Jonathan Y. Tsou examines and defends positions on central issues in philosophy of psychiatry. The positions defended assume a naturalistic and realist perspective and are framed against skeptical perspectives on biological psychiatry. Issues addressed include the reality of mental disorders; mechanistic and disease explanations of abnormal behavior; definitions of mental disorder; natural and artificial kinds in psychiatry; biological essentialism and the projectability of psychiatric categories; looping effects and the stability of mental disorders; psychiatric classification; and the validity of the DSM's (...) diagnostic categories. The main argument defended by Tsou is that genuine mental disorders are biological kinds with harmful effects. This argument opposes the dogma that mental disorders are necessarily diseases that result from biological dysfunction. Tsou contends that the broader ideal of biological kinds offers a more promising and empirically ascertainable naturalistic standard for assessing the reality of mental disorders and the validity of psychiatric categories. (shrink)

A minimal essentialism (‘intrinsic biological essentialism’) about natural kinds is required to explain the projectability of human science terms. Human classifications that yield robust and ampliative projectable inferences refer to biological kinds. I articulate this argument with reference to an intrinsic essentialist account of HPC kinds. This account implies that human sciences (e.g., medicine, psychiatry) that aim to formulate predictive kind categories should classify biological kinds. Issues concerning psychiatric classification and pluralism are examined.

The past decade has witnessed a growing awareness of conceptual and methodological hurdles within psychology and neuroscience that must be addressed for taxonomic and explanatory progress in understanding psychological functions to be possible. In this paper, I evaluate several recent knowledge-building initiatives aimed at overcoming these obstacles. I argue that while each initiative offers important insights about how to facilitate taxonomic and explanatory progress in psychology and neuroscience, only a “coordinated pluralism” that incorporates positive aspects of each initiative will have (...) the potential for success. (shrink)

Martin Luther King Jr. claimed that “the salvation of the world lies in the hands of the maladjusted”. I elaborate on King’s claim by focusing on the way in which we treat and understand ‘maladjustment’ that is responsive to severe trauma (e.g. PTSD that is a result of military combat or rape). Mental healthcare and our social attitudes about mental illness and disorder will prevent us from recognizing real injustice that symptoms of mental illness can be appropriately responding to, unless (...) we recognize that many emotional states (and not just beliefs!) that constitute those symptoms are warranted by the circumstances they are responsive to. I argue that there is a failure to distinguish between PTSD symptoms that are warranted emotional responses to trauma and those that are not. This results in us focusing our attention on “fixing” the agent internally, but not on fixing the world. It is only by centering questions of warrant that we will be able to understand and expose the relationship between agents’ internal mental states and their oppression. But we also need to ask when someone’s emotional response is unwarranted by their experience (as in the case of someone who develops PTSD after a non-traumatic event). If we fail to do this—as, I claim, both our mental healthcare and the broader social world fail to do—we treat warranted and unwarranted emotions as on a par. This undermines the epistemic judgment of the agent who has warranted PTSD symptoms, resulting in her failing to trust her evaluation of whether her emotional response to her own trauma is warranted by that trauma, and thus failing to recognize her own oppression. (shrink)

Accounts of mental disorders focusing either on the brain as neurophysiological substrate or on systematic connections between symptoms are insufficient to account for the multifactorial nature of mental illnesses. Recently, multiplexes have been suggested to provide a holistic view of psychopathology that integrates data from different factors, at different scales, or across time. Intuitively, these multi-layered network structures present quite appealing models of mental disorders that can be constructed by powerful computational machinery based on increasing amounts of real-world data. In (...) this paper, I systematically examine what challenges psychopathology models face and to what extent different species of psychopathology models can address them. My analysis highlights that while multiplexes, as they are usually conceived, appear promising, they suffer from the same problems as other approaches. To remedy this, I suggest, we must go a step further and combine different kinds of multiplexes into 4D models. Once we embrace 4D multiplexes and identify appropriate ways to constrain them, we might unlock the true potential of multiplexes for making headway in psychopathology research. (shrink)

