Phenomenological Psychopathology and Psychiatric Classification

In this chapter, I provide an overview of phenomenological approaches to psychiatric classification. My aim is to encourage and facilitate philosophical debate over the best ways to classify psychiatric disorders. First, I articulate phenomenological critiques of the dominant approach to classification and diagnosis—i.e., the operational approach employed in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) and the International Classification of Diseases (ICD-10). Second, I describe the type or typification approach to psychiatric classification, which I distinguish into three different versions: ideal types, essential types, and prototypes. I argue that despite their occasional conflation in the contemporary literature, there are important distinctions among these approaches. Third, I outline a new phenomenological-dimensional approach. I show how this approach, which starts from basic dimensions of human existence, allows us to investigate the full range of psychopathological conditions without accepting the validity of current diagnostic categories

Phenomenology and Dimensional Approaches to Psychiatric Research and Classification

Contemporary psychiatry finds itself in the midst of a crisis of classification. The developments begun in the 1980s—with the third edition of the Diagnostic and Statistical Manual of Mental Disorders —successfully increased inter-rater reliability. However, these developments have done little to increase the predictive validity of our categories of disorder. A diagnosis based on DSM categories and criteria often fails to accurately anticipate course of illness or treatment response. In addition, there is little evidence that the DSM categories link up with genetic findings, and even less evidence that they..

The variation of invariant graphs in forced systems

In skew-product systems with contractive factors, all orbits asymptotically approach the graph of the so-called sync function; hence, the corresponding regularity properties primarily matter. In the literature, sync function Lipschitz continuity and differentiability have been proved to hold depending on the derivative of the base reciprocal, if not on its Lyapunov exponent. However, forcing topological features can also impact the sync function regularity. Here, we estimate the total variation of sync functions generated by one-dimensional Markov maps. A sharp condition for bounded variation is obtained depending on parameters, that involves the Markov map topological entropy. The results are illustrated with examples

On the Subject Matter of Phenomenological Psychopathology

“On the Subject Matter of Phenomenological Psychopathology” provides a framework for the phenomenological study of mental disorders. The framework relies on a distinction between (ontological) existentials and (ontic) modes. Existentials are the categorial structures of human existence, such as intentionality, temporality, selfhood, and affective situatedness. Modes are the particular, concrete phenomena that belong to these categorial structures, with each existential having its own set of modes. In the first section, we articulate this distinction by drawing primarily on the work of Martin Heidegger—especially his study of the ontological structure of affective situatedness (Befindlichkeit) and its particular, ontic modes, which he calls moods (Stimmungen). In the second section, we draw on a study of grief to demonstrate how this framework can be used when conducting phenomenological interviews and analyses. In the concluding section, we explain how this framework can be guide phenomenological studies across a broad range of existential structures

Of apples and oranges? The evolution of “monogamy” in non-human primates

Behavioral ecologists, evolutionary biologists, and anthropologists have been long fascinated by the existence of “monogamy” in the animal kingdom. Multiple studies have explored the factors underlying its evolution and maintenance, sometimes with contradicting and contentious conclusions. These studies have been plagued by a persistent use of fuzzy terminology that often leads to researchers comparing “apples with oranges” (e.g., comparing a grouping pattern or social organization with a sexual or genetic mating system). In this review, we provide an overview of research on “monogamy” in mammals generally and primates in particular, and we discuss a number of problems that complicate comparative attempts to understand this issue. We first highlight why the muddled terminology has hindered our understanding of both a rare social organization and a rare mating system. Then, following a short overview of the main hypotheses explaining the evolution of pair-living and sexualmonogamy, we critically discuss various claims about the principal drivers of “monogamy” that have been made in several recent comparative studies.We stress the importance of using only high quality and comparable data. We then propose that a productive way to frame and dissect the different components of pair-living and sexual or genetic monogamy is by considering the behavioral and evolutionary implications of those components from the perspectives of all participants in a species’ social system. In particular, we highlight the importance of integrating the perspective of “floater” individuals and considering their impacts on local operational sex ratios, competition, and variance in reproductive success across a population. We stress that pair-living need not imply a reduced importance of intrasexual mate competition, a situation that may have implications for the sexual selection potential that have not yet been fully explored. Finally, we note that there is no reason to assume that different taxa and lineages, even within the same radiation, should follow the same pathway to or share a unifying evolutionary explanation for “monogamy”. The study of the evolution of pair-living, sexual monogamy, and genetic monogamy remains a challenging and exciting area of research.Fieldwork related to the data discussed and presented here was supported through grants awarded to AD, EF-D, and their students by the Wenner-Gren Foundation, the L.S.B. Leakey Foundation, the J. William Fulbright Scholar Program, Primate conservation, Inc., Idea Wild, the National Geographic Society, as well by the New York Consortium in Evolutionary Primatology, New York University, the Zoological Society of San Diego, the University of Pennsylvania, the University of Texas at Austin, and Yale University, as well as through grants awarded to Eckhard W. Heyman and MH by the Deutsche Forschungsgesellschaft (HE 1870/10-1,2,3, HU1746-2/1). The Owl Monkey Project of Argentina was supported through the following grants to EFD: NSF-BCS-0621020, 1232349, 1503753 and 1848954; NSF-REU 0837921, 0924352 and 1026991; NSFRAPID-1219368; NIA- P30 AG012836-19, and NICHD R24 HD-044964-11

