Rodrigues and Banzato related the validity of diagnostic categories to their meaningfulness and I wish to explore this relation further without attempting to make criticisms. To commence, if a diagnostic category is to be valid, it must mean something.
Dear Editor, in a previous paper we have tried to delve into what validity means in the context of psychiatric nosology, arguing for a pragmatic view of it. Here we want to briefly reassert the basic points of our analysis, make a few clarifications and address some issues raised by commentators.
Aims: The Research Diagnostic Criteria for Temporomandi¬bular Disorders (RDC/TMD) Axis I diagnostic algorithms were demonstrated to be reliable but below target sensitivity and specificity. Empirical data supported Axis I algorithm revisions that were valid. Axis II instruments were shown to be both reliable and valid. An international consensus workshop was convened to obtain recommendations and finalization of new Axis I diagnostic algorithms and new Axis II instruments. Methods: A comprehensive search of published TMD diagnostic literature was (...) followed by review and consensus via a formal structured process by a panel of experts for revision of the RDC/TMD. Results: The recommended Diagnostic Criteria for TMD (DC/TMD) Axis I protocol includes both a valid screener for pain diagnoses and valid criteria for the most common pain-related TMDs and for one intra-articular disorder. The Axis II protocol retains selected RDC/TMD screening instruments augmented with new instruments to better assess the interactions between pain and psychosocial functioning. A comprehensive classification system is also presented. Conclusion: The recommended evidence-based DC/TMD protocol is appropriate for use in both the clinical and research settings. Simple Axis I and II screening tests augmented by validated Axis I and Axis II instruments allow for identification of simple to complex TMD patients. (shrink)
We raise a problem of applicability of RCTs to validate nuclear diagnostic imaging tests. In spite of the wide application of PET and other similar techniques that use radiopharmaceuticals for diagnostic purposes, RCT-based evidence on their validity is sparse. We claim that this is due to a general conceptual problem that we call Prevalence of Treatment, which arises in connection with designing RCTs for testing any diagnostic procedure in the present context of medical research, and is (...) particularly apparent in this case. We also identify three practical reasons why RCTs do not qualify as the best option for PET validation, which have to do with specific characteristics of nuclear diagnostic imaging, and of radiopharmaceuticals. The paper is meant to contribute both to the philosophical discussion on the EBM hierarchy of evidence, and on the specific debate on radiopharmaceuticals in nuclear medicine. (shrink)
The aim of the Validation Theory (VT) as a meta-empirical construct is to introduce a new vista in the reorganization of the neuroscience, in its role of a science of the Mind-and-Brain unification. The present study focuses on existing discrepancies and contradictions between the methods of basic neurosciences and those prescribed by the psychological science. Our view is that these discrepancies are based on a high penetration of traditional neuroscience methods into the biological processes, coupled with low extrapolation (experimenting with (...) animal models) and vice versa for the psychological and psychopathological methods. A novel epistemological model for integrating psychological and neuroscientific knowledge is proposed. It is represented as a simultaneous investigation of the brain activity with penetrating high resolution functional Magnetic Resonance Imaging and in extenso application of set of psychological tests for exploring correspondence (cross-validation) between their compounds. The proposed approach leads to a revision of the neuroscientific and psychological terms, methods and data, followed by a revision of their relative interplay. This would make possible a practical exchange of expensive but objective fMRI with the lower costing psychological instruments (effect of "minimization"). The approaches proceeding from VT will infiltrate diagnostics and prevention in psychiatry. On a further stage the pharmaco-psychological monitoring will uncover new opportunities. This proofs' based research and practice represents an integral counterpart of the values-based mental health care. In conclusion VT is an evolutionary corner stone in order to traverse the stage of a Brain-Brain paradigm and to reach the point of development of the Mind-Brain paradigm. (shrink)
The failure of psychiatry to validate its diagnostic constructs is often attributed to the prioritizing of reliability over validity in the structure and content of the Diagnostic and Statistical Manual of Mental Disorders. Here I argue that in fact what has retarded biomedical approaches to psychopathology is unwarranted optimism about diagnostic discrimination: the assumption that our diagnostic tests group patients together in ways that allow for relevant facts about mental disorder to be discovered. I consider (...) the Research Domain Criteria framework as a new paradigm for classifying objects of psychiatric research that solves some of the challenges brought on by this assumption. (shrink)
What makes a high-quality biomarker experiment? The success of personalized medicine hinges on the answer to this question. In this paper, I argue that judgment about the quality of biomarker experiments is mediated by the problem of theoretical underdetermination. That is, the network of biological and pathophysiological theories motivating a biomarker experiment is sufficiently complicated that it often frustrates valid interpretation of the experimental results. Drawing on a case-study in biomarker diagnostic development from neurooncology, I argue that this problem (...) of underdetermination can be overcome with greater coordination across the biomarker research trajectory. I then sketch an account for how coordination across a research trajectory can be evaluated. I ultimate conclude that what makes a high-quality biomarker experiment must be judged by the epistemic contribution it makes to this coordinated research effort. (shrink)
Background: Despite being often taken as the benchmark of quality for diagnostic and classificatory tools, 'validity' is admitted as a poorly worked out notion in psychiatric nosology. Objective: Here we aim at presenting a view that we believe to do better justice to the significance of the notion of validity, as well as at explaining away some misconceptions and inappropriate expectations regarding this attribute in the aforementioned context. Method: The notion of validity is addressed taking into (...) account its role, the framework according to which it should be assessed and the specific contents to which it refers within psychiatric nosology. Results and Conclusions: The notion of validity has an epistemological thrust and its foremost role is distinguishing correct reasoning and truth from what is irrational or false. From it follows not only that 'validity' always refers to elements of knowledge and rationality such as arguments, inferences and propositions, but also that the appropriate frameworks to assess 'validity' are logics and scientific methodology. When the validity of a psychiatric diagnostic category is at stake, the contents to which it refers are those relevantly related to the notion of 'diagnostic concept'. The consequences of our reading on the notion of 'validity' are discussed vis-à-vis the challenges faced by psychiatric nosology in order to have its diagnostic categories validated. (shrink)
Let’s begin by imagining a hypothetical psychotic illness called “Schneider’s Disease”, recognized for over 100 years. Let’s assume there has been great controversy as regards the “most valid” set of diagnostic criteria for SD.
