Thursday, 8 January 2015

Classifying Psychopathology: Mental Kinds and Natural Kinds

In this post, Harold Kincaid and Jackie Sullivan present their edited volume titled Classifying Psychopathology: Mental Kinds and Natural Kinds (MIT Press, 2014)

Harold Kincaid
We are Harold Kincaid and Jackie Sullivan. Harold is Professor in the School of Economics and Director of the Research Unit in Behavioural Economics and Neuroeconomics at the University of Cape Town. He works primarily in the philosophy of the social sciences and has published numerous books and articles on topics in this research area. Jackie is Assistant Professor in the Department of Philosophy and a member of the Rotman Institute of Philosophy at the University of Western Ontario. She works primarily in the philosophy of neuroscience and is the author of multiple recent journal articles on topics in this research area.

Together, we edited a volume entitled Classifying Psychopathology: Mental Kinds and Natural Kinds, which was published by MIT Press in April 2014. The volume asks whether psychiatry as a science may better position itself to cure mental health disorders by considering whether improvements to current criteria for classifying mental disorders are warranted or whether the classification schemes are fine as they stand. Either directly or indirectly, the authors take up the question of whether mental disorders are natural kinds.
The basic idea behind the concept of natural kinds is that science identifies the most fundamental entities of nature and shows how they are interrelated. In the case of mental disorders, psychiatric categories ought to group together phenomena in such a way that those phenomena are subject to the same type of causal explanation and respond similarly to the same kinds of causal interventions. If psychiatric categories do not find such groupings, then there may be good grounds to revise and/or eliminate existing classifications, including the most recent version of the Diagnostic and Statistical Manual of Mental Disorders (DSM-V).
Jackie Sullivan

Two primary themes emerge from the chapters in the volume. First, current classification systems of mental disorders are insufficient for the purposes of successful diagnosis, treatment, and research. Second, the assumptions upon which current classification systems are based are problematic. However, the contributors provide different answers as to why the current classification systems fail, different ideas on how the failures might be overcome and different suggestions as to how the assumptions on which the systems are based might be revised.

Some of the authors (e.g., Haslam, Kincaid, Stein, Tekin, Zachar) argue that some or many behaviors labeled as psychopathological are not best thought of as natural kinds in the strong essentialist sense; there are weaker notions of psychopathological kinds that may be useful in understanding some mental disorders. Other authors direct their criticisms at the Diagnostic and Statistical Manual of Mental Disorders in claiming that insofar as current categories of mental disorders lack either predictive validity (e.g., Poland) or construct validity (e.g., Sullivan) or are based on folk psychological notions (e.g., Ross, Murphy), they fail to serve as an appropriate basis for scientific research into the causes of mental illness. The conclusion is that better classification systems and more robust clinical screens for recruiting subjects for research into the causes of mental disorders are required. Another problem with current classification systems addressed in the volume is that some

DSM categories have been historically shaped by professional and financial pressures (e.g. major depressive disorder (Horwitz) as well as racism (e.g., oppositional defiant disorder (Potter)), and thus fail to correspond to objectively real kinds of things in the world. Other issues addressed in the volume include: the question of whether mental disorders are real (Graham), which is prerequisite to assessing if they constitute natural kinds; whether being diagnosed with a mental disorder impacts an individual’s self concept to the extent that developing objective criteria for psychiatric classification is not possible (Tekin); and whether abandoning current systems of psychiatric classification (i.e., DSM) for new taxonomies of cognitive dysfunction is likely to better position psychiatry to discover the causes of mental illness or put it on worse footing (Sullivan).

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