OVERVIEW

• FOCUS ON M.I. AS SOCIAL CATEGORY NOT ON PEOPLE WITH M.I.

• HOW GROUPS CREATE, USE, AND EXPAND CATEGORIES OF M.I.

• PROFESSIONAL, FAMILY, ECONOMIC• EXAMPLES OF SEXUAL DYSFUNCTION,

SOCIAL ANXIETY, AUTISM, ADD

FINDINGS

• 43 % OF WOMEN AND 31% OF MEN HAVE SEXUAL DYSFUNCTION

• VERY WIDESPREAD PUBLIC HEALTH PROBLEM

• PEOPLE MUST KNOW THAT MEDICATIONS ARE AVAILABLE TO HELP

DSM SYMPTOMS

• LACK INTEREST IN SEX

• ANXIETY ABOUT PERFORMANCE

• AROUSAL DIFFICULTIES

• UNABLE TO HAVE ORGASM

• CLIMAX TOO QUICKLY

• FIND SEX PAINFUL

• SEX NOT PLEASURABLE

SEXUAL DYSFUNCTION

• BEST PREDICTOR?

• LOW SATISFACTION WITH PARTNER

• PEOPLE WHO DON’T ENJOY SEX WITH PARTNERS ARE CALLED MENTALLY ILL AND SHOULD TAKE MEDICATION

FINDINGS

• FIRST APPEARED IN DSM-III (1980)

• FIRST STUDY - “COMPELLING DESIRE” TO AVOID SITUATIONS – 2.75% PREVALENCE IN 1984

• NCS – “UNREASONABLY STRONG FEAR” – 13.3% PREVALENCE IN 1994

WHY PERPETUATED?

• PERPETUATED BECAUSE BENEFITS PARTICULAR GROUPS

• PHARMACEUTICAL COMPANIES

• RESEARCHERS

• CONSUMERS

AUTISM

• 273% INCREASE FROM 1990-2000

• BELIEF IN AUTISM EPIDEMIC

• SEARCH FOR CAUSES (E.G. VACCINATION)

GERNSBACHER

• BEFORE 1990, NOT EVEN REPORTED

• RISE TOO GREAT TO BE BELIEVABLE

• IN FACT, EXPANDED DSM CRITERIA MAKE IT EASIER TO GET DIAGNOSIS

• BENEFITS FROM DIAGNOSIS STARTING IN 1991 (IDEA)

AUTISM

• ADVANTAGES FROM DIAGNOSIS FOR FAMILIES

• COALESCE INTO SOCIAL MOVEMENT

• IMPORTANCE OF LAY GROUPS IN PROMOTING DIAGNOSIS

ADD DIAGNOSES 1980 - 2000

0

500,000

1,000,000

1,500,000

2,000,000

2,500,000

3,000,000

3,500,000

4,000,000

4,500,000

1980 1990 2000

PRESCRIPTIONS FOR METHYLPHENIDATE

02,000,0004,000,000

6,000,0008,000,00010,000,000

12,000,00014,000,00016,000,00018,000,000

20,000,000

1990 2000

REASONS

• 1991 CHANGE IN FEDERAL DISABILITY POLICY

• FAMILIES – ENHANCE PERFORMANCE, CONTROL BEHAVIOR

• TEACHERS – MORE CONTROL IN CLASSROOM

• DRUG COMPANIES• LAY GROUPS - CHADD

BENEFITS

• BETTER ACADEMIC PERFORMANCE

• BOOST SELF-ESTEEM

• HELP PARENTS AND TEACHERS

COSTS

• EFFECT OF LONG-TERM MEDICATION REGIME

• STIGMA?

• ABUSE OF DIAGNOSIS

SUMMARY

TREMENDOUS RECENT RISE IN RATES OF TREATED M.I.

INFLUENCE OF PHARMACEUTICAL CO.

INFLUENCE OF FAMILY GROUPS

INFLUENCE OF DSM

BENEFITS AND COSTS