To date, diagnosing Attention Defi cit Hyperactivity Disorder remains indeed one of the most controversial issues in contemporary psychiatry and behavioural sciences. Most of the conceptual problems regarding the validity of this diagnostic category arise from the heterogeneity of syndromal pictures and the high rate of comorbidity observed in subjects diagnosed with ADHD at all stages of the longitudinal course of the disorder. In this regard, DSM 5 increased complexity by allowing a diagnosis of comorbidity between ADHD and (...) autism spectrum disorders while these two diagnoses were mutually exclusive in DSM-IV-TR. (shrink)
This paper addresses philosophical issues concerning whether mental disorders are natural kinds and how the DSM should classify mental disorders. I argue that some mental disorders (e.g., schizophrenia, depression) are natural kinds in the sense that they are natural classes constituted by a set of stable biological mechanisms. I subsequently argue that a theoretical and causal approach to classification would provide a superior method for classifying natural kinds than the purely descriptive approach adopted by the DSM since DSM-III. My argument (...) suggests that the DSM should classify natural kinds in order to provide predictively useful (i.e., projectable) diagnostic categories and that a causal approach to classification would provide a more promising method for formulating valid diagnostic categories. (shrink)
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 large part of the controversy surrounding the publication of DSM-5 stems from the possibility of replacing the purely descriptive approach to classification favored by the DSM since 1980. This paper examines the question of how mental disorders should be classified, focusing on the issue of whether the DSM should adopt a purely descriptive or theoretical approach. I argue that the DSM should replace its purely descriptive approach with a theoretical approach that integrates causal information into the DSM’s descriptive (...) class='Hi'>diagnostic categories. The paper proceeds in three sections. In the first section, I examine the goals (viz., guiding treatment, facilitating research, and improving communication) associated with the DSM’s purely descriptive approach. In the second section, I suggest that the DSM’s purely descriptive approach is best suited for improving communication among mental health professionals; however, theoretical approaches would be superior for purposes of treatment and research. In the third section, I outline steps required to move the DSM towards a hybrid system of classification that can accommodate the benefits of descriptive and theoretical approaches, and I discuss how the DSM’s descriptive categories could be revised to incorporate theoretical information regarding the causes of disorders. I argue that the DSM should reconceive of its goals more narrowly such that it functions primarily as an epistemic hub that mediates among various contexts of use in which definitions of mental disorders appear. My analysis emphasizes the importance of pluralism as a methodological means for avoiding theoretical dogmatism and ensuring that the DSM is a reflexive and self-correcting manual. (shrink)
In this chapter, I provide an overview of phenomenological approaches to psychiatric classification. My aim is to encourage and facilitate philosophical debate over the best ways to classify psychiatric disorders. First, I articulate phenomenological critiques of the dominant approach to classification and diagnosis—i.e., the operational approach employed in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) and the International Classification of Diseases (ICD-10). Second, I describe the type or typification approach to psychiatric classification, which I distinguish into three (...) different versions: ideal types, essential types, and prototypes. I argue that despite their occasional conflation in the contemporary literature, there are important distinctions among these approaches. Third, I outline a new phenomenological-dimensional approach. I show how this approach, which starts from basic dimensions of human existence, allows us to investigate the full range of psychopathological conditions without accepting the validity of current diagnostic categories. (shrink)
The psychiatric diagnostic system, as exemplified by the DSM, is a pseudo-scientific framework for diagnosing sick Cartesian isolated minds. As such, it completely overlooks the exquisite context sensitivity and radical context dependence of human emotional life and of all forms of emotional disturbance. In Descartes’s vision, the mind is a “thinking thing,” ontologically decontextualized, fundamentally separated from its world. Heidegger’s existential phenomenology mended this Cartesian subject-object split, unveiling our Being as always already contextualized, a Being-in-the-world. Here I offer a (...) critique of studies in “phenomenological psychopathology” that presuppose the validity of the psychiatric diagnostic system and leave it unchallenged. In this vein, I contend that all emotional disturbances are constituted in an indissoluble context of human interrelatedness. Specifically, I claim that all emotional disturbances, including those objectified by the DSM, take form in relational contexts of severe emotional trauma. There are no psychiatric entities, only devastating contexts. Additionally, I show that Heidegger’s analyses of Angst, world-collapse, uncanniness, and thrownness into Being-toward-death provide extraordinary philosophical tools for grasping the existential significance of such contexts of emotional trauma. Applying Heidegger’s concept of authenticity, I suggest that emotional health entails an ease of passage—i.e., an absence of dissociation—between the world of trauma and the world of everydayness. (shrink)
