Pop Psychology Diagnoses

Pop Psychology that a condition qualifies as a pop psychology diagnosis does not mean that it is invalidated, Diagnoses only that it is unvalidated. As a hoary scientific D. Anne Winiarski, Sarah Francis dictum reminds us, absence of evidence is not Smith, and Scott O. Lilienfeld evidence of absence. In the case of most pop Emory University, U.S.A. psychology diagnoses, the problem is more the former than the latter. Evaluating the validity of pop psychology Inmanyrespects,thelandscapeofpsychi- diagnoses is not a straightforward task, in part atric classification and diagnosis is a tale of because the boundaries between valid and two worlds. One world comprises academic invalid diagnoses are fuzzy. In evaluating the psychiatry and psychology, in which classifica- validity of pop psychology diagnoses, we adopt tion systems and the diagnoses they subsume the criteria laid out by Eli Robins (1921–94) are informed largely (although by no means and Samuel Guze (1923–2000) in a classic arti- entirely; see Greenberg, 2013, for withering cle. There, Robins and Guze (1970) delineated critiques of the evidentiary basis of DSM-5)by several benchmarks for ascertaining whether systematic research. The other world comprises a psychiatric diagnosis is valid. According to popular (“pop”) psychology, in which formal them, a valid diagnosis should (a) distinguish classification systems are typically absent, as the disorder from similar disorders (or what diagnoses are not organized within concep- psychologists call “discriminant validity”), tually or empirically informed subgroupings. (b) display a clear-cut pattern of familial Moreover, in this second world, diagnoses are aggregation, (c) predict diagnosed individuals’ based largely on anecdotal reports, self-help performance on laboratory and psychometric books, and the entertainment media rather measures, and (d) forecast the natural history than on controlled research. This entry exam- (course and outcome) of diagnosed individ- ines the scientific status of influential pop uals. Although not mentioned explicitly by psychology diagnoses. Robins and Guze, a valid diagnosis should There is no formal or widely accepted opera- also ideally (e) predict diagnosed individuals’ tionalization of pop psychology diagnoses, nor response to treatment. Nevertheless, because any clear-cut distinction between academic a condition’s treatment response does not and pop psychology diagnoses. Nevertheless, necessarily inform us about its etiology, this for the purposes of this entry, we propose the fifth criterion should be regarded as a desider- following working definition. Pop psychology atum rather than a formal requirement. Some diagnoses are conditions that have (a) received authors have offered friendly amendments to considerably more attention in popular psy- the Robins and Guze criteria by incorporating chology (e.g., self-help books, newsstand additional external validating indicators, such magazines, television talk shows, radio call-in as measures of presumed endophenotypes shows) than in academic psychology, (b) (e.g., biological markers). Still, the Robins received scant validation in controlled studies, and Guze rubric is a helpful starting point for and (c) not been incorporated into formal clas- evaluating the validity of psychiatric diagnoses, sification schemes, such as DSM-5 or ICD-10. including pop psychology diagnoses. As a consequence of (b) and (c), the scientific The Robins and Guze framework reminds status of pop psychology diagnoses is contro- us that a valid diagnosis must provide us with versialatbest,dubiousatworst.Still,thefact surplus information: knowledge that was not The Encyclopedia of Clinical Psychology, First Edition. Edited by Robin L. Cautin and Scott O. Lilienfeld. © 2015 John Wiley & Sons, Inc. Published 2015 by John Wiley & Sons, Inc. DOI: 10.1002/9781118625392.wbecp568 2 POP PSYCHOLOGY DIAGNOSES available to us before the diagnosis was made. are black rage (acts of violence perpetrated by In this context, Millon (1975) distinguished African Americans that are apparently trig- diagnoses from labels, with the former offering gered by repeated discrimination), road rage surplus information and the latter, being essen- (acts of intense reactive aggression directed tially descriptive, offering little or no surplus toward offending drivers), urban survival information. For example, the DSM diag- syndrome (a predisposition toward violence nosis of schizophrenia affords us additional resulting from prolonged exposure to ghetto information that we did not have previously; “war zones”), parental alienation syndrome the knowledge that a person meets diagnostic (the longstanding estrangement of a child from criteria for schizophrenia tells us something a parent, stemming from the