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Certified peer specialists (CPS) are mental health professionals who draw their expertise from lived experience with mental illness and mental distress. They tale a nonmedical, nonclinical approach to providing support to community members with mental health difficulties and in doing so, emphasize the role of social environmental factors that contribute to mental distress. Their perspectives are contrary to the biomedical perspective of mainstream psychiatry. While there is a significant body of literature on CPS, there is a dearth of research on how CPS engage in and perceive the broader mental health system. They resist the biomedicalization of mental illness by moving past labels and the language of pathology to facilitate recovery from mental illness and to resist stigma. Drawing from in-depth interviews with peer specialists, participant observation of a peer-run organization, and a survey of peer specialists across the United States, I ask the following research questions: How and why are CPS challenging the medical model of mental illness? How do CPS consider social environmental factors in the etiology of distress and what are the potential implications for resistance to both biomedicalization and stigmatization? My data suggest that CPS, in their critiques of the medical model and the mental health system, are actively resisting the biomedicalization of mental illness and focus on social environmental factors that contribute to experiences of distress. This research has meaningful implications for research on CPS and hope for recovery from mental illness. • Peer specialists' approach to mental illness is nonmedical. • Peer specialists work to resist the biomedicalization of mental illness. • Resisting biomedicalization can also lead to destigmatization. • A focus on trauma emphasizes social environmental causes of distress. [ABSTRACT FROM AUTHOR]

A growing body of social science literature is devoted to describing processes of biomedicalization. The issue of biomedicalization is especially relevant for individuals suffering from end-stage cancer and hoping that aggressive end-of-life interventions, which are riddled with uncertainty around quantity or quality of life, will produce a ‘cure’. To examine hospice underutilization among end-stage cancer patients, we apply the anthropological concept ‘political economy of hope,’ which describes how personal and collective ‘hope’ is associated with the political and economic structures that produce biomedicalization processes. Previous studies have examined hospice underutilization among end-stage cancer patients and have identified barriers stemming from patient and physician characteristics or health insurance reimbursement policies. Yet, these studies do not provide an organized synthesis of how barriers articulate, how they are part of the longitudinal decision-making process, or describe the sociocultural context surrounding hospice care enrollment decisions. This paper focuses on US-specific mechanisms and is based on qualitative, in-depth, interviews with physicians at an academic hospital (N = 24). We find that hospice underutilization results from a web of interconnected constraints surrounding end-stage cancer patients. Our research reveals how hospice care contradicts the political and economic structures associated with end-stage cancer care and illustrates how end-stage cancer patients are transformed into a form of biovalue, a fundamental commodity sustaining the political economy of hope. [ABSTRACT FROM AUTHOR]

For over twenty years, medical doctors writing self-help books for major trade publishers have promoted hormone balance as a desirable physical state, particularly for women. To understand how hormone balance is presented as an actualizable health objective, we examine self-help hormone balance books written by medical doctors and published between 2003 and 2021 by major American trade presses. Books deploy a model of endocrine determinism that defines most health conditions as the consequence of imbalanced hormones, particularly for women whose bodies are said to be perpetually at risk of imbalance. The pathway to balanced hormones, we find, involves intensive lifestyle changes and consumption practices that are unachievable except for the most privileged readers. Our analysis reveals hormone balance to be a fantasy biological state that reflects a fundamental tension in neoliberal modernity, that of bodies breaking down from the strain modern life places on individuals, and bodies needing to accomplish more under ever-demanding social and economic conditions. We conclude with a reflection on the semantic flexibility of "balance" as an ambiguous term that can signify the very opposite of harmony and moderation, and the role of medical doctors as self-help entrepreneurs. • We use critical discourse analysis to analyze self-help hormone balance books written by medical doctors. • Books use a model of endocrine determinism that considers health to be determined by hormones. • Book suggest that women are most susceptible to hormone imbalances. • Hormone balance is promoted through intensive lifestyle and consumption practices. • Hormone balance reflects an ambiguous health objective that signifies the opposite of moderation. [ABSTRACT FROM AUTHOR]

