©2004 by MEDIMOND S.r.l. 99 E516R9005 Reconceptualising Reproductive Disorders: The Development of a Material-Discursive-Intrapsychic Approach J.M. Ussher PsyHealth: Research in Gender, Culture and Health, School of Psychology, University of Western Sydney, Australia Summary This paper critically examines the positivist-realist paradigm that dominates medicine and psychology, arguing that it leads to the pathologisation of distress associated with women’s reproductive health. Taking the case of post-natal depression, an alternative material-discur- sive-intrapsychic model is proposed, which acknowledges the myriad causes of women’s distress, and avoids either biological or psychologi- cal reductionism. Introduction Within medicine and psychology, disciplines dominated by a posi- tivist-realist epistemological perspective, the desire for valid and reli- able comparison across epidemiological and treatment studies, and the need to facilitate research into etiological mechanisms, has precipitated the desire to establish consensus definitions of problems associated with women’s reproductive health – such as premenstrual syndrome (PMS), postnatal depression (PND), and menopausal distress. The diagnostic categories reified in DSMIV are the archetypal case. The desire for a scientific approach and uniform definitions of reproductive health prob- lems may appear on the surface to be a necessary first step for both research and clinical intervention. However, the very notion of catego- rization of experience into psychiatric syndromes, within a positivist- realist model, has been criticised from many different avenues. For example, take the case of Post Natal Depression. The focus on