Language, Prejudice, and the Aims of Hermeneutic Phenomenology: Terminological Reflections on “Mania"

In this paper I examine the ways in which our language and terminology predetermine how we approach, investigate and conceptualise mental illness. I address this issue from the standpoint of hermeneutic phenomenology, and my primary object of investigation is the phenomenon referred to as “mania”. Drawing on resources from classical phenomenology, I show how phenomenologists attempt to overcome their latent presuppositions and prejudices in order to approach “the matters themselves”. In other words, phenomenologists are committed to the idea that in our everyday, natural attitude, we take for granted a number of prejudices and presuppositions that predetermine how we conceive of and understand what we experience. In order to properly approach the phenomena themselves, we need to find ways of neutralising our presuppositions and prejudices in order to develop new (and hopefully more accurate) accounts of the phenomena under investigation. One of the most popular examples of such an attempt at neutralisation is what Edmund Husserl calls the epoché, which is the practice of bracketing out or suspending presuppositions. However, later phenomenologists developed alternative approaches. Martin Heidegger, for instance, engaged in etymological analyses to discover latent meanings in our language and terminology. Hans-Georg Gadamer also engaged in historical analyses of how our traditions sediment into latent prejudices. After discussing the various ways in which phenomenologists have attempted to neutralise presuppositions and prejudices prior to engaging in their investigations, I apply some of these principles and methods to the domain of psychopathology, and discuss some of the prejudices inherent in contemporary discussions of the phenomenon of mania. I examine recent attempts to link the phenomenon that we today refer to as “mania” with the ancient Greek concept of “μανία” (mania), and argue that the practice of linking contemporary and historical concepts can be detrimental to attempts at reclassifying disorders. In addition, I consider the implications of the shift in terminology from “manic depressive illness” to “bipolar disorder” – especially how conceiving of mania as one of two “poles” predetermines its description by both clinicians and patients. Finally, I address the implications of the headings under which mania and bipolar disorder are discussed within diagnostic manuals. For example, I discuss the removal of the headings of affective and mood disorders in the DSM-5, and the explicit decision by the authors to place bipolar disorder between depressive disorders and schizophrenia. What I aim to accomplish in this paper is not so much a phenomenological investigation of mania as it is a pre-phenomenological investigation. In other words, I offer a preparatory investigation of the phenomenon (or phenomena) referred to as “mania” in contemporary discourse, with the intention of laying the groundwork for further phenomenological and psychological research

Reconsidering the affective dimension of depression and mania: towards a phenomenological dissolution of the paradox of mixed states

In this paper, I examine recent phenomenological research on both depressive and manic episodes, with the intention of showing how phenomenologically oriented studies can help us overcome the apparently paradoxical nature of mixed states. First, I argue that some of the symptoms included in the diagnostic criteria for depressive and manic episodes in the DSM-5 are not actually essential features of these episodes. Second, I reconsider the category of major depressive disorder (MDD) from the perspective of phenomenological psychopathology, arguing that severe depressive episodes should not be characterized by any particular moods (such as sadness, hopelessness, or guilt), and should instead be characterized by a diminished capacity for finding ourselves situated in and attuned to the world at all. In other words, the affective dimension of depression should be characterized as a change in the way we have moods, not as a change from one kind of mood to another. Third, I turn to mania, arguing that manic episodes, taken as the opposite of depressive episodes, should be characterized not by any particular moods (such as euphoria, grandiosity, or even irritability), but should instead be characterized by an enhanced or heightened capacity for finding ourselves situated in and attuned to the world. In other words, the affective dimension of mania, like the affective dimension of depression, should be understood as a change in the way we have moods, not as a change from one kind of mood to another. Fourth, I return to the phenomenon of mixed states and argue that the affective dimension of depression and mania, when conceived along the phenomenological lines I set forth in the previous sections, dissolves the paradox of mixed states by showing that the essential characteristics of depression and mania cannot and do not coincide. Many cases of mixed states are diagnosed because moods that we take to be essential features of either depression or mania arise within the context of what is considered to be the opposite kind of episode (e.g. dysphoria, typically associated with depression, often arises in what is otherwise considered a manic state). However, if we conceive of the affective dimension of depression as a decrease in the degree to which one is situated in and attune to the world through moods, and the affective dimension of mania as an increase in the degree to which one is situated in and attuned to the world through moods, then the particular mood one finds oneself in is simply irrelevant to the diagnosis of either depression or mania. As a result, the manifestation of any particular moods in what otherwise seems to be a pure manic or depressive episode does not constitute a mixed state