Scientists cannot devise theories, construct models, propose explanations, make predictions, or even carry out observations, without first classifying their subject matter. The goal of scientific taxonomy is to come up with classification schemes that conform to nature's own. Another way of putting this is that science aims to devise categories that correspond to 'natural kinds.' The interest in ascertaining the real kinds of things in nature is as old as philosophy itself, but it takes on a different guise when one (...) adopts a naturalist stance in philosophy, that is when one looks closely at scientific practice and takes it as a guide for identifying natural kinds and investigating their general features. This Element surveys existing philosophical accounts of natural kinds, defends a naturalist alternative, and applies it to case studies in a diverse set of sciences. This title is also available as Open Access on Cambridge Core. (shrink)

Disruptions in theory of mind faculties and the ability to relate to an intersubjective reality are widely thought to be crucial to schizophrenic symptomology. This paper applies a cognitive linguistic framework to analyze spontaneous perspective-taking in two corpora of stories told by people with a schizophrenia diagnosis. We elicited natural narrative language use through life story interviews and a guided storytelling task and analyzed the linguistic construal of viewpoint in these stories. For this analysis, we developed a reliable and widely (...) applicable viewpoint model that allows for the categorization and quantification of speakers’ linguistic presentation and navigation of spatiotemporal domains. We found that our participants skillfully presented, navigated and embedded different narrative viewpoints through a variety of linguistic viewpoint devices. They presented complex viewpoints of other people in both the here-and-now of the interaction and the there-and-then of a narrative, and made use of transition markers to demarcate spatiotemporal discourse domains. We found no differences in viewpoint variables when comparing their guided stories to a control group. If problems with intersubjectivity are indeed an essential part of schizophrenia, an explanation of how this group can take on and navigate complex linguistic viewpoints in natural narrative interaction is called for. (shrink)

Recent trends in psychiatry involve a transition from categorical to dimensional frameworks, in which the boundary between health and pathology is understood as a difference in degree rather than as a difference in kind. A major tenet of dimensional approaches is that no qualitative distinction can be made between health and pathology. As a consequence, these approaches tend to characterize such a threshold as pragmatic or conventional in nature. However, dimensional approaches to psychopathology raise several epistemological and ontological issues. First, (...) we review major sources of evidence usually recruited in support of the dimensional trend (focusing on clinical observation and biological data), and we show that these are connected to different conceptualizations of how dimensional traits extend across health and pathology. Second, we criticize two unquestioned assumptions that stand at the core of the dimensional trend: a) that there is continuity from health to pathology at the symptomatic level; b) that such continuity reflects an underlying continuity in the genetic liability for pathological conditions. Third, we argue against the idea of a conventional threshold by showing that such a view implies a linear relationship between the genotype and the phenotype. Fourth, drawing on epigenetics and developmental biology, we offer a characterization of mental disorders as stable and dynamic constellations of multi-level variables that differ qualitatively from ‘healthy states’. We conclude by showing that our account has several theoretical advantages over both categorical and dimensional approaches. Notably, it provides crucial insights into psychological development over time and individual differences, with major implications in terms of intervention and clinical decision-making. (shrink)

There has been a spurt in both fundamental and translational research that examines the underlying mechanisms of the human microbiome in psychiatric disorders. The personalized and dynamic features of the human microbiome suggest the potential of its manipulation for precision psychiatry in ways to improve mental health and avoid disease. However, findings in the field of microbiome also raise philosophical and ethical questions. From a philosophical point of view, they may yet be another attempt at providing a biological cause for (...) phenomena that ultimately cannot be so easily localized. From an ethical point of view, it is relevant that the human gut microbiome comprises data on the individual’s lifestyle, disease history, previous medications, and mental health. Massive datasets of microbiome sequences are collected to facilitate comparative studies to identify specific links between the microbiome and mental health. Although this emerging research domain may show promise for psychiatric patients, it is surrounded by ethical challenges regarding patient privacy, health risks, effects on personal identity, and concerns about responsibility. This narrative overview displays the roles and advances of microbiome research in psychiatry and discusses the philosophical and ethical implications of microbiome big data and microbiome-based interventions for psychiatric patients. We also investigate whether these issues are really “new,” or “old wine in new bottles.”. (shrink)

