Causation and Mechanisms in Psychiatry

In K. W. M. Fulford, Martin Davies, Richard Gipps, George Graham, John Sadler, Giovanni Stanghellini & Tim Thornton (eds.), The Oxford handbook of philosophy and psychiatry. Oxford: Oxford University Press (2013)
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Abstract

This chapter reviews the problem of finding the 'right level' of causal explanation in psychiatry. This is not a purely philosophical problem, but one that frequently arises in practice for psychiatrists. For most scientists, experiment is the crucial test of a causal hypothesis: for X to cause Y is for intervention on X to be reflected in a change in the value of Y. But this kind of approach cannot tell us the right "level" at which to specify the causes of a particular outcome. The natural idea is the right level is one that specifies the 'mechanism' by which Y is produced. But the notion of a "mechanism" in psychiatry is obviously problematic. This chapter attempts to locate the sources of the difficulty here, looking at both a priori and empirical views as to when a "mechanism" has been correctly specified.

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