‘Emerging severe personality disorder’ in childhood: the reification and rhetorical functions of a proposed developmental disorder

Hdl Handle:
http://hdl.handle.net/10142/321994
Title:
‘Emerging severe personality disorder’ in childhood: the reification and rhetorical functions of a proposed developmental disorder
Authors:
Clark, Dawn
Abstract:
This research employed Discursive Psychology and some Foucaudian concepts to explore discourses concerning proposals for ‘Emerging Severe Personality Disorder’ (ESPD) to interrogate potential ‘effects in the real’ for patients, clinicians and approaches to psychological interventions. The constructivist review of literature explores reification processes in propositions for ESPD in a brief reconsideration of historical ‘personality disorder’ discourses with a particular focus towards UK policy. This traces ESPD’s inextricable links to revival of the ‘psychopathy’ construct via invention of the ‘psychopathy checklist’, policy-makers ‘Dangerous and Severe Personality Disorder’ (DSPD) terminology and the ‘interventionist imperatives’ in youth justice driven by the Crime and Disorder Act (1998). Fourteen interviews highlighted rhetorical strategies by which practitioners worked up their epistemological entitlements to use ESPD appropriately by undermining entitlements of others. Some demonstrated autonomy by refusing to use the term ESPD at all. Other practitioners positioned those ‘outside mental health’ as potentially misusing ESPD while erroneously reifying it themselves as a formal ‘diagnosis’ or something that children ‘are’. Associated repertoires concerned iatrogenic or exclusionary ‘effects in the real’ linked to frustration at being ‘forced’ by the government to work with the ‘untreatable’. Ideological dilemmas arose throughout, most notably where practitioners who were concerned the label ESPD could exclude children from treatment discursively excluded ‘high-risk’ older children with beliefs ‘early intervention’ only. This saw children subject positioned similarly to their historically assumed ‘untreatable’ adult counterparts with ‘personality disorder’ diagnoses rather than being ‘at risk of’. A final ideological dilemma arose for practitioners as many believed in ‘early intervention’ but conceded that risk prediction in psychiatry was unreliable and could lead to over use of ESPD, with potentially damaging outcomes. The review and analysis are discussed in terms of bringing about a new version of ESPD’s reification with emphasis on encouraging further discussion concerning potential objectification of future ESPD category recipients, assumed ‘prognosis’, advances towards clinical intervention and issues regarding possible further exclusion from services or residential care. It is argued studies with a discursive focus can investigate labelling concerns in ways which positivist methodologies in the medico-legal approach fail to and that this embraces counselling psychology’s historical aims towards ‘social justice’ in its (assumed) critical approach to psychopathology which, (if it has one at all) is consistently tested in this current political climate of ‘evidence-based practice’.
Publisher:
Roehampton University
Issue Date:
6-Jan-2014
URI:
http://hdl.handle.net/10142/321994
Type:
Thesis or dissertation
Language:
en
Appears in Collections:
PhD Theses