In this paper, we explore the conceptual problems arising when using network analysis in person- centered care (PCC) in psychiatry. Personalized network models are potentially helpful tools for PCC, but we argue that using them in psychiatric practice raises boundary problems, i.e., problems in demarcating what should and should not be included in the model, which may limit their ability to provide clinically-relevant knowledge. Models can have explanatory and representational boundaries, among others. We argue that we can make more explicit (...) what kind of questions personalized network models can address in PCC, given their representational and explanatory boundaries, using perspectival reasoning. (shrink)

This paper proposes an account of neurocognitive activity without leveraging the notion of neural representation. Neural representation is a concept that results from assuming that the properties of the models used in computational cognitive neuroscience must literally exist the system being modelled. Computational models are important tools to test a theory about how the collected data has been generated. While the usefulness of computational models is unquestionable, it does not follow that neurocognitive activity should literally entail the properties construed in (...) the model. While this is an assumption present in computationalist accounts, it is not held across the board in neuroscience. In the last section, the paper offers a dynamical account of neurocognitive activity with Dynamical Causal Modelling that combines dynamical systems theory mathematical formalisms with the theoretical contextualisation provided by Embodied and Enactive Cognitive Science. (shrink)

Human behavior and thought often exhibit a familiar pattern of within group similarity and between group difference. Many of these patterns are attributed to cultural differences. For much of the history of its investigation into behavior and thought, however, cognitive science has been disproportionately focused on uncovering and explaining the more universal features of human minds—or the universal features of minds in general. -/- This entry charts out the ways in which this has changed over recent decades. It sketches the (...) motivation behind the cultural turn in cognitive science, and situates some of its central findings with respect to the questions that animate it and the debates that it has inspired. Woven throughout the entry are examples of how the cognitive science of culture, and especially its elevated concern with different forms of diversity and variation, continues to influence and be influenced by philosophers. -/- One cluster of philosophical work falls within the traditional subject matter of philosophy of science, in this case of the cognitive and social sciences. Philosophers have analyzed and assessed the methods and evidence central to the scientific study of cognition and culture, and have offered conceptual scrutiny, clarification, and synthesis. Research in a second vein sees philosophers themselves contributing more directly to cognitive scientific projects, (co)constructing theories, helping build computational models, even gathering empirical data. A third kind of work is naturalistic philosophy or philosophy of nature, wherein philosophers seek to use results from the cognitive science of culture to inform or transform debates over long-standing philosophical questions, including questions about the nature of philosophy and philosophical methodology itself. (shrink)

This paper asks when a natural disease kind is truly 'reactive' and when it is merely associated with a corresponding social kind. I begin with a permissive account of real kinds and their structure, distinguishing natural kinds, indifferent kinds and reactive kinds as varieties of real kind characterised by super-explanatory properties. I then situate disease kinds within this framework, arguing that many disease kinds prima facie are both natural and reactive. I proceed to distinguish ‘simple dependence’, ‘secondary dependence’ and ‘essential (...) dependence’ between a natural kind and its classification, and argue that a natural kind is only really reactive, in an important sense, under conditions of essential dependence. On this basis, I offer a principled hypothesis for why psychiatric kinds tend to be more metaphysically unstable than paradigm somatic disease kinds. (shrink)

How we ought to diagnose, categorise and respond to spectrum disabilities such as autism and Attention Deficit/Hyperactivity Disorder (ADHD) is a topic of lively debate. The heterogeneity associated with ADHD and autism is described as falling on various continua of behavioural, neural, and genetic difference. These continua are varyingly described either as extending into the general population, or as being continua within a given disorder demarcation. Moreover, the interrelationships of these continua are likewise often vague and subject to diverse interpretations. (...) -/- In this paper, I explore geneticists' and self-advocates’ perspectives concerning autism and ADHD as continua. These diagnoses are overwhelmingly analysed as falling on a continuum or continua of underlying traits, which supports the notion of “the neurodiversity spectrum”, i.e., a broader swath of human neural and behavioural diversity on which some concentrations of different functioning are diagnosed. I offer a taxonomy of conceptions of the genetic, phenotypic, and endophenotypic dimensionality within and beyond these diagnostic categories, and suggest that the spectrum of neurodiversity is characteristically endophenotypic. (shrink)

