Agree with need for discriminative accuracy, too many one size fits all terms. “Attention Deficit…..” good example. Used more to justify drugs for insurance than any examination of individual and evoking conditions. In any prison, “Antisocial personality disorder” the most common, something like 40% of population there. Defined as someone defied laws and got caught, basically. Duhhh.
I was in charge of a small tax-based community mental health center, in fact two different places, and the DSM was used exclusively for insurance reimbursement purposes; no “V” codes in the DSM were used because to do so prevented insurance reimbursement. That’s a common practice.
Looking back on my reply, I see that I may not have presented my intended point.
Defiance-oppositional disorder might sound like some sort of insurance scam, but it does have an important place in the world of psychiatric/psychological diagnosis for those instances when it actually does apply to a particular person. Without going into all sorts of detail about the ins and outs of how I assume the child I mentioned became the way he became, I’ll just say that he was so defiant and oppositional that no teacher he’d ever had in his life had been able to include him in the classroom activities. Once he got diagnosed with something resembling a description of a part of his personality, he transformed over the course of two years into a child his teachers and his mother could handle. He’s no longer even in a special ed class, and the roots of this outcome can be found in a diagnosis that made some modicum of sense.
In other words, a silly-sounding diagnosis might have been exactly what this child needed. “Tourettes” worked in his favor because it’s a proper-sounding diagnosis, but it was entirely inaccurate. What he in fact had was defiance-oppositional disorder, which no one paid much attention to because such a diagnosis was seen to have bullshit etiology. (It was one of about 5 aberrations listed in his then-current psychological assessment.)
Sorry for the lack of clarity in my previous post.