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)

This article critically examines Louis Charland’s claim that personality disorders are moral rather than medical kinds by exploring the relationship between personality disorders and virtue ethics. We propose that the conceptual resources of virtue theory can inform psychiatry’s thinking about personality disorders, but also that virtue theory as understood by Aristotle cannot be reduced to the narrow domain of ‘the moral’ in the modern sense of the term. Some overlap between the moral domain’s notion of character-based ethics and the medical (...) domain’s notion of character-based disorders is unavoidable. We also apply a modified version of John Sadler’s “moral wrongfulness test” to borderline and narcissistic personality disorders. With respect to both diagnoses, we argue that they involve negative moral evaluations, but may also have indispensable nonmoral features and, therefore, classify legitimate psychiatric disorders. (shrink)

Philosophers’ traditional emphasis on theories, theoretical modeling, and explanation misguides research in philosophy of science. Articulating and applying core theories is part of scientific practice, but it is not the essence of scientific practice. Insofar as science has an essence, it is to systematically investigate and learn about what is not yet understood. This lecture analyzes genetics to articulate a broad-practice-centered approach to philosophy of science. It concludes by arguing that this approach can lead to richer, deeper, and more useful (...) philosophies of science, philosophies that can better inform science policy and the public’s understanding of science. (shrink)

Philosophers have long been interested in a series of interrelated questions about natural kinds. What are they? What role do they play in science and metaphysics? How do they contribute to our epistemic projects? What categories count as natural kinds? And so on. Owing, perhaps, to different starting points and emphases, we now have at hand a variety of conceptions of natural kinds—some apparently better suited than others to accommodate a particular sort of inquiry. Even if coherent, this situation isn’t (...) ideal. My goal in this article is to begin to articulate a more general account of ‘natural kind phenomena’. While I do not claim that this account should satisfy everyone—it is built around a certain conception of the epistemic role of kinds and has an obvious pragmatic flavour—I believe that it has the resources to go further than extant alternatives, in particular the homeostatic property cluster view of kinds. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Philosophy, Psychiatry, & Psychology 9.3 (2002) 237-241 [Access article in PDF] Practical, Functional, and Natural Kinds Nick Haslam Keywords: Classification, essentialism, natural kinds, practical kinds. I am grateful to the two commentators for giving my paper their serious attention, and for writing such stimulating, clarifying, and challenging responses. In a brief response I can only begin to discuss a select few issues, although both commentaries could generate a great (...) deal of profitable exchange.Zachar's commentary elaborates his practical kinds model, discusses several of the graded series of kinds proposed in my taxonomy of psychiatric categories, and disputes some aspects of my treatment of natural kinds. Zachar and I have no quarrel on his first point. I recognize his practical kinds model as a general theory of psychiatric classification rather than simply as a description of one type of category, the "practical kind." It was perhaps bad form to pilfer a term from Zachar's model and give it a more circumscribed role in my own, although by doing so I intended both to acknowledge the importance of the concept and to situate it among some of its alternatives.All the same, I stand by the account of practical kinds developed in my paper, even if it reflects a narrower sense than Zachar's. In my sense, practical kinds are pragmatically drawn distinctions imposed on continuous dimensions, whereas to Zachar all psychiatric categories are at least to some degree practical. He therefore proposes a broad "continuum" of practical kinds. The difficulty that I have with this proposal is that such a continuum implies a fundamental unity among psychiatric categories: categories are all to be understood first and foremost in pragmatic terms and differences in kind between them in internal structure are to be neglected. In my view, although the pragmatic bases of psychiatric classification are vitally important, and perhaps inadequately formulated in my paper, the neglect of internal structure and of possible breaks in the continuum of kinds are real limitations of the practical kinds model. Although Zachar is partially justified in claiming that his view is pluralistic, allowing as it does for variability in degrees of practicality, by failing to acknowledge distinctly different kinds of categories in the psychiatric domain, his view is less pluralistic than I believe it should be.One example of what I take to be this neglect of structural differences is a conflation of two sorts of practicality in Zachar's work. On the one hand, certain categories such as hypertension or obesity are defined on pragmatic grounds, a binary distinction being drawn in the absence of an internal discontinuity, because individuals identified as category members are adjudged to [End Page 237] be at significantly elevated risk. On the other hand, some categories just happen to have high practical utility. Zachar argues that schizotaxia, for example, is practical because it affords a variety of scientific and clinical inferences.It seems to me that these sorts of practicality—or perhaps these sorts of relations to practicality—are importantly different. Hypertension is defined as a category because of its practical utility—because a certain blood pressure threshold marks an inflection in actuarial risk of other illnesses—and might therefore be said to have "front-end" or constitutive practicality. Schizotaxia, which taxometric research shows to be a discrete kind (Haslam, 2003), is not defined and identified primarily on the basis of its relation to an external criterion, but on the basis of its internal structure. Its features cohere in a way that indicates a category with a determinate prevalence. It has "back-end" or consequential practicality to the degree that this category enables useful predictions. These two proposed forms of practicality are equally important: both mean that categories will be pragmatically valuable. However, they are also different, being characteristic of different kinds of categories and perhaps even negatively related. Kinds with front-end practicality, that is, may tend to have a more restricted range of practical implications, defined as they are in relation to specific external criteria. Kinds with back-end practicality, in contrast, may enable a wider array of predictions to the extent that... (shrink)