The observation that a crisis of confidence regarding Psychiatry exists is a notion shared even among psychiatrists themselves. Psychiatry has a checkered history and its alliance with the pharmaceutical industry, aka Big-Pharma, continues to reinforce a need for healthy skepticism. Why? Mainly, an over-reliance on the questionable expertise and authority afforded psychiatry as the specialists of mental health. I contend that the authority of psychiatry is misplaced and too often harmful. Since the criteria required to justify and satisfy psychiatric expertise (...) is not fully established as can be substantiated by compelling reasons to rethink its authority as a reliable profession in its current form. Psychiatric expertise is not particularly scientific and this is especially dangerous in a sector that prescribes mind-altering drugs. There are a number of identified criteria that would otherwise substantiate psychiatric expertise and whilst partially existent, are nonetheless deficient. These major yet deficient aspects of psychiatric practice concern diagnostic problems – reliability and verification of diagnoses and accurate testable validity of diagnoses - mainly due to an absence of identifiable underlying biomarkers ordinarily related to disease or biological conditions. Psychiatrists often fail to distinguish between reactive-depression (reaction to external event or circumstance) and endogenous-depression (biological) resulting, in part, from incorrectly distinguishing between conditions constitutive of ‘trait’ (endogenous) and of those of ‘state’ (e.g. reactive depression; adverse effects from medication, etc.). (shrink)
This chapter examines philosophical issues surrounding the classification of mental disorders by the Diagnostic and Statistical Manual of Mental Disorders (DSM). In particular, the chapter focuses on issues concerning the relative merits of descriptive versus theoretical approaches to psychiatric classification and whether the DSM should classify natural kinds. These issues are presented with reference to the history of the DSM, which has been published regularly by the American Psychiatric Association since 1952 and is currently in its fifth edition. While (...) the first two editions of the DSM adopted a theoretical (psychoanalytic) and etiological approach to classification, subsequent editions of the DSM have adopted an atheoretical and purely descriptive (“neo-Kraepelinian”) approach. It is argued that largest problem with the DSM at present—viz., its failure to provide valid diagnostic categories—is directly related to the purely descriptive methodology championed by the DSM since the third edition of the DSM. In light of this problem, the chapter discusses the prospects of a theoretical and causal approach to psychiatric classification and critically examines the assumption that the DSM should classify natural kinds. (shrink)
A pressing need for interrater reliability in the diagnosis of mental disorders emerged during the mid-twentieth century, prompted in part by the development of diverse new treatments. The Diagnostic and Statistical Manual of Mental Disorders (DSM), third edition answered this need by introducing operationalized diagnostic criteria that were field-tested for interrater reliability. Unfortunately, the focus on reliability came at a time when the scientific understanding of mental disorders was embryonic and could not yield valid disease definitions. Based on (...) accreting problems with the current DSM-fourth edition (DSM-IV) classification, it is apparent that validity will not be achieved simply by refining criteria for existing disorders or by the addition of new disorders. Yet DSM-IV diagnostic criteria dominate thinking about mental disorders in clinical practice, research, treatment development, and law. As a result, the modernDSMsystem, intended to create a shared language, also creates epistemic blinders that impede progress toward valid diagnoses. Insights that are beginning to emerge from psychology, neuroscience, and genetics suggest possible strategies for moving forward. (shrink)
The Salivaomics Knowledge Base (SKB) is designed to serve as a computational infrastructure that can permit global exploration and utilization of data and information relevant to salivaomics. SKB is created by aligning (1) the saliva biomarker discovery and validation resources at UCLA with (2) the ontology resources developed by the OBO (Open Biomedical Ontologies) Foundry, including a new Saliva Ontology (SALO). We define the Saliva Ontology (SALO; http://www.skb.ucla.edu/SALO/) as a consensus-based controlled vocabulary of terms and relations dedicated to the salivaomics (...) domain and to saliva-related diagnostics following the principles of the OBO (Open Biomedical Ontologies) Foundry. The Saliva Ontology is an ongoing exploratory initiative. The ontology will be used to facilitate salivaomics data retrieval and integration across multiple fields of research together with data analysis and data mining. The ontology will be tested through its ability to serve the annotation ('tagging') of a representative corpus of salivaomics research literature that is to be incorporated into the SKB. Background Saliva (oral fluid) is an emerging biofluid for non-invasive diagnostics used in the detection of human diseases. The need to advance saliva research is strongly emphasized by the National Institute of Dental and Craniofacial Research (NIDCR), and is included in the NIDCR's 2004- 2009 expert panel long-term research agenda [1]. The ability to monitor health status, disease onset, progression, recurrence and treatment outcome through noninvasive means is highly important to advancing health care management. Saliva is a perfect medium to be explored for personalized individual medicine including diagnostics, offering a non-invasive, easy to obtain means for detecting and monitoring diseases. Saliva testing potentially allows the patient to collect their own saliva samples at home, yielding convenience for the patient and savings in health costs, and facilitating multiple sampling. Specimen collection is less objectionable to patients and easier in children and elderly individuals. Due to these advantages. (shrink)
