Pharmacological Interventions and the Neurobiological Basis of Mental Disorders

In psychiatry, pharmacological research has played a crucial role in the formulation, revision, and refinement of neurobiological theories of psychopathology. Besides being utilized as potential treatments for various mental disorders, pharmacological drugs play an important epistemic role as experimental instruments that help scientists uncover the neurobiological underpinnings of mental disorders (Tsou, 2012). Interventions with psychiatric patients using pharmacological drugs provide researchers with information about the neurobiological causes of mental disorders that cannot be obtained in other ways. This important source of evidence for the biological causes of mental disorder is often overlooked in philosophical analyses of psychiatry, especially in skeptical analyses that debase the biological aspects of psychopathology (e.g., Szasz, 1960; Scheff, 1963; Laing, 1967). In discussing pharmacological interventions as a form of evidence for the physical basis of mental disorders, this paper aims to clarify the nature, reliability, and limitations of this evidence. In addition, it illustrates the central role that pharmacological findings in applied clinical contexts play in the acquisition of neurobiological knowledge in research contexts

Natural Kinds, Psychiatric Classification and the History of the DSM

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

Philosophy of Science, Psychiatric Classification, and the DSM

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

Biological Essentialism, Projectable Human Kinds, and Psychiatric Classification

A minimal essentialism (‘intrinsic biological essentialism’) about natural kinds is required to explain the projectability of human science terms. Human classifications that yield robust and ampliative projectable inferences refer to biological kinds. I articulate this argument with reference to an intrinsic essentialist account of HPC kinds. This account implies that human sciences (e.g., medicine, psychiatry) that aim to formulate predictive kind categories should classify biological kinds. Issues concerning psychiatric classification and pluralism are examined

Genetic Epistemology and Piaget's Philosophy of Science: Piaget vs. Kuhn on Scientific Progress

This paper concerns Jean Piaget's (1896–1980) philosophy of science and, in particular, the picture of scientific development suggested by his theory of genetic epistemology. The aims of the paper are threefold: (1) to examine genetic epistemology as a theory concerning the growth of knowledge both in the individual and in science; (2) to explicate Piaget's view of ‘scientific progress’, which is grounded in his theory of equilibration; and (3) to juxtapose Piaget's notion of progress with Thomas Kuhn's (1922–1996). Issues of scientific continuity, scientific realism and scientific rationality are discussed. It is argued that Piaget's view highlights weaknesses in Kuhn's ‘discontinuous’ picture of scientific change

The Ambiguous Legacy of Kuhn's Structure for Normative Philosophy of Science

This chapter examines the legacy of Kuhn’s Structure for normative philosophy of science. As an argument regarding the history of 20th century philosophy of science, I contend that the main legacy of Structure was destructive: Structure shifted philosophy of science away from addressing general normative philosophical issues (e.g., the demarcation problem, empirical testability) towards more deflationary and local approaches to normative issues. This is evident in the first generation of post-Structure philosophers of science in the 1980s and 1990s, who adopted a pluralist approach to HPS. As a metaphilosophical argument regarding the methods adopted in HPS, I argue that there are a plurality of legitimate philosophical methodologies for inferring normative claims from historical cases. I frame this argument as a response to Pitt’s dilemma of case studies. I reject Pitt’s dilemma for its presupposition of an unrealistic and unfruitful standard (viz., epistemic certainty) for assessing HPS arguments and its analysis of philosophical methodology at the level of individual arguments. Pitt’s dilemma is most usefully understood as identifying potential points of criticism for HPS arguments. The chapter begins with an examination of Kuhn’s normative philosophy of science in Structure and his position that historical cases provide evidence for philosophical claims. Kuhn’s philosophical methodology is insufficiently articulated, and his utilization of case studies is subject to objections (viz., interpretative bias, hasty generalization) implied by Pitt’s dilemma. I subsequently examine four post-Kuhnian methodological perspectives: (1) Ian Hacking’s particularism, (2) Helen Longino’s practice-based approach, (3) Michael Friedman’s neo-Kantianism, and (4) Hasok Chang’s complementary science. These views suggest alternative methodological strategies in HPS for addressing normative issues. I conclude by articulating some outstanding methodological challenges for the pluralist tradition of HPS—associated with the Stanford and Minnesota schools of philosophy of science—that emerged in the 1980s and remains influential

Biological Essentialism, Projectable Human Kinds, and Psychiatric Classification

A minimal essentialism (‘intrinsic biological essentialism’) about natural kinds is required to explain the projectability of human science terms. Human classifications that yield robust and ampliative projectable inferences refer to biological kinds. I articulate this argument with reference to an intrinsic essentialist account of HPC kinds. This account implies that human sciences (e.g., medicine, psychiatry) that aim to formulate predictive kind categories should classify biological kinds. Issues concerning psychiatric classification and pluralism are examined

Social Construction, HPC Kinds, and the Projectability of Human Categories

This paper addresses the question of how human science categories yield projectable inferences by critically examining Ron Mallon’s ‘social role’ account of human kinds. Mallon contends that human categories are projectable when a social role produces a homeostatic property cluster (HPC) kind. On this account, human categories are projectable when various social mechanisms stabilize and entrench those categories. Mallon’s analysis obscures a distinction between transitory and robust projectable inferences. I argue that the social kinds discussed by Mallon yield the former, while classifications of biological kinds yield the latter. Classifications from psychiatry (‘schizophrenia,’ ‘hysteria’) are discussed as examples

Function, Dysfunction, and the Concept of Mental Disorder

Naturalistic accounts of mental disorder aim to identify an objective basis for attributions of mental disorder. This goal is important for demarcating genuine mental disorders from artificial or socially constructed disorders. The articulation of a demarcation criterion provides a means for assuring that attributions of 'mental disorder' are not merely pathologizing different forms of social deviance. The most influential naturalistic and hybrid definitions of mental disorder identify biological dysfunction as the objective basis of mental disorders: genuine mental..

Philosophy of Psychiatry

Jonathan Y. Tsou examines and defends positions on central issues in philosophy of psychiatry. The positions defended assume a naturalistic and realist perspective and are framed against skeptical perspectives on biological psychiatry. Issues addressed include the reality of mental disorders; mechanistic and disease explanations of abnormal behavior; definitions of mental disorder; natural and artificial kinds in psychiatry; biological essentialism and the projectability of psychiatric categories; looping effects and the stability of mental disorders; psychiatric classification; and the validity of the DSM's diagnostic categories. The main argument defended by Tsou is that genuine mental disorders are biological kinds with harmful effects. This argument opposes the dogma that mental disorders are necessarily diseases that result from biological dysfunction. Tsou contends that the broader ideal of biological kinds offers a more promising and empirically ascertainable naturalistic standard for assessing the reality of mental disorders and the validity of psychiatric categories