LEUERS
little
relation
to
socioeconomic
class,
tends
to
be
a child
and
poverty
of content
of speech
and
TO THE
in seven
EDITOR
other
entries.
unwanted by either parent; frequently this is the only child of an unmarried mother who rejects both hen pregnancy and her child (3). Another type of unsocialized offender, the unsocialized
The negative religious exception of a single tions mean
no other particular area of human experience. Does this that religion is a sign of mental disorder? After a thor-
runaway,
ough
literature
was
described
in 1967
(5). This
type,
as well
as the
other two, was found in a population of 300 delinquent boys committed to the New York State Training School for Boys. Group or cooperative delinquents were defined by catalogued behaviors, and unsocialized aggressive delinquents and unsocialized runaway delinquents were similarly defined. These three groups appeared in DSM-II as group delinquent reaction of childhood (or adolescence), unsocialized aggressive
reaction
away reaction These three ground factors. ing
parental
groups quents. much quents
of childhood
(or
adolescence),
and
of childhood (on adolescence). behavioral categories differ in family Clearly, parental rejection and factors rejection
differentiate
both
of the
run-
backfavor-
unsocialized
from the cooperative or group type (socialized) delinUnsocialized runaway delinquents have experienced more rejection than unsocialized aggressive delin(5), who are able to react with anger and aggressive-
ness.
Unsocialized
to be aggressive. sive diagnosis, pictures.
The
conduct
chapter
with
risk
runaways
lack
DSM-III
for
to embrace
disorder
conduct
are
at greater
risk
for
and
self-belief
an inclu-
all three
clinical
in the monograph
disorder.
tend to occur in large families; tends to be an only child. The families
courage
an abstraction,
disorder,
on conduct
factors
the
created
Group
the unsocialized chapter indicates conduct
disorder,
deals
delinquents
delinquent that large which
sim-
ply indicates that the group or socialized type of conduct disorder is more frequent than the unsocialized types. In this chapter an abstraction, conduct disorder, is homogenized. This
treatment
of conduct
disorder
resembles
taking
an apple,
a prickly pear, and a lemon, homogenizing them, and then inquiring about what kind of tree would bean such a fruit. It is my earnest hope that DSM-IV will make it possible to recognize and distinguish apples, prickly pears, and lemons.
REFERENCES
1. Shaffer D, Philips I, Enzer NB (eds): Prevention of Mental Disorders, Alcohol and Other Drug Use in Children and Adolescents: OSAP Prevention Monograph 2. Rockville, Md, Office for Substance Abuse Prevention, Department of Health and Human Services, 1989 2. Jenkins RL, Hewitt L: Types of personality structure encountered in child guidance clinics. Am J Orthopsychiatry 1944; 14:84-94 3. Hewitt LE, Jenkins RL: Fundamental Patterns of Maladjustment: The Dynamics of Their Origin. State of Illinois, 1946 4. Jenkins RL: Psychiatric syndromes in children and their relation to family background. Am J Orthopsychiatry 1966; 36:450457 5. Jenkins RL, Boyer A: Types of delinquent behavior and background factors. Int J Soc Psychiatry 1967; 14:65-76 RICHARD
DSM-HI-R
and
L. JENKINS, M.D. Iowa City, Iowa
Religion
examples reference
search,
stand out because, with the to politics, the glossary men-
I am not
aware
of proof
that
in the
religious context there is an unusually high incidence of mental illness. Negative religious bias in DSM-III-R is present in the entry “Magical Thinking,” quoted here in part: “The person believes that his or her thoughts, words, or actions might, or will in some manner, cause or prevent a specific outcome in some .
.
.