Lying is one of the characteristic features of psychopathy, and has been recognized in clinical and diagnostic descriptions of the disorder, yet individuals with psychopathic traits have been found to have reduced neural activity in many of the brain regions that are important for lying. In this study, we examine brain activity in sixteen individuals with varying degrees of psychopathic traits during a task in which they are instructed to falsify information or tell the truth about autobiographical and non-autobiographical (...) facts, some of which was related to criminal behavior. We found that psychopathic traits were primarily associated with increased activity in the anterior cingulate, various regions of the prefrontal cortex, insula, angular gyrus, and the inferior parietal lobe when participants falsified information of any type. Associations tended to be stronger when participants falsified information about criminal behaviors. Although this study was conducted in a small sample of individuals and the task used has limited ecological validity, these findings support a growing body of literature suggesting that in some contexts, individuals with higher levels of psychopathic traits may demonstrate heightened levels of brain activity. (shrink)
Precision medicine and molecular systems medicine (MSM) are highly utilized and successful approaches to improve understanding, diagnosis, and treatment of many diseases from bench-to-bedside. Especially in the COVID-19 pandemic, molecular techniques and biotechnological innovation have proven to be of utmost importance for rapid developments in disease diagnostics and treatment, including DNA and RNA sequencing technology, treatment with drugs and natural products and vaccine development. The COVID-19 crisis, however, has also demonstrated the need for systemic thinking and transdisciplinarity and the limits (...) of MSM: the neglect of the bio-psycho-social systemic nature of humans and their context as the object of individual therapeutic and population-oriented interventions. COVID-19 illustrates how a medical problem requires a transdisciplinary approach in epidemiology, pathology, internal medicine, public health, environmental medicine, and socio-economic modeling. Regarding the need for conceptual integration of these different kinds of knowledge we suggest the application of general system theory (GST). This approach endorses an organism-centered view on health and disease, which according to Ludwig von Bertalanffy who was the founder of GST, we call Organismal Systems Medicine (OSM). We argue that systems science offers wider applications in the field of pathology and can contribute to an integrative systems medicine by (i) integration of evidence across functional and structural differentially scaled subsystems, (ii) conceptualization of complex multilevel systems, and (iii) suggesting mechanisms and non-linear relationships underlying the observed phenomena. We underline these points with a proposal on multi-level systems pathology including neurophysiology, endocrinology, immune system, genetics, and general metabolism. An integration of these areas is necessary to understand excess mortality rates and polypharmacological treatments. In the pandemic era this multi-level systems pathology is most important to assess potential vaccines, their effectiveness, short-, and long-time adverse effects. We further argue that these conceptual frameworks are not only valid in the COVID-19 era but also important to be integrated in a medicinal curriculum. (shrink)
Contemporary psychiatry finds itself in the midst of a crisis of classification. The developments begun in the 1980s—with the third edition of the Diagnostic and Statistical Manual of Mental Disorders —successfully increased inter-rater reliability. However, these developments have done little to increase the predictive validity of our categories of disorder. A diagnosis based on DSM categories and criteria often fails to accurately anticipate course of illness or treatment response. In addition, there is little evidence that the DSM categories (...) link up with genetic findings, and even less evidence that they... (shrink)
Discussions of psychiatric nosology focus on a few popular examples of disorders, and on the validity of diagnostic criteria. Looking at Anorexia Nervosa, an example rarely mentioned in this literature, reveals a new problem: the DSM has a strict taxonomic structure, which assumes that disorders can only be located on one branch. This taxonomic assumption fails to fit the domain of psychopathology, resulting in obfuscation of cross-category connections. Poor outcomes for treatment of Anorexia may be due to it (...) being pigeonholed as an Eating Disorder, when a disturbance of body perception may be a more central symptom than food restriction. This paper explores the possibility of restructuring the DSM taxonomy to allow for a pluralist classification of disorders. This change could improve treatment and research without requiring any changes to diagnostic criteria. (shrink)
Abstract: malaria is one of the most frequent hemoparasitic infections in tropical and sub-tropical countries. Malaria in Sudan is the major public health problem. This study was aimed to investigate the association of intraleukocytic pigment with malaria infection (severity, diagnosis and prognosis), and to investigate the correlation of parasite density levels with Malaria Severity. A total of 176 participants was drawn from the population of sudanese patient above 5 years, who attended or were admitted to the Bashayer Hospital, with diagnosis (...) suggestive of malaria, they were selected for inclusion in the study. Blood films were examined first for malaria parasites diagnosis ,this was followed by detection of malaria pigment in both negative and positive films.Then Immunochromatography test was done, Subsequently haemoglobin concentration was determined. This study was approves that malaria pigment in peripheral blood leukocytes is evident for malaria disease , and makes the method of pigment determination appropriate and useful in malaria diagnosis, especially in patients with an illness consistent clinically with malaria but with negative blood smear due to haemolytic anaemia .A total of 176, 73 male and 103 female aged from 7 years to 69 years , drawn to Bashayer hospital with symptoms of malaria showed ICT positive result .Blood films were positive in 98(55.7%) and negative in 78 (44.3%) of patients . Malaria pigment was observed with the mean (22.07). There was an association between ICT and malaria pigment (P-value = 0.000).There was no association between BF and malaria pigment ( P-value = 0.40).This study also approved that malaria pigment can be used in prognosis, were thirty five patient showed complications(19.9%) and 141 showed no complication(80.1%) ,there was association between complications