The comorbidity of personality disorders and mental disorders is commonly understood through three types of theoretical models: either a) personality disorders precede mental disorders, b) mental disorders precede personality disorders, c) mental disorders and personality disorders share common etiological grounds. Although these hypotheses differ with respect to their idea of causal direction, they all imply a latent variable perspective, in which it is assumed that either personality and mental disorders are latent variables that have certain causal relations [models a) and (...) b)]; or that, as in model c), the common etiology is in fact a latent variable that causes symptomatology of both personality and mental disorders. We aim to provide another perspective on the comorbidity between personality and mental disorders, namely a network perspective. To this end, we investigated Major Depression and Borderline Personality Disorder and hypothesized that symptoms of BPD and MD could interact with one another rather than being caused by a latent variable. To illustrate this theoretical network conceptualization of the comorbidity of BPD and MD we analyzed a cross-sectional clinical dataset of 376 patients who were asked to complete the Structured Clinical Interview for DSM-IV Axis II Disorders and the Beck Depression Inventory II. The results identify direct associations between symptoms of MD and BPD. If we take the links in this empirical network to be ‘substantive', this suggests a radical shift of our current conceptualization of the comorbidity of mental disorders and personality disorders. (shrink)

According to Oude Maatman (2020), our recent suggestion (Borsboom et al., 2019) that symptom networks are irreducible because they rely on folk psychological descriptions, threatens to undermine the main achievements of the network approach. In this article, we take up Oude Maatman’s challenge and develop an argument showing in what sense folk psychological concepts describe features of reality, and what it means to say that folk psychology is a causal language.

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)

This article aims to provide a historical overview of the relationship between epilepsy and religiosity. Although the link between epilepsy and religiosity has been observed since ancient times, empirical research has not supported the direct relationship between epilepsy and religiosity in any unequivocal way. The rich reference to the historical relationship between epilepsy and religiosity often served as a kind of evidence in itself, even though observations of epileptic religiosity were far less detailed as modern scholars referred to them. A (...) detailed analysis of the connection between epilepsy and religiosity only emerged in the 20th century. By introducing a symbolic level of interpretation, psychoanalysis significantly contributed to the psychological theory of the epileptic personality in general and epileptic religiosity in particular. The older concept of the epileptic personality (and religiosity) mixed with psychoanalytic interpretation was preserved in the Szondi Test. Based on the present historical analysis, the author concludes that the connection between epilepsy and increased religiosity was overstated in the 20th century. (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)

The contemporary brain disorders debate echoes a century-long conflict between two different approaches to mental suffering: one that relies on natural sciences and another drawing from the arts and humanities. We review contemporary neuroimaging studies and find that neither side has won. The study of mental differences needsboththe sciences and the arts and humanities. To help develop an approach mindful of both, we turn to physician-writer Anton Chekhov’s story “A Nervous Breakdown.” We review the value of the arts and humanities (...) as a coequal partner with natural sciences in the creation of a robust mental health humanities. (shrink)

Despite the remarkable advances in behavioral and brain sciences over the last decades, the mind/body (brain) problem is still an open debate and one of the most intriguing questions for both cognitive neuroscience and philosophy of mind. Traditional approaches have conceived this problem in terms of a contrast between physicalist monism and Cartesian dualism. However, since the late sixties, the landscape of philosophical views on the problem has become more varied and complex. The Multiple Realization Thesis (MRT) claims that mental (...) properties can be (or are) realized, and mental processes can be (or are) implemented by neural correlates of different kinds. Thus, MRT challenges the psychoneural type-identity theory and the corresponding reductionism. Many philosophers have acknowledged the a priori plausibility of MRT. However, the existence of empirical evidence in favor of intraspecific, human multiple realizations of mental processes and properties is still controversial. Here we illustrate some cases that provide empirical evidence in support of MRT. Recently, it has been proposed that foveal agnosic vision, like peripheral vision, can be restored by increasing object parts’ spacing (Strappini et al., 2017a; Crutch and Warrington, 2007). Agnosic fovea and normal periphery are both limited by crowding, that impairs object recognition, and provides the signature of visual integration. Here we define a psychological property of restored object identification and we cross-reference the data of visually-impaired patients with different etiologies. In particular, we compare the data of two stroke patients, two patients with posterior cortical atrophy (PCA), six cases of strabismic amblyopia, and one case with restored sight. We also compare these patients with unimpaired subjects tested in the periphery. We show that integration (i.e. restored recognition) seems to describe quite accurately the visual performance in all these cases. While the patients have different etiologies and different neural correlates, the unimpaired subjects have no neural damage. Thus similarity in the psychological property given the differences in the neural substrate can be interpreted in relation to MRT and provide evidence in its support. Finally, we will frame our contribution within the current debate concerning MRT providing new and compelling empirical evidence. (shrink)

