Microsoft powerpoint - david pilgrim - hpp dsm.ppt [compatibility mode]

• Germ theory boosted confidence in role of ‘magic bullets’ for physical illness • Eugenic philosophy underpinned scientific medicine and reflected in Kraepelin’s work • Together they created a biomedical model based upon discrete categories of illness located in the body (the brain in the case of mental disorder) - Ontology and epistemology important and should be • Compounds known but not utilised (first approached sceptically avoiding both the naivety of psychiatric positivism and linguistic reductionism of - Generative mechanisms about both mental disorder and • Compounds for one condition found to forms of knowledge about it: what were the material • Chemical stocks after WW II appropriated - The entwined relationship between economic and and utilised (rocket propellant hydrazine ideological factors: facts and values cannot be separated • Strong Kraepelinian tradition preceded • Cognitive interests of biological psychiatry and ‘pharmacological revolution’ of 1950s commercial industry of Big Pharma become enmeshed when developing antipsychotics and • Early druggists sold potions, cosmetics • At first drug companies indifferent to brain disease theory but its advantages emerged in French) formed first part of the organic relation to the magic bullet possibilities of neurotransmitters researched: acetylcholine; glutamate; dopamine; noradrenaline; gamma-amino-butyric acid; endorphins; and serotonin • The strength of psychodynamic and social psychiatric models reflected in DSM I (1918) ICD-6 (1948) and DSM II (1968) threatened the companies to warrant their sale of magic • By the 1970s the drug company funded emphasis on magic bullets to alter named instate Kraepelin’s original epistemology (about • DSM III (1980) shifted to behavioural checklists • It confirms the neo-Kraepelinian constructs of and abandoned aetiologically-based diagnoses biological psychiatry (natural categories) and its • This negated the previous developmental assumption about mental abnormality as forms linkages from psychoanalysis or social causes • It individualises a wide range of deviations from • The substantive gain then was to establish social norms. This medicalisation affords power categorical targets for magic bullets and authority to biological psychiatrists (and some psychological therapists) • The drug companies outside of DSM could then expand aetiological assumptions about specific • It obscures the psycho-social context of brain diseases. DSM provided the marketable madness misery and personal dysfunction in targets and drug research provided the products both the past and the present. Problems then lay in defective individuals not their social context.
symbiosis between Big Pharma and biological psychiatry CBT could gain from its claims to drug equivalence • Hence naïve realism of CBT ‘for’ ‘GAD’, ‘OCD’, ‘panic disorder’, ‘depression’, ‘schizophrenia’ etc. etc. Note the complicity of clinical psychology with DSM

Source: http://www.spn.org.uk/fileadmin/SPN_uploads/Documents/DPilgrim.pdf