and malaria pigment ( P-value = 0.004) .This study also validates the presence of malaria pigment in leukocyte as a marker for disease severity, there was association between severity and malaria pigment (P-value = 0.02). While there is no association between density and severity (P-value = 0.980). So we conclued, intraleukocytic malaria pigment produced by parasites during intra erythrocytic development is associated with severe disease, mortality and it is a useful diagnostic indicator in anaemic patients with negative blood smears. The varied complexities of the current diagnostic methods make the method of pigment determination appropriate and useful. Secondly, malaria pigment is significantly associated with severe malaria. Thirdly, parasitaemia levels are neither associated nor correlated with malaria severity and therefore parasitaemia alone is not a reliable measure of malaria severity. We recommend the use of malaria pigment as marker for malaria disease severity. We recommend that parasitaemia should not be used alone as an indicator of malaria severity. We further recommend that, the presence of pigment in leukocytes to be adopted for diagnosis of malaria especially in cases of negative blood films, and recommend using malaria pigment as indicator for malaria prognosis. (shrink)
In spite of a considerable progress in comorbidity research and huge literature on it, this phenomenon is one of the greatest epistemological, research and clinical challenges to contemporary psychiatry and medicine. Mental disorders are very often comorbidly expressed, both among themselves and with various sorts of somatic diseases and illnesses. Therefore, comorbidity studies have been expected to be an impetus to research on the validity of current diagnostic systems as well as on establishing more effective and effi cient (...) treatment within the frame of person centered transdisciplinary psychiatry and integrative medicine. This review focuses fi rst on conceptual chaos and different connotations, then on transdisciplinary perspectives of comorbidity and multimorbidity. The authors compiled an extensive set of various views and perspectives, dilemmas and controversies, in order to evaluate what we know and what we don’t about comorbidity, what comorbidity is and what comorbidity is not, what are facts and what are non-facts on comorbidity and multimorbidity. (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)
Experimental philosophy’s much-discussed ‘restrictionist’ program seeks to delineate the extent to which philosophers may legitimately rely on intuitions about possible cases. The present paper shows that this program can be (i) put to the service of diagnostic problem-resolution (in the wake of J.L. Austin) and (ii) pursued by constructing and experimentally testing psycholinguistic explanations of intuitions which expose their lack of evidentiary value: The paper develops a psycholinguistic explanation of paradoxical intuitions that are prompted by verbal case-descriptions, and presents (...) two experiments that support the explanation. This debunking explanation helps resolve philosophical paradoxes about perception (known as ‘arguments from hallucination’). (shrink)
In order to ensure stable functioning and development of the enterprise, they evaluate the effectiveness of economic activity. An effective tool for assessing economic activity in modern conditions is economic diagnostics, which allows you to analyze the main indicators of the enterprise, to explore the factors that led to the change in the relevant results and adversely affected the activities of the enterprise. Agricultural enterprises also need such methodological tools for economic diagnostics. However, the existing tools for assessing the effectiveness (...) of economic activity does not allow for a comprehensive assessment of indicators. In addition, the management system of agricultural enterprises raises the requirements for providing a more effective and justified system of evaluating indicators using economic diagnostics. (shrink)
Modern business conditions require from economic entities to use appropriate methodological tools for assessing their activities. In economics science a fairly significant set of approaches, methods and techniques are now known that positively contribute to solving problems regarding ensure of competitiveness the economic entities. However, active influence of the internal and external environment on their activities, as well as the specificity of economic management the economic entities, requires the use of more effective methodological tools that can identify threats of the (...) external environment and explore the strengths of activity the economic entities. (shrink)
The current rise of neurodevelopmental disorders poses a critical need to detect risk early in order to rapidly intervene. One of the tools pediatricians use to track development is the standard growth chart. The growth charts are somewhat limited in predicting possible neurodevelopmental issues. They rely on linear models and assumptions of normality for physical growth data – obscuring key statistical information about possible neurodevelopmental risk in growth data that actually has accelerated, non-linear rates-of-change and variability encompassing skewed distributions. Here, (...) we use new analytics to profile growth data from 36 newborn babies that were tracked longitudinally for 5 months. By switching to incremental (velocity-based) growth charts and combining these dynamic changes with underlying fluctuations in motor performance – as the transition from spontaneous random noise to a systematic signal – we demonstrate a method to detect very early stunting in the development of voluntary neuromotor control and to flag risk of neurodevelopmental derail. (shrink)
This paper reviews the recent (post-DSM) history of subjective and semi-structured methods of psychiatric diagnosis, as well as evidence for the superiority of structured and computer-aided diagnostic techniques. While there is evidence that certain forms of therapy are effective for alleviating the psychiatric suffering, distress, and dysfunction associated with certain psychiatric disorders, this paper addresses some of the difficult methodological and ethical challenges of evaluating the effectiveness of therapy.
