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Defossez, Ellen (2018) AMBIGUITY, TEMPORALITY, AND AGENCY IN ONLINE HEALTH COMMUNITIES FOR DYSTHYMIA. Doctoral Dissertation, University of Pittsburgh. (Unpublished)

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Within the heterogeneous amalgam that constitutes “depression” exists dysthymia—a chronic, mild subtype that is rarely the sole focus of public discussion or academic research on the subject of depression. If depression in general is an experientially and linguistically ambiguous phenomenon, as is often claimed, then dysthymia can be considered especially ambiguous given that its chronic, low-grade symptoms are difficult to distinguish from one’s habitual self. Informed by Kenneth Burke’s views on the rhetorical productivity of ambiguity, this dissertation provides a rhetorical account of dysthymia’s ambiguity. It traces a rhetorical history of the conditions that led to dysthymia’s construction as a strategically ambiguous diagnostic entity in the DSM-III, as well as the conditions that led to dysthymia’s replacement with “Persistent Depressive Disorder” in the DSM-5. In addition to providing historical context, this dissertation rhetorically analyzes interactions in online health communities for dysthymia, identifying the ways in which dysthymia’s ambiguity functions as a rhetorical resource. Despite conventional wisdom suggesting that recent biopsychiatric explanations of depression have fully displaced previous psychoanalytic explanations, Chapter 2 of this dissertation observes that explanatory aspects of both paradigms blend together in dysthymia online health communities, which provides a useful strategy for negotiating matters of agency. Focusing on temporality, Chapter 3 argues that the temporal perspectives present in online accounts of dysthymia are marked by temporal expansion rather than the temporal contraction often seen in accounts of chronic physical illness. In contrast to temporal contraction, which is thought to often bolster an individual’s felt sense of agency in the present, this chapter argues that temporal expansion may tend to attenuate one’s felt sense of agency in the present. Chapter 4 explores online health community members’ widespread dissatisfaction with the label of dysthymia, most of which centers upon the disorder’s designation as “mild.” This chapter describes the rhetorical conundrum occasioned by being diagnosed with a “mild” or “high-functioning” mood disorder, and identifies the strategies used to challenge the aptness of “mild” as a descriptor for the subjective experience of dysthymia.


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Item Type: University of Pittsburgh ETD
Status: Unpublished
CreatorsEmailPitt UsernameORCID
Defossez, Ellenejd34@pitt.eduejd34
ETD Committee:
TitleMemberEmail AddressPitt UsernameORCID
Committee ChairMalin,
Committee MemberKuchinskaya,
Committee MemberZboray,
Committee MemberLukacs,
Date: 26 September 2018
Date Type: Publication
Defense Date: 13 June 2018
Approval Date: 26 September 2018
Submission Date: 23 August 2018
Access Restriction: No restriction; Release the ETD for access worldwide immediately.
Number of Pages: 246
Institution: University of Pittsburgh
Schools and Programs: Dietrich School of Arts and Sciences > Communication: Rhetoric and Communication
Degree: PhD - Doctor of Philosophy
Thesis Type: Doctoral Dissertation
Refereed: Yes
Uncontrolled Keywords: depression, online health, rhetoric, agency, ambiguity, temporality
Date Deposited: 26 Sep 2018 23:38
Last Modified: 26 Sep 2018 23:38


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