tag:blogger.com,1999:blog-929120080777377869.post6618831325096057572..comments2024-02-19T02:33:16.495-08:00Comments on Psychodiagnosticator: What do you mean "invalid"?Huwtubehttp://www.blogger.com/profile/11269941937374416664noreply@blogger.comBlogger3125tag:blogger.com,1999:blog-929120080777377869.post-11247194132101874042016-10-13T13:19:23.479-07:002016-10-13T13:19:23.479-07:00At a practical level, my experience in an NHS area...At a practical level, my experience in an NHS area colonised by Crit Psy, was that if an SU was smart enough to understand the issues around validity and felt invalidated by an imposed formulation, then chances are she probably just wouldn't meet caseness criteria for intervention. Which meant Equivalence Fallacy FTW. There were more than enough people willing to have a formulation imposed on them, such that the odd pesky one clinging to any part of a diagnosis wouldn't be missed or heard. ;)<br /><br />Interesting to hear where the "invalid construct" debate began. Do you know the origins of the psychological formulation?<br /><br />I like the word "diagnosis". I'm sorry but I do. I think it rolls off the tongue deliciously and combines the elements of the mystical and the esoteric that seem to be equally present in both psychology and psychiatry.<br /><br />It's too bad that a "formulation" sounds like something you'd collect from a pharmacy after being diagnosed with an illness!<br /><br />anniesunshinehttps://www.blogger.com/profile/01198924323449455607noreply@blogger.comtag:blogger.com,1999:blog-929120080777377869.post-79691650665731197642016-10-12T17:20:41.995-07:002016-10-12T17:20:41.995-07:00Thankyou for this comment. It is always nice when ...Thankyou for this comment. It is always nice when someone has obviously read carefully and tried to understand what I am getting at. Perhaps I have been unclear here in what I intended to say so let me try and flesh it out better. We agree that many specific DSM diagnoses leave a lot to be desired in terms of psychometric validity. So the claim that "[X] diagnosis is invalid" makes sense in that context. What I wanted (but I think failed) to bring out is that there are people who would say "I have a diagnosis of [x]", and who would identify that diagnosis as making sense of their experience in a substantive way. Now, we still cannot avoid the fact that diagnosis [x] may not have validity in the professionally defined psychometric sense of that term. However, in the broader, dictionary sense of "valid", things are less clear cut. Is it invalid (in that latter sense) for a person to say "I have an illness called 'x'" where "x" is a psychiatric construct with poor *psychometric* properties? I feel uncomfortable saying it is. So I am left feeling that, absent a context in which it is clearly psychometric validity under discussion, it could be problemtic to simply say "[x] is an invalid term", as it can imply "[x] is an invalid way for anyone to describe or make sense of their experiences". That is why I try to bring out two senses of the term "invalid". I certainly agree with you that the validity debate is useful (in fact essential) for mental health professionals and I also agree it pertains to specific diagnoses, not an illness/non-illness divide. Thus, I don't *think* you have said anything I feel ideologically precluded from stating explicitly. You can point it out to me if I am wrong about that though - our own ideological positions are kind of hard to spot (how could it be otherwise?!).<br /><br />Thanks :-)<br /><br />Huwtubehttps://www.blogger.com/profile/11269941937374416664noreply@blogger.comtag:blogger.com,1999:blog-929120080777377869.post-39812161119245553402016-10-11T21:31:16.077-07:002016-10-11T21:31:16.077-07:00Hi
That's a very clear and concise explainer ...Hi<br /><br />That's a very clear and concise explainer of validity from a psychometric pov--offhand, I think it might be the best way to describe it to an audience that isn't familiar with all the ins and outs of the discussion (since DSM-III, as you rightly say).<br /><br />But I'm a bit confused as to the purpose of the remainder of your post. In that yes, the psychometric properties and discussions of invalidity might well be misunderstood. But IMO, the missing piece of the puzzle is the fact that mental illness isn't unitary. Nor ought it to be automatically invalidating the experience to be told that's one's distress doesn't represent a mental illness.<br /><br />What I think I'm trying to say are two things:<br /><br />1. Mental illness isn't unitary, and the validity of mental illness isn't often discussed as a cross-cutting broad term--it's the validity of /A/ specific mental disorder, say schizophrenia. <br /><br />2. this connects to the point above, because if one takes away the fuzzy mental disorder category set that's indefinable, or at least problematic to define, the residual is a general "distress" axis, to which mental illness is only one contributor.<br /><br />So the validity debate is useful for mental health professionals because it defines an illness as separate from other illnesses, as much as it divides Illness from Normalcy. because one presumes that each illness has some unique features whose identification would have additional value. Surely this needs to be stated? I wonder if you have a different ideological position, that militates against stating this explicitly. <br /><br />It's been a while since I put this in words, and I must admit my views on validity have evolved so much since I first entered med school. And I still find that its a slippery concept to grasp in all its dimensions.<br /><br />Thanks!vkhttps://www.blogger.com/profile/18431024402106146262noreply@blogger.com