Diagnostic categories for domestic violence have shifted over time, transforming from a disorder of psychological passivity and acute injury into a chronic and somatically invasive condition. This paper links these changing diagnoses to constructions of the abused body and to victim-blaming narratives. Based on an analysis of medical journal articles, this research identifies two logics that undergird domestic violence diagnoses, the body, and victim-blaming: 1) the logic of injury (1970s–1980s); and 2) the logic of health (late 1980s–present). The logic of injury is associated with overt victim-blaming, a temporally bounded and injured body, and psychological passivity. Once the feminist anti-violence movement gained mainstream credibility, however, the logic of injury fell out of favor as an explanation for domestic violence. What surfaced next was the logic of health, which is associated with chronic diagnoses and what the author calls a temporally extended body. The temporally extended body is flexible and layered, linking up past, present, and future states of disordered embodiment. The author suggests that, rather than ushering in hope and possibility via the logic of health's somatic flexibility, this abused body creates spaces into which new forms of blame and self-responsibility can take shape. [ABSTRACT FROM AUTHOR]

Positive Plus One is the first large-scale mixed methods study of mixed HIV serostatus couples in Canada. We aimed to understand how biomedicalization i.e., a social process of commodification and expansion of the jurisdiction of medicine over health, influenced the everyday relationships of these couples. We completed 51 semi-structured interviews among a purposive sample of HIV-positive (n = 27) and HIV-negative (n = 24) partners in current or past mixed-serostatus relationships. Participants were recruited after completing an online survey where they consented to be re-contacted for qualitative interviews. Participants represented a diversity of sexual orientations, gender identities, and other sociodemographic characteristics. Drawing on inductive thematic analysis to identify patterns within couples, across serostatus and sexual orientations, we argue that everyday lives of mixed-serostatus couples were shaped by biomedical knowledge and enacted through routine adherence to obtain and maintain viral load undetectability. Our findings illustrated the importance of learning biomedical knowledge for mixed-serostatus couples in this study, the empowering influence of undetectable = untransmittable (U U) discourse, and its role in rendering HIV mundane through routine ART adherence. We introduce the concept of 'dual pharmaceutical citizenship' to underscore a process by which particular biopolitical and biomedical expectations are fulfilled in mixed-serostatus relationships. These findings have implications for people who do not readily accept or have access to biomedical knowledge, particularly when treatment-as-prevention frames a "right" and "wrong" approach to HIV management. Future studies should focus on couples where at least one partner does not readily accept or have access to biomedical knowledge. • Novel contribution to emerging dyadic analyses of mixed-status couples. • Over time, HIV became a mundane part of life for mixed-status couples. • Agreement on HIV facts and adherence to HIV treatment are important. • Dual pharmaceutical citizenship signifies biopolitical expectations for each partner. • Both partners must believe that the work of medical management is worth it. [ABSTRACT FROM AUTHOR]

Abstract: This article examines historical trends in the reporting of health and medicine in The New York Times and Chicago Tribune from the 1960s to the 2000s. It focuses on the extent to which health reporting can be said to have become increasingly politicized, or to have shifted from treating the production of medical knowledge as something belonging to a restricted, specialized sphere, to treating it as a part of the general arena of public debate. We coded a sample of 400 stories from the two newspapers for four different Implied Audiences which health stories can address: Scientific/Professional, Patient/Consumer, Investor and Citizen/Policymaker. Stories were also coded for the origin of the story, the sources cited, the presence of controversy, and the positive or negative representation of biomedical institutions and actors. The data show that through all five decades, news reporting on health and medicine addressed readers as Citizen/Policymakers most often, though Patient/Consumer and Investor-oriented stories increased over time. Biomedical researchers eclipsed individual physicians and public health officials as sources of news, and the sources diversified to include more business sources, civil society organizations and patients and other lay people. The reporting of controversy increased, and portrayals of biomedicine shifted from lopsidedly positive to more mixed. We use these data in pinpointing how media play a constitutive role in the process of “biomedicalization,” through which biomedicine has both extended its reach into and become entangled with other spheres of society and of knowledge production. [Copyright &y& Elsevier]

