Oh G-d, A Borderline: Clinical Diagnostics As Fundamental Attribution Error Page: 5
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Narrow, Kuhl, & Kepfer, 2009). A nomothetic approach underwritten with functional analysis
might ease communication and simultaneously provide meaningful direction for treatment
(Bissett & Hayes, 1999). Such an emphasis on functional analysis of disordered behavior might
exorcise internalized demonic "mental illnesses" as causes for behavior and set clinicians and
researchers alike to the task of determining the variables that maintain maladaptive behavior.
One organizing functional class of behaviors, experiential avoidance, has been shown to
be meaningfully related to a broad spectrum of disorders and symptoms as catalogued by the
DSM system (Hayes, Wilson, Gifford, Follette, & Strosahl, 1996; Kashdan, Barrios, Forsyth, &
Steger, 2006). What's more, changes in experiential avoidance have been shown to co-occur
with, and sometimes precede, changes in therapeutic outcome measures of symptomology and
quality of life (Kashdan et al., 2006; Schmalz & Murrell, in press). Those researchers and
clinicians who utilize experiential avoidance as a tool to understanding, researching, and treating
maladaptive behaviors recognize that experientially avoidant behaviors are not indicators of
"illness," rather they are the products of socially and naturally mediated reinforcers (Hayes et al.,
1996), much like Szasz talked of "problems in living."
The question that this project proposed to answer was whether merely mentioning
diagnostic labels could alter how clinicians view others; centuries ago "she's a witch!" affected
how even the most educated responded. More specifically, this project assessed the following: do
diagnoses lead mental health clinicians to ignore the role that context plays in a person's
behavior and attribute the cause of behavior to internalized characteristics of the person? Does a
label lead clinicians to fail to see what is there as they search for what ought to be? To fully
discuss the possibility of environmental insensitivity due to diagnostic labels, the remainder of
this literature review covers: 1) the diagnostic system, including consideration that it may not
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Schmalz, Jonathan. Oh G-d, A Borderline: Clinical Diagnostics As Fundamental Attribution Error, thesis, December 2011; Denton, Texas. (digital.library.unt.edu/ark:/67531/metadc103389/m1/11/: accessed May 27, 2017), University of North Texas Libraries, Digital Library, digital.library.unt.edu; .