More on secrecy behind the new book of human troubles

Advances in the History of Psychology has just alerted me to a new programme on NPR Radio about the debates over the ‘in revision’ version of the American Psychiatric Association’s diagnostic manual that defines mental illness for significant parts of the world.

It covers some of the most contentious potential diagnoses in the to-be-released DSM V and doesn’t have the most balanced discussion in some cases (e.g. the guy claiming that people against the diagnoses of gender identity disorder – transexualism – just ‘see the stigma’ of the condition).

Most interestingly though, it quotes part of the non-disclosure agreement that members of the DSM committee have had to sign, making a legally binding restriction against discussing:

All work product unpublished manuscripts and draft and other prepublication materials, group discussions, internal correspondence, information about the development process and any other written or unwritten information, in any form, that emanates from, or relates to, my work with the APA task force or work group.

Yes, there is a legal restriction banning members from discussing the development of one of the most important documents in medicine.

The DSM committee vice-chair Darrel Regier says this is a good thing because otherwise “it would just be cacophony and mass confusion” – presumably referring to the annoying tendency of public debate to raise points that you hadn’t thought of before.

Diagnoses decided by an unelected committee in secret sessions that are legally prevented from discussing their work. Science marches on.

Link to NPR Radio on DSM-V development (via AHP).

Sex, orgasm and childbirth: a discomforting mix

Photo by Flickr user Photo Mojo. Click for sourcePetra Boyton has a fantastic piece on the experience of orgasm during birth – the focus of an upcoming documentary and a subject likely to cause discomfort in some.

Petra discusses the relationship between sexual stimulation and labour noting that sexual pleasure has been reported during childbirth in the medical literature.

This is from a 1987 review article on sexuality and childbirth:

Newton (1971 , 1973) argued that women’s three reproductive acts: coitus, parturition, and lactation are psychophysiologically interrelated and trigger caretaking behavior, a necessity for species survival. Features that are evident in both coitus (sexual arousal and orgasm) and in undisturbed childbirth include changes in respiration (hyperpnea and tachypnea), vocalization, strained facial expression, rhythmic uterine contractions, loosening of the cervical mucous plug, frequent supine position with thighs adducted, a tendency to become uninhibited, exceptional muscular strength, an altered state of consciousness with rapid return to alert awareness after orgasm or birth, and a profound feeling of joy or ecstasy following orgasm or delivery. In addition, clitoral engorgement usually associated with sexual arousal has been described in labor in a number of parturients, beginning at 8-9cm cervical dilation (clitoral engorgement has also been described on occasion during stressful situations, without sexual stimulation) (Rossi, 1973). Intense orgasmic sensations have also been described during the second stage of labor (Masters and Johnson, 1966; Sarlin, 1963).

However, there is also evidence that sexual stimulation during labour has been shown to help delivery and ease labour-related pain – such as research on the benefits of breast stimulation during birthing.

However, Petra’s write-up makes clear that systematic research is still lacking, so we’re still not sure about how many women experience orgasm during birth, or how effective all types of active sexual stimulation might be to assist birth.

However, this topic is contentious owing to the psychological discomfort it causes. Perhaps the clash between the stereotypes that birth is innocent and pure while sex is dirty and salacious mean that some people will just find the whole subject too much to handle.

There are many of these areas in medicine. For example, sexual relationships between people with learning disabilities.

The thought of two people with Down syndrome having sex causes great discomfort in many people, despite the fact that it is perfectly possible for some people with Down’s understand and consent to the situation.

If we assume that all people who are able to consent and have found a willing consenting partner should be able to freely participate in a sexual relationship, perhaps it would be useful to develop a test to help evaluate people with learning abilities to make sure they are both able to understand and consenting.

These sorts of tests are common for testing the capacity for other sorts of decisions – such as financial responsibility, or decisions to refuse medical care – but discomfort factor tends to mean that these areas are under-researched.

With reference to the upcoming documentary, the website for the film has quite a curious tone, and I have to say, is slightly sensational.

Buy the DVD or CD!

Share Orgasmic Birth with your friends and family this holiday season with our special 5 pack of DVD’s and CD soundtrack and SAVE. Subtitled in French, Spanish, German, and Portuguese.

I can’t say a 5 pack of the Orgasmic Birth (and soundtrack!) would the first thing that comes to mind when buying Christmas presents, but there you go.

Link to Dr Petra on ‘Is there such a thing as an ‚Äòorgasmic birth‚Äô?’

2009-01-02 Spike activity

Quick links from the past week in mind and brain news:

Neuroanthropology publishes the list of best online anthropology writing of 2008.

A thorough and accessible academic article on Facebook and the social dynamics of privacy is available in draft form from lawyer James Grimmelmann.

PsyBlog has an excellent piece on a simple but evidence-based exercise on gratitude that has been shown to increase well-being.

Average THC content in US marijuana increasing, reports Wired.

Seed magazine has an interesting piece on how maths and sociology can predict the next big thing in music.

Developmental psychologist Elizabeth Spelke and philosopher Joshua Knobe discuss what babies tell us about cognitive development, math and racism in a video discussion over at 3QuarksDaily.

Wired has an short article on the anthropology of YouTube. Stupid title, good write-up.

Nine-month-old babies can tell the difference between happy and sad music, according to research covered by the BPS Research Digest.

Neuronarrative has video of a talk by Terry Pratchett discussing having Alzheimer’s disease.

The use of MDMA (ecstasy) to assist psychological treatment for trauma is discussed by The Economist.

Dana has an interesting piece where Eric Kandel discusses the year in neuroscience. Bizarrely, he seems to uncritically accept the ‘autism epidemic’ shadyness.

A free neuroaesthetics conference is being held in Berkley, California. My Mind on Books has the details.

Channel N has a list of its best videos of 2008.

Drug companies have agreed to stop giving free trinkets to doctors, according to The New York Times, in what seems like a token effort to make themselves more ethical.

The Economist has an interesting article discussing the politics of evolutionary explanations for behaviour.

A study on texting as a sign of cognitive recovery after loss of consciousness is covered by The Neurocritic.

Neurophilosophy has a great piece on a new study showing that the ability to recognise our own faces can de disrupted by touch.