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The aim of this paper is to assess highly toxic leaders and dysfunctional organizations as presented via management consulting and executive coaching assignments.

The paper employs an action research approach via two participant observer case studies incorporating the DSM IV‐TR: Diagnostic and Statistical Manual of Mental Disorders.

The paper finds that the nexus of dysfunctional organizational systems may be located in “pre‐existing” leadership pathologies.

First, additional research will be needed to confirm and extend the findings of individual pathologies in leaders to dysfunctional organizational systems; second, a closer look is necessary at the applicability of the DSM IV‐TR to pathologies at the organizational level; third, due to the action research, case study approach utilized, there is somewhat limited generalizability; fourth, there are limitations re: the applicability of DSM IV‐TR as an assessment tool for management researchers due to the necessity of training in clinical psychology.

The importance of distinguishing personality disorders in leaders from toxic behaviors falling within a range of “normal pathology,” and the ability to assess individual leadership pathology within organizational systems via the clinically trained usage of the DSM IV‐TR; providing clinical assessment tools for reducing the number of misdiagnoses of leadership pathology in the workplace; encouraging collaboration between management and psychology researchers and practitioners.

This paper fills a gap in the toxic organizations research by identifying personality disorders in leaders and providing an action research agenda for incorporating the DSM IV‐TR as a means of extending the repertoire of assessment tools;

In the field of autism spectrum research, there has been a tendency to examine autistics without intellectual disabilities. This focus has come at the expense of examining their peers with intellectual disabilities, who are generally regarded as needing more assistance due to more complex support needs. This chapter begins by defining intellectual disability, followed by an examination of the literature about the prevalence of intellectual disability in the autistic population. The results from the American Government's Centres for Disease Control and Prevention (CDC) Autism and Developmental Monitoring (ADDM) Network about the proportion of autistics with intellectual disabilities are then outlined. Following this, the results from studies about the proportion of autistics with intellectual disabilities are presented. The goal of this section is to show that despite there being evidence that about a quarter of the autistic population have an intellectual disability, this cohort is underrepresented within research about the autism spectrum. Two reasons for this discrepancy are then outlined. This chapter concludes with three suggestions for where more research can be conducted into autistics who have an intellectual disability.

The original contribution that this chapter makes to the field of autism research is to highlight the lack of literature about members of the autistic community who have an intellectual disability as well as presenting several reasons for this lack of research and directions for research in the future.

In the past, leadership scholars have tended to focus on leadership as a force for good and productivity (Ashworth, 1994; Higgs, 2009; Padilla, Hogan, & Kaiser, 2007). However, recently attention has been given to the ‘dark side’ of leadership (see Higgs, 2009; Judge, Piccolo, & Kosalka, 2009). The aim of this chapter is to explore dark leadership from the perspective of the narcissistic leader using a fictional character from a popular film.

Using the Diagnostic and Statistical Manual of Mental Disorders, 4th edition, 1994 (DSM-IV) (American Psychiatric Association, 2000) as an operational definition of narcissistic personality disorder we explore the psychology of the narcissistic leader through a fictional character study in a popular film.

We have created a psychological profile of a narcissistic leader which identifies specific behavioural characteristics within a toxic organizational culture.

This study has implications for employees within any organizational culture. It is significant because it can illustrate how dark leadership can impact negatively within organizations.

The use of actual living persons on which to base case study material in the study of dark leadership is problematic and constrained by ethical issues. However, the use of characters in fiction, such as contemporary film and drama, represents an excellent source of case study material. Given that little empirical works exists on narcissistic leaders and leadership, the chapter adds originality and value to the field.

According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR, American Psychiatric Association (APA), 2000), autistic spectrum disorders (ASD) are a collection of chronic conditions that include Autistic Disorder, Rett's Disorder, Childhood Disintegrative Disorder, Aspeger's Disorder, and Pervasive Developmental Disorder Not Otherwise Specified. Typically, ASD are often identified during infancy or the toddler years. Most individuals with ASD have some degree of mental retardation. According to Deisinger (2001), genetic factors, abnormalities in brain structure and biochemistry, and complications during pregnancy have been implicated as possible causes of these disorders. Generally, students with ASD have difficulties with daily activities such as language, self-care, mobility, and independent functioning. The focus of this chapter examines the many features that must be considered before diagnosing and classifying individuals with ASD.

We sought to evaluate the capacity of the Edinburgh Postnatal Depression Scale (EPDS) in discriminating mental disorders other than depression in pregnant women in northern Mexico. Three hundred pregnant women attending prenatal consultations in a public hospital in Durango City, Mexico submitted a validated EPDS and were examined for mental disorders other than depression using the Diagnostic and Statistical Manual of Mental Disorders - 4th Ed. (DSM-IV) criteria. Sensitivity and specificity of cut-off points of the EPDS, and positive and negative predictive values were calculated. Of the 300 pregnant women studied, 21 had mental disorders other than depression by the DSM-IV criteria. The best EPDS score for screening mental disorders other than depression was 8/9. This threshold showed a sensitivity of 52.4%, a specificity of 67.0%, a positive predictive value of 11.5%, a negative predictive value of 95.4%, and an area under the curve of 0.643 (95% confidence interval: 0.52-0.76). The EPDS can be considered for screening mental disorders other than depression in Mexican pregnant women whenever a cut-off score of 8/9 is used. However, the tool showed small power to separate pregnant women with and without mental disorders other than depression.

