New Disorders

[BPSDB]In his excellent book “Bad Science”, one of Ben Goldacre’s targets is the medicalising of social issues by both the pharmaceutical giants and the alternative pill peddlers. I was reminded of this recently when I read of a mother of a teenager who was claiming that giving him an ASBO was unfair because his medical condition was not being taken into account.

He had been given the usual warning that if he breached the terms of his ASBO he would wind up in the slammer (I’m paraphrasing slightly here). This was discriminatory, apparantly, because said teenager allegedly suffers from a condition that causes him to do the opposite of what those in authority tell him. It is called Oppositional Defiance Disorder (I swear I am not making this up but I strongly suspect somebody is).

I am not convinced that this disorder exists but it will be easy to test for. Expose a live high voltage wire in front of some ‘sufferers’ and order them on no account to touch said wire. It is my hypothesis that these ODD kids’ sense of self-preservation would take over. Somehow I don’t think I’ll get this past an ethics committee.

I have a niggling suspicion that this acronym was invented on the spur of the moment by a teacher (or possibly a social worker). I can visualise somebody writing of a pupil/client/customer “X is such an ODD child” (capitalising for emphasis), then, when taken to task for daring to use such judgemental language excusing him/herself by saying “ODD” is an acronym and inventing an appropriate disorder.

With that in mind, I thought I’d celebrate the end of term by inventing disorders that will allow you to use judgemental and non-PC words to describe your little cherubs.

DUMB = Defiance Underpinning Maladaptive Behaviour (this obviously is the American use of dumb to mean stupid rather than the British meaning of mute)

THICKO = Teach Holistically. Imbibes Concrete Knowledge Only

NUMPTIES = Nugatory Understanding May Prevent The Ideal Exam Standard. This works best in Scotland:- “Mr McTaggert will be teaching the NUMPTIES this year.”

If I think of anymore I’ll add them.

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2 Responses to “New Disorders”

  1. endlesspsych Says:

    I’m no aufait with the evidence base for ODD but what you describe isn’t it going by the diagnostic criteria.

    Interestingly a diagnosis of ODD includes the following:
    “Conduct disorder, usually occurring in younger children, primarily characterized by markedly defiant, disobedient, disruptive behaviour that does not include delinquent acts or the more extreme forms of aggressive or dissocial behaviour.”

    If the ASBO is for some delinquent behaviour (which seems likely) the young gent has just proven he doesn’t have ODD.

    Going by the DSM criteria I’d probably agree that this is an example of medicalisation:
    “Diagnostic Criteria
    A pattern of negativistic, hostile, and defiant behavior lasting at least 6 months, during which four (or more) of the following are present:
    Note: Consider a criterion met only if the behavior occurs more frequently than is typically observed in individuals of comparable age and developmental level.
    often loses temper
    often argues with adults
    often actively defies or refuses to comply with adults’ requests or rules
    often deliberately annoys people
    often blames others for his or her mistakes or misbehavior
    is often touchy or easily annoyed by others
    is often angry and resentful
    is often spiteful or vindictive
    The disturbance in behavior causes clinically significant impairment in social, academic, or occupational functioning.
    The behaviors do not occur exclusively during the course of a psychotic or mood disorder.
    Criteria are not met for conduct disorder, and, if the individual is age 18 years or older, criteria are not met for antisocial personality disorder.
    If the child meets at least four of these criteria, and they are interfering with the child’s ability to function, then he or she technically meets the definition of oppositionally defiant.”

  2. europhile Says:

    Could you tell them to go out and break windows and torture the neighbour’s cat? Then they might stay at home and do their homework.

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