UC Santa Cruz

This dissertation explores the entanglement of ethics and epistemology in the domain of psychiatric research, considering the ways that measurement practices and ethical values interrelate. If psychiatric clinicians, researchers, and patients are not acutely aware of the relationship between experimental configurations and the meaning of scientific data, unhealthy realities that take psychiatric constructs as fixed parts of nature will persist.

The core of this work consists of case studies on the emergence and stabilization of two psychiatric diagnostic categories, Attention Deficit Hyperactivity Disorder (ADHD) and Depersonalization Disorder (DPD). Carefully examining the experimental configurations employed in the measurement of psychiatric disorders, this study shows how the neurobiological description of a psychiatric disorder is produced by employing a broad array of measurement techniques including psychopharmacological interventions, neuropsychological assessments, self-rating scales, historical studies, behavioral observations, psychophysical apparatuses, brain scanning devices, guided interviews etc. The dependence of each of these techniques upon others demonstrates the highly contingent status of diagnostic categories.

The findings of this study include the claim that the current best-confirmed neurobiological description of ADHD, the catecholamine hypothesis, could not have been developed without the treatment and measurement of the disorder with psychostimulant medications. This observation and others suggest that the knowledge produced regarding psychiatric diagnostic categories needs to be carefully examined to avoid treatment plans that implement research data that is not well understood. I conclude that researchers, clinicians and patients are responsible for the data produced in scientific studies, and should therefore take a critical stance to conclusions drawn from scientific data when making decisions about treatment.