Ideology and Etiology

Engelhardt, H. Tristram

doi:10.1093/jmp/1.3.256

Cited by 140 publications

(26 citation statements)

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“…This distinction implies that there are at least two aspects of ill health; a theoretical and a clinical one (33,34,35). Recognizing that there are alternative interpretations of the concepts (see e.g.…”

Section: Medical and Lay Concepts Of Ill Healthmentioning

confidence: 99%

Towards a theory of perceived and medically defined need

Mägi

Allander²

1981

Sociology Health & Illness

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This paper presents a theoretical model to be used for comparative studies of lay and medically defined need for medical care. The model is based on an analysis of the concept of need and need statements, lay and medical concepts of ill health and the relationships between need, ill health and utilization of medical care. It is concluded, on both theoretical and empirical grounds, that need is relative to time, place and assessor. The most important determinants of assessments of for what and when one should seek medical attention are assumed to be the assessor's perception and valuation of the health status and his expectations of the probable out-come of medical care use. Assessment of need is seen as a process in which past experiences and expectations of the future course of the health status affect decision-making. It is emphasized that the points of view of both client and provider should be taken into consideration in medical practice, as well as in health care planning, because the two perspectives tend to be only partially congruent. The nature and extent of these incongruences could be studied by the application of the proposed model.

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Section: Medical and Lay Concepts Of Ill Healthmentioning

confidence: 99%

Towards a theory of perceived and medically defined need

Mägi

Allander²

1981

Sociology Health & Illness

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“…With the cause now identified, rou-tine water testing and microscopic assays can be used to track prevalence of Vibrio cholera. Ever since, the study of disease distribution (Last, 2001) and disease causation (Engelhardt, 1976) has been profitably juxtaposed within the framework of epidemiology.…”

Section: Discussionmentioning

confidence: 99%

Estimates & Implications of Obsessive Compulsive Personality Disorder (OCPD) Prevalence: OCPD as a Common Disorder with a Cosmopolitan Distribution or Rare Strategy with a Northerly Distribution?

Hertler

2015

PSYWRIT

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to fall between 2.1 and 7.9 percent, making it one of the most prevalent personality disorders in the general population. Yet, obsessive prevalence is reported without its significance being appreciated. After reviewing the estimates of several studies, this paper pursues the theme of obsessive prevalence, showing why it was ignored, how it changes etiological assumptions, and, in turn, how newly generated etiologies engender the understanding of obsessive prevalence. High prevalence, when paired with high heritability, undermines psychoanalytic etiologies and invalidates psychiatric classification, suggesting that OCPD is a rare type, rather than a common disorder. Following this, evolutionary theory is used to illustrate the conditions from which this rare phenotype arose, and the mechanistic laws that maintain it within its present proportions. As treated within the discussion section, high prevalence, when contextualized within an evolutionary explanatory paradigm, suggests an ecologically determined biogeography of OCPD.Key Words: Obsessive Compulsive Personality Disorder; Prevalence; Epidemiology; Evolution; Negative Frequency dependent Balancing Selection; Heritability.El DSM-V estima que la prevalencia del trastorno obsesivo-compulsivo oscila entre el 2,1 y el 7,9 por ciento, lo que lo convierte en uno de los trastornos de personalidad de mayor prevalencia en la población general. Sin embargo, la prevalencia del trastorno se suele publicar sin valorar las implicaciones de este hecho. Tras la revisión de las estimaciones que aparecen en varios estudios, este artículo analiza por qué se ha ignorado la prevalencia de este trastorno, cómo cambia este hecho los supuestos etiológicos y el modo en que las nuevas etiologías propuestas ayudan a comprender la prevalencia del trastorno obsesivo-compulsivo. La elevada prevalencia unida a la alta heredabilidad ponen en tela de juicio la etiología psicoanalítica e invalidan la clasificación psiquiátrica, y además sugieren que el trastorno obsesivo-compulsivo no es común, sino infrecuente. Siguiendo esta línea argumental, se utiliza la teoría evolucionista para ilustrar las condiciones bajo las que surge este fenotipo infrecuente y las leyes mecanicistas que lo mantienen en sus actuales proporciones. Tal y como se plantea en la discusión, cuando la elevada prevalencia del trastorno obsesivo-compulsivo se contextualiza dentro de un paradigma evolucionista, aflora la existencia de una biogeografía ecológicamente determinada de este trastorno.Palabras Clave: Trastorno de personalidad obsesivo-compulsivo; Prevalencia; Epidemiología; Evolución; Selección equilibrada dependiente de la frecuencia negativa; Heredabilidad. Disponible online 30 de abril de 2015

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“…Thinking of health and disease in terms of normality and abnormality not only brackets important normative aspects that are embedded in what constitutes an undesirable condition, but it also assumes that physiological descriptions have an ontological and epistemic primacy over and above other factors, including social and cultural factors (Margolis, 1976;Engelhardt 1975Engelhardt , 1976Goosens 1980 Nonetheless, the emphasis on the role of social values in health and disease ascriptions does not deter normativists from claiming that the proper unit of ascription is still the individual human being. Engelhardt, for example, notes, "there is an emphasis upon the individual, not the disease, as the reality in the illness" (1975,131).…”

Section: Section 12 Normativism and Individualismmentioning

confidence: 99%