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      Las clasificaciones en la formación psiquiátrica. Una aproximación postcolonial Translated title: Classifications in Psychiatric Education. A Postcolonial Approach

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          Abstract

          Resumen: este artículo contribuye a la comprensión de las clasificaciones psiquiátricas partiendo de un enfoque postcolonial de la ciencia y la tecnología, para lo cual examino el caso de un programa de formación psiquiátrica en una ciudad intermedia de Colombia. Como método utilicé la etnografía, participando en clases, presentaciones de casos y reuniones académicas. Se encontró que el aprendizaje de estas clasificaciones involucra dinámicas en las que se reconfiguran lo global y lo local de acuerdo con las posiciones que asumen los psiquiatras y los estudiantes de psiquiatría. En este estudio, algunos participantes manifestaron que hay una dominación cultural de la psiquiatría norteamericana sobre su contraparte colombiana y que, por tanto, debían ceñirse a la clasificación de la primera; otros plantearon que la formación psiquiátrica debía seguir la orientación europea y dejar de lado la clasificación norteamericana; y un grupo minoritario consideró que debían remitirse a clasificaciones latinoamericanas. Concluyo que los manuales de la Asociación Americana de Psiquiatría y la Organización Mundial de la Salud se establecen como lo que Rodríguez Medina llama objetos subordinantes, mientras que las clasificaciones latinoamericanas se ubican como entidades locales que obedecen a objetivos concretos. Sin embargo, las jerarquías involucradas en la geopolítica del conocimiento pueden ser disputadas dentro de prácticas pedagógicas cotidianas.

          Translated abstract

          Abstract: This article contributes to the understanding of psychiatric classifications by adopting a postcolonial approach to science and technology. For this purpose, I examine the case of a psychiatry training program in a medium-sized city in Colombia. The method I used was ethnography, taking part in classes, case presentations, and academic meetings. It was found that learning about psychiatric classifications involves dynamics in which the global and the local are reconfigured according to the positions assumed by psychiatrists and psychiatry students. In this study, some participants stated that there is a cultural domination of North American psychiatry over its Colombian counterpart, and, therefore, they should adhere to the classification of the former. Others argued that psychiatric education should follow the European orientation and leave the North American classification aside. And a small group considered that they should use Latin American classifications. I conclude that the manuals of the American Psychiatric Association and the World Health Organization are established as what Rodríguez Medina calls subordinating objects, while Latin American classifications are positioned as local entities that serve specific purposes. However, the hierarchies involved in the geopolitics of knowledge can be contested in daily pedagogical practices.

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            Diagnostic ambivalence: psychiatric workarounds and the Diagnostic and Statistical Manual of Mental Disorders.

            In 1980 the American Psychiatric Association (APA), faced with increased professional competition, revised the Diagnostic and Statistical Manual of Mental Disorders (DSM). Psychiatric expertise was redefined along a biomedical model via a standardised nosology. While they were an integral part of capturing professional authority, the revisions demystified psychiatric expertise, leaving psychiatrists vulnerable to infringements upon their autonomy by institutions adopting the DSM literally. This research explores the tensions surrounding standardisation in psychiatry. Drawing on in-depth interviews with psychiatrists, I explore the 'sociological ambivalence' psychiatrists feel towards the DSM, which arises from the tension between the desire for autonomy in practice and the professional goal of legitimacy within the system of mental health professions. To carve a space for autonomy for their practice, psychiatrists develop 'workarounds' that undermine the DSM in practice. These workarounds include employing alternative diagnostic typologies, fudging the numbers (or codes) on official paperwork and negotiating diagnoses with patients. In creating opportunities for patient input and resistance to fixed diagnoses, the varied use of the DSM raises fundamental questions for psychiatrists about the role of the biomedical model of mental illness, especially its particular manifestation in the DSM.
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              La estructura de las revoluciones científicas

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                Author and article information

                Journal
                trilo
                Trilogía Ciencia Tecnología Sociedad
                Trilogía. Cienc. Tecnol. Soc.
                Instituto Tecnológico Metropolitano (Medellín, Antioquia, Colombia )
                2145-7778
                August 2022
                : 14
                : 27
                : e204
                Affiliations
                [1] Pereira orgnameInstitución Universitaria Visión de las Américas Colombia jorge.daza@ 123456uam.edu.co
                Article
                S2145-77782022000200204 S2145-7778(22)01402700204
                10.22430/21457778.2298
                c2b63189-b853-4188-8267-1e63d829676d

                This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.

                History
                : 29 January 2022
                : 31 March 2022
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 27, Pages: 0
                Product

                SciELO Colombia

                Categories
                Artículos de investigación

                scientific culture,decolonization,enseñanza de las ciencias,science education,sistemas de clasificación,descolonización,cultura científica,Classification systems

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