The DSM wasn’t supposed to change all of culture—it was created to standardize hospital recordkeeping. Now, people use it to understand who they are and what to fix. Diagnostic labels have their uses, but they can also trap you. (View Highlight)
The DSM is a big deal today, but this wasn’t inevitable. DSM-I (1952) was mostly a bureaucratic and administrative effort to standardize hospital records. In day-to-day practice, most psychiatrists didn’t rely on it much (this was also true for DSM-II, 1968.) Hospital based psychiatry was in decline while outpatient talk therapy was on the rise. The real turning point came with DSM-III in 1980—not just in how disorders were classified, but in how the DSM itself became socially important. (View Highlight)
DSM
“diagnosis” as the formal act creating standardized categories—a “nosology,” in psychiatric jargon (View Highlight)
Nosología
The true paradigm shift—both within medicine and in society—was powerfully driven by forces beyond the profession: growing government involvement in mental health research and policy, mounting pressure from insurers, and the rise of the pharmaceutical industry, which needed specific diseases to market products. As Rick Mayes and Allan Horwitz argue, the DSM-III’s standardization was both cause and effect: it resulted from those pressures on the profession, and then that standardization brought further financial, professional, and intellectual benefits. A reinforcing feedback loop between the content of the manual and its social role ensued. (View Highlight)
Sobre cómo la explicación de la revolución del DSM se dio en la tercera versión a propósito de la relación de feedback positivo entre la estrategia nosológica de categorización sintomática en lugar de una “metapsicológica” y la as instituciones y mercados interesados en el diagnóstico de condiciones de salud mental.
Simply put, DSM-III gave psychiatry a common language that made its categories useful to insurers, researchers, epidemiologists, regulators, and pharmaceutical companies—and, soon enough, seemingly, to the rest of humanity. Once diagnosis became the shared language of research, clinical practice, and marketing, it naturally filtered into popular culture. That alignment of powerful forces—science, policy, commerce—is what made diagnosis culturally significant. Without that, the DSM is just a bunch of definitions in a book that few people bother to read. With it, DSM-III is instrumental in research, insurance coverage, public policy, law, self-understanding, and the day-to-day practice of medicine. (View Highlight)
with essentialist thinking—how people perceive psychiatric categories as more “real” than they really are. (View Highlight)
¿Habrá un concepto para hacer referencia a este fenómeno? Tiene algo de efecto Rumpelstiltskin en el sentido de que las personas asumen que se encontró una respuesta definitiva a su malestar, pero esto sólo se sostiene en una simplificación del estatus ontológico de las categorías diagnósticas.