Translation as philosophical program: An explorative reviewWhat does the concept of translation mean in the expression ‘translational neuroscience’? What are the different steps, or components, in the translation of neuroscientific findings to psychiatry? There are serious concerns about the validity and productivity of the traditional idea of a translational pipeline, starting in the fundamental sciences (chemistry, molecular and cellular biology) and ending in the practice of clinical medicine, including psychiatry. The article defends the thesis that the difficulties in the traditional (...) approach result, at least partially, from insufficient reflection on the philosophical premises upon which the concept of translation is based. The linear pipeline model is strongly determined by the traditional biomedical approach to disease. The translation crisis signifies some of the limitations of this approach, especially in the realm of clinical practice and patient experience. The biomedical model suggests that illness manifestations should be conceived as causally determined expressions of an underlying biological derailment or dysfunction. This model lacks the language and conceptual tools to address the role of contextual and person-bound factors in the manifestation of illness. It is only recently that personalized and context-sensitive approaches to psychopathology have gained scientific attention. In the wake of this conceptual and practical reform, network-like approaches to translation have emerged. These network approaches are based on a different conception of transdisciplinarity. They address all stakeholders, by asking them what kind of translation they need. Stakeholders are not only scientists and clinicians, but also patient- and family support groups; and parties that are responsible for the institutional embedding, the financial and logistic infrastructure, and the legal frameworks that support psychiatric care. It is the interaction between science (as producer of knowledge) and the contexts that are supposed to benefit from this knowledge, that should be put at the centre of conceptual reflection. The degree and fruitfulness of this interaction will be decisive for the future of both psychiatry and clinical neuroscience. Philosophy can play an important role in this interaction, by making explicit underlying logical and practical tensions and ambiguities in this interaction. (shrink)

We received 23 spirited commentaries on our target article from across the disciplines of philosophy, economics, evolutionary genetics, molecular biology, criminology, epidemiology, and law. We organize our reply around three overarching questions: (1) What is a cause? (2) How are randomized controlled trials (RCTs) and within-family genome-wide association studies (GWASs) alike and unalike? (3) Is behavior genetics a qualitatively different enterprise? Throughout our discussion of these questions, we advocate for the idea that behavior genetics shares many of the same pitfalls (...) and promises as environmentally oriented research, medical genetics, and other arenas of the social and behavioral sciences. (shrink)

Machine learning heralds highly transformative approaches to the automation of numerous clinical tasks, from diagnosis to risk assessment, and from prognosis to informing treatment decisions....

According to the Argument for Autonomous Mental Disorder, mental disorder can occur in the absence of brain disorder, just as software problems can occur in the absence of hardware problems in a computer. This article argues that the AAMD is unsound. I begin by introducing the “natural dysfunction analysis” of disorder, before outlining the AAMD. I then analyze the necessary conditions for realizer autonomous dysfunction. Building on this, I show that software functions disassociate from hardware functions in a way that (...) mental functions do not disassociate from brain functions. It follows that mental disorders are brain disorders necessarily. (shrink)

Are mental disorders natural kinds or socially constructed categories? What is at stake if either of these views prove to be true? This paper offers a qualified defence for the view that there may be natural kinds of mental disorder, but also that the implications of this claim are generally overestimated. Especially concerns about over-inclusiveness of diagnostic categories and medicalisation of abnormal behaviour are not addressed by the debate. To arrive at these conclusions the paper opens with a discussion of (...) kind formation in science, followed by an analysis of natural kinds. Seven principled and empirically informed objections to the possibility of natural kinds of mental disorder are considered and rejected. The paper ends with a reflection on diagnostics of mental health problems that don’t fall into natural kinds. Despite the defence of the possibility of natural kinds of mental disorder, this is likely to be the majority of cases. (shrink)

