DSM-IV AND CONSTRUCTIVISM
Lindsay Oades ( (no email) )
3 Sep 1995 17:58:26 +1000
Following the circulation of "Some Unarticulated Premises in the Rhetorical
Construction of DSM Categories" and the plenary in Barcelona invlolving
Leitner, Winter, Viney & B. Neimeyer I have had several thoughts about DSM and
the possibility of nosologies in general. These thoughts constitute an ongoing
struggle for me as a graduate student with "constructivist tendencies" but
constrained within the traditional clinical psychological curriculum teaching
DSM-IV- onto which cognitive-behavioural researchers like to map their work.
Hence I have had several thoughts about what a "constructivist DSM" might look
like- realising that prima-facie, such a thing is in itself an oxymoron-
perhaps? What however is our alternative. I have thought of the following
ideas that could possibly guide such an endeavour:
1) Instead of being based on simple symptom listing and categorisation, the
"constructivist DSM" could employ 'professional constructs' defining disorder
in terms of imbalances between psychological processes - eg tight and loose
construing -a la Winter and Kelly
2) Instead of listing and categorising symptoms similarities and differences
in meanings of peoples experiences (and/ or the narratives they employ or are
employed about them) within the above defined 'disorders'.
3)The diagnostic process would aim in no way to adopt any quasi-realist feel.
That is, it would serve the purpose of a direction for assisting the client-
a transitive diagnosis- forming the basis of Leitner's dispositional
assessment.
4)"Being constructivist DSM", rather simply matching disorder with treatment
(and making the mistake of treating the therapist as a fixed-effect) it seems
that there would be more interest in matching client, therapist and treatment
approach by epistemic assumptions.
These are just a few initial ideas. What do people think?
Lindsay G Oades
Wollongong
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