NOTE: Abnormal psychology revolves around two major schools of thought to explain mental disorders: the “psychodynamic paradigm” and the “biological paradigm.” The psychodynamic paradigm focuses more on humanistic, cognitive and behavioral causes and effects, while the biological paradigm focuses on physical factors, such as genetics and neurochemistry.
The danger of inappropriate and/or ineffective treatment is in no way unique to the biological paradigm of psychopathology. (In the 1980’s therapists operating under the psychodynamic paradigm, inspired by reported links between sexual abuse and maladaptive behavior, convinced a number of patients that they had “repressed” memories of sexual abuse – events that, in most cases, never took place). However, backed by a profit-driven industry and supported by popular culture, the biological paradigm does threaten a distinct level of potential malpractice – a potential inherently fused with its pharmaceutical treatments: “designer drugs” (anti-psychotics, anti-depressants, mood stabilizers, and stimulants).
Just as diagnostic classifications pose the risk of oversimplification – of “inevitably los[ing] an array of personal details about the actual person who has the disorder” (Butcher et al.) – designer drugs also flirt with a dangerous temptation to generalize. As the authors of Abnormal Psychology point out, “the person is not the diagnosis.” There are a number of factors (including: specific history, personality traits, idiosyncrasies) that differentiate one patient from the next. Will the growing popularity of designer drugs (fueled by seemingly immediate results) overshadow the importance of these factors and instead lead to a one-size-fits-all treatment plan, based primarily on shorthand classifications? This potential is further exacerbated by the fact that patients are often treated by their family physician rather than by a mental health specialist. In this sense, concern for the individual intimates a larger danger facing each of the other paradigms of psychopathology: an eclipse of previously favored treatments and a disregard for variety of approach.
In “Ethical Issues in Educational Neuroscience: Raising Children in a Brave New World,” the authors argue that “there is a key distinction between raising children and designing children, and that the ethical application of neuroscience research to education critically depends upon ensuring that we are raising children.” While focusing on concerns unique to a school-aged population (i.e., mandated prescriptions in educational contexts), this article does suggest a vein of more relevant questioning: Will aversion to socially undesirable behavior lead to knee-jerk prescriptions of “quick fix” designer drugs? After all, evaluation of abnormal behavior depends heavily on societal norms. If society labels certain behavior “abnormal” and the solution is as simple as one or two pills, what type of ethical issues will this raise for medical professionals? And what type of pressure will it put on patients?
While the biological paradigm has made a number of exciting contributions to the field of psychopathology, a number of questions remain (i.e., What are the long-term effects of designer drugs? What is the proper balance of biological treatment for a comorbid patient?). However, despite these challenges, the paradigm itself is ripe with optimism.
Only time will tell what type of potential its designer drugs will fulfill.
Carson, S. (2010, September 7). Paradigms of Psychopathology and Diagnostic Issues. Lecture given in Abnormal Psychology, Harvard University, Cambridge, MA.
Stein, Z., della Chiesa, B. Hinton, C., Fischer, K.W. (forthcoming, 2010). Ethical issues in Educational Neuroscience: Raising Children in a Brave New World. Oxford Handbook of Neuroethics. (Illes & Sahakian, eds.) Oxford University Press.
Butcher, J., Hooley, J., and Mineka, S. (2010). Abnormal Psychology (14th ed.). Boston: Allyn and Bacon.
EDITOR”S NOTE: Article was originally written on assignment for Dr. Carson’s Abnormal Psychology course, Harvard University, 2010.