Beautifully written article and a breath of fresh air with all the psychobabble floating around on the internet. I would also like to add some more detail here.
While you have pointed out the strong influence of Psychoanalysis on Mental health treatment in the 1960s, rating scales were being used to assess patients before BDI as well. Ham-D(developed in the late 1950s) has been the most widely used clinician administered rating scale, specially for assessing the effectiveness of anti-depressants. Initially BDI relied on theory of Cognitive distortions unlike HAM-D which was developed mainly using widely reported symptoms of depression at the time. The Ham-D was quite influential in pushing clinicians in looking towards symptoms-their pattern and severity.
Both BDI and HAM-D represent different perspectives of depression in a different era. So while objectivity still hadn't entered the picture in the strictest sense of the word, there was still more structure than the varied diagnoses being used prior.
Contrasting the use of BDI with the subjectivity of psychoanalytic diagnoses may therefore paint a slightly distorted picture. Rating scales and their purported objectivity have been long questioned by both statisticians and traditional psychoanalysts with varying reasons. Today even Psychoanalysts have embraced empiricism and it is sad that a lot of professionals in the field themselves don't try to understand the difference among assessment, measurement and diagnosis. In that aspect, your question towards the training of MHPs is pertinent. A stronger emphasis towards conceptual clarity in statistics for MHPs might foster a nuanced understanding of using rating scales in treatment and research( and consequently more cautious, I suppose).
Again, much appreciation for your efforts in writing this blog.
My ug research was done using BDI. Although the data collection had wildly unfair means iykuk. Even i always thought self repport scales are not for diagnosis or even mental state assessment that much as we are complex. It is also fairly easy to be dishonest and deceptive in a self report scale.
Hi Arjun,
Beautifully written article and a breath of fresh air with all the psychobabble floating around on the internet. I would also like to add some more detail here.
While you have pointed out the strong influence of Psychoanalysis on Mental health treatment in the 1960s, rating scales were being used to assess patients before BDI as well. Ham-D(developed in the late 1950s) has been the most widely used clinician administered rating scale, specially for assessing the effectiveness of anti-depressants. Initially BDI relied on theory of Cognitive distortions unlike HAM-D which was developed mainly using widely reported symptoms of depression at the time. The Ham-D was quite influential in pushing clinicians in looking towards symptoms-their pattern and severity.
Both BDI and HAM-D represent different perspectives of depression in a different era. So while objectivity still hadn't entered the picture in the strictest sense of the word, there was still more structure than the varied diagnoses being used prior.
Contrasting the use of BDI with the subjectivity of psychoanalytic diagnoses may therefore paint a slightly distorted picture. Rating scales and their purported objectivity have been long questioned by both statisticians and traditional psychoanalysts with varying reasons. Today even Psychoanalysts have embraced empiricism and it is sad that a lot of professionals in the field themselves don't try to understand the difference among assessment, measurement and diagnosis. In that aspect, your question towards the training of MHPs is pertinent. A stronger emphasis towards conceptual clarity in statistics for MHPs might foster a nuanced understanding of using rating scales in treatment and research( and consequently more cautious, I suppose).
Again, much appreciation for your efforts in writing this blog.
Best,
Aditi
My ug research was done using BDI. Although the data collection had wildly unfair means iykuk. Even i always thought self repport scales are not for diagnosis or even mental state assessment that much as we are complex. It is also fairly easy to be dishonest and deceptive in a self report scale.