Philosophical Issues in Psychiatry II: Nosology (International Perspectives in Philosophy and Psychiatry)

Psychiatric and psychological practice and research is critically dependent on diagnosis. Yet the nature of psychiatric diagnosis and the rules by which disorders should be created and organized have been highly controversial for over 100 years. Unlike simple medical disorders (like infectious diseases), psychiatric disorders cannot be traced to one simple etiologic agent. The last two generations have seen major conceptual shifts in the approach to diagnosis with the rise of operationalized criteria and an emphasis on a descriptive rather than etiological approach to diagnosis. The interest in psychiatric diagnoses is particularly heightened now because both of the major psychiatric classifications in the world - DSM and ICD - are now undergoing major revisions. What makes psychiatric nosology so interesting is that it sits at the intersection of philosophy, empirical psychiatric/psychological research, measurement theory, historical tradition and policy. This makes the field fertile for a conceptual analysis. 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. Some of the questions addressed include i) what is the nature of psychiatric illness? Can it be clearly defined and if so how? ii) What is the impact of facts versus values in psychiatric classification? iii) How have concepts of psychiatric diagnosis changed over time? iv) How can we best conceptualize the central idea of diagnostic validity? And v) Can psychiatric classification be a cumulative enterprise seeking improvements at each iteration of the diagnostic manual? Each individual chapter is introduced by the editors and is followed by a commentary, resulting in a dynamic discussion about the nature of psychiatric disorders. This book will be valuable for psychiatrists, psychologists and other mental health trainees and professionals with an interest in the questions and problems of psychiatric diagnosis, as well as philosophers and philosophy students interested in the problems posed by psychiatry, particularly those working in the philosophy of science. Content: pt. I The basics: the definition of psychiatric illness and rules for classification -- ch. 1 Classification and causal mechanisms: a deflationary approach to the classification problem / Derek Bolton -- Introduction / Kenneth S. Kendler -- Comments: The National Institute of Mental Health Research Domain Criteria (RDoC) project: moving towards a neuroscience-based diagnostic classification in psychiatry / Michael B. First -- ch. 2 Progress and the calibration of scientific constructs: the role of comparative validity / Peter Zachar -- Introduction / Kenneth S. Kendler -- Comments: Progress and the calibration of scientific constructs: a new look at validity / Rachel Cooper -- ch. 3 Taking disease seriously: beyond "pragmatic" nosology / S. Nassir Ghaemi -- Introduction / Josef Parnas -- Comments: What is psychiatric disease? A commentary on Dr Ghaemi's paper / Derek Bolton -- ch. 4 Is psychiatric classification a good thing? / Rachel Cooper -- Introduction / Kenneth S. Kendler -- Comments: Diagnoses as labels / S. Nassir Ghaemi -- pt. II The historical development of modern psychiatric diagnoses -- ch. 5 The nosological entity in psychiatry: a historical illusion or a moving target? / Assen Jablensky -- Introduction / Josef Parnas -- Comments: The Kraepelinian pipe organ model (for a more dimensional) DSM-5 classification / Darrel A. Regier -- ch. 6 The 19th-century nosology of alienism: history and epistemology / German E. Berrios -- Introduction / Kenneth S. Kendler -- Comments: The nature of the psychiatric object and classification / Josef Parnas -- ch. 7 The development of DSM-III from a historical/conceptual perspective / Michael B. First -- Introduction / Kenneth S. Kendler -- Comments: Evaluating DSM-III: structure, process and outcomes / Harold Alan Pincus -- ch. 8 DSM-IV: context, concepts and controversies / Harold Alan Pincus -- Introduction / Kenneth S. Kendler -- Comments: DSM-IV: some critical remarks / Mario Maj -- pt. III The problem of validity -- ch. 9 A philosophical overview of the problems of validity for psychiatric disorders / Kenneth F. Schaffner -- Introduction / Josef Parnas -- Comments: Validity, utility and reality: explicating Schaffner's pragmatism / Peter Zachar -- ch. 10 Structural validity and the classification of mental disorders / Nicholas R. Eaton -- Introduction / Kenneth S. Kendler -- Comments: Seeing sense in psychiatric diagnoses / Paul R. McHugh -- pt. IV Application