Assessment and identification of children with emotional and behavioral disorders (EBD) is complex and involves multiple techniques, levels, and participants. While federal law sets the general parameters for identification in school settings, these criteria are vague and may lead to inconsistencies in selection and interpretation of assessment measures. Assessment practice across school settings is greatly influenced by clinical guidelines such as the DSM-IV, which more specifically defines emotional and behavioral disorders and highlights the issue of co-morbidity. Before a student is assessed for special education eligibility under the IDEIA category of emotional disturbance, screening techniques and pre-referral interventions are needed. Positive Behavioral Supports and Response to Intervention models provide empirically supported frameworks for establishing the need for formal psychological assessment. Collaboration among members of the multidisciplinary team, including parents, helps to ensure that identification and intervention efforts have ecological validity. Tests and techniques vary considerably, but developmental histories, interviews, observations across settings, and behavioral checklists and rating scales are recommended, along with cognitive and achievement testing. While problems exist in the reliability and validity of projective techniques, they continue to be used in school-based assessment for EBD. Multitrait, multisetting, and multimethod approaches are essential for culturally fair assessment and reduction of bias in identification and placement.

Purpose – The purpose of this chapter is to theorize the relationship between diagnosis and medicalization through an examination of the medicalization of childhood gender variance and the Gender Identity Disorder of Childhood diagnosis.

Methodology/approach – The chapter examines textual data (published clinical and research literatures, and critiques of the diagnosis appearing in a range of venues) to track how childhood gender variance is medicalized over time and the role of diagnosis in that medicalization.

Findings – While diagnosis certainly plays a role in shoring up medicalization, this case study reveals the many ways in which diagnoses may also become key tools in attempts to curtail medicalization.

Research limitations/implications – As a case study, the findings are not generalizable to all diagnoses. As a study of an instance of the medicalization of deviance, these findings may be particularly applicable to analogous cases.

Social implications – These findings show the sometimes tenuous nature of medicalization processes, and the social uses of diagnoses in those processes.

Originality/value of paper – This chapter sheds light on a relationship that is often assumed to be unidirectional (e.g., that the formation of diagnosis results in increased medicalization), and answers calls for a more nuanced sociology of diagnosis, including greater attention to the relationship between diagnosis and medicalization.

Purpose – This chapter explores the changing definition of bipolar disorder, examining how debates within psychiatry actually construct the definition of mental illness, thereby creating the appearance of an emerging epidemic with increasing prevalence.

Method – I review the recent psychiatric and epidemiological research to reveal that the intellectual and scientific debates that occur in the psychological laboratory and in survey research are in fact falsely increasing the figures that show that an epidemic of bipolar is emerging.

Findings – For centuries, bipolar disorder was equated with severe psychosis and had a prevalence rate between 0.4% and 1.6%. As spectrum and subthreshold conceptions of bipolar disorder become established in official psychiatric diagnostic manuals, however, estimates of the prevalence of bipolar spectrum disorders have risen to almost 25%. I demonstrate that nearly all of this increase is a result of changes in the scientific and intellectual definition of bipolar disorders among psychiatric professionals, and that rates of symptoms are not in fact increasing.

Contribution to field – The arbitrariness of diagnostic thresholds naturally leads researchers to argue for lower thresholds. This allows more individuals who were previously considered psychiatrically normal to be reclassified as psychiatrically disordered. Lowering diagnostic thresholds increases the risk of confusing normal elation or sadness with disordered states, increasing the potential of false-positive diagnoses and the false impression of rising rates of disorder.

Child psychiatrist Leo Kanner (pronounced “Konner;” Feinstein, 2010, p. 19) published a ground-breaking paper in 1943 that introduced the world to the present-day concept of autism (Fombonne, 2003; Goldstein & Ozonoff, 2009; Roth, 2010). Prior to Kanner, however, several physicians described the condition of autism without identifying it as such. A textbook published in 1809, titled Observations on Madness and Melancholy, contained a description of a boy whose symptoms fit the modern definition of autism (Feinstein, 2010; Vaillant, 1962). The book's author, Dr. John Haslam, wrote about a 5-year-old male who was admitted to the Bethlem Asylum in 1799 with a medical history that included a case of measles when he was 1 year old. The boy's mother claimed that at age 2 years, her son became harder to control. She also indicated that he did not begin to walk until he was 2½ years of age and did not talk until he was 4 years old. Once hospitalized, the boy cried only briefly upon separation from his mother and was “constantly in action” (Vaillant, 1962, p. 376), suggesting that he was hyperactive. Hyperactivity is a characteristic commonly found in children with ASDs (APA, 2000; Wicks-Nelson & Israel, 2009). Although this child watched other boys at play in the hospital, he never joined them and played intently with toy soldiers by himself. The boy could not learn to read and always referred to himself in the third person (Vaillant, 1962). Grammatical errors in speech can be observed among individuals with ASDs (Roth, 2010; Wicks-Nelson & Israel, 2009).