Jonathan Y. Tsou

A large part of the controversy surrounding the publication of DSM-5 stems from the possibility of replacing the purely descriptive approach to classification favored by the DSM since 1980. This paper examines the question of how mental disorders should be classified, focusing on the issue of whether the DSM should adopt a purely descriptive or theoretical approach. I argue that the DSM should replace its purely descriptive approach with a theoretical approach that integrates causal information into the DSM’s descriptive diagnostic categories. The paper proceeds in three sections. In the first section, I examine the goals (viz., guiding treatment, facilitating research, and improving communication) associated with the DSM’s purely descriptive approach. In the second section, I suggest that the DSM’s purely descriptive approach is best suited for improving communication among mental health professionals; however, theoretical approaches would be superior for purposes of treatment and research. In the third section, I outline steps required to move the DSM towards a hybrid system of classification that can accommodate the benefits of descriptive and theoretical approaches, and I discuss how the DSM’s descriptive categories could be revised to incorporate theoretical information regarding the causes of disorders. I argue that the DSM should reconceive of its goals more narrowly such that it functions primarily as an epistemic hub that mediates among various contexts of use in which definitions of mental disorders appear. My analysis emphasizes the importance of pluralism as a methodological means for avoiding theoretical dogmatism and ensuring that the DSM is a reflexive and self-correcting manual.

This dissertation examines psychiatry from a philosophy of science perspective, focusing on issues of realism and classification. Questions addressed in the dissertation include: What evidence is there for the reality of mental disorders? Are any mental disorders natural kinds? When are disease explanations of abnormality warranted? How should mental disorders be classified? In addressing issues concerning the reality of mental disorders, I draw on the accounts of realism defended by Ian Hacking and William Wimsatt, arguing that biological research on mental disorders supports the inference that some mental disorders (e.g., schizophrenia, mood disorders, and anxiety disorders) are real theoretical entities, and that the evidence supporting this inference is causal and abductive. In explicating the nature of such entities, I argue that real mental disorders are natural kinds insofar as they are natural classes of abnormal behavior whose members share the same causal structure. I present this position in terms of Richard Boyd’s homeostatic cluster property theory of natural kinds, and argue that this perspective reveals limitations of Hacking’s account on the looping effects of human kinds, which suggests that the objects classified by psychiatrists are unstable entities. I subsequently argue that a subset of mental disorders (e.g., schizophrenia and Down syndrome) are mental illnesses insofar as they are disorders caused by a dysfunctional biological process that leads to harmful consequences for individuals. I present this analysis against Thomas Szasz’s argument that mental illness is a myth. In addressing issues of psychiatric classification, my analysis focuses on the Diagnostic and Statistical Manual of Mental Disorders (DSM), which has been published regularly by the American Psychiatric Association since 1952, and is currently in its fourth edition. After examining the history of DSM in the twentieth century, and in particular, DSM’s shift to an atheoretical and purely descriptive system in the 1980s, I consider the relative merits of descriptive versus causal systems of classification. Drawing on Carl Hempel’s analysis of taxonomic systems in psychiatry, I argue that a causal classification system would provide a superior approach to psychiatric classification than the descriptive system currently favored by DSM.

An essential overview of this important intellectual movement. This latest volume in the longest-standing and most influential series in the field of the philosophy of science extends and expands on the discipline's recent historical turn. These essays take up the historical, sociological, and philosophical questions surrounding the particular intellectual movement of logical empiricism--both its emigration from Europe to North America in the 1930s and 1940s and its development in North America through the 1940s and 1950s. With an introduction placing them in their philosophical and historical context, these essays bear witness to the fact that the history of the philosophy of science, far more than a mere repository of anecdote and chronology, might be able to produce a decisive transformation in the philosophy of science itself

In psychiatry, pharmacological drugs play an important experimental role in attempts to identify the neurobiological causes of mental disorders. Besides being developed in applied contexts as potential treatments for patients with mental disorders, pharmacological drugs play a crucial role in research contexts as experimental instruments that facilitate the formulation and revision of neurobiological theories of psychopathology. This paper examines the various epistemic functions that pharmacological drugs serve in the discovery, refinement, testing, and elaboration of neurobiological theories of mental disorders. I articulate this thesis with reference to the history of antipsychotic drugs and the evolution of the dopamine hypothesis of schizophrenia in the second half of the twentieth century. I argue that interventions with psychiatric patients through the medium of antipsychotic drugs provide researchers with information and evidence about the neurobiological causes of schizophrenia. This analysis highlights the importance of pharmacological drugs as research tools in the generation of psychiatric knowledge and the dynamic relationship between practical and theoretical contexts in psychiatry.

