Tyreman and Loughlin make many varied and interesting comments, but neither, it is encouraging to find, is prepared to defend the psychogenic inference. Indeed, Loughlin finds the paper “somewhat shocking.” “The psychogenic inference,” Loughlin writes, “seems such an obvious fallacy, yet he [Sykes] shows, with detailed reference to both diagnostic practice and the literature on mental disorders, the extraordinary pervasiveness of its influence, extending even to the systematic ambiguities built into key diagnostic terms” (2010, 305). The main points of disagreement (...) are Tyreman’s defense of the term functional in certain contexts and Loughlin’s criticism of the claim that there has been a paradigm shift .. (shrink)

The Paper Begins by introducing the Siren “psychogenic inference”. It then deals with the impact of this inference on the navigation of medical and psychiatric seafarers. The next two parts are more theoretical; the first deals with the entrenchment of the psychogenic inference in some central terms used in discussing medically unexplained symptoms (MUS). The second uncovers the damaging influence of the psychogenic inference on the navigational charts—on the somatoform disorder sections of the two major classifications used internationally, namely the (...) Diagnostic and Statistical Manual, 4th edition Text revision (DSM-IV-TR; American Psychiatric Association [APA] 1994), produced by the APA and of the International .. (shrink)