Realists about mental disorder have been hasty about dismissing social explanations of how mental disorder is constituted. However, many social ontologies are realist ontologies. In order to create a meaningful distinction between realism and social metaphysics about mental disorder, I propose that realism about mental disorder is best understood as Individual Trait Realism (ITR) about them. For ITR, mental disorders exist in virtue of traits. I defend the view that ITR is compatible with social metaphysics, arguing that, in asking whether (...) constituents in the social sphere figure the metaphysics of psychopathology, we are asking questions on three different strata of explanation: the strata of demarcation, instantiation, and individual traits. Distinguishing between these strata allows for nuanced realism that need not reject the social constitution of mental disorder. (shrink)

This paper offers an overview of the philosophical work on epistemic injustices as it relates to psychiatry. After describing the development of epistemic injustice studies, we survey the existing literature on its application to psychiatry. We describe how the concept of epistemic injustice has been taken up into a range of debates in philosophy of psychiatry, including the nature of psychiatric conditions, psychiatric practices and research, and ameliorative projects. The final section of the paper indicates future directions for philosophical research (...) of epistemic injustices and psychiatry, concerning neurocognitive disorders, identity prejudices in psychiatric illness, concepts of epistemic privilege in psychiatry, and the prospects for combining phenomenological psychopathology and epistemic justice. We argue that much remains to be done in the conceptualization of these epistemic injustices and suggest that this future work should be multidisciplinary in character and sensitive to the phenomenology of psychiatric conditions. (shrink)

Recently there has been a trend of moving towards biological and neurocognitive based classifications of mental disorders that is motivated by a dissatisfaction with the syndrome-based classifications of mental disorders. The Research Domain Criteria (indicated with the acronym RDoC) represents a bold and systematic attempt to foster this advancement. However, RDoC faces theoretical and conceptual issues that need to be addressed. Some of these difficulties emerge when we reflect on the plausible reading of the slogan “mental disorders are brain disorders”, (...) that according to proponents of RDoC constitutes one of its main presuppositions. Some authors think that endorsing this idea commits RDoC to a form of biological reductionism. We offer empirical and theoretical considerations for concluding that the slogan above should not be read as a reductionist thesis. We argue, instead, that the slogan has a pragmatic function whose aim is to direct research in psychopathology. We show how this function might be captured in the framework of a Carnapian explication as a methodological tool for conceptual engineering. Thus, we argue that a charitable interpretation of the aims of the proponents of RDoC should be understood as an attempt at providing an explication of the concept of mental disorder in terms of brain disorder whose main goal is to provide a more precise and fruitful notion that is expected to have a beneficial impact on classification, research, and treatment of psychiatric conditions. (shrink)

Much research in the philosophy of psychiatry has been devoted to the characterization of the normal and the pathological. In this article, we identify and deconstruct two postulates that have held sway in the philosophy of psychiatry. The first postulate concerns the belief that clinicians would benefit from conceiving of psychiatric disorders as stable entities with clear boundaries. By relying on a symptom-based approach, we support a conception of psychiatric disorders whose symptoms are the products of many activated mechanisms in (...) mutual interactions. The second postulate concerns the way in which the philosophy of psychiatry has approached the question of harm. We posit that clinicians perceive harms primarily through networks of clinical manifestations. The identification and deconstruction of these two postulates leads us to propose a practical definition of a psychiatric disorder that is useful for the clinician, while adopting a principle of prudential conservatism that does not exclude other theoretical definitions of psychiatric disorder that are useful as an epistemic hub. Thus, we propose the following definition of a psychiatric disorder that is relevant to clinical practice: “a set of clinical manifestations belonging to the prototypical central core of psychiatry, organized in a causal network, involving at least one harm, and whose set of harms exceeds the traditional threshold of significance for a given psychiatric disorder, directly related to an activated mechanism. Such a network composed of clinical manifestations is frozen in a state that is unable to allow the deactivation of these manifestations spontaneously without a therapeutic intervention”. (shrink)

