Who benefits from diagnostic labels for developmental disorders?

The number of diagnoses of developmental disorders is on the rise and the use of labels for developmental disorders, such as attention-deficit/hyperactivity disorder and autism spectrum disorder, is widening. Diagnostic labels can play an important role in helping those who display atypical behaviour and their caregivers to cope with associated challenges and, possibly, to get treatment. But these labels are increasingly contested and associated with a variety of harmful effects. In this paper, we analyze the role diagnostic labels can play in four different contexts (scientific, therapeutic, social, and administrative) and identify what various stakeholders stand to gain or lose with continued, expanded, or abolished use of those labels. Our analysis reveals labels serve different purposes in each of these contexts, benefitting different stakeholders. Any overall evaluation, critique, or defence of labels needs to consider the interests of all stakeholders in these contexts.

QUEM SE BENEFICIA DOS RÓTULOS DIAGNÓSTICO PARA TRANSTORNOS DO DESENVOLVIMENTO?: O número de diagnósticos de transtornos do desenvolvimento está aumentando e o uso de rótulos para transtornos do desenvolvimento, como transtorno de déficit de atenção/hiperatividade e transtorno do espectro autista, está se ampliando. Os rótulos diagnósticos podem desempenhar um papel importante para ajudar aqueles que apresentam comportamento atípico e seus cuidadores a lidar com os desafios associados e, possivelmente, a obter tratamento. Mas esses rótulos são cada vez mais contestados e associados a uma variedade de efeitos nocivos. Neste artigo, analisamos o papel que os rótulos diagnósticos podem desempenhar em quatro contextos diferentes (científico, terapêutico, social e administrativo) e identificamos o que várias partes interessadas podem ganhar ou perder com o uso contínuo, expandido ou abolido desses rótulos. Nossa análise revela que os rótulos atendem a diferentes propósitos em cada um desses contextos, beneficiando diferentes públicos. Qualquer avaliação geral, crítica ou defesa de rótulos precisa considerar os interesses de todas as partes interessadas nesses contextos.

The Explanations People Give for Going to Bed Late: A Qualitative Study of the Varieties of Bedtime Procrastination.

Background/Objective: Bedtime procrastination is a prevalent cause of sleep deprivation, but little is known about why people delay their bedtimes. In the present research, we conducted a qualitative study with bedtime procrastinators to classify their self-reported reasons for later-than-intended bedtime. Participants: Participants (N = 17) were selected who frequently engaged in bedtime procrastination, but whose sleep was not otherwise affected by diagnosed sleep disorders or shift work. Method: We conducted in-depth, semistructured interviews and used thematic analysis to identify commonly recurring themes in the interviews. Results and conclusions: Three emerging themes were identified: deliberate procrastination, mindless procrastination, and strategic delay. For the form of procrastination we classified as deliberate procrastination, participants typically reported wilfully delaying their bedtime because they felt they deserved some time for themselves. For the category of mindless procrastination, a paradigmatic aspect was that participants lost track of the time due to being immersed in their evening activities. Finally, participants who engaged in strategic delay reported going to bed late because they felt they needed to in order to fall asleep (more quickly), which suggests that despite describing themselves as "procrastinating," their bedtime delay may actually be linked to undiagnosed insomnia. The conceptual distinctions drawn in this paper deepen our understanding of bedtime delay and may be helpful for designing effective interventions.

Too Depleted to Turn In: The Relevance of End-of-the-Day Resource Depletion for Reducing Bedtime Procrastination.

Bedtime procrastination is an important predictor of sleep insufficiency in the general population (Kroese et al., 2014b), but little is known about the determinants of this self-undermining behavior. As the phenomenon has been conceptualized in the literature as a form of self-regulation failure (Kroese et al., 2014a), we hypothesized that people's self-regulatory resources in the evening would be predictive of going to bed later than they intended. Specifically, we examined whether the cumulative effect of resisting desires, a measure of self-regulatory resource depletion (Hofmann et al., 2012b), relates to bedtime procrastination. Participants (N = 218) reported how many desires they had tried to resist during the previous day and the extent of their bedtime procrastination. Results show that people who attempted to resist more desires were more likely to engage in bedtime procrastination, suggesting that people may be less likely to stick to their intended bedtime after a particularly taxing day. Implications for intervention strategies are discussed.