Sociopaths are “outstanding” members of society in two senses: politically, they draw our attention because of the inordinate amount of crime they commit, and psychologically, they hold our fascination because most ofus cannot fathom the cold, detached way they repeatedly harm and manipulate others. Proximate explanations from behavior genetics, child development, personality theory, learning theory, and social psychology describe a complex interaction of genetic and physiological risk factors with demographic and micro environmental variables that predispose a portion of the population (...) to chronic antisocial behavior. More recent, evolutionary and game theoretic models have tried to present an ultimate explanation of sociopathy as the expression of a frequency-dependent life strategy which is selected, in dynamic equilibrium, in response to certain varying environmental circumstances. This paper tries to integrate the proximate, developmental models with the ultimate, evolutionary ones, suggesting that two developmentally different etiologies of sociopathy emerge from two different evolutionary mechanisms. Social strategies for minimizing the incidence of sociopathic behavior in modern society should consider the two different etiologies and the factors that contribute to them. (shrink)

How psychopaths and their capacity for moral action are viewed is not only philosophically interesting but is also important and relevant for policy. The philosophical discussion of psychopathy has focussed upon the psychological faculties that are prerequisites for moral responsibility and empirical findings regarding psychopathy that are relevant to philosophical accounts of moral understanding and motivation. However, there are legitimate worries about whether psychopathy is a robust scientific construct, and there are risks attached to reifying psychopathy or other psychiatric constructs. (...) We defend the concept of psychopathy by pointing out the relevance of empirical studies about it for our ordinary practices of ascribing moral responsibility and folk psychological accounts of moral understanding and motivation. (shrink)

In this paper I offer a unified causal account of natural kinds. Using as a starting point the widely held view that natural kind terms or predicates are projectible, I argue that the ontological bases of their projectibility are the causal properties and relations associated with the natural kinds themselves. Natural kinds are not just concatenations of properties but ordered hierarchies of properties, whose instances are related to one another as causes and effects in recurrent causal processes. The resulting account (...) of natural kinds as clusters of core causal properties that give rise to clusters of derivative properties enables us to distinguish genuine natural kinds from non-natural kinds. For instance, it enables us to say why some of the purely conventional categories derived from the social domain do not correspond to natural kinds, though other social categories may. (shrink)

It has been argued that a biomarker-informed classification system for antisocial individuals has the potential to overcome many obstacles in current conceptualizations of forensic and psychiatric constructs and promises better targeted treatments. However, some have expressed ethical worries about the social impact of the use of biological information for classification. Many have discussed the ethical and legal issues related to possibilities of using biomarkers for predicting antisocial behaviour. We argue that prediction should not raise the most pressing ethical worries. Instead, (...) issues connected with ‘biologisation’, such as stigmatization and negative effects on self-image, need more consideration. However, we conclude that also in this respect there are no principled ethical objections against the use of biomarkers to guide classification and treatment of adult antisocial individuals. (shrink)

In their paper “Is psychopathy a mental disease?”, Thomas Nadelhoffer and Walter Sinnott-Armstrong argue that according to any plausible account of mental disorder, neural and psychological abnormalities correlated with psychopathy should be regarded as signs of a mental disorder. I oppose this conclusion by arguing that at least on a naturalistically grounded account, such as Wakefield’s ‘Harmful Dysfunction’ view, currently available empirical data and evolutionary considerations indicate that psychopathy is not a mental disorder.

