Dissertation Research: (Un) Bounding DSM 300.3: Exploring the Negotiation of Obsessive Compulsive Disorder in Three Communities of Practice

University Of Illinois At Urbana-Champaign, Urbana IL

Investigators

Abstract

This Science and Society Social Studies of Science, Engineering, and Technology Program Dissertation Improvement Grant will provide research funding for a Ph.D student to help her complete her dissertation on the local negotiation of psychiatric diagnostic categories, in particular the discourses, technologies, and practices used in negotiations with obsessive compulsive disorder, and in turn, the novel subjectivities and social formations to which the category gives rise. Over the last twenty years the Diagnostic and Statistical Manual of Mental Disorders (DSM) -- a tool which provides standardized criteria for the diagnosis of psychiatric conditions -- has grown considerably in size and scope, a notable development since its definitions of mental disorders have become increasingly integral to the psychiatric conceptualization/management of mental suffering. While this trend has stimulated much research within the sociology of mental health, limited attention has been given to issues related to the category of obsessive compulsive disorder (OCD), even though OCD holds the reputation of being the fourth most common mental disorder found in the US population (Krochmalik & Menzies 2003: 18). OCD moreover is regarded as a chronic, poorly understood condition, meaning that, for many, dealing with a diagnosis signifies perpetual negotiation with the ambiguities inherent to this category. In addition to filling this substantive gap, this dissertation proposal seeks to extend technoscience studies of medical practices to the realm of psychiatric practices, redressing the shortage of empirical research on the use of [psychiatric] diagnoses (Manning 2001: 78). Examining local engagements with psychiatric diagnoses holds the potential to illuminate the utility of such categories, alternative modes of imagining and managing mental suffering (which, in the case of those who have received a psychiatric clinical diagnosis, often emerge through interactions with the official conceptualization), as well as lived experiences. This dissertation project proposes the following research question: How is obsessive compulsive disorder negotiated within and between three spaces through which it travels: the academic research laboratory, the clinic, and the lives of those who have been diagnosed as such? By examining negotiations within and between multiple communities, the dialectical processes through which the official ontology is reproduced, or alternative ontologies are imagined, can be studied. Funding for this proposal supports research expenses related to interviewing members of these communities, as well as travel expenses and fees required for participant-observation at the conferences and group therapy sessions attended by those who treat, and those diagnosed with, obsessive compulsive disorder. This dissertation makes a theoretical contribution to the sociology of mental health by opening a space for the study of the practices and material/discursive tools employed in the negotiation of psychiatric diagnostic categories; this study additionally seeks to prompt a return to qualitative empirical study of chronic mental disorders, which in the last few decades has been overshadowed by discursive studies of psychiatry and epidemiological studies of mental illness (Mulvaney 2001). Furthermore and as noted above, this study seeks to extend technoscience studies of medical practice to the field of psychiatric practice, thereby broadening the purview of this subdivision of science and technology studies. As for its broader impact, a critical, yet nondismissive, qualitative empirical study of a psychiatric category potentially will open a space for similar types of research, thereby (a) increasing the existing knowledge of psychiatric categories from the perspectives of those negotiating them, and (b) ultimately paving the way toward a greater collaboration between qualitative sociologists and mental health professionals, and thus potentially incorporating the results of empirical qualitative research into the design of clinical and/or community-based management practices.