For semantic inferentialists, the basic semantic concept is validity. An inferentialist theory of meaning should offer an account of the meaning of "valid." If one tries to add a validity predicate to one's object language, however, one runs into problems like the v-Curry paradox. In previous work, I presented a validity predicate for a non-transitive logic that can adequately capture its own meta-inferences. Unfortunately, in that system, one cannot show of any inference that it is invalid. Here (...) I extend the system so that it can capture invalidities. (shrink)
The authors of the book have come to the conclusion that it is necessary to effectively use modern management mechanisms and development strategies of economic entities in order to increase the efficiency of their activities. Basic research focuses on diagnostics threat of bankruptcy, assessment of bioenergy potential, intellectual property, efficiency of corporate governance, use of information support, ensuring competitiveness of banking institutions, functioning of the tax system and its decentralization, assessment of the investment climate and investment risks, functioning of a (...) small business. The research results have been implemented in the different models of cluster structures, mechanisms for monitoring the quality of health care, predicting the convergence of economic development, innovative development models, and development strategies of economic entities in various sectors of the economy in the context of euro integration. The results of the study can be used in decisionmaking at the level of international business, ministries and departments that regulate the processes development of economic systems, ensuring stability and efficiency. The results can also be used by students and young scientists in modern concepts of the development of economic entities in the context of institutional transformations of the global environment. (shrink)
This paper explores how the diagnosis of mental disorder may affect the diagnosed subject’s self-concept by supplying an account that emphasizes the influence of autobiographical and social narratives on self-understanding. It focuses primarily on the diagnoses made according to the criteria provided by the Diagnostic Statistical Manual of Mental Disorders (DSM), and suggests that the DSM diagnosis may function as a source of narrative that affects the subject’s self-concept. Engaging in this analysis by appealing to autobiographies and memoirs written (...) by people diagnosed with mental disorder, the paper concludes that a DSM diagnosis is a double-edged sword for self- concept. On the one hand, it sets the subject’s experience in an established classificatory system which can facilitate self-understanding by providing insight into subject’s condition and guiding her personal growth, as well as treatment and recovery. In this sense, the DSM diagnosis may have positive repercussions on self-development. On the other hand, however, given the DSM’s symptom-based approach and its adoption of the Biomedical Disease model, a diagnosis may force the subject to make sense of her condition divorced from other elements in her life that may be affecting her mental- health. It may lead her frame her experience only as an irreversible imbalance. This form of self-understanding may set limits on the subject’s hopes of recovery and may create impediments to her flourishing. (shrink)
In this paper we describe a few interrelated issues for validating theories that posit levels of consciousness. First, validating levels of consciousness requires consensus about the ordering of conscious states, which cannot be easily achieved. This problem is particularly severe if we believe conscious states can be irreducibly smeared over time. Second, the relationship between conscious states is probably sometimes intransitive, which means levels of consciousness will not be amenable to a single continuous measure. Finally, even if a multidimensional approach (...) to levels of consciousness is adopted, we argue that there are further problems for its validation. (shrink)
(English then french abstract) -/- This article, which can be read by non-psychoanalysts, intends to browse in four stages through the issue offered to our thinking : two (odd-numbered) stages analyzing the argument that provides its context, and two (even-numbered) of propositions presenting our views on what could be the content of the analytic discourse in the coming years. After this introduction, a first reading will point by point but informally review the argument of J.-P. Journet by showing that each (...) of its clauses may generate a “bifurcated” comment able to serve or go against the analytic discourse. Hence the interest of the “differential diagnosis” mentioned in our title, which makes glimpse the traps that the homonymy may set to this speech. Then, to prepare a second scan which sticks neither to the analytical doxa, nor to the even authoritative opinions of our tenors and seniors, it will be proposed two attempts at redefinitions (“apophatic” and “recursive”) of what psychoanalysis is, as well as methodological tools operating downstream from these redefinitions to thwart the obstacles of “external” and “internal” homonymy (starting from a syllogism which can make consensus).The third stage will precisely be made of our second scan of the issue, whose elements will be reviewed and analyzed more methodically :“external differential diagnosis” between the analytic discourse and psychology, philosophy, sociology, and modern science, and “internal differential diagnosis” on the entanglement between theoretical advances of psychoanalysts and the repeated survival of fantasmatic elements...Finally, a fourth part will present propositions and perspectives resulting from these analysis (principle of economy as to the source of psychoanalytical theorizations; dialogue with the other fields, but without compromising; specific relations with the discourse of science), all this leading to an invitation, beyond disputes, to renew the content of the analytic discourse on some points... -/- --------------------------------------------------------------------- -/- Cet article, qui se veut lisible aux non-analystes, se propose de parcourir en quatre temps la problématique offerte à notre réflexion : deux temps (de rang impair) d'analyse de l'argument qui en fournit le contexte, et deux (de rang pair) de propositions présentant nos vues sur ce que pourrait être la teneur du discours analytique dans les prochaines années. Après cette introduction, un premier parcours réexaminera point par point mais informellement l'argument de J.-P. Journet en montrant que chacune de ses propositions peut donner lieu à un commentaire “bifide” à même de servir ou de desservir le discours analytique. D'où l'intérêt du “diagnostic différentiel” évoqué dans notre titre, qui fait entrevoir les pièges que l'homonymie peut tendre à ce discours.Puis, pour préparer un second balayage qui ne s'en tienne ni à la doxa analytique, ni aux opinions même autorisées de nos ténors et seniors, il sera proposé deux tentatives de redéfinitions (“apophatique” et “récursive”) de ce qu'est l'analyse, ainsi que des outils méthodologiques fonctionnant en aval de ces redéfinitions pour déjouer les embûches de l'homonymie “externe” et “interne” (à partir d'un syllogisme pouvant faire consensus). Le troisième temps sera fait justement de ce second balayage de la problématique, dont les éléments seront reconsidérés et analysés plus méthodiquement : “diagnostic différentiel externe” entre le discours analytique et les discours psychologique, philosophique, sociologique et celui de la science moderne ; et “diagnostic différentiel interne” portant sur l'intrication entre avancées théoriques des analystes et survivance à répétition d'éléments fantasmatiques...Enfin une quatrième partie exposera propositions et perspectives résultant de ces analyses (principe d'économie quant à la source des théorisations analytiques ; dialogue avec les autres champs, mais sans compromissions ; relations spécifiques avec le discours de la science), l'ensemble débouchant sur une invitation, au delà des différends, à renouveler sur certains points la teneur du discours analytique... (shrink)
What are people who disagree about logic disagreeing about? The paper argues that (in a wide range of cases) they are primarily disagreeing about how to regulate their degrees of belief. An analogy is drawn between beliefs about validity and beliefs about chance: both sorts of belief serve primarily to regulate degrees of belief about other matters, but in both cases the concepts have a kind of objectivity nonetheless.