Abstract: Feminist research has shown repeatedly the extent to which medical accounts pathologize menstruation, yet there has been very little examination of how clinicians and medical researchers actually study and assess menstruation. This paper analyzes 30 US medical journal articles to examine how researchers work to distinguish the specific menstrual disorder of menorrhagia, or excessive bleeding, from normal menstruation. I focus specifically on measurement as a key process in diagnosing menstrual pathology, arguing that measurement practices construct women''s bodies as appropriate objects of medical attention in ways that also shape women''s positions as participants in knowledge production. I begin with the alkaline hematin method''s narrow focus on physical proof of bleeding that proves or disproves women''s complaints and trace the emergence of new methods that incorporate women''s own assessments of bleeding. Changing ways of measuring menstruation point to shifts in understandings of the body as the object of medical treatment and of patients as medical subjects. [Copyright &y& Elsevier]

Abstract: Medicalization studies have changed dramatically in the past decade in part due to the increased attention to the role of pharmaceuticals and the pharmaceutical industry in modern life. This review paper explores the relationship between the concepts of medicalization and the newly developed terms of pharmaceuticalization and the pharmaceuticalization of public health. We show how and why modernist thinking limits the terms'' utility to explain a world in which both modern and postmodern objects and people interact with each other. We provide a framework for reconceptualizing and empirically studying these key processes of the 21st century. [Copyright &y& Elsevier]

Over the past two decades, evidence and regulatory responses have surfaced regarding associations between selective serotonin reuptake inhibitors (SSRIs) and serious adverse effects, especially akathisia, aggression and suicidality. Given increasing concern about depression prevalence and harm, the dominance of biomedical approaches, and the normalisation of antidepressant use, reports about the potential for serious adverse effects from SSRIs present a dilemma for people working in depression intervention: the drugs are linked to “two conflicting claims” that they may either decrease or increase harm. We present data from in-depth semi-structured interviews with nine professionals in New Zealand working in fields relating to depression and supportive of SSRIs, to investigate the negotiation of this dilemma. We analysed participants’ talk about akathisia, aggression and suicidality associated with SSRIs, and found the use of rhetorical strategies that minimised the significance of risks, countered risks with notions of benefit and/or questioned the validity of risks. These discursive resources provided ways of mitigating the dilemma otherwise posed by evidence of adverse drug effects. However in doing so they referenced notions of SSRI benefit that relied upon assumptions about the efficacy of the drugs, risks of untreated depression, and the impact of adverse effects. Overall, our analysis highlights ways in which evidence of serious adverse effects from SSRIs can be rhetorically contained and undermined. [Copyright &y& Elsevier]

Breast pump marketing promises mothers that they will be able to follow cultural and scientific mandates to breastfeed their babies, but on their own schedules, including working outside of the home. Relatively little attention has been paid to the problems that women may experience with breast pumps. The Food and Drug Administration (FDA) regulates breast pumps as medical devices, and the agency collects data on adverse events experienced by consumers and recalls. Existing literature on breast pumps was reviewed in the contexts of medicalization and biomedicalization, and regulatory data were analyzed using mixed methods to examine the problems that women have experienced with breast pumps, which include electrical problems, suction problems, fluid leaks, injuries, and infections. While electric breast pumps promise women convenience and efficiency in pumping, women may incur personal costs, in the form of pain, injuries, and infections. These findings have implications regarding the risks of using these devices, the design of future pumps, and the future research into medical devices for reproductive and women's health. • The FDA received over 4500 adverse reports by 2018. • Mothers experienced breast tissue damage, rashes, burns, and infections. • Malfunctions included electrical, suction, and sterility problems. • Eleven pumps were recalled, for sterility, device design, and malfunctioning. • Devices, at the nexus of medical sociology and science and technology studies, warrant inquiry. [ABSTRACT FROM AUTHOR]

