4 ms·

The PCL-R is not part of the DSM, but it is framed in a similar way. http://en.wikipedia.org/wiki/Hare_Psychopathy_Checklist http://en.wikipedia.org/wiki/Hare_

The PCL-R is not part of the DSM, but it is framed in a similar way. http://en.wikipedia.org/wiki/Hare_Psychopathy_Checklist http://en.wikipedia.org/wiki/Hare_Psychopathy_Checklist There are definitely imperfections in the way psychiatric disorders are defined and diagnosed. Most of the difficulties happen in the edge cases. A person who scores a 0 or a "perfect 40" on the PCL is a pretty clear diagnosis. Interestingly, the signature of sociopathy (aka psychopathy) appears to have an organic basis - it can be observed via functional MRI. See, for example, the article about Dr Kent Kiehl in the New Yorker. http://www.newyorker.com/reporting/2008/11/10/081110fa_fact_seabrook?printable=true&currentPage=all http://www.newyorker.com/reporting/2008/11/10/081110fa_fact_...

lutusp 13y ago
> The PCL-R is not part of the DSM, but it is framed in a similar way. If psychology were a science, there would be precisely one catalog of mental conditions, not as many as there are people who care to publish their own list. And the catalog would list causes as well as effects, something famously absent in modern psychological practice. > There are definitely imperfections in the way psychiatric disorders are defined and diagnosed Imperfections? Psychiatrists and psychologists famously and consistently cannot agree on diagnoses, when confronted by the same subjects. The reason is that no one knows what causes these conditions, which makes psychological clinical practice an exercise in symptomatic relief. > Most of the difficulties happen in the edge cases. Asperger Syndrome was removed from DSM-5 because all the cases were edge cases -- the diagnosis had no objective validity whatsoever. This pattern is true for many similar conditions. Tom Widiger, who served as head of research for DSM-IV, says "There are lots of studies which show that clinicians diagnose most of their patients with one particular disorder and really don't systematically assess for other disorders. They have a bias in reference to the disorder that they are especially interested in treating and believe that most of their patients have." > Interestingly, the signature of sociopathy (aka psychopathy) appears to have an organic basis - it can be observed via functional MRI. If the work were more advanced (if it were anything more than a correlation), we might consider removing sociopathy from the domain of psychology and give it to neuroscience. But we won't get away with that -- psychologists are notoriously protective of their turf. Also, the "signature" to which you refer is a correlation, not a cause-effect relationship, it isn't definitive and it doesn't identify a source for the condition. And finally, present evidence suggests that all serious mental conditions are ultimately organic, so describing them as having an organic basis is sort of self-evident.

lutusp 13y ago

> The PCL-R is not part of the DSM, but it is framed in a similar way. If psychology were a science, there would be precisely one catalog of mental conditions, not as many as there are people who care to publish their own list. And the catalog would list causes as well as effects, something famously absent in modern psychological practice. > There are definitely imperfections in the way psychiatric disorders are defined and diagnosed Imperfections? Psychiatrists and psychologists famously and consistently cannot agree on diagnoses, when confronted by the same subjects. The reason is that no one knows what causes these conditions, which makes psychological clinical practice an exercise in symptomatic relief. > Most of the difficulties happen in the edge cases. Asperger Syndrome was removed from DSM-5 because all the cases were edge cases -- the diagnosis had no objective validity whatsoever. This pattern is true for many similar conditions. Tom Widiger, who served as head of research for DSM-IV, says "There are lots of studies which show that clinicians diagnose most of their patients with one particular disorder and really don't systematically assess for other disorders. They have a bias in reference to the disorder that they are especially interested in treating and believe that most of their patients have." > Interestingly, the signature of sociopathy (aka psychopathy) appears to have an organic basis - it can be observed via functional MRI. If the work were more advanced (if it were anything more than a correlation), we might consider removing sociopathy from the domain of psychology and give it to neuroscience. But we won't get away with that -- psychologists are notoriously protective of their turf. Also, the "signature" to which you refer is a correlation, not a cause-effect relationship, it isn't definitive and it doesn't identify a source for the condition. And finally, present evidence suggests that all serious mental conditions are ultimately organic, so describing them as having an organic basis is sort of self-evident.