Full metadata record

DC FieldValue Language
dc.contributor.authorClark, Dawnen
dc.date.accessioned2014-06-19T10:23:03Z-
dc.date.available2014-06-19T10:23:03Z-
dc.date.issued2014-01-06-
dc.identifier.urihttp://hdl.handle.net/10142/321994-
dc.description.abstractThis research employed Discursive Psychology and some Foucaudian concepts to explore discourses concerning proposals for ‘Emerging Severe Personality Disorder’ (ESPD) to interrogate potential ‘effects in the real’ for patients, clinicians and approaches to psychological interventions. The constructivist review of literature explores reification processes in propositions for ESPD in a brief reconsideration of historical ‘personality disorder’ discourses with a particular focus towards UK policy. This traces ESPD’s inextricable links to revival of the ‘psychopathy’ construct via invention of the ‘psychopathy checklist’, policy-makers ‘Dangerous and Severe Personality Disorder’ (DSPD) terminology and the ‘interventionist imperatives’ in youth justice driven by the Crime and Disorder Act (1998). Fourteen interviews highlighted rhetorical strategies by which practitioners worked up their epistemological entitlements to use ESPD appropriately by undermining entitlements of others. Some demonstrated autonomy by refusing to use the term ESPD at all. Other practitioners positioned those ‘outside mental health’ as potentially misusing ESPD while erroneously reifying it themselves as a formal ‘diagnosis’ or something that children ‘are’. Associated repertoires concerned iatrogenic or exclusionary ‘effects in the real’ linked to frustration at being ‘forced’ by the government to work with the ‘untreatable’. Ideological dilemmas arose throughout, most notably where practitioners who were concerned the label ESPD could exclude children from treatment discursively excluded ‘high-risk’ older children with beliefs ‘early intervention’ only. This saw children subject positioned similarly to their historically assumed ‘untreatable’ adult counterparts with ‘personality disorder’ diagnoses rather than being ‘at risk of’. A final ideological dilemma arose for practitioners as many believed in ‘early intervention’ but conceded that risk prediction in psychiatry was unreliable and could lead to over use of ESPD, with potentially damaging outcomes. The review and analysis are discussed in terms of bringing about a new version of ESPD’s reification with emphasis on encouraging further discussion concerning potential objectification of future ESPD category recipients, assumed ‘prognosis’, advances towards clinical intervention and issues regarding possible further exclusion from services or residential care. It is argued studies with a discursive focus can investigate labelling concerns in ways which positivist methodologies in the medico-legal approach fail to and that this embraces counselling psychology’s historical aims towards ‘social justice’ in its (assumed) critical approach to psychopathology which, (if it has one at all) is consistently tested in this current political climate of ‘evidence-based practice’.en
dc.description.provenanceSubmitted by Sarah-Louise Hall (sarah-louise.hall@roehampton.ac.uk) on 2014-06-19T10:22:20Z No. of bitstreams: 3 DAWN CLARK PSYCHD ESPD THESIS.pdf: 1514139 bytes, checksum: 5628db78cc0b25060feefa8a3145b752 (MD5) license_text: 21753 bytes, checksum: 33cf0001a25ca1ed06c2f13d62a9011b (MD5) license_rdf: 23148 bytes, checksum: 9da0b6dfac957114c6a7714714b86306 (MD5)en
dc.description.provenanceApproved for entry into archive by Sarah-Louise Hall (sarah-louise.hall@roehampton.ac.uk) on 2014-06-19T10:23:02Z (GMT) No. of bitstreams: 3 DAWN CLARK PSYCHD ESPD THESIS.pdf: 1514139 bytes, checksum: 5628db78cc0b25060feefa8a3145b752 (MD5) license_text: 21753 bytes, checksum: 33cf0001a25ca1ed06c2f13d62a9011b (MD5) license_rdf: 23148 bytes, checksum: 9da0b6dfac957114c6a7714714b86306 (MD5)en
dc.description.provenanceMade available in DSpace on 2014-06-19T10:23:03Z (GMT). No. of bitstreams: 3 DAWN CLARK PSYCHD ESPD THESIS.pdf: 1514139 bytes, checksum: 5628db78cc0b25060feefa8a3145b752 (MD5) license_text: 21753 bytes, checksum: 33cf0001a25ca1ed06c2f13d62a9011b (MD5) license_rdf: 23148 bytes, checksum: 9da0b6dfac957114c6a7714714b86306 (MD5) Previous issue date: 2014-01-06en
dc.language.isoenen
dc.publisherRoehampton Universityen
dc.title‘Emerging severe personality disorder’ in childhood: the reification and rhetorical functions of a proposed developmental disorderen
dc.typeThesis or dissertationen
dc.type.qualificationnamePsychD Counselling Psychologyen
dc.type.qualificationlevelDoctoralen
dc.subject.keywordPsychD-
This item is licensed under a Creative Commons License
Creative Commons
All Items in RURR are protected by copyright, with all rights reserved, unless otherwise indicated.