A pluralistic view of psychiatric classification is defended, according to which psychiatric categories take a variety of structural forms. An ordered taxonomy of these forms—non-kinds, practical kinds, fuzzy kinds, discrete kinds, and natural kinds—is presented and exemplified. It is argued that psychiatric categories cannot all be understood as pragmatically grounded, and at least some reflect naturally occurring discontinuities without thereby representing natural kinds. Even if essentialist accounts of mental disorders are generally mistaken, they are not implied whenever a psychiatric category (...) that is not pragmatically grounded is posited. (shrink)

Richard Boyd’s Homeostatic Property Cluster Theory is becoming the received view of natural kinds in the philosophy of science. However, a problem with HPC Theory is that it neglects many kinds highlighted by scientific classifications while at the same time endorsing kinds rejected by science. In other words, there is a mismatch between HPC kinds and the kinds of science. An adequate account of natural kinds should accurately track the classifications of successful science. We offer an alternative account of natural (...) kinds that better recognizes the diversity of epistemic aims scientists have for constructing classifications. That account introduces the idea of a classificatory program and provides criteria for judging whether a classificatory program identifies natural kinds. (shrink)

With this manifesto, John Dupré systematically attacks the ideal of scientific unity by showing how its underlying assumptions are at odds with the central conclusions of science itself.

Psychopathy attracts considerable interdisciplinary interest. The idea of a group of people with abnormal morality and interpersonal relations raises important philosophical, legal, and clinical issues. However, before engaging these issues, we ought to examine whether this category is scientifically grounded. We frame the issue in terms of the question whether ‘psychopathy’ designates a natural kind according to the cluster approaches. We argue that currently there is no sufficient evidence for an affirmative answer to this question. Furthermore, we examine three ways (...) of dealing with the category of psychopathy. We could eliminate the category, revise it, or subscribe to a more encompassing account of kinds, which could capture psychopathy as it is currently conceptualized. We argue that while a revision of the category of psychopathy is to be expected with empirical and theoretical advancements, we also emphasize its role in clinical and forensic research that makes it an important pragmatic kind. (shrink)

Essentialism is one of the most pervasive problems in mental health research. Many psychiatrists still hold the view that their nosologies will enable them, sooner or later, to carve nature at its joints and to identify and chart the essence of mental disorders. Moreover, according to recent research in social psychology, some laypeople tend to think along similar essentialist lines. The main aim of this article is to highlight a number of processes that possibly explain the persistent presence and popularity (...) of essentialist conceptions of mental disorders. One such process is the general tendency of laypeople to essentialize conceptual structures, including biological, social, and psychiatric categories. Another process involves the allure of biological psychiatry. Advocating a categorical and biological approach, this strand of psychiatry probably reinforced the already existing lay essentialism about mental disorders. As such, the question regarding why we essentialize mental disorders is a salient example of how cultural trends zero in on natural tendencies, and vice versa, and how both can boost each other. (shrink)

THE FIRST EDITION of this book was based primarily on experience with adult male psychopaths hospitalized in a closed institution. Though a great many other psychopaths had come to my attention, most of the patients who were observed over years and from whom emerged the basic concepts presented in 1941 were from this group. During the next decade a much more diverse group became available. Female patients, adolescents, people who had never been admitted to a psychiatric hospital, all in large (...) numbers, became available for study and afforded an opportunity to observe the disorder in a very wide range of variety and of degree. This additional clinical experience, helpful comment in the reviews of the first edition, enlightening discussion with colleagues, and an improved acquaintance with the literature all contributed to modify concepts formulated approximately ten years earlier. In attempting to revise the book for the second edition (1950), I found it was impossible to do justice to the subject by minor additions, deletions, and modifications. It was necessary to write a new and much larger book. (shrink)

What are species? Are they objective features of the world? If so, what sort of features are they? Do everyday intuitions that species are real stand up to philosophical and scientific scrutiny? Two rival accounts of species' reality have dominated the discussion: that species are natural kinds defined by essential properties and that species are individuals. Unfortunately, neither account fully accommodates biological practice. In Are Species Real?, Slater presents a novel approach to this question aimed at accommodating the attractions to (...) both realism and antirealism about species. (shrink)

