Philosophical Issues in Psychiatry II Nosology

by Kendler, Kenneth S.; Parnas, Josef

• ISBN13: 9780199642205
• ISBN10: 0199642206
• Edition: 1st
• Format: Paperback
• Copyright: 2012-05-23
• Publisher: Oxford University Press

Summary

Psychiatric and psychological practice and research is critically dependent on diagnosis. Yet the nature of psychiatric diagnosis and the rules by which disorders should be created and organized have been highly controversial for over 100 years. Unlike simple medical disorders (like infectious diseases), psychiatric disorders cannot be traced to one simple etiologic agent. The last two generations have seen major conceptual shifts in the approach to diagnosis with the rise of operationalized criteria and an emphasis on a descriptive rather than etiological approach to diagnosis. The interest in psychiatric diagnoses is particularly heightened now because both of the major psychiatric classifications in the world - DSM and ICD - are now undergoing major revisions. What makes psychiatric nosology so interesting is that it sits at the intersection of philosophy, empirical psychiatric/psychological research, measurement theory, historical tradition and policy. This makes the field fertile for a conceptual analysis. This book brings together established experts in the wide range of disciplines that have an interest in psychiatric nosology. The contributors include philosophers, psychologists, psychiatrists, historians and representatives of the efforts of DSM-III, DSM-IV and DSM-V. Some of the questions addressed include i) what is the nature of psychiatric illness? Can it be clearly defined and if so how? ii) What is the impact of facts versus values in psychiatric classification? iii) How have concepts of psychiatric diagnosis changed over time? iv) How can we best conceptualize the central idea of diagnostic validity? And v) Can psychiatric classification be a cumulative enterprise seeking improvements at each iteration of the diagnostic manual? Each individual chapter is introduced by the editors and is followed by a commentary, resulting in a dynamic discussion about the nature of psychiatric disorders. This book will be valuable for psychiatrists, psychologists and other mental health trainees and professionals with an interest in the questions and problems of psychiatric diagnosis, as well as philosophers and philosophy students interested in the problems posed by psychiatry, particularly those working in the philosophy of science.

Table of Contents

List of Contributors	p. xi
Introduction	p. xiii
The basics: the definition of psychiatric illness and rules for classification
Introduction	p. 3
Chapter: Classification and causal mechanisms: a deflationary approach to the classification problem	p. 6
Comments: The National Institute of Mental Health Research Domain Criteria (RDoC) project: moving towards a neuroscience-based diagnostic classification in psychiatry	p. 12
Introduction	p. 19
Chapter: Progress and the calibration of scientific constructs: the role of comparative validity	p. 21
Comments: Progress and the calibration of scientific constructs: a new look at validity	p. 35
Introduction	p. 41
Chapter: Taking disease seriously: beyond "pragmatic" nosology	p. 42
Comments: What is psychiatric disease? A commentary on Dr Ghaemi's paper	p. 54
Introduction	p. 59
Chapter: Is psychiatric classification a good thing?	p. 61
Comments: Diagnoses as labels	p. 71
The historical development of modern psychiatric diagnoses
Introduction	p. 75
Chapter: The nosological entity in psychiatry: a historical illusion or a moving target?	p. 77
Comments: The Kraepelinian pipe organ model (for a more dimensional) DSM-5 classification	p. 95
Introduction	p. 99
Chapter: The 19th-century nosology of alienism: history and epistemology	p. 101
Comments: The nature of the psychiatric object and classification	p. 118
Introduction	p. 125
Chapter: The development of DSM-III from a historical/conceptual perspective	p. 127
Comments: Evaluating DSM-III: structure, process and outcomes	p. 141
Introduction	p. 143
Chapter: DSM-IV: context, concepts and controversies	p. 145
Comments: DSM-IV: some critical remarks	p. 161
The problem of validity
Introduction	p. 167
Chapter: A philosophical overview of the problems of validity for psychiatric disorders	p. 169
Comments: Validity, utility and reality: explicating Schaffner's pragmatism	p. 190
Introduction	p. 197
Chapter: Structural validity and the classification of mental disorders	p. 199
Comments: Seeing sense in psychiatric diagnoses	p. 213
Application to major depression and schizophrenia
Introduction	p. 219
Chapter: When does depression become a mental disorder?	p. 221
Comments: A sea of distress	p. 229
Introduction	p. 235
Chapter: DSM-IV and the founding prototype of schizophrenia: are we regressing to a pre-Kraepelinian nosology?	p. 237
Comments: Phenomenology, nosology and prototypes	p. 260
The way(s) forward
Introduction	p. 267
Chapter: Rendering mental disorders intelligible: addressing psychiatry's urgent challenge	p. 269
Comments: A search for coherence	p. 280
Introduction	p. 283
Chapter: Diagnostic threshold considerations for DSM-5	p. 285
Comments: The tangible burden of mental disorder in the absence of mental disorder categories in nature: some reflections on Regier's contribution	p. 298
Introduction	p. 303
Chapter: Epistemic iteration as a historical model for psychiatric nosology: promises and limitations	p. 305
Comments: Coherentist approaches to scientific progress in psychiatry: comments on Kendler	p. 323
Index	p. 331
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