This paper explores Paul Feyerabend's (1924-1994) skeptical arguments for "anarchism" in his early writings between 1960 to 1975. Feyerabend's position is encapsulated by his well-known suggestion that the only principle for scientific method that can be defended under all circumstances is: "anything goes." I present Feyerabend's anarchism as a recommendation for pluralism that assumes a realist view of scientific theories. The aims of this paper are threefold: (1) to present a defensible view of Feyerabend's anarchism and its motivations, (2) to articulate the minimal form of realism that such a view presupposes, and (3) to consider the implications and limitations of such a perspective in contemporary philosophy of science.

In this paper I argue that a principal argument in favor of the existence of non-conceptual content (henceforth NCC) fails. That is, I do not accept that considerations regarding the richness of our perceptual experiences support the existence of NCC. I argue instead that the existence of NCC is empirically motivated. Here is an outline of the paper. First, I set out the distinction between conceptual content and NCC as we understand it. Second, I consider the richness argument (RA), and argue that it fails. I argue in particular that RA (or RA-style arguments) are either self-defeating or confl ict with reasonably established accounts of early perceptual processing. Third, I tackle a residual phenomenological puzzle and offer a solution to it. Fourth, I argue that the existence of NCC enjoys empirical support. I argue in particular that states associated with early stages of visual perceptual processing have NCC.

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.

This highly multidisciplinary collection discusses an increasingly important topic among scholars in science and technology studies: objectivity in science. It features eleven essays on scientific objectivity from a variety of perspectives, including philosophy of science, history of science, and feminist philosophy. Topics addressed in the book include the nature and value of scientific objectivity, the history of objectivity, and objectivity in scientific journals and communities. Taken individually, the essays supply new methodological tools for theorizing what is valuable in the pursuit of objective knowledge and for investigating its history. The essays offer many starting points, while suggesting new avenues of research. Taken collectively, the essays exemplify the very virtues of objectivity that they theorize—in reading them together, the reader can sense various anxieties about the dangerously subjective in our age and locate commonalities of concern as well as differences of approach. As a result, the volume offers an expansive vision of a research community seeking a communal understanding of its own methods and its own epistemic anxieties, struggling to enunciate the key problems of knowledge of our time and offer insight into how to overcome them. (Contributors: Alex Csiszar, Scott Edgar, Peter Galison, Ian Hacking, Sandra Harding, Moira Howes, Paolo Savoia, Judy Segal, Joan Steigerwald, and Alison Wylie)

Abstract Recently, some philosophers of psychiatry (viz., Rachel Cooper and Dominic Murphy) have analyzed the issue of psychiatric classification. This paper expands upon these analyses and seeks to demonstrate that a consideration of the history of the Diagnostic and Statistical Manual of Mental Disorders (DSM) can provide a rich and informative philosophical perspective for critically examining the issue of psychiatric classification. This case is intended to demonstrate the importance of history for philosophy of psychiatry, and more generally, the potential benefits of historically-informed approaches to philosophy of science

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.

In this article, I argue that depression and suicide are natural kinds insofar as they are classes of abnormal behavior underwritten by sets of stable biological mechanisms. In particular, depression and suicide are neurobiological kinds characterized by disturbances in serotonin functioning that affect various brain areas (i.e., the amygdala, anterior cingulate, prefrontal cortex, and hippocampus). The significance of this argument is that the natural (biological) basis of depression and suicide allows for reliable projectable inferences (i.e., predictions) to be made about individual members of a kind. In the context of assisted suicide, inferences about the decision-making capacity of depressed individuals seeking physician-assisted suicide are of special interest. I examine evidence that depression can hamper the decision-making capacity of individuals seeking assisted suicide and discuss some implications.

According to David Chalmers, the hard problem of consciousness consists of explaining how and why qualitative experience arises from physical states. Moreover, Chalmers argues that materialist and reductive explanations of mentality are incapable of addressing the hard problem. In this chapter, I suggest that Chalmers’ hard problem can be usefully distinguished into a ‘how question’ and ‘why question,’ and I argue that evolutionary biology has the resources to address the question of why qualitative experience arises from brain states. From this perspective, I discuss the different kinds of evolutionary explanations (e.g., adaptationist, exaptationist, spandrel) that can explain the origins of the qualitative aspects of various conscious states. This argument is intended to clarify which parts of Chalmers’ hard problem are amenable to scientific analysis.