to major depression and schizophrenia -- ch. 11 When does depression become a mental disorder? / Mario Maj -- Introduction / Josef Parnas -- Comments: A sea of distress / Josef Parnas -- ch. 12 DSM-IV and the founding prototype of schizophrenia: are we regressing to a pre-Kraepelinian nosology? / Josef Parnas -- Introduction / Assen Jablensky -- Comments: Phenomenology, nosology and prototypes / Kenneth S. Kendler -- pt. V The way(s) forward -- ch. 13 Rendering mental disorders intelligible: addressing psychiatry's urgent challenge / Paul R. McHugh -- Introduction / Josef Parnas -- Comments: A search for coherence / Assen Jablensky -- ch. 14 Diagnostic threshold considerations for DSM-5 / Darrel A. Regier -- Introduction / Kenneth S. Kendler -- Comments: The tangible burden of mental disorder in the absence of mental disorder categories in nature: some reflections on Regier's contribution / Robert F. Krueger -- ch. 15 Epistemic iteration as a historical model for psychiatric nosology: promises and limitations / Kenneth S. Kendler -- Introduction / Josef Parnas -- Comments: Coherentist approaches to scientific progress in psychiatry: comments on Kendler / Kenneth F. Schaffner. Cover 1 Contents 8 List of Contributors 12 Introduction 14 Part I: The basics: the definition of psychiatric illness and rules for classification 18 Chapter 1 Introduction 20 Chapter: Classification and causal mechanisms: a deflationary approach to the classification problem 23 Comments: The National Institute of Mental Health Research Domain Criteria (RDoC) project: moving towards a neuroscience-based diagnostic classification in psychiatry 29 Chapter 2 Introduction 36 Chapter: Progress and the calibration of scientific constructs: the role of comparative validity 38 Comments: Progress and the calibration of scientific constructs: a new look at validity 52 Chapter 3 Introduction 58 Chapter: Taking disease seriously: beyond “pragmatic” nosology 59 Comments: What is psychiatric disease? A commentary on Dr Ghaemi’s paper 71 Chapter 4 Introduction 76 Chapter: Is psychiatric classification a good thing? 78 Comments: Diagnoses as labels 88 Part II: The historical development of modern psychiatric diagnoses 90 Chapter 5 Introduction 92 Chapter: The nosological entity in psychiatry: a historical illusion or a moving target? 94 Comments: The Kraepelinian pipe organ model (for a more dimensional) DSM-5 classification 112 Chapter 6 Introduction 116 Chapter: The 19th-century nosology of alienism: history and epistemology 118 Comments: The nature of the psychiatric object and classification 135 Chapter 7 Introduction 142 Chapter: The development of DSM-III from a historical/conceptual perspective 144 Comments: Evaluating DSM-III: structure, process and outcomes 158 Chapter 8 Introduction 160 Chapter: DSM-IV: context, concepts and controversies 162 Comments: DSM-IV: some critical remarks 178 Part III: The problem of validity 182 Chapter 9 Introduction 184 Chapter: A philosophical overview of the problems of validity for psychiatric disorders 186 Comments: Validity, utility and reality: explicating Schaffner’s pragmatism 207 Chapter 10 Introduction 214 Chapter: Structural validity and the classification of mental disorders 216 Comments: Seeing sense in psychiatric diagnoses 230 Part IV: Application to major depression and schizophrenia 234 Chapter 11 Introduction 236 Chapter: When does depression become a mental disorder? 238 Comments: A sea of distress 246 Chapter 12 Introduction 252 Chapter: DSM-IV and the founding prototype of schizophrenia: are we regressing to a pre-Kraepelinian nosology? 254 Comments: Phenomenology, nosology and prototypes 277 Part V: The way(s) forward 282 Chapter 13 Introduction 284 Chapter: Rendering mental disorders intelligible: addressing psychiatry’s urgent challenge 286 Comments: A search for coherence 297 Chapter 14 Introduction 300 Chapter: Diagnostic threshold considerations for DSM-5 302 Comments: The tangible burden of mental disorder in the absence of mental disorder categories in nature: some reflections on Regier’s contribution 315 Chapter 15 Introduction 320 Chapter: Epistemic iteration as a historical model for psychiatric nosology: promises and limitations 322 Comments: Coherentist approaches to scientific progress in psychiatry: comments on Kendler 340 Index 348 A 348 B 348 C 348 D 349 E 350 F 350 G 350 H 351 I 351 J 351 K 351 L 351 M 351 N 352 O 352 P 352 R 353 S 353 T 354 U 355 V 355 W 355 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, and historians. Abstract: 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. Read more...