6 Comments
Mar 10Liked by Awais Aftab

I wonder how many psychiatrists agree with this statement by the study authors: "Since DSM-III, our field has moved toward a reification of DSM that implicitly assumes that psychiatric disorders are actually just the DSM criteria." I have read articles by psychiatrists who use DSM criteria for billing and administrative purposes but consider them to be oversimplifications of complex conditions.

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Many psychiatrists disagree with a constitutive understanding of DSM criteria, that’s certainly true, but I think it’s also correct to say that collectively the field (in education, research, public communication, etc) has often acted as if DSM criteria were constitutive.

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Mar 13Liked by Awais Aftab

"...the thing itself isn’t a fixed, stable entity but consists of variable and heterogeneous subsets of internalizing and neurocognitive symptoms..."

Borsboom's claim: "Recent work has put forward the hypothesis that we cannot find central disease mechanisms for mental disorders because no such mechanisms exist" in Borsboom D. (2017). A network theory of mental disorders. World psychiatry : official journal of the World Psychiatric Association (WPA), 16(1), 5–13.

Translation: there are just dynamic interactions between an agent's metaphysical presuppositions relative to the population at large, the neural state of that particular body, and the contexts they find themselves in.

Conclusion: there is no such thing as a substantial form of mental disorder that can be eternally defined from a nomothetic paradigm.

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This research tallies really well with C.A. Soper's theory of mental illness. Soper believes that mental illness isn't really an illness but a biological adaptation designed to keep us from killing ourselves. He thinks the traits of mental illness, like numbing, listlessness, delusion, work to make us incapable of decisive action and rational planning when we're in extreme psychic pain so that it becomes harder for us to commit suicide. He thinks that these different traits can occur in any combination and thus that traditional categories like schizophrenia or depression are invalid. https://open.substack.com/pub/eclecticinquiries/p/what-if-mental-illnesses-arent-illnesses?r=4952v2&utm_campaign=post&utm_medium=web

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Mar 11Liked by Awais Aftab

Color me dumb, but the word index is throwing me off - 'MDD indexes a varying and heterogenous subset of symptoms/syndromes, and what is common about these varying subsets is that depressed mood and/or anhedonia are prominent aspects of the presentation.' I interpret that as 'MDD serves as a label for a varying and heterogenous...'.

Am I thinking along the right lines?

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Yes. “Labels,” “points towards,” “identifies,” etc.

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