In this paper, we want to take a critical stance towards Tsou’s recent proposal that a neuro-oriented version of the homeostatic property cluster kind model (MPCK) should be an ideal for the DSM. Our strategy will be to discuss the creation of the Social Pragmatic Communication Disorder (SPCD) in DSM-5 to show the limits of MPCK as an ideal for the next DSM deliberations over a set of diagnoses revisions. We argue that an ideal model for the DSM should address (...) the issues of deep uncertainties and pragmatic considerations to be useful in this context. (shrink)

This article examines the distinction between active matter and active materials, and it offers foundational remarks toward a system of classification for active materials. Active matter is typically identified as matter that exhibits two characteristic features: self-propelling parts, and coherent dynamical activity among the parts. These features are exhibited across a wide range of organic and inorganic materials, and they are jointly sufficient for classifying matter as active. Recently, the term “active materials” has entered scientific use as a complement, supplement, (...) and extension of “active matter.” At the same time, new work in the philosophy of science has considered the problem of how to classify the products of synthetic and laboratory processes, and the extent to which the aims of classifying natural kinds compare and contrasts with the aims of classifying these synthetic kinds. In this article, I apply those considerations to the problems of classifying and characterizing active materials. In doing so, I also argue for a conception of active materials’ coherent dynamical activity as multiscale, rather than emergent, and I discuss how the special non-equilibrium status of active materials factors in to classificatory concerns. (shrink)

The article advances a new way of thinking about classifications in general and the classification of mental disorders in particular. By applying insights from measurement practice to the context of classification, I defend a notion of epistemic accuracy that allows one to evaluate and improve classifications by comparing different classifying methods to each other. Progress in classification arises from the mutual development of classification systems and classifying methods. Based on this notion of accuracy, the article illustrates with an example how (...) psychiatric classifications can be improved via circumscribed comparisons of different perspectives on mental disorders, without relying on complete models of their complex aetiology. When applying this strategy, the traditional opposition between symptom-based and causal approaches is of little consequence for making progress in the epistemic accuracy of psychiatric classification. (shrink)

The latest edition of the Diagnostic and Statistical Manual of Mental Disorders included the Social Communication Disorder as a new mental disorder characterized by deficits in pragmatic abilities. Although the introduction of SPCD in the psychiatry nosography depended on a variety of reasons—including bridging a nosological gap in the macro-category of Communication Disorders—in the last few years researchers have identified major issues in such revision. For instance, the symptomatology of SPCD is notably close to that of Autism Spectrum Disorder. This (...) opens up the possibility that individuals with very similar symptoms can be diagnosed differently and receive different clinical treatments and social support. The aim of this paper is to review recent debates on SPCD, particularly as regards its independence from ASD. In the first part, we outline the major aspects of the DSM-5 nosological revision involving ASD and SPCD. In the second part, we focus on the validity and reliability of SPCD. First, we analyze literature on three potential validators of SPCD, i.e., etiology, response to treatment, and measurability. Then, we turn to reliability issues connected with the introduction of the grandfather clause and the use of the concepts of spectrum and threshold in the definition of ASD. In the conclusion, we evaluate whether SPCD could play any role in contemporary psychiatry other than that of an independent mental disorder and discuss the role that non-epistemic factors could play in the delineation of the future psychiatry nosography. (shrink)

