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)

In this article, I explain why stabilizing constructs is important to the success of the Research Domain Criteria Project and identify one measure for facilitating such stability.

Popular interest in the topic of food has exploded in the past decade. Due in part to books by Michael Pollan, Barbara Kingsolver, and Eric Schlosser and films such as Food, Inc., Super Size Me, and Forks over Knives, people are starting to think critically about where their food originates, how it is processed, and how their consumption choices affect the environment, nonhuman animals, and other people. At the same time, there is rising concern about the dangers of obesity. Although (...) the voices raising these concerns are by no means monolithic, one of the most common solutions offered to various food-related issues is the suggestion that people educate themselves and make.. (shrink)

L’anorexie fait partie des troubles du comportement ou de la conduite alimentaire qui sont répertoriés dans le Manuel diagnostique et statistique des troubles mentaux, publié par la Société américaine de psychiatrie. Elle figure parmi les troubles majeurs cliniques, à côté de la dépression, du trouble bipolaire, de la schizophrénie, et de la boulimie à laquelle elle est associée comme s’il s’agissait de l’autre face d’une même pathologie addictive. Au-delà des critiques que ce rapprochement peut susciter, parce qu’il ne permet pas (...) d’analyser la spécificité du mode d’expression des personnes qui s’imposent ces.. (shrink)

There are many ways of construing the claim that some categories are more “natural" than others. One can ask whether a system of categories is innate or acquired by learning, whether it pertains to a natural phenomenon or to a social institution, whether it is lexicalized in natural language or requires a compound linguistic expression. This renders suspect any univocal answer to this question in any particular case. Yet another question one can ask, which some authors take to have a (...) bearing on the issue of the naturalness of categories, is whether a system of categories constitutes a unique way of organizing a particular set of entities or phenomena, or whether there are other legitimate classification schemes that can coexist with it. Another way of putting this is by asking whether systems of categories can cut across one another, and if so, under what circumstances. Some philosophers have claimed that crosscutting systems of categories cannot exist as genuine natural kinds. This paper examines that claim and puts forward some counterexamples, concluding that this notion of natural kind is not in tune with scientific classification and ought to be rejected in favor of an alternative. (shrink)

Although researchers in psychiatry have been trying for decades to elucidate the pathophysiology underlying mental disorders, relatively little progress has been made. One explanation for this failure is that diagnostic categories in psychiatry are unlikely to track underlying neurological mechanisms. Because of this, the US National Institutes of Mental Health has recently developed a novel ontology to guide research in biological psychiatry: the Research Domain Criteria. In this paper, I argue that while RDoC may lead to better neuroscientific explanations for (...) mental disorders, it is unlikely that this new knowledge will then lead to an improved diagnostic system. I therefore suggest that researchers in psychiatry should work toward the development of two new ontologies: one for research and one for clinical practice. (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)

Psychiatry has long struggled with the nature of its diagnoses. 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.

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)

There seems to be no dimension of bodily awareness that cannot be disrupted. To account for such variety, there is a growing consensus that there are at least two distinct types of body representation that can be impaired, the body schema and the body image. However, the definition of these notions is often unclear. The notion of body image has attracted most controversy because of its lack of unifying positive definition. The notion of body schema, onto which there seems to (...) be a more widespread agreement, also covers a variety of sensorimotor representations. Here, I provide a conceptual analysis of the body schema contrasting it with the body image as well as assess whether the body schema can be specifically impaired, while other types of body representation are preserved; and the body schema obeys principles that are different from those that apply to other types of body representation. (shrink)