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"Horwitz, Allan V."
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Personality Disorders
The fascinating and controversial history of personality disorders.The concept of personality disorders rose to prominence in the early twentieth century and has consistently caused controversy among psychiatrists, psychologists, and social scientists. In Personality Disorders, Allan V. Horwitz traces the evolution of defining these disorders and the historical dilemmas of attempting to mold them into traditional medical conceptions of disorder. Using the Diagnostic and Statistical Manual of Mental Disorders, or DSM, as a guide, Horwitz explores the group of conditions that make up personality disorders and considers when they have been tied to or separated from other types of mental illnesses. He also examines how these disorders have often entailed negative moral and cultural evaluations more focused on perceived social deviance than on actual medical conditions. Deep conflicts exist in a variety of disciplines in determining the nature of these disorders. During the twentieth century, a particularly sharp division arose between researchers who study personality disorders and the clinicians who treat them. Because researchers strive to develop general laws and clinicians attempt to understand individuals' specific problems, their values, methods, and goals often conflict. Synthesizing historical and contemporary scholarship, Horwitz examines controversies over the definitions and diagnoses of personality disorders and how the perception of these illnesses has changed over time.
eBook
Distinguishing distress from disorder as psychological outcomes of stressful social arrangements
Some studies in the sociology of stress conceptualize their outcome variables as distress, while others treat the same outcomes as mental disorder. This article focuses on the importance of distinguishing between the two. It argues that there are fundamental differences between distress that arises in non-disordered persons and genuine mental disorder but that studies of stress typically fail to distinguish between these conditions. The article outlines the historical developments that led the field to conflate distress and disorder. Finally, it indicates some advantages for research, treatment and policy that can accrue when distress that is initiated and maintained by social conditions is distinguished from mental disorders that are dysfunctions of internal psychological mechanisms.
Journal Article
What's normal? : reconciling biology and culture
\" Since the emergence of Western philosophy and science among the classical Greeks, debates have raged over the relative significance of biology and culture on an individual's behavior. Today, recent advances in genetics and biological science have pushed most scholars past the tired nature vs. nurture debate to examine the ways in which the natural and the social interact to influence human behavior. In What's Normal?, Allan Horwitz brings a fresh approach to this emerging perspective. Rather than try to solve these issues universally, Horwitz demonstrates that both social and biological mechanisms have varying degrees of influence in different situations. Through case studies of human universals such as incest aversion, fear, appetite, grief, and sex, Horwitz first discusses the extreme instances where biology determines behavior, where culture dominates, and where culture overrides basic biological instincts. He then details the variety of ways in which genes and environments interact; for instance, the primal drive to eat and store calories when food supplies were scarce and behavioral patterns in a society where food is abundant and obesity stigmatized. Now that it's often easier to change our biology rather than our culture, an understanding of which behaviors and traits are simply normal or abnormal, and which are pathological or necesitate treatment is more important than ever. Wide-ranging and accessible, What's Normal? provides a crucial guide to the biological and social bases of human behavior at the heart of these matters. \"-- Provided by publisher.
Book
Sequencing and Its Consequences: Path Dependence and the Relationships between Genetics and Medicalization
Both advocacy for and critiques of the Human Genome Project assume a self-sustaining relationship between genetics and medicalization. However, this assumption ignores the ways in which the meanings of genetic research are conditional on its position in sequences of events. Based on analyses of three conditions for which at least one putative gene or genetic marker has been identified, this article argues that critical junctures in the institutional stabilization of phenotypes and the mechanisms that sustain such classifications over time configure the practices and meanings of genetic research. Path dependence is critical to understanding the lack of consistent fit between genetics and medicalization.
Journal Article
The Impact of Childhood Abuse and Neglect on Adult Mental Health: A Prospective Study
This paper examines the impact of three types of victimization in childhood- sexual abuse, physical abuse, and neglect-on lifetime measures of mental health among adults. In contrast to research that relies on retrospective recall of childhood victimization, this work uses a prospective sample gathered from records of documented court cases of childhood abuse and neglect in a midwestern city around 1970. These subjects were interviewed about twenty years later. In addition, this research compares outcomes of the 641 members of the abuse and neglect group with a matched control group of 510 persons who did not have documented cases of abuse or neglect. The results indicate that men who were abused and neglected as children have more dysthymia and antisocial personality disorder as adults than matched controls, but they did not have more alcohol problems. Abused and neglected women report more symptoms of dysthymia, antisocial personality disorder, and alcohol problems than controls. After controlling for stressful life events, however, childhood victimization had little direct impact on any lifetime mental health outcome. This research indicates the importance of adopting an approach that places childhood victimization in the context of other life stressors and of prospective changes over the life course.
Journal Article
Diagnosis, Therapy, and Evidence
Employing historical and contemporary data and case studies, the authors also examine tonsillectomy, cancer, heart disease, anxiety, and depression, and identify differences between rhetoric and reality and the weaknesses in diagnosis and treatment.
eBook
DSM : a history of psychiatry's bible
The first comprehensive history of \"psychiatry's bible\"—the Diagnostic and Statistical Manual of Mental Disorders.
Over the past seventy years, the Diagnostic and Statistical Manual of Mental Disorders, or DSM, has evolved from a virtually unknown and little-used pamphlet to an imposing and comprehensive compendium of mental disorder. Its nearly 300 conditions have become the touchstones for the diagnoses that patients receive, students are taught, researchers study, insurers reimburse, and drug companies promote. Although the manual is portrayed as an authoritative corpus of psychiatric knowledge, it is a product of intense political conflicts, dissension, and factionalism. The manual results from struggles among psychiatric researchers and clinicians, different mental health professions, and a variety of patient, familial, feminist, gay, and veterans' interest groups. The DSM is fundamentally a social document that both reflects and shapes the professional, economic, and cultural forces associated with its use.
In DSM, Allan V. Horwitz examines how the manual, known colloquially as \"psychiatry's bible, \" has been at the center of thinking about mental health in the United States since its original publication in 1952. The first book to examine its entire history, this volume draws on both archival sources and the literature on modern psychiatry to show how the history of the DSM is more a story of the growing social importance of psychiatric diagnoses than of increasing knowledge about the nature of mental disorder. Despite attempts to replace it, Horwitz argues that the DSM persists because its diagnostic entities are closely intertwined with too many interests that benefit from them.
This comprehensive treatment should appeal to not only specialists but also anyone who is interested in how diagnoses of mental illness have evolved over the past seven decades—from unwanted and often imposed labels to resources that lead to valued mental health treatments and social services.
eBook