scholarly journals Diagnostic Overshadowing in Psychiatric-Somatic Comorbidity: A Case for Structural Testimonial Injustice

Erkenntnis ◽  
2021 ◽  
Author(s):  
Anke Bueter
Keyword(s):  
Diagnostic Overshadowing ◽  
Somatic Comorbidity ◽  
Testimonial Injustice

Prescribing stigma in mental disorders: A comparative study of Portuguese psychiatrists and general practitioners

2021 ◽  
pp. 002076402110025
Author(s):  
Bárbara Almeida ◽  
Ana Samouco ◽  
Filipe Grilo ◽  
Sónia Pimenta ◽  
Ana Maria Moreira
Keyword(s):  
Mental Health ◽  
Mental Disorder ◽  
General Practitioners ◽  
Psychiatric Patients ◽  
Self Report ◽  
Cross Sectional ◽  
Medical Speciality ◽  
Diagnostic Overshadowing ◽  
Related Stigma ◽  
Health Related

Background: Physicians, including psychiatrists and general practitioners (GPs), have been reported as essential sources of stigma towards people diagnosed with a mental disorder (PDMDs), which constitutes an important barrier to recovery and is associated with poorer clinical outcomes. Therefore, psychiatrists and GPs are key populations where it is crucial to examine stigma, improve attitudes and reduce discrimination towards psychiatric patients. Aims: This study is the first to explore mental health-related stigma among Portuguese psychiatrists and GPs, examining the differences between these two specialities and assessing whether sociodemographic and professional variables are associated with stigma. Method: A cross-sectional study was performed between June 2018 and August 2019. A consecutive sample of 55 Psychiatrists and 67 GPs working in Porto (Portugal) filled a 25-item self-report questionnaire to assess their attitudes towards PDMDs in clinical practice. The instrument was designed by the authors, based on previous mental health-related stigma studies and validated scales. The questionnaire includes 12 stigma dimensions ( Autonomy, Coercion, Incompetence, Dangerousness, Permanence, Pity, Responsibility, Segregation, Labelling, Diagnostic Overshadowing, Shame and Parental Incompetence), and its total score was used to measure Overall Stigma (OS). Sample characteristics were examined using descriptive statistics, and the factors affecting stigma were assessed through regression analysis. Results: GPs exhibit significantly higher OS levels than psychiatrists, and present higher scores in the dimensions of dangerousness, parental incompetence, diagnostic overshadowing and responsibility. Besides medical speciality, several other sociodemographic variables were associated with sigma, including age, gender, having a friend with a mental disorder, professional category, agreement that Psychiatry diverges from core medicine and physician’s interest in mental health topics. Conclusions: Our data suggest that both psychiatrists and GPs hold some degree of stigmatizing attitudes towards PDMDs. Overall, these results bring new light to stigma research, and provide information to tailor anti-stigma interventions to Portuguese psychiatrists and GPs.

Prenatal Genetic Screening, Epistemic Justice, and Reproductive Autonomy

Hypatia ◽  
2021 ◽  
Vol 36 (1) ◽  
pp. 1-21
Author(s):  
Amber Knight ◽  
Joshua Miller
Keyword(s):  
Prenatal Testing ◽  
Relevant Information ◽  
Medical Professionals ◽  
Reproductive Decisions ◽  
Reproductive Autonomy ◽  
Noninvasive Prenatal Testing ◽  
Epistemic Justice ◽  
Reproductive Decision Making ◽  
Testimonial Injustice ◽  
And Control

AbstractNoninvasive prenatal testing (NIPT) promises to enhance women's reproductive autonomy by providing genetic information about the fetus, especially in the detection of genetic impairments like Down syndrome (DS). In practice, however, NIPT provides opportunities for intensified manipulation and control over women's reproductive decisions. Applying Miranda Fricker's concept of epistemic injustice to prenatal screening, this article analyzes how medical professionals impair reproductive decision-making by perpetuating testimonial injustice. They do so by discrediting positive parental testimony about what it is like to raise a child with DS. We argue that this testimonial injustice constitutes a twofold harm: (1) people with DS and their family members who claim that parenting a child with DS may be a rewarding and joyous experience are harmed when they are systematically silenced, disbelieved, and/or denied epistemic credibility by medical professionals, and (2) pregnant women are harmed since they might make poorly informed choices without access to all relevant information. The broader implication of the analysis is that epistemic justice is a precondition of reproductive autonomy. We conclude by calling for federal oversight of the acquisition and dissemination of information that prospective parents receive following a positive diagnosis of DS to ensure that it is comprehensive and up to date.