Introduction The Defining Issues Test (DIT) aimed to measure one’s moral judgment development in terms of moral reasoning. The Neo-Kohlbergian approach, which is an elaboration of Kohlbergian theory, focuses on the continuous development of postconventional moral reasoning, which constitutes the theoretical basis of the DIT. However, very few studies have directly tested the internal structure of the DIT, which would indicate its construct validity. Objectives Using the DIT-2, a later revision of the DIT, we examined whether a bi-factor model (...) or 3-factor CFA model showed a better model fit. The Neo-Kohlbergian theory of moral judgment development, which constitutes the theoretical basis for the DIT-2, proposes that moral judgment development occurs continuously and that it can be better explained with a soft-stage model. Given these assertions, we assumed that the bi-factor model, which considers the Schema-General Moral Judgment (SGMJ), might be more consistent with Neo-Kohlbergian theory. Methods We analyzed a large dataset collected from undergraduate students. We performed confirmatory factor analysis (CFA) via weighted least squares. A 3-factor CFA based on the DIT-2 manual and a bi-factor model were compared for model fit. The three factors in the 3-factor CFA were labeled as moral development schemas in Neo-Kohlbergian theory (i.e., personal interests, maintaining norms, and postconventional schemas). The bi-factor model included the SGMJ in addition to the three factors. Results In general, the bi-factor model showed a better model fit compared with the 3-factor CFA model although both models reported acceptable model fit indices. Conclusion We found that the DIT-2 scale is a valid measure of the internal structure of moral reasoning development using both CFA and bi-factor models. In addition, we conclude that the soft-stage model, posited by the Neo-Kohlbergian approach to moral judgment development, can be better supported with the bi-factor model that was tested in the present study. (shrink)
This paper looks at the question of what it means for a psychological test to have construct validity. I approach this topic by way of an analysis of recent debates about the measurement of implicit social cognition. After showing that there is little theoretical agreement about implicit social cognition, and that the predictive validity of implicit tests appears to be low, I turn to a debate about their construct validity. I show that there are two questions at (...) stake: First, what level of detail and precision does a construct have to possess such that a test can in principle be valid relative to it? And second, what kind of evidence needs to be in place such that a test can be regarded as validated relative to a given construct? I argue that construct validity is not an all-or-nothing affair. It can come in degrees, because both our constructs and our knowledge of the explanatory relation between constructs and data can vary in accuracy and level of detail, and a test can fail to measure all of the features associated with a construct. I conclude by arguing in favor of greater philosophical attention to processes of construct development. (shrink)
This paper explores an idea of Stoic descent that is largely neglected nowadays, the idea that an argument is valid when the conditional formed by the conjunction of its premises as antecedent and its conclusion as consequent is true. As it will be argued, once some basic features of our naıve understanding of validity are properly spelled out, and a suitable account of conditionals is adopted, the equivalence between valid arguments and true conditionals makes perfect sense. The account of (...)validity outlined here, which displays one coherent way to articulate the Stoic intuition, accords with standard formal treatments of deductive validity and encompasses an independently grounded characterization of inductive validity. (shrink)
What is a valid measuring instrument? Recent philosophy has attended to logic of justification of measures, such as construct validation, but not to the question of what it means for an instrument to be a valid measure of a construct. A prominent approach grounds validity in the existence of a causal link between the attribute and its detectable manifestations. Some of its proponents claim that, therefore, validity does not depend on pragmatics and research context. In this paper, I (...) cast doubt on the possibility of a context-independent causal account of validity. I assess several versions, arguing that all of them fail to judge the validity of measuring instruments correctly. Because different research purposes require different properties from measuring instruments, no account of validity succeeds without referring to the specific research purpose that creates the need for measurement in the first place. (shrink)
We report on an exploratory study of the way eight mid-level undergraduate mathematics majors read and reflected on four student-generated arguments purported to be proofs of a single theorem. The results suggest that mid-level undergraduates tend to focus on surface features of such arguments and that their ability to determine whether arguments are proofs is very limited -- perhaps more so than either they or their instructors recognize. We begin by discussing arguments (purported proofs) regarded as texts and validations of (...) those arguments, i.e., reflections of individuals checking whether such arguments really are proofs of theorems. We relate the way the mathematics research community views proofs and their validations to ideas from reading comprehension and literary theory. We then give a detailed analysis of the four student-generated arguments and finally analyze the eight students' validations of them. (shrink)
According to a standard story, part of what we have in mind when we say that an argument is valid is that it is necessarily truth preserving: if the premises are true, the conclusion must also be true. But—the story continues—that’s not enough, since ‘Roses are red, therefore roses are coloured’ for example, while it may be necessarily truth-preserving, is not so in virtue of form. Thus we arrive at a standard contemporary characterisation of validity: an argument is valid (...) when it is NTP in virtue of form. Here I argue that we can and should drop the N; the resulting account is simpler, less problematic, and performs just as well with examples. (shrink)
