Psychiatric Disorders qua Natural Kinds: The Case of the ‘‘Apathetic Children’’ (original) (raw)

"Relaxed" Natural Kinds and Psychiatric Classification

Studies in History and Philosophy of Science , 2018

This paper starts out highlighting a particular criticism that psychiatry faces and continues by investigating approaches to classification in psychiatry that operate with a " relaxed " (non-essentialist) notion of natural kind. Two accounts are examined, one by Rachel Cooper (2005; 2013) and one based on the work of Richard Boyd (1991; 1999; 2003; 2010). While these accounts do not directly pursue such a goal, the main aim is to probe whether deploying a " relaxed " notion of natural kind would be able to neutralize the criticism. While the conclusion is in the negative, the analysis raises doubts that it is possible to completely neutralize this criticism without assuming an overly simplistic view of the causal structure of the world.

Kincaid defensible natural kinds in psychopathology

In this chapter I argue for two main theses in this chapter-: that there are some types of psychopathology that can reasonably and usefully be thought of as constituting natural kinds, given a naturalist take on the latter, and that those kinds are best thought of as categorical rather than dimensional. I also make some arguments about what must be done-but largely has not been done-methodologically to identity psychopathologic kinds of the sort I defend. In section 1, I argue for one picture of natural kinds, theories, and explanation appropriate for the social and behavioral sciences. Section In section 2, I looks at a number of mostly confused arguments that psychopathology must be thought of as dimensional. I either reject them or show how they are compatible with categorical approaches. Section In section 3 applies, I apply the perspective from of section 1 and insights from section 2 to argue that there is a plausible case to be made that certain types of depression constitute natural kinds in my favored sense. 206 8.1 Natural Kinds, Theories, and the Social and Behavioral

Mental disorder between naturalism and normativism

Philosophy Compass

Worries about the potential medicalization of social and moral problems has propelled the debate on the nature of mental disorder, with normativists insisting that psychiatric classification is inherently value‐laden and naturalists maintaining that a purely descriptive account of disease is possible. In recent work, some authors take a different path, accepting that the concepts of disease and mental disorder are value‐laden but maintaining that this does not prevent objective truths regarding mental disorder attribution. This paper explores two such accounts and the important steps they provide toward rethinking the nature and metaphysical status of mental disorder. The challenges raised in this paper are meant to contribute to the further development of this stimulating work.

Mental illness as mental: in defence of psychological realism

Humana.Mente, 2009

This paper argues for psychological realism in the conception of psychiatric disorders. We review the following contemporary ways of understanding the future of psychiatry: (1) psychiatric classification cannot be successfully reduced to neurobiology, and thus psychiatric disorders should not be conceived of as biological kinds; (2) psychiatric classification can be successfully reduced to neurobiology, and thus psychiatric disorders should be conceived of as biological kinds. Position (1) can lead either to instrumentalism or to eliminativism about psychiatry, depending on whether psychiatric classification is regarded as useful. Position (2), which is inspired by the growing interest in neuroscience within scientific psychiatry, leads to biological realism or essentialism. In this paper we endorse a different realist position, which we label psychological realism. Psychiatric disorders are identified and addressed on the basis of their psychological manifestations which are often described as violations of epistemic, moral or social norms. A couple of examples are proposed by reference to the pathological aspects of delusions, and the factors contributing to their formation.

HYPOTHESIS AND THEORY ARTICLE The third wave of biological psychiatry

In this article I will argue that we are witnessing at this moment the third wave of biological psychiatry. This framework conceptualizes mental disorders as brain disorders of a special kind that requires a multilevel approach ranging from genes to psychosocial mechanisms. In contrast to earlier biological psychiatry approaches, the mental plays a more prominent role in the third wave. This will become apparent by discussing the recent controversy evolving around the recently published DSM-5 and the competing transdiagnostic Research Domain Criteria approach of the National Institute of Mental Health that is build on concepts of cognitive neuroscience. A look at current conceptualizations in biological psychiatry as well as at some discussions in current philosophy of mind on situated cognition, reveals that the thesis, that mental brain disorders are brain disorders has to be qualified with respect to how mental states are constituted and with respect to multilevel explanations of which factors contribute to stable patterns of psychopathological signs and symptoms.

