A Behavioral Approach to Mental Disorders

Philip had a kidney transplant on Wednesday, after eleven years on dialysis. He is temporarily off the air, but hopes to be back in a week to ten days. Best wishes.

It was widely reported last week that James Holmes, the alleged cinema shooter, will be pursuing a “mental illness” defense. Details are scarce because the judge has issued a gag order, but it is likely, given the available information, that the lawyers will argue that because of his psychiatric history he is incompetent to stand trial. It is also likely that they will bring in some eminent psychiatrist(s) who will confirm his “diagnosis” and claim that at the time of the offense he didn’t know what he was doing, or something similar. ...

A regular reader has sent me a link to an article in Mail Online called “British scientist caught smuggling drugs ‘for Miss Bikini World’ blames it on his ‘gullibility disorder.’” Apparently Paul Frampton, an eminent British physicist currently working at the University of North Carolina, established a relationship on an online dating site with a person whom he says he believed was Miss Bikini World 2007. He flew to La Paz, Bolivia, to meet her. Of course she wasn’t there, but a nice gentleman gave him “her” suitcase and asked if he’d be kind enough to take it to Buenos Aires. ...

The current issue of the National Psychologist (July/August 2012) has an interesting article about the impending introduction in Australia of mental health checks for three-year-olds. The examinations are part of a nationwide, government-funded program called Healthy Kids Check. (Doesn’t that sound good?) The program, which will be voluntary, is supported by the Australian Medical Association. The idea, of course, is to scoop children into the mental health maw at an early age, ensuring them client-for-life status. ...

I came across an interesting article the other day. It Is Time to Rename the DSM, by Bruce A. Thyer, PhD, Florida State University, Ethical Human Psychology and Psychiatry, Vol 8, No. 1, Spring 2006 Dr. Thyer points out that although the DSM claims to be atheoretical, its contention that the various “mental illnesses” reside within the individual, as opposed, for instance, to being understandable reactions to adverse life events, is in itself a theoretical stance. Dr. Thyer also points out that in the manual’s description of conduct disorder there is a little known (and in my experience even less used) caveat to the effect that this so-called diagnosis should not be assigned if the misbehavior is “…simply a reaction to the immediate social context.” This is laudable, of course, on the part of the APA, but Dr. Thyer goes on to pose the obvious question: Why is this exclusion not applied to all the conditions listed? He then answers his own question: Because “…if this practice was followed, the very concept of mental disorders threatens to evaporate, in favor of viewing these as environmentally driven phenomena.” ...

De-Medicalizing Misery, edited by Mark Rapley, Joanna Moncrieff, and Jacqui Dillon This book is a collection of papers by various authors, most of whom have experience working with clients and are also associated with prestigious British universities. Here are some quotes: “The architects of modern biological psychiatry have constructed a system that does little justice to the myriad problems it claims to address, while creating multiple iatrogenic problems for those to whom it is applied.” (p 1) ...

A few days ago it was reported in the media that the defense lawyers representing Jerry Sandusky, the football coach accused of sexually molesting young boys, plan to present evidence that he has histrionic personality disorder, and to argue that this should be accepted as a mitigating factor. The logic here is sound. Most jurisdictions accept the presence of a bona fide illness as a mitigating factor – sometimes to the point of total exculpation. Consider the case of a middle-aged man who has a heart attack while driving a car. He passes out and the car, out of control, kills someone. In cases like this the driver frequently isn’t even charged. ...

I have been writing this blog for the past three years. The primary concepts are scattered throughout the blog, and I thought it might be helpful to draw together the essential underlying concepts in one post. Some of this repeats material covered under the individual “diagnoses,” and for this I apologize to my regular readers, but the notion that there are no mental illnesses (which I repeat regularly) is unorthodox and warrants clarification. ...

Christopher Lane has a post up on Psychology Today (May 14 2012) called: DSM-5 Is Diagnosed, With a Stinging Rebuke to the APA. About a year ago, the APA announced the new “diagnoses” that they proposed to include in the upcoming DSM-5. This kind of expansion is nothing new. The APA has been engaged in the medicalization of every conceivable human problem for the past 50 or 60 years. But on this occasion, some of their more creative and potentially damaging creations generated a good deal of fairly vocal opposition. The upshot of this is a decision by the APA to drop two of the more contentious “diagnoses:” - “attenuated psychosis syndrome” and “mixed anxiety and depression.” ...

Yahoo News recently ran an Associated Press article with the above heading. Here are some quotes: Disturbing new research says the number of U.S. babies born with signs of opiate drug withdrawal has tripled in a decade because of a surge in pregnant women's use of legal and illegal narcotics, including Vicodin, OxyContin and heroin, researchers say. The number of newborns with withdrawal symptoms increased from a little more than 1 per 1,000 babies sent home from the hospital in 2000 to more than 3 per 1,000 in 2009, the study found. More than 13,000 U.S. infants were affected in 2009, the researchers estimated. ...