other parent’s new about his or her likely family history, indoctrination of the child into a negative risk for other conditions (e.g., alcohol-use view of his or her partner), child sexual abuse disorder), and probable course and outcome. accommodation syndrome (a constellation Incontrast,apsychiatriclabeltellsuslittle of behaviors, such as secrecy and delays in or nothing about the person that we did not reporting of sexual abuse, that supposedly already know. If we were to identify a distinct stem from a child feeling responsible for the class of people who feel compelled to watch abuse), rape trauma syndrome (a presumed baseball games at every opportunity, com- distinct reaction to rape marked by puzzling pulsivelymemorizebaseballstatistics,track behaviors, such as the victim’s continuing to the results of every major and minor league maintain contact with the rapist and neglecting baseball game, and experience anguish when- to report the rape), and battered woman’s syn- ever they cannot immediately access baseball drome (a pattern of behavior characterized by news, we could christen their ostensible afflic- learned helplessness stemming from an abu- tion with the moniker of “baseball addiction sive relationship). The last condition featured syndrome.” Yet it is unclear what, if any, new prominently in the widely publicized 2013 trial information this new label would provide. The of Jodi Arias, an Arizona woman convicted label would be merely descriptive, succinctly of murdering her boyfriend. Precious few of summarizing the features of the “condition” these contested legal labels have been the sub- without offering surplus knowledge. jects of extensive scientific research (McCann, Most of the putative conditions reviewed Shindler, & Hammond, 2003). in this entry are probably closer to labels Because of space constraints, in this entry we than to diagnoses. In this respect, the phrase focus on pop psychology diagnoses that have “pop psychology diagnoses” is arguably a mis- received the lion’s share of public and media nomer, although it is used here for the sake of attention over the past few decades. In each continuity with previous literature. case, we briefly survey the historical origins of There are dozens, perhaps even hundreds, the label and the modest research base bearing of pop psychology diagnoses. Among those on its validity. that have received intermittent media attention over the past several decades are Peter Pan Codependency syndrome (a label affixed to adults who do not seem to want to grow up), Cinderella complex The concept of codependency traces its roots (a pathological and unconscious desire to be to the field of chemical dependency, and first cared for by others), and television intoxica- gained recognition in the early to mid 1980s. tion (an all-consuming devotion to the small This concept grew out of treatment programs screen). In addition to these pop-psychology for family members of people with alcoholism, diagnoses are a plethora of informal labels such as Al-Anon (Morgan, 1991). At that time, that have been introduced periodically into codependency referred to a pattern of behav- courtrooms as legal defenses. Among them iors displayed by partners of alcoholics that POP PSYCHOLOGY DIAGNOSES 3 was believed to result from living with them. literatures for nearly 30 years, it has received This pattern comprises “enabling” behaviors, minimal research attention. Some evidence in which partners of alcoholic individuals suggests that individuals with backgrounds become pathologically dependent on their ostensibly linked to codependency (e.g., off- partner and unintentionally reinforce their spring of an alcoholic parent) are more willing dependency. Eventually, the codependency to help exploitative than nurturing individ- concept expanded to encompass dysfunctional uals, whereas healthy individuals display the relationships of many kinds, including those opposite pattern. Bradshaw (1988) described in which a partner engages in irresponsible codependency as a shame-based condition behaviors other than drinking, such as domes- marked by low self-esteem. Some evidence tic abuse or excessive gambling. Codependent supports this assertion, as codependency is individuals purportedly believe that they negatively associated with self-esteem (Wells, should be able to alter their partner’s unhealthy Glickauf-Hughes, & Jones, 1999). Never- behavior, even when this belief is unrealistic theless, numerous psychological conditions, (Morgan, 1991). such as mood disorders, are also tied to low Cermak (1986) was among the first to pro- self-esteem, so this attribute is unlikely to be pose standardized criteria for “co-dependent diagnostically discriminating. Codependency personality disorder.”

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