3 Stabilizing Mental Disorders: Prospects and Problems

A primary focus of the debates in philosophy of psychiatry addressed in each of the chapters in this volume is whether mental disorders are natural kinds. The question subdivides into several interrelated questions: Are mental disorders real and stable regularities in nature that exist independent of our systems of classifying them? Do the sets of necessary and sufficient conditions that constitute the categories of mental disorders put forward in the Diagnostic and Statistical Manual of Mental Disorders and in the International Classification of Diseases track these regularities? Are those groups of phenomena individuated by the categories suitable for discovering their causes and identifying viable targets for therapeutic intervention? The vast majority of philosophers of psychiatry are realists about mental disorders. The consensus, however, is that current mental disorder categories do not pick out stable regularities in nature that are subject to the same causal-mechanical explanations. see also the chapters in this volume by Kincaid and Murphy.) Yet if the categories do not track real divisions in nature — if research into mental disorders begins with indefinite and poorly circumscribed explanatory targets — it is likely that the projects of identifying their causes and developing successful therapeutic interventions to treat them will also fail. That scientific explanation requires well-delineated explanatory targets, and mental disorders do not seem to qualify, is one of the primary reasons why philosophers of psychiatry have been reluctant to abandon the natural kinds ideal for psychiatric classification and why debates about whether or not mental disorders are natural kinds persist in the philosophical literature. Some of the chapters in this volume (those by Kincaid, Horwitz, Murphy, and Ross) focus on how to revise current categories of mental disorders so that the disorders they individuate correspond to bona fide regularities in

Classifying Psychopathology: Mental Kinds and Natural Kinds

The MIT Press eBooks, 2014

According to the Mental Health Atlas (World Health Organization 2011 , p. 13), " neuropsychiatric disorders are estimated to contribute to 13% of the global burden of disease "-that is, more than 450 million people suffer from neuropsychiatric disorders. They are leading causes of disabilityadjusted life years, accounting for 37 percent of the healthy years lost from all non-communicable diseases. Depression alone accounts for one-third of this (Insel 2011). The global cost of mental illness is estimated at 2.5 trillion US dollars and is expected to increase to more than 6 trillion dollars by 2030 (World Health Organization 2011). In the United States alone, estimates indicate that mental-health disorders account for 59 percent of the economic costs that stem from injury or illness-related loss of productivity (ibid.). Perhaps surprisingly, the economic burden of mental-health disorders stems less from the cost of care than from loss of income due to unemployment, expenses for social supports, and a range of indirect costs due to chronic disability that begins early in life (Insel 2011). According to the director of the National Institutes for Mental Health, " considering that those with mental illness are at high risk for developing cardiovascular disease, respiratory disease, and diabetes, the true costs of mental illness must be even higher " (ibid.). While awareness of the cost of mental disorders is increasing, doubts about overmedicalization-about treating what really are problems in living as if they were medical diseases calling for pharmacological treatment-are also increasing. For example, there is evidence that certain sociological and economic pressures on the development of manuals such as the Diagnostic and Statistical Manual of Mental Disorders have eroded historically preserved distinctions between categories differentiating " normal " types of human suffering from mental disorder and dysfunction.

REVIEW Open Access The six most essential questions in psychiatric

2013

In the conclusion to this multi-part article I first review the discussions carried out around the six essential questions in psychiatric diagnosis – the position taken by Allen Frances on each question, the commentaries on the respective question along with Frances ’ responses to the commentaries, and my own view of the multiple discussions. In this review I emphasize that the core question is the first – what is the nature of psychiatric illness – and that in some manner all further questions follow from the first. Following this review I attempt to move the discussion forward, addressing the first question from the perspectives of natural kind analysis and complexity analysis. This reflection leads toward a view of psychiatric disorders – and future nosologies – as far more complex and uncertain than we have imagined. General conclusion In concluding this multi-part article, let me begin once again with a brief review of what we have already covered. For the full text of the Gene...