Borsboom and colleagues have recently proposed a “network theory” of psychiatric disorders that conceptualizes psychiatric disorders as relatively stable networks of causally interacting symptoms. They have also claimed that the network theory should include non-symptom variables such as environmental factors. How are environmental factors incorporated in the network theory, and what kind of explanations of psychiatric disorders can such an “extended” network theory provide? The aim of this article is to critically examine what explanatory strategies the network theory that includes (...) both symptoms and environmental factors can accommodate. We first analyze how proponents of the network theory conceptualize the relations between symptoms and between symptoms and environmental factors. Their claims suggest that the network theory could provide insight into the causal mechanisms underlying psychiatric disorders. We assess these claims in light of network analysis, Woodward’s interventionist theory, and mechanistic explanation, and show that they can only be satisfied with additional assumptions and requirements. Then, we examine their claim that network characteristics may explain the dynamics of psychiatric disorders by means of a topological explanatory strategy. We argue that the network theory could accommodate topological explanations of symptom networks, but we also point out that this poses some difficulties. Finally, we suggest that a multilayer network account of psychiatric disorders might allow for the integration of symptoms and non-symptom factors related to psychiatric disorders and could accommodate both causal/mechanistic and topological explanations. (shrink)

Mental health professionals working in hospitals or community clinics inevitably face the realisation that we possess imperfect conceptual means to understand mental disorders. In this paper the authors bring together ideas from the fields of Philosophy, Psychiatry, Cognitive Psychology and Linguistics to reflect on the ways we represent phenomena of high practical importance that we often take for granted, but are nevertheless difficult to define in ontological terms. The paper follows through the development of the concept of psychosis over the (...) last two centuries in the interplay of three different conceptual orientations: the categorical, dimensional and network approaches. Each of these represent the available knowledge and dominant thinking styles of the era in which they emerged and take markedly different stances regarding the nature of mental phenomena. Without particular commitment to any ontological positions or models described, the authors invite the reader into a thinking process about the strengths and weaknesses of these models, and how they can be reconciled in multidisciplinary settings to benefit the process of patient care. (shrink)

A new method of observation is currently emerging in psychiatry, based on data collection and behavioral profiling of smartphone users. Numerical phenotyping is a paradigmatic example. This behavioral investigation method uses computerized measurement tools in order to collect characteristics of different psychiatric disorders. First, it is necessary to contextualize the emergence of these new methods and to question their promises and expectations. The international mental health research framework invites us to reflect on methodological issues and to draw conclusions from certain (...) impasses related to the clinical complexity of this field. From this contextualization, the investigation method relating to digital phenotyping can be questioned in order to identify some of its potentials. These new methods are also an opportunity to test psychoanalysis. It is then necessary to identify the elements of fruitful analysis that clinical experience and research in psychoanalysis have been able to deploy regarding the challenges of digital technology. An analysis of this theme's litterature shows that psychoanalysis facilitates a reflection on the psychological effects related to digital methods. It also shows how it can profit from the research potential offered by new technical tools, considering the progress that has been made over the past fifty years. This cross-fertilization of the potential and limitations of digital methods in mental health intervention in the context of theoretical issues at the international level invites us to take a resolutely non-reductionist position. In the field of research, psychoanalysis offers a specific perspective that can well be articulated to an epistemology of networks. Rather than aiming at a numerical phenotyping of patients according to the geneticists' model, the case formulation method appears to be a serious prerequisite to give a limited and specific place to the integration of smartphones in clinical investigation. (shrink)

This essay provides an analysis of the clinical problems that arise at the borderline between neurology and psychiatry. We postulate that psychopathological and neuropathological constructs have distinct referents and conceptual fields, but they are not mutually exclusive categories. After establishing criteria for defining neuropsychiatric constructs, we outline rules for identifying cases where a significant relationship exists between neuropathological and psychopathological patterns. We propose three approaches to establishing this relationship: a clinical epidemiology approach, a clinical neuroscience approach offering a mechanistic model, (...) and a longitudinal study of individual cases incorporating idiographic perspectives. We discuss the logic of brain-behavior relationships and emphasize the need for closer academic feedback between neuroscientific research and clinical practice to better understand the causality of psychopathological phenomena in the context of neuropsychiatry. While precise demarcation may be challenging in some cases, we provide two types of examples: first, straightforward cases where neuropathology explains psychopathological patterns; second, complex cases that require studying the causal interactions between neuropathological factors, psychological factors, and sociocultural contexts, leading to intricate clinical patterns that demand cognitive neuropsychiatry resources, and a multidisciplinary approach to clinical care. (shrink)