Abstract: In an era of biomedicalization where findings in genetic and neurobiological research are seen as “breakthroughs” by the media and hence by the general public, it is important for social scientists to acknowledge the effect of their contributions to the alcohol field not only to their own colleagues but also to the public at-large. Contributions of social science research to the development and evaluation of alcohol policies are illustrated in the following four areas: (1) alcohol epidemiological research focusing on the importance of examining drinking patterns and their relation to alcohol-related problems; (2) alcohol''s contribution to the burden of disease; (3) alcohol control policies and their impact; and (4) brief interventions that provide strategies for at-risk drinkers as well as those who are alcohol dependent. [Copyright &y& Elsevier]

The common practice of delaying and/or avoiding end-of-life conversations with medically frail older adults is an important clinical issue. Most research investigating this practice focuses on clinician training and developing conversation skills. Little is known about the socio-political factors shaping the phenomenon of end-of-life conversations between clinicians and medically frail older patients. Using the critical lens of biomedicalization we consider how two dominant discourses, successful aging and frailty , and subsequent constructions of bodies as malleable or senescent , shape patient subjectivities and influence normative expectations about appropriate healthcare conversations and the consumption of biomedicine for medically frail adults. We highlight the uneven ways medically frail older adults are clinically positioned as successful or frail agers and briefly discuss how gender, class, and race may impact this tension and ambiguity. We conclude by arguing that end-of-life conversations with medically frail older adults is constrained by the pervasiveness of the successful aging discourse and the tendency within medical institutions to construct older bodies as malleable and in need of medical intervention to promote health and longevity. • First critical examination of socio-political factors shaping EOL conversations with medically frail older adults • Genealogy of discourses, successful aging and frailty, highlighting their influence on the self, body and EOL conversations • Ontological assumptions about medically frail bodies as malleable or senescent informs appropriateness of EOL conversations • Future research should examine discourses, social structures and EOL conversations. [ABSTRACT FROM AUTHOR]

This article examines historical trends in the reporting of health, illness and medicine in UK and Italian newspapers from 1984 to 2017. It focuses on the increasing "biomedicalization" of health reporting and the framing of health and medicine as a matter of technoscientific interventions. Methodologically, we relied on two large datasets consisting of all the health- and medicine-related articles published in the online archives of The Guardian (UK) and la Repubblica (Italy). These articles underwent a quantitative analysis, based on topic modelling techniques, to identify and analyse relevant topics in the datasets. Moreover, we developed some synthetic indices to support the analysis of how medical and health news are "biomedicalized" in media coverage. Theoretically, we emphasise that media represent a constitutive environment in shaping biomedicalization processes. Our analyses show that across the period under scrutiny, biomedicalization is a relevant, even if sometimes ambivalent, frame in the media sphere, placing growing centrality on three dimensions: i) health and well-being as a matter of individual commitment to self-monitoring and self-surveillance; ii) biomedicine as a large technoscientific enterprise emerging from the entanglement between research fields and their technological embodiments; iii) the multiverse reforms of welfare systems in facing the trade-off between universal health coverage and the need to render the national healthcare system more sustainable and compatible with non-expansionary monetary policies and austerity approaches in managing state government budgets. • Historical trends in newspapers coverage on health and medicine are explored. • Analysis of health and medicine in newspapers covers three decades in UK and Italy. • A new method and indices to study health and medicine in newspapers is developed. • Mainstream media is used as a source for analysing the biomedicalization theory. • The role of mainstream media in the biomedicalization process is discussed. [ABSTRACT FROM AUTHOR]