Somatic Comorbidity in Female Patient with Psychiatric Disorders

2015 ◽  
Vol 30 ◽  
pp. 317
Author(s):  
V. Baric ◽  
D. Bagaric ◽  
J. Beus ◽  
M. Herceg ◽  
M. Zivkovic
Keyword(s):  
Psychiatric Disorders ◽  
Female Patient ◽  
Somatic Comorbidity

testimonial injustice ‘out here in the projects’ – misrecognising victimhood in the bed intruder meme

2021 ◽  
Vol 5 (2) ◽  
Author(s):  
M’Balia Thomas
Keyword(s):  
Social Support ◽  
Thematic Analysis ◽  
Stylistic Analysis ◽  
Moral Concern ◽  
Broadcast News ◽  
Potential Threat ◽  
The Public ◽  
The Social ◽  
Youtube Videos ◽  
Testimonial Injustice

In the wake of ‘Black Lives Matter’, this paper examines the concept of testimonial injustice and the prejudicial stances held towards victims that diminishes the credibility of their claims and the social support they receive from the public. To explore this concept, the following work revisits the widely parodied U.S. originating broadcast news report, The Bed Intruder. In the broadcast, victims of a home invasion and attempted rape deliver a public call that outlines the conditions of their victimhood and the potential threat to the community. A rhetorical stylistic analysis of the victims’ testimonial discourse and a thematic analysis of a sample of YouTube videos that reappropriate and parody their discourse are conducted. The analyses highlight the memetic elements of the video parodies that acknowledge the victimisation and yet strategically misconstrue events in ways that 1) render the victims and their claims less credible and 2) fail to provide them with the moral concern such an acknowledgement deserves.

Diagnostic Overshadowing of the Psychiatric Population in the Emergency Department: Physiological Factors Identified for an Early Warning System

2017 ◽  
Vol 24 (4) ◽  
pp. 327-331 ◽  
Author(s):  
Michelle Geiss ◽  
Jill Chamberlain ◽  
Tamsyn Weaver ◽  
Carrie McCormick ◽  
Ashley Raufer ◽  
...  
Keyword(s):  
Emergency Department ◽  
Heart Rate ◽  
Warning System ◽  
The United States ◽  
Behavioral Symptoms ◽  
Medical Conditions ◽  
Physiological Factors ◽  
Diagnostic Overshadowing ◽  
Psychiatric Population ◽  
Abnormal Temperature

BACKGROUND: Many people with mental disorders in the United States remain either medically untreated or inadequately treated, which is often attributed to diagnostic overshadowing, a common occurrence across the nation in emergency departments. OBJECTIVE: The aim of this research is to create a tool that supports accurate assessment and distinguishing behavioral symptoms between psychiatric illness and coexisting medical conditions in the emergency department, thus leading to appropriate care and placement. DESIGN: Retrospective cohort design of 133 psychiatric admissions were reviewed between the years 2011 and 2015. RESULTS: Logistic regression retained three factors: age greater than 70 years (odds ratio [OR] = 6.575, 95% confidence interval [CI] = 2.58-16.76), abnormal heart rate (OR = 8.48, 95% CI = 3.39-28.42), and abnormal temperature (OR = 9.82, 95% CI = 3.91-18.40). The three factors were then placed into a screening tool. The presence of each factor equaled 1 point. If the total score was greater than 2, the sensitivity of the tool was 68.7% and the specificity of the tool was 85.8%. CONCLUSIONS: Coexisting medical conditions in the psychiatric population may present as behavioral symptoms; however, the use of a tool that focuses assessment toward medical factors such as abnormal heart rate, abnormal temperature, and advanced age can direct further investigation of behavioral symptoms.

scholarly journals Incident somatic comorbidity after psychosis: results from a retrospective cohort study based on Flemish general practice data

2011 ◽  
Vol 12 (1) ◽  
Author(s):  
Carla Truyers ◽  
Frank Buntinx ◽  
Jan De Lepeleire ◽  
Marc De Hert ◽  
Ruud Van Winkel ◽  
...  
Keyword(s):  
General Practice ◽  
Cohort Study ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Somatic Comorbidity

scholarly journals Mansplaining as Epistemic Injustice

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Nicole Dular
Keyword(s):  
Alternative Model ◽  
Epistemic Communities ◽  
Epistemic Injustice ◽  
The Common ◽  
Testimonial Injustice

“Mansplaining” is by now part of the common cultural vernacular. Yet, academic analyses of it—specifically, philosophical ones—are missing. This paper sets out to address just that problem. Analyzed through a lens of epistemic injustice, the focus of the analysis concerns both what it is, and what its harms are. I argue it is a form of epistemic injustice distinct from testimonial injustice wherein there is a dysfunctional subversion of the epistemic roles of hearer and speaker in a testimonial exchange. As these are roles of power and are crucial to our existence and functioning within epistemic communities, the wrong and harms suffered from this injustice are serious and, I argue, distinct from other types already discussed in the literature. I close by considering an alternative model of mansplaining as a form of silencing, as well as briefly diagnosing its general underlying cause and possible solutions.

Somatic comorbidity and depression in the hospital setting

1998 ◽  
Vol 13 (S4) ◽  
pp. 258s-258s
Author(s):  
M. Ruiz Ruiz ◽  
A. Rodríguez-Rosado ◽  
J.M. Pena Andreu
Keyword(s):  
Hospital Setting ◽  
Somatic Comorbidity
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