Critics who are concerned over the epistemological status of psychiatric diagnoses often describe them as being constructed. In contrast, those critics usually see symptoms as relatively epistemologically unproblematic. In this paper I show that symptoms are also constructed. To do this I draw upon the demarcation between data and phenomena. I relate this distinction to psychiatry by portraying behaviour of individuals as data and symptoms as phenomena. I then draw upon philosophers who consider phenomena to be constructed to argue that (...) symptoms are also constructed. Rather than being ready made in the world I show how symptoms are constructs we apply to the world. I highlight this with a historical example and describe methodological constraints on symptom construction. I show the epistemic problems with psychiatric diagnoses are also applicable to symptoms. Following this, I suggest that critics of psychiatric diagnoses should extend their criticism to symptoms or, if they still believe symptoms are relatively epistemologically unproblematic, should rethink their concerns over psychiatric diagnoses. (shrink)

The Diagnostic and Statistical Manual of Mental Disorders has elicited numerous criticisms throughout its history. Its particularly controversial status has not been resolved by the recent release of the DSM-5 ; rather, the new edition has amplified debates in psychiatry as well as philosophy and the wider public. To a certain extent, such controversies are to be expected because of the influential role the DSM plays in science and health care. Researchers have often been required to use the DSM classification (...) to get funded and published, clinicians need to use it for diagnosis, and patients need a DSM code to get reimbursed for treatment.1 Classification in psychiatry shapes the course of research... (shrink)

In the debate on causal explanation in biology, in the past two decades largely influenced by the new mechanist approach, the concept of a pathway has recently reemerged as a promising research agenda, 551-572, 2018; The British Journal for the Philosophy of Science, 72, 131-158, 2021). Ross’ account of biological explanation differentiates several autonomous types of causal structures that play explanatory and other roles across the life sciences. NM, however, prioritizes mechanisms as vehicles of biological explanations. According to this program, (...) the causal architecture of biological pathways and other causal structures, such as cascades and processes, can be interpreted with at least one of the NM’s mechanism concepts. In other words, these alternative causal structures are not sufficiently distinctive to merit the explanatory autonomy with regard to the NM corresponding concepts. We examine the explanatory practice of molecular biology and concur with Ross that there are indeed distinct types of causal structures, not all falling under the concept of a mechanism. Nonetheless, we show that the concept of mechanism is referring to a privileged causal structure, at the center of explanatory efforts in molecular biology. Pathways and other causal concepts, while somewhat distinct from mechanisms themselves, are explanatorily relevant to the degree in which they exhibit mechanistic features, are parts of a mechanistic architecture, or may lead to a mechanistic arrangement. What emerges in that manner is a hierarchy of causal structures with mechanisms at the explanatory top, and lower levels differing in the degree in which they contribute to mechanistic arrangements. (shrink)

Causal selection has to do with the distinction we make between background conditions and “the” true cause or causes of some outcome of interest. A longstanding consensus in philosophy views causal selection as lacking any objective rationale and as guided, instead, by arbitrary, pragmatic, and non-scientific considerations. I argue against this position in the context of causal selection for disease traits. In this domain, causes are selected on the basis of the type of causal control they exhibit over a disease (...) of interest. My analysis clarifies the principled rationale that guides this selection and how it involves both pragmatic and objective considerations, which have been overlooked in the extant literature. (shrink)

Causal selection has to do with a distinction between mere background conditions and the "true" causes of some outcome of interest. Mainstream philosophical views claim that causal selection is "groundless" in the sense that it lacks any type of principled rationale. I argue against this position in the context of biochemistry where causal factors are selected in explanations of metabolic processes. These factors are selected on the basis of a principled rationale, which is best understood in terms of the causal (...) control that they provide over an outcome of interest. (shrink)