The Three Faces of PMS: The Professional, Gendered, and Scientific Structuring of a Psychiatric Disorder

The case examined here concerns the 1986 decision by the Board of Trustees of the American Psychiatric Association (APA) to include Late Luteal Phase Dysphoric Disorder (LLPDD)—a PMS-related diagnosis—in its Diagnostic and Statistical Manual of Mental Disorders, Third Edition, Revised (DSM-111-R). Drawing on a social worlds perspective in the sociology of science, I argue that this controversy was not restricted to conflict between feminists and the APA as was portrayed in the popular press; nor, was it a natural result of scientific progress set within rational procedures of the revision process within the APA. Rather, I argue that as a result of sustained debate and conflict, the diagnosis of LLPDD assumed different forms and even became a different artifact: I) In the “health and mental health domain,” LLPDD became the object of struggle for professional control over mental disorders among the various scientific, medical, and mental health fields; 2) in the “woman domain,” LLPDD was defined as a result of struggle for control over the definition of a normal and healthy woman; 3) in the “science domain,” LLPDD was a site in which the definition of the “truth” about PMS was debated publicly and the knowledge used in settling social and policy issues in powerful organizations like the APA.