- Undertakes a searching analysis of tools used to screen for and diagnose addiction.
- Scrutinises the validity and reliability claims made about the tools.
- Critically analyses validation as a concept in itself.
- Shows how tools participate in making addiction and shaping affected individuals.
In this article, we critically examine the operations of these validation techniques as applied to substance addiction tools. Framed by feminist and other scholarship that decentres the epistemological guarantees of objectivity and validity, we structure our analysis using concepts of ‘refuting’ (showing a thesis to be false) and ‘unmasking’ (undermining a thesis). Under ‘refuting’, we consider the methodological validation processes on their own terms, identifying contradictory claims, weak findings and inconsistent application of methodological standards. Under ‘unmasking’, we critically analyse validation as a concept in itself.
Here we identify two fundamental problems: symptom learning and feedback effects; and circularity and assumptions of independence and objectivity. Our analysis also highlights the extra-theoretical functions and effects of the tools. Both on their own terms and when subjected to more searching analysis, then, the validity claims the tools make fail to hold up to scrutiny.
In concluding, we consider some of the effects of the processes we identify. Not only do these tools make certainty where there is none, we contend, they actively participate in the creation of social objects and social groups, and in shaping affected individuals and their opportunities. In unpacking in detail the legitimacy of the tools, our aim is to open up for further scrutiny the processes by which they go about making (rather than merely reflecting) the disease of addiction.
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