.2 Insights from the philosophy of technology ; 9.3 Psychiatric classification as technological ; 9.4 Poietic vs technological diagnostic practice ; 9.5 Toward a balanced poietic-technological practice ; PART 10: POLITICS ; 10.1 Political meanings ; 10.2 The politics-science dichotomy syndrome ; 10.3 Externalist political landscapes and classification ; 10.4 Toward a political architecture for DSM-IV ; 10.5 Good politics for science and classification ; PART 11: VALUES AND PSYCHIATRIC DIAGNOSIS ; 11.1 What is diagnosis? ; 11.2 A gardener's allegory and the point of mental disorder classification ; 11.3 Grasping the whole of values in classification ; 11.4 Just how did values guide action in the DSM-IV? ; 11.5 Just how should values guide action in future DSMs?

Reviews

As one who has little formal training in philosophy, but who has been practicing philosophy without a license (as do, surely, many respected colleagues who resort to the DSM codes primarily for reimbursement), I celebrate the birth of this book and wish it well. People in the field are all amateur philosophers, and they can use some professional help. The book would serve for a semester course in the last year of college and in graduate school. Every psychiatric residency and clinical psychology program should devote at least an annual grand rounds or case conference to this work. It should be required reading for anyone who has anything to do with the current use and the future development of the DSM. PsycCRITIQUES, Vol 50, No 15 This is a well written and rigorous examination of values and their effects on psychiatric diagnosis. It is complex and not intended for the casual reader. The author does an excellent job of explaining the philosophical language that he applies throughout the book and breaking down societal values into their core elements. His insights are provocative and compelling. He demonstrates the richness that can be psychiatry and suggests methods of improving both clinical practice and theory in light of the value judgements that are a part of classifying mental illness. Doody's Journal John Sadler mounts a persuasive argument that values, usually seen as subjective (and therefore fallable), are impossible to separate from those concepts, even facts , we consider objective ... The bulk of his discussion concerns the Diagnostic and Statistical Manual of Mental Disorders and the ontological assumptions - as Sadler puts it, assumptions about the way things are - that underlie its efforts. He offers us what he calls an alternative path , to better enable diagnosticians in understanding their own cultural assumptions and biases. This is no abstract exercise, especially now, when, as Sadler notes, the term 'values' is often used to shore up all sorts of political agendas, social reform intentions, and voter turnout . It's a bracing approach, challenging to all struggling to reconcile the needs of clinical practice with the unsettling fear that categorisations of any sort merely serve the collective interest. The Lancet

Advance praise for Values and Psychiatric Diagnosis: `One thinks of the great cartographers at work in reading Dr Sadler's exploration of the values embedded in current psychiatric diagnostic classifications - the DSM-IV. This is a huge, ten-year, interdisciplinary undertaking. Usually, authors who cut across disciplines are at home in one, but inexpertly borrow from the others, their extractions somewhat derivative and impoverished. But Sadler enriches as he draws on science, clinical practice, cultural analysis, the history of science and philosophy. While exposing the changes in value assumptions in each of the successive DSMs through DSM-IV, Sadler doesn't unmask and demean the profession of psychiatry, but shows how it can grow rather than devour itself in its value permutations.' William F May, Fellow of the Institute for Practical Ethics and Public Life, University of Virginia `At last we have in-depth understanding of the controversies that underline the passionate disagreements about the classification of mental disorders. If there is any doubt as to why psychiatry is the most fascinating and important specialty of medicine, Dr Sadler has put that to rest with this provocative in-depth discussion of the values that are intrinsic to psychiatry.' Steven S Sharfstein, President-Elect of the American Psychiatric Association `The long awaited volume is a worthy successor to John Sadler's ground-braking previous research on values in diagnostic classification. Impeccably argued and researched, Values and Psychiatric Diagnosis will prove an indispensable tool for anyone wishing to understand the nature, and importance, of psychiatry. In a readable, clear and unadorned style, Sadler skilfully develops his case that psychiatry is a value-saturated practice and persuades us that rather than its weakness, this is psychiatry's great strength.' Jennifer Radden, Professor of Philosophy, University of Massachusets, Boston, USA `Values and Psychiatric Diagnosis is interdisciplinary scholarship at its best. A wide range of readers will find this work filled with insights that Sadler's lively, yet precise writing style makes readily available. Sadler's analysis is clear and compelling. In this work, complex technical questions are discussed with wit and wisdom. Sadler has managed to define the function and significance of values across the entire field of psychiatric diagnosis; he has written a reliable guide to the wide range of issues involved.' George J Agich, Chair Bioethics, Cleveland Clinic Foundation, Cleveland, USA

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