(Mis)Diagnosed: How Bias Distorts Our Perception of Mental Health by Jonathan Foiles
My rating: 4 of 5 stars
Out: September 7, 2021
I’m fascinated by the challenges of mental health diagnostics. From the Rosenhan experiments (mentally well researchers checked into psychiatric hospitals) to the perpetual disappointment with new editions of the Diagnostic and Statistical Manual of Mental Disorders (DSM,) a lot has been written about the difficulties of diagnosing disorders that largely express themselves through subjective experiences. Foiles’ book looks at how this challenge (combined race, gender, and gender identity biases) leads to differential diagnoses between various demographic groups.
The book serves as a call to action to be more aware of biases, and how they play into diagnoses. Though, in some cases it does a better job of that than in others. The six chapters present six faces of the problem: race and psychosis, race and ADHD [Attention Deficit Hyperactivity Disorder,] sex and Borderline Personality Disorder, and changing (though skewed) views of gender dysphoria, trauma, and intelligence.
Overall, I felt I learned something from the book, but sometimes it wasn’t as strong in supporting assertions and objectively presenting evidence as other times. For example, Chapter three examines how borderline personality disorder was (at least until recently) overwhelming seen as a female disorder. It went on to say that now it’s believed to have the same incidence in males, but that men present with different symptoms. To a neophyte, this sounds a lot like: “The Smiths eat meatloaf 50% of the time for dinner on Wednesday. Until recently, it was thought that the Joneses only ate meatloaf 10% of Wednesdays, but then it was discovered they also had meatloaf 50% of the time – but the Joneses meatloaf was made of ingredients such that it usually looked like chicken pot pie.] What?
For the most part, I found this book intriguing and informative, and would recommend it for those interested in the issue.
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