The notion of 'natural kinds' has been central to contemporary discussions of metaphysics and philosophy of science. Although explicitly articulated by nineteenth-century philosophers like Mill, Whewell and Venn, it has a much older history dating back to Plato and Aristotle. In recent years, essentialism has been the dominant account of natural kinds among philosophers, but the essentialist view has encountered resistance, especially among naturalist metaphysicians and philosophers of science. Informed by detailed examination of classification in the natural and social sciences, (...) this book argues against essentialism and for a naturalist account of natural kinds. By looking at case studies drawn from diverse scientific disciplines, from fluid mechanics to virology and polymer science to psychiatry, the author argues that natural kinds are nodes in causal networks. On the basis of this account, he maintains that there can be natural kinds in the social sciences as well as the natural sciences. (shrink)

Especially troublesome in this dispute is the status of the natural sciences, and this is where Hacking finds some of his most telling cases, from the conflict ...

The question of whether biologists should continue to use the Linnaean hierarchy has been a hotly debated issue. Invented before the introduction of evolutionary theory, Linnaeus's system of classifying organisms is based on outdated theoretical assumptions, and is thought to be unable to provide accurate biological classifications. Marc Ereshefsky argues that biologists should abandon the Linnaean system and adopt an alternative that is more in line with evolutionary theory. He traces the evolution of the Linnaean hierarchy from its introduction to (...) the present. He illustrates how the continued use of this system hampers our ability to classify the organic world, and then goes on to make specific recommendations for a post-Linnaean method of classification. Accessible to a wide range of readers by providing introductory chapters to the philosophy of classification and the taxonomy of biology, the book will interest both scholars and students of biology and the philosophy of science. (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)

The paper considers whether psychiatric kinds can be natural kinds and concludes that they can. This depends, however, on a particular conception of ‘natural kind’. We briefly describe and reject two standard accounts – what we call the ‘stipulative account’ (according to which apparently a priori criteria, such as the possession of intrinsic essences, are laid down for natural kindhood) and the ‘Kripkean account’ (according to which the natural kinds are just those kinds that obey Kripkean semantics). We then rehearse (...) a more permissive account: Richard Boyd’s ‘homeostatic property cluster’ (HPC) account. We argue that psychiatric kinds can in principle count as natural kinds on the HPC account. Moreover, specific psychiatric kinds (Tourette’s, schizophrenia, etc.) can be natural kinds even if the category psychiatric disorder is not itself a natural kind. (shrink)

This chapter argues that the conditions under the umbrella “personality disorders” actually constitute two very different kinds of theoretical entities. In particular, several core personality disorders are actually moral, and not medical, conditions. Thus, the categories that are held to represent them are really moral, and not medical, theoretical kinds. The chapter works back from the possibility of treatment to the nature of the kinds that are allegedly treated, revisiting 18th-century ideas of moral treatment along the way. The discussion closes (...) with a reflection on how the ambiguous medical status of personality disorders and their treatment today is reminiscent of the ideological tug of war that pits alienist “mad doctors” like Pinel against their lay counterparts such as Tuke as they battled over who should be in charge of treating the mad. (shrink)

In this article, I argue that depression and suicide are natural kinds insofar as they are classes of abnormal behavior underwritten by sets of stable biological mechanisms. In particular, depression and suicide are neurobiological kinds characterized by disturbances in serotonin functioning that affect various brain areas (i.e., the amygdala, anterior cingulate, prefrontal cortex, and hippocampus). The significance of this argument is that the natural (biological) basis of depression and suicide allows for reliable projectable inferences (i.e., predictions) to be made about (...) individual members of a kind. In the context of assisted suicide, inferences about the decision-making capacity of depressed individuals seeking physician-assisted suicide are of special interest. I examine evidence that depression can hamper the decision-making capacity of individuals seeking assisted suicide and discuss some implications. (shrink)

This chapter introduces a distinctive approach for scientific metaphysics. Instead of drawing metaphysical conclusions by interpreting the most basic theories of science, this approach draws metaphysical conclusions by analyzing how multifaceted practices of science work. Broadening attention opens the door to drawing metaphysical conclusions from a wide range of sciences. This chapter analyzes conceptual practice in genetics to argue that the reality investigated by biologists lacks an overall structure. It expands this conclusion to motivate the no general structure thesis, which (...) states that the world lacks a general, overall structure that spans scales. It concludes that the no general structure thesis counts as metaphysics because it says something very important and general about the world. This thesis informs science as well as philosophy of science, and it provides a useful perspective for societies that look upon science to help solve complex problems in our changing world. (shrink)