This paper indicates how continental philosophy may contribute to a diagnostics of contemporary life sciences research, as part of a “diagnostics of the present”. First, I describe various options for an oblique reading of emerging scientific discourse, bent on uncovering the basic “philosophemes” of science. Subsequently, I outline a number of radical transformations occurring both at the object-pole and at the subject-pole of the current knowledge relationship, namely the technification of the object and the anonymisation or collectivisation of the subject, (...) under the sway of automation, ICT and big machines. Finally, I further elaborate the specificity of the oblique perspective with the help of Lacan’s theorem of the four discourses. Philosophical reflections on contemporary life sciences concur neither with a Master’s discourse, nor with university discourse, nor with what Lacan refers to as hysterical discourse, but rather with the discourse of the analyst, listening with evenly-poised attention to the scientific files in order to bring to the fore the cupido sciendi which both inspires and disrupts contemporary life sciences discourse. (shrink)
This study used a structural equation modelling approach to assess the association between employee work- life policies, psychological empowerment, and academic staff job commitment in universities in Cross River State, Nigeria. Three null hypotheses were formulated to guide the study following a descriptive survey research design. Multistage sampling procedure was adopted in the selection of 315 academic staff from two universities in the study area. “Work-Life Policies, Psychological Empowerment and Job Commitment Questionnaire (WPPEJCQ)” was used as the instrument for data (...) collection. The construct validity of the instrument was ascertained through an Exploratory Factor Analysis (EFA) using the Principal Component Analysis (PCA). The Kaiser-Meyer-Ohlin of .894 and the Bartlett coefficient of 7795.820 were obtained. Several fit indices of Confirmatory Factor Analysis were used to accept the model such as RMSEA=.031, TLI=.969, CFI=.971 and many others. The null hypotheses were all tested using Path analysis. Findings revealed, among others, that there is a significant effect of work-life policies on the affective (β=.774,t=21.636,p<.05), continuance (β=.450,t=8.932,p<.05), and normative (β=490,t=9.967,p<.05) dimensions of academic staff commitment; furthermore, psychological empowerment has a significant effect on the affective (β=.795,t=23.199,p<.05), continuance (β=.501,t=10.261,p<.05) and normative (β = .520, t = 10.795, p< .05) dimensions of staff commitment; and there is a significant composite effect of work-life policies and psychological empowerment on the affective, continuance, and normative commitment levels of academic staff in universities. Based on these findings, conclusions and recommendations were made. (shrink)
If someone unintentionally breaks the rules, do they break the rules? In the abstract, the answer is obviously “yes.” But, surprisingly, when considering specific examples of unintentional, blameless rule-breaking, approximately half of people judge that no rule was broken. This effect, known as excuse validation, has previously been observed in American adults. Outstanding questions concern what causes excuse validation, and whether it is peculiar to American moral psychology or cross-culturally robust. The present paper studies the phenomenon cross-culturally, focusing on Korean (...) and American adults, and proposes a new explanation of why people engage in excuse validation, in terms of competing forces in human norm-psychology. The principal findings are that Americans and Koreans engaged in excuse validation at similar levels, and older adults were more likely to engage in excuse validation. (shrink)
There is a need recognized by the National Institute of Dental & Craniofacial Research and the National Cancer Institute to advance basic, translational and clinical saliva research. The goal of the Salivaomics Knowledge Base (SKB) is to create a data management system and web resource constructed to support human salivaomics research. To maximize the utility of the SKB for retrieval, integration and analysis of data, we have developed the Saliva Ontology and SDxMart. This article reviews the informatics advances in saliva (...) diagnostics made possible by the Saliva Ontology and SDxMart. (shrink)
Beall and Murzi :143–165, 2013) introduce an object-linguistic predicate for naïve validity, governed by intuitive principles that are inconsistent with the classical structural rules. As a consequence, they suggest that revisionary approaches to semantic paradox must be substructural. In response to Beall and Murzi, Field :1–19, 2017) has argued that naïve validity principles do not admit of a coherent reading and that, for this reason, a non-classical solution to the semantic paradoxes need not be substructural. The aim of (...) this paper is to respond to Field’s objections and to point to a coherent notion of validity which underwrites a coherent reading of Beall and Murzi’s principles: grounded validity. The notion, first introduced by Nicolai and Rossi, is a generalisation of Kripke’s notion of grounded truth, and yields an irreflexive logic. While we do not advocate the adoption of a substructural logic, we take the notion of naïve validity to be a legitimate semantic notion that points to genuine expressive limitations of fully structural revisionary approaches. (shrink)
Instructional material is an integral part of teaching and learning process. Validating instructional materials is imperative to ensure quality before widespread utilization. This study validated the developed Gamified Instructional Material (GIM) in genetics for grade 12 STEM students. It employed the descriptive-developmental research design involving 41 STEM students and 11 Biology education experts chosen through purposive sampling. Findings revealed that students and experts strongly agreed that the GIM satisfied the criteria for a sound and valid instructional material. Further, the significant (...) change in the pretest and posttest scores of students indicated an improvement of their knowledge in genetics. It is recommended that the GIM be used as supplementary instructional material in teaching genetics. (shrink)
Patient centred diagnosis is best practised through shared decision making; an iterative dialogue between doctor and patient, whichrespects a patient’s needs, values, preferences, and circumstances. -/- Shared decision making for diagnostic situations differs fundamentally from that for treatment decisions. This has important implications when considering its practical application. -/- The nature of dialogue should be tailored to the specific diagnostic decision; scenarios with higher stakes or uncertainty usually require more detailed conversations.
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