Early 20th century philosopher Henri Bergson posited an initial push that propelled the diversity of life forward into a varied, novel future: The élan vital, a necessary force or impulse that animated life’s progress and development. His idea had largely been abandoned by mid-century. Even so, much of the conceptual and explanatory work this impulse targeted is yet in want of an explanation. In particular, Bergson’s derelict ideas on evolution addressed three areas that have once again become relevant in the (...) effort to unite evolutionary genetics, biological development, and ecological context : the purposeful nature of individual organisms and their parts; the integrative, holistic, non-linear emergent dynamics seen in evolutionary processes; and how genuine novelty emerges into the universe :422, 2016; Simondon et al. in On the mode of existence of technical objects. Univocal series, Univocal Publishing LLC, Minneapolis, 2017; Bang, in: Winther-Lindqvist, Bang, Valsiner Nothingness: philosophical insights into psychology, Transaction Publishers, Somerset, 2016; Moreno and Mossio in Biological autonomy: a philosophical and theoretical enquiry. History, philosophy and theory of the life sciences, Springer, Dordrecht, 2015). In this paper I argue that Bergson’s ideas may yet be relevant to these questions, and his work warrants a reexamination in light of current problems in evolutionary biology. This is not a call to ‘return’ to Bergson, nevertheless his notions about complexity suggest ways of looking at current biological problems in ways that offer a heuristic insight worth entertaining. Bergson’s Nobel Prize-winning book, Creative Evolution, provided a strikingly prescient early 20th century framework for understanding how Darwinian evolution acts as an engine for generating new forms, University Press of America, Lanham, Bergson 1911). (shrink)

Here we defend the view that one ought to categorize and classify at least some mental disorders as clusters of interrelated dysfunctions of (usually, several) cognitive capacities – that is, the kinds of capacities that are postulated in cognitive science; capacities that are understood as entities that are primarily individuated in cognitive-functional terms (CF-systems); systems that have a set of peculiar properties in their manner of operation when processing information or representations. Usually, some of the mental disorders postulated in psychiatry (...) are clinically heterogeneous with respect to their symptoms, and tend to be comorbid – that is, one disorder is often accompanied by other disorders – for example, schizophrenia often comes with major depression. We argue that describing the manner in which CF-systems operate within themselves and with other CF-systems as well as with stimuli and other kinds of information can best explain why certain mental disorders are very heterogeneous with respect to their symptoms, and why comorbidity is so frequent among these disorders. A consequence is that both within-category heterogeneity and comorbodity are not necessarily indications of defective classifications but are rather a consequence of the actual cognitive functional architecture itself and are therefore to be expected in these cases. (shrink)

Thinking through other minds encompasses new dimensions in computational psychiatry: social interaction and mutual sense-making. It questions the nature of psychiatric manifestations in light of recent data on social interaction in neuroscience. We propose the concept of “social physiology” in response to the call by the conceivers of TTOM for the renewal of computational psychiatry.

Machine learning (ML) has emerged as a promising tool in psychiatry, revolutionising diagnostic processes and patient outcomes. In this paper, I argue that while ML studies show promising initial results, their application in mimicking clinician-based judgements presents inherent limitations (Shatte et al. in Psychol Med 49:1426–1448. https://doi.org/10.1017/S0033291719000151, 2019). Most models still rely on DSM (the Diagnostic and Statistical Manual of Mental Disorders) categories, known for their heterogeneity and low predictive value. DSM's descriptive nature limits the validity of psychiatric diagnoses, which (...) leads to overdiagnosis, comorbidity, and low remission rates. The application in psychiatry highlights the limitations of supervised ML techniques. Supervised ML models inherit the validity issues of their training data set. When the model's outcome is a DSM classification, this can never be more valid or predictive than the clinician’s judgement. Therefore, I argue that these models have little added value to the patient. Moreover, the lack of known underlying causal pathways in psychiatric disorders prevents validating ML models based on such classifications. As such, I argue that high accuracy in these models is misleading when it is understood as validating the classification. In conclusion, these models will not will not offer any real benefit to patient outcomes. I propose a shift in focus, advocating for ML models to prioritise improving the predictability of prognosis, treatment selection, and prevention. Therefore, data selection and outcome variables should be geared towards this transdiagnostic goal. This way, ML can be leveraged to better support clinicians in personalised treatment strategies for mental health patients. (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)