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Layering Control: Medicalization, Psychopathy, and the Increasing Multi-institutional Management of Social Problems

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Handbook of the Sociology of Health, Illness, and Healing

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Abstract

Scholars interested in the medicalization of deviance tend to draw a clear line between major institutions of social control – namely law, religion, and medicine – and describe a process whereby medicine becomes more dominant than other institutions in terms of defining and controlling problematic behavior (Friedson [1970]1988). This is not surprising, as the study of the medicalization of deviance has been primarily about a shift in both the definition and the locus of control of a problem from one institutional domain into another (Conrad 1975; Conrad and Schneider [1980]1992). However, some forms of deviant behavior cross-cut institutional arenas and the medicalization of these problems happen concurrently with other institutional controls, such as increased criminalization of mental illness, or the reverse, increased medicalization of criminal behavior (Hiday 1999). Instead of nudging aside law and religion in favor of medicine, these cases demonstrate the layering of institutional control and the increasing multi-institutional management of social problems.

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Notes

  1. 1.

    Conduct Disorder is a diagnostic category similar to APD, but applied to children under the age of 18.

  2. 2.

    The tension that this issue has caused may well lead to changes in the criteria that will be adopted in the DSM V, currently scheduled for 2013. At least two workgroups, the ADHD and Disruptive Behavior Disorders Work Group and the Personality and Personality Disorders Work Group, are considering related issues.

  3. 3.

    Two illustrative letters to the editor in the New York Times illustrate this perceived misuse and correction: one written by Jack Olsen, Feb 26, 1986, “Psychotic or Psychopathic” and another written by Janet Hebb, March 17, 1991, “Psychopaths on film; What’s in a Name?”

  4. 4.

    Researchers also hope that studying psychopathy in children can contribute to the understanding of the developmental pathways that lead to adult psychopathy (Lynam et al. 2009). The most commonly used assessment tools for identifying psychopathic traits in children and adolescents (Campbell et al. 2009) include the Antisocial Process Screening Device (Frick and Hare 2001), the Childhood Psychopathy Scale (Lynam 1997), and the Youth Psychopathic Traits Inventory (Andershed et al. 2002).

  5. 5.

    The large majority of the studies mentioned rely on the PCL-R to identify their “test” (e.g., psychopathic individuals) and control populations and most, but not all (i.e., Raine et al. 2004; Blair et al. 2001) recruit their “test” subjects from forensic settings.

  6. 6.

    The Ethics Guidelines for the Practice of Forensic Psychiatry states that: “Forensic psychiatrists practice at the interface of law and psychiatry, each of which has developed its own institutions, policies, procedures, values, and vocabulary. As a consequence, the practice of forensic psychiatry entails inherent potentials for complications, conflicts, misunderstandings and abuses” (Source: http://www.aapl.org/pdf/ethicsgdlns.pdf, accessed January 27, 2010).

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  1. Department of Sociology, Indiana University, Ballantine 744, Bloomington, IN, 47405, USA

    Tait R. Medina

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  2. Ann McCranie
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  1. Institute of Social Research, Indiana University, E. Third Street 1022, Bloomington, 47405, Indiana, USA

    Bernice A. Pescosolido

  2. Institute of Social Research, Indiana University, E. Third Street 1022, Bloomington, 47405, Indiana, USA

    Jack K. Martin

  3. Institute of Social Research, Indiana University, E. Third Street 1022, Bloomington, 47405, Indiana, USA

    Jane D. McLeod

  4. , National Primary Care Research and Devel, The University of Manchester, Oxford Street, Manchester, M13 9PL, United Kingdom

    Anne Rogers

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Medina, T.R., McCranie, A. (2011). Layering Control: Medicalization, Psychopathy, and the Increasing Multi-institutional Management of Social Problems. In: Pescosolido, B., Martin, J., McLeod, J., Rogers, A. (eds) Handbook of the Sociology of Health, Illness, and Healing. Handbooks of Sociology and Social Research. Springer, New York, NY. https://doi.org/10.1007/978-1-4419-7261-3_8

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