This chapter examines the history of philosophy of psychology and philosophy of psychiatry as subfields of philosophy of science that emerged in the late twentieth and early twenty-first century. The chapter also surveys related literatures that developed in psychology and psychiatry. Philosophy of psychology (or philosophy of cognitive science) has been a well-established subfield of philosophy of mind since the 1990s and 2000s. This field of philosophy of psychology is narrowly focused on issues in cognitive psychology and cognitive science. Compared (...) to the thriving subfield of philosophy of cognitive science, there has been a lack of corresponding interest among philosophers of science in broader methodological questions about different paradigms and fields of study in psychology. These broader methodological questions about psychology have been addressed in the field of theoretical psychology, which is a subfield of psychology that materialized in the 1980s and 1990s. Philosophy of psychiatry emerged as a subfield of philosophy of science in the mid-2000s. Compared to philosophy of psychology, the philosophy of psychiatry literature in philosophy of science engaged with issues examined in an older and more interdisciplinary tradition of philosophy of psychiatry that developed after the 1960s. The participation of philosophers of science in the literature on theoretical psychology, by contrast, has been limited. (shrink)

Scientists represent their world, grouping and organizing phenomena into classes by means of concepts. Philosophers of science have historically been interested in the nature of these concepts, the criteria that inform their application and the nature of the kinds that the concepts individuate. They also have sought to understand whether and how different systems of classification are related and more recently, how investigative practices shape conceptual development and change. Our aim in this paper is to provide a critical overview of (...) some of the key developments in this philosophical literature and identify some interesting issues it raises about the prospects of the so-called “special sciences”, including psychiatry, psychology, and the mind-brain sciences more generally, to discover natural kinds. (shrink)

Researchers attempting to explain and treat psychiatric disorders have long discussed the need for new disorder categories. A common proposal is to develop a causal classification system whereby psychiatric disorders are classified according to the causal processes that produce and sustain them. I evaluate the prospects for causal classification of psychiatric disorders. First, I motivate the need for a causal classification system of psychiatric disorders. Second, I introduce one framework for causal classification, the exemplar model. Third, I examine multiple forms (...) of causal complexity that the exemplar model must successfully navigate if it is to be a viable classification model for psychiatry. I argue that the exemplar model can handle some issues of causal complexity but not others. I conclude that psychiatry should utilize two models of classification, the exemplar model and the network model, because each fulfills some, but not all, of the purposes of classification systems. (shrink)

Crime is a serious social problem, but its causes are not exclusively social. There is growing consensus that explaining and preventing it requires interdisciplinary research efforts. Indeed, the landscape of contemporary criminology includes a variety of theoretical models that incorporate psychological, biological and sociological factors. These multi-disciplinary approaches, however, have yet to radically advance scientific understandings of crime and shed light on how to manage it. In this paper, using conceptual tools on offer in the philosophy of science in combination (...) with theoretical work represented in this special volume of Psychology, Crime and Law, I provide some perspective on why explanatory progress in criminology has remained elusive and evaluate some positive proposals for attaining it. -/- . (shrink)

First-person reports of Major Depressive Disorder reveal that when an individual becomes depressed a profound change or ‘shift’ to one’s conscious experience occurs. The depressed person reports that something fundamental to their experience has been disturbed or shifted; a change associated with the common but elusive claim that when depressed one finds oneself in a ‘different world’ detached from reality and other people. Existing attempts to utilise these phenomenological observations in a psychiatric context are challenged by the fact that this (...) experiential ‘shift’ characteristic of depression appears mysterious and resists analysis in scientific terms. This paper offers a way out of this predicament. The hypothesis proposed is that when an individual becomes depressed, the individual departs from a state of ordinary wakeful consciousness and enters a distinctive global state of consciousness akin to dreaming and the psychedelic state. After unpacking and motivating this hypothesis in the context of research in consciousness science, I outline two of its important implications for the neurobiology of depression and psychedelic psychiatry. The upshot is a promising and conceptually well-motivated hypothesis about depression which is apt for empirical uptake and development. (shrink)

This paper is a loose commentary on Marcinów’s book (2017). The commentary is focused on the objects of psychopathological investigations and the role of psychology / psychiatry tension in the process of singling out, tracking, and describing them. As a consequence, there are limitations of collaborative and integrative efforts between psychologists and psychiatrists where questions of psychopathology are concerned.