A central mechanism by which medicalization occurs is through domain expansion, wherein an existing diagnostic definition widens to include cases beyond its original scope. This has been especially commonplace with respect to mental illness diagnoses. In contrast, there are few clear instances of domain contraction. The controversy surrounding the revisions to autism in advance of the publication of the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) is thus of considerable importance. Many autism advocates feared the new definition of autism would exclude a significant number of individuals who are already diagnosed. We examine lay claims making to this perceived instance of domain contraction through a content analysis of online reader comments to a high-profile New York Times article reporting on the DSM-5 autism criteria. Our analysis points to an amorphous group of social stakeholders who express a variety of concerns about unabated medicalization. We also identify the stance of diagnostic domain defense, which is an oppositional response by laypeople with a personal connection to a diagnosis to a real or perceived challenge to the definitional boundaries of that diagnosis. Our analysis explicates the dimensions of diagnostic domain defense, which include its grounding in experiential certainty and anguish, and the accrual and deployment of diagnostic resources. We make a case for the utility of this concept for theorizing the relationship between lay claims making, diagnoses, and medicalization. We also make a case for the use of online reader comments as a way to unobtrusively study lay claims making related to pressing social problems in the Internet era.
Incarcerated fathers often experience early life risk factors that cumulate over time and are compounded by the negative repercussions of imprisonment. These dynamics may contribute to the intergenerational transmission of risk and help explain the persistent link between paternal incarceration and poor child outcomes. Contact between incarcerated fathers and their children can benefit them both, but there is limited research on the factors that affect father–child contact. Using data from the 2004 Survey of Inmates in State Correctional Facilities and a sample of fathers with at least one minor child (N = 5,809), the authors found that incarcerated fathers who experienced more childhood risk factors had less frequent contact with their children. A variety of inmate characteristics were also significant predictors of father–child contact. Parenting interventions could address incarcerated fathers’ childhood risk experiences, which likely undermine the development and maintenance of family relationships, to help them develop prosocial skills.
“The criminal no longer seems a totally unsociable being, a sort of parasitic element, a strange and unassimilable body,” Emile Durkheim wrote. And after nearly 10 hourswithmy Inside classmates, I've come to learn that he's right.
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