•  127
    Cognitive Science and Explanations of Psychopathology
    In K. W. M. Fulford (ed.), The Oxford Handbook of Philosophy and Psychiatry, Oxford University Press. pp. 413-433. 2013.
    This chapter examines the core explanatory strategies of cognitive science and their application to the study of psychopathology. In addition to providing a taxonomy of different strategies, we illustrate their application, with special attention to Autism Spectrum Disorder and Major Depressive Disorder. We conclude by considering two challenges to the prospects of a developed cognitive science of psychopathology.
  •  105
    Psychological Mechanisms
    In V. Zeigler-Hill & T. Shackelford (eds.), Encyclopedia of Personality and Individual Differences, . pp. 4145-4154. 2020.
    In the most inclusive sense, psychological mechanisms offer a type of causal explanation of mental states and behavior, often with reference to underlying processes, systems, activities, or entities. By postulating and investigating such mechanisms, researchers have sought explanations of a wide range of psychological phenomena. However, the concept has been deployed in dramatically different ways, with very different meanings, depending upon the particular school or tradition of psychology (and…Read more
  •  105
    The field of mental health continues to struggle with the question of how best to structure its diagnostic systems. This issue is of considerable ethical importance, but the implications for public health approaches to mental health have yet to be explored in any detail. In this article I offer a preliminary treatment, drawing out several core issues while sounding a note of caution. A central strand of the debates over diagnosis has been the contrast between categorical and dimensional models, …Read more
  •  104
    The Ethics of Coercion and Other Forms of Influence
    In Serife Tekin & Robyn Bluhm (eds.), The Bloomsbury Companion to Philosophy of Psychiatry, Bloomsbury. pp. 283-304. 2019.
    Across the health sector there is increased recognition of the ethical significance of interventions that constrain or coerce. Much of the recent interest stems from debates in public health over the use of quarantines and active monitoring in response to epidemics, as well as the manipulation of information in the service of health promotion (or ‘nudges’). But perhaps the area in which these issues remain most pressing is mental health, where the spectre of involuntary treatment has always loom…Read more
  •  87
    In recent years there has been increased recognition of the global burden of mental disorders, which in turn has led to the expansion of preventive initiatives at the community and population levels. The application of such public health approaches to mental health raises a number of important ethical questions. The aim of this collection is to address these newly emerging issues, with special attention to the principle of prevention and the distinctive ethical challenges in mental health. The c…Read more
  •  71
    Despite widespread recognition that psychiatry would be better served by a classificatory system based on etiology rather than mere description, it goes without saying that much of the necessary work is yet to be done. In this chapter I take up the increasingly important question of how mechanistic explanation fits into the larger effort to build a scientifically sound etiological and nosological framework. I sketch a rough picture of what mechanistic explanation should look like in the context …Read more
  •  64
    In this chapter we outline ethical issues raised by the application of public health approaches to the field of mental health. We first set out some of the basics of public health ethics that are particularly relevant to mental health, with special attention to the ongoing debate over the traditional presumption of non-infringement, increased recognition of the social determinants of health, and the concept of prevention. Then we turn to the moral particularities of mental health, focusing on qu…Read more
  •  55
    Nudges and Coercion: Conceptual, Empirical, and Normative Considerations
    Monash Bioethics Review 33 (2-3): 210-218. 2015.
    Given that the concept of coercion remains a central concern for bioethics, Quigley's (Monash Bioethics Rev 32:141–158, 2014) recent article provides a helpful analysis of its frequent misapplication in debates over the use of ‘nudges’. In this commentary I present a generally sympathetic response to Quigley’s argument while also raising several issues that are important for the larger debates about nudges and coercion. I focus on several closely related topics, including the definition of coerc…Read more
  •  51
    Global Mental Health and the United Nations' Sustainable Development Goals
    with Timothy K. Mackey
    Families, Systems and Health 36 (2): 225-229. 2018.
    Increased awareness of the importance of mental health for global health has led to a number of new initiatives, including influential policy instruments issued by the World Health Organization (WHO) and the United Nations (UN). This policy brief describes two WHO instruments, the Mental Health Action Plan for 2013–2020 (World Health Organization, 2013) and the Mental Health Atlas (World Health Organization, 2015), and presents a comparative analysis with the Sustainable Development Goals (SDGs)…Read more
  •  43
    Structural Model
    In V. Zeigler-Hill & T. Shackelford (eds.), Encyclopedia of Personality and Individual Differences, . pp. 5261-5266. 2020.
    The mind is not unitary. Despite enduring Cartesian influences, the idea that mental activity is the work of an assortment of processes remains one of the more plausible guiding assumptions of psychological research. Freud endorsed a distinctive variant of this broader explanatory commitment. Beginning with his earlier metapsychological works, he slowly developed a view of the mind as a collection of closely related systems. Famously, these ultimately became known as the id, ego, and super-ego. …Read more
  •  41
    Revisiting Freud and Kohut on Narcissism
    Theory & Psychology 26 (3): 333-359. 2016.
    Narcissism continues to be an important topic of research, with a great deal of ongoing empirical work in social and personality psychology. But there are theoretical issues that have received less attention recently, including those that relate to the foundational theories of the psychoanalytic tradition. As the first step in a larger project of reevaluation, this article offers a critical review of Freud and Heinz Kohut’s theories of narcissism. Centered on a theoretical reconstruction, it cla…Read more
  •  40
    The History and Ethics of the Therapeutic Relationship
    In Trachsel Manuel, Şerife Tekin, Nikola Biller-Adorno, Jens Gaab & John Sadler (eds.), Oxford Handbook of Psychotherapy Ethics, Oxford University Press. pp. 65-84. 2021.
    This chapter reviews past and present debates about the therapeutic relationship in order to draw out the ethical implications of relational practices in psychotherapy. The therapeutic relationship has been understood differently across psychotherapeutic approaches, with each tradition responding to the attendant ethical challenges in distinctive ways. Aside from practitioners’ theoretical and practical commitments, the therapeutic relationship has also been, and continues to be, shaped by broad…Read more
  •  37
    Refugee Mental Health, Global Health Policy, and the Syrian Crisis
    with Mohamad Adam Brooks and Tim K. Mackey
    Frontiers in Public Health 9. 2021.
    The most recent global refugee figures are staggering, with over 82.4 million people forcibly displaced and 26.4 million registered refugees. The ongoing conflict in Syria is a major contributor. After a decade of violence and destabilization, over 13.4million Syrians have been displaced, including 6.7 million internally displaced persons and 6.7 million refugees registered in other countries. Beyond the immediate political and economic challenges, an essential component of any response to this …Read more
  •  37
    Bioethics Education and Nonideal Theory
    In Elizabeth Victor & Laura K. Guidry-Grimes (eds.), Applying Nonideal Theory to Bioethics: Living and Dying in a Nonideal World, Springer. pp. 119-142. 2021.
    Bioethics has increasingly become a standard part of medical school education and the training of healthcare professionals more generally. This is a promising development, as it has the potential to help future practitioners become more attentive to moral concerns and, perhaps, better moral reasoners. At the same time, there is growing recognition within bioethics that nonideal theory can play an important role in formulating normative recommendations. In this chapter we discuss what this shift …Read more
  •  36
    Human Rights and Global Mental Health: Reducing the Use of Coercive Measures
    with Marisha Wickremsinhe and Timothy K. Mackey
    In A. Dyer, B. Kohrt & P. J. Candilis (eds.), Global Mental