.
way that defies Magical thinking
the normal laws is seen in children,
itive cultures,
and in Schizotypal
phrenia,
Obsessive
and
is placed tendency
termed possibility
of cause and effect in people in prim-
Personality
Compulsive
Disorder,
Disorder.”
in the context of magical thinking, toward fantasy in violation of the “reality principle.” No mention
of sane
prayer,
so prayer
Here,
Schizoprayer
which implies a what might be is made of the
generally
appears
sus-
pect. Prayful people are linked with children and primitive cultures. This ridicule applies to 90% of the American public (1). Such insensitivity can only widen the unfortunate gap between psychiatry and its surrounding culture. Another entry in the glossary, “Poverty of Content of Speech,” is also insensitive to religious persons: “Speech that is adequate in amount but conveys little information because of vagueness, empty repetitions, or use of stereotyped or obscure phrases . . . . Example: Interviewer: ‘O.K. Why is it, do you think, that people believe in God?’ Patient: ‘Well, first of all because, He is the person that, is their personal sayion . . . . Myself, I am pointed in the ways of uh, knowing night from wrong, and doing it. I can’t do any more, on not less than that.’ “ This example is the only one offered, and it
is specific
to religion.
It implies
for those
who
do not know
better that a religious wonldview is typically accepted by persons incapable of clear thought and speech. But these passages do not indicate poverty of content of speech. They can easily be translated into a dialect that the interviewer could understand. The patient responds roughly as follows: “People believe in God because they feel that God is their personal savior . . . . Myself, I go with God, and with a clear desire to do the right rather than the wrong. I can do nothing more, but surely nothing less.” The interviewer here shows no rapport with the inner-city believer who finds hope in Bible and hymn. Could one expect an empathic relationship
with
the
patient
Few psychiatrists
under
such
are trained
circumstances?
to understand
religion,
much
less treat it sympathetically. One wonders how academics would feel if negative examples were borrowed exclusively from their sphere? Fortunately, psychiatry does not view neligious phenomena only through the prism of DSM-III-R (2).
REFERENCES 1. Gallup G: Gallup Opinion Index: Religion in America. Princeton, NJ, American Institute of Public Opinion, 1981 2. Knoll J, Sheehan W: Religious beliefs and practices among 52 psychiatric inpatients in Minnesota. Am J Psychiatry 1989; 146:67-72
SIR:
negative catatonic
Am
J
In
DSM-III-R “Glossary of Technical Terms,” religious examples are presented in the entries for posturing, delusion, incoherence, magical thinking, the
Psychiatry
147:6,
June
1990
STEPHEN
GARRARD
POST, Cleveland,
PH.D. Ohio
813
little
relation
to
socioeconomic
class,
tends
to
be
a child
and
poverty
of content
of speech
and
TO THE
in seven
EDITOR
other
entries.
unwanted by either parent; frequently this is the only child of an unmarried mother who rejects both hen pregnancy and her child (3). Another type of unsocialized offender, the unsocialized
The negative religious exception of a single tions mean
no other particular area of human experience. Does this that religion is a sign of mental disorder? After a thor-
runaway,
ough
literature
was
described
in 1967
(5). This
type,
as well
as the
other two, was found in a population of 300 delinquent boys committed to the New York State Training School for Boys. Group or cooperative delinquents were defined by catalogued behaviors, and unsocialized aggressive delinquents and unsocialized runaway delinquents were similarly defined. These three groups appeared in DSM-II as group delinquent reaction of childhood (or adolescence), unsocialized aggressive
reaction
away reaction These three ground factors. ing
parental
groups quents. much quents
of childhood
(or
adolescence),
and
of childhood (on adolescence). behavioral categories differ in family Clearly, parental rejection and factors rejection
differentiate
both
of the
run-
backfavor-
unsocialized
from the cooperative or group type (socialized) delinUnsocialized runaway delinquents have experienced more rejection than unsocialized aggressive delin(5), who are able to react with anger and aggressive-
ness.
Unsocialized
to be aggressive. sive diagnosis, pictures.
The
conduct
chapter
with
risk
runaways
lack
DSM-III
for
to embrace
disorder
conduct
are
at greater
risk
for
and
self-belief
an inclu-
all three
clinical
in the monograph
disorder.
tend to occur in large families; tends to be an only child. The families
courage
an abstraction,
disorder,
on conduct
factors
the
created
Group
the unsocialized chapter indicates conduct
disorder,
deals
delinquents
delinquent that large which
sim-
ply indicates that the group or socialized type of conduct disorder is more frequent than the unsocialized types. In this chapter an abstraction, conduct disorder, is homogenized. This
treatment
of conduct
disorder
resembles
taking
an apple,
a prickly pear, and a lemon, homogenizing them, and then inquiring about what kind of tree would bean such a fruit. It is my earnest hope that DSM-IV will make it possible to recognize and distinguish apples, prickly pears, and lemons.
REFERENCES
1. Shaffer D, Philips I, Enzer NB (eds): Prevention of Mental Disorders, Alcohol and Other Drug Use in Children and Adolescents: OSAP Prevention Monograph 2. Rockville, Md, Office for Substance Abuse Prevention, Department of Health and Human Services, 1989 2. Jenkins RL, Hewitt L: Types of personality structure encountered in child guidance clinics. Am J Orthopsychiatry 1944; 14:84-94 3. Hewitt LE, Jenkins RL: Fundamental Patterns of Maladjustment: The Dynamics of Their Origin. State of Illinois, 1946 4. Jenkins RL: Psychiatric syndromes in children and their relation to family background. Am J Orthopsychiatry 1966; 36:450457 5. Jenkins RL, Boyer A: Types of delinquent behavior and background factors. Int J Soc Psychiatry 1967; 14:65-76 RICHARD
DSM-HI-R
and
L. JENKINS, M.D. Iowa City, Iowa
Religion
examples reference
search,
stand out because, with the to politics, the glossary men-
I am not
aware
of proof
that
in the
religious context there is an unusually high incidence of mental illness. Negative religious bias in DSM-III-R is present in the entry “Magical Thinking,” quoted here in part: “The person believes that his or her thoughts, words, or actions might, or will in some manner, cause or prevent a specific outcome in some .
.
.
.
way that defies Magical thinking
the normal laws is seen in children,
itive cultures,
and in Schizotypal
phrenia,
Obsessive
and
is placed tendency
termed possibility
of cause and effect in people in prim-
Personality
Compulsive
Disorder,
Disorder.”
in the context of magical thinking, toward fantasy in violation of the “reality principle.” No mention
of sane
prayer,
so prayer
Here,
Schizoprayer
which implies a what might be is made of the
generally
appears
sus-
pect. Prayful people are linked with children and primitive cultures. This ridicule applies to 90% of the American public (1). Such insensitivity can only widen the unfortunate gap between psychiatry and its surrounding culture. Another entry in the glossary, “Poverty of Content of Speech,” is also insensitive to religious persons: “Speech that is adequate in amount but conveys little information because of vagueness, empty repetitions, or use of stereotyped or obscure phrases . . . . Example: Interviewer: ‘O.K. Why is it, do you think, that people believe in God?’ Patient: ‘Well, first of all because, He is the person that, is their personal sayion . . . . Myself, I am pointed in the ways of uh, knowing night from wrong, and doing it. I can’t do any more, on not less than that.’ “ This example is the only one offered, and it
is specific
to religion.
It implies
for those
who
do not know
better that a religious wonldview is typically accepted by persons incapable of clear thought and speech. But these passages do not indicate poverty of content of speech. They can easily be translated into a dialect that the interviewer could understand. The patient responds roughly as follows: “People believe in God because they feel that God is their personal savior . . . . Myself, I go with God, and with a clear desire to do the right rather than the wrong. I can do nothing more, but surely nothing less.” The interviewer here shows no rapport with the inner-city believer who finds hope in Bible and hymn. Could one expect an empathic relationship
with
the
patient
Few psychiatrists
under
such
are trained
circumstances?
to understand
religion,
much
less treat it sympathetically. One wonders how academics would feel if negative examples were borrowed exclusively from their sphere? Fortunately, psychiatry does not view neligious phenomena only through the prism of DSM-III-R (2).
REFERENCES 1. Gallup G: Gallup Opinion Index: Religion in America. Princeton, NJ, American Institute of Public Opinion, 1981 2. Knoll J, Sheehan W: Religious beliefs and practices among 52 psychiatric inpatients in Minnesota. Am J Psychiatry 1989; 146:67-72
SIR:
negative catatonic
Am
J
In
DSM-III-R “Glossary of Technical Terms,” religious examples are presented in the entries for posturing, delusion, incoherence, magical thinking, the
Psychiatry
147:6,
June
1990
STEPHEN
GARRARD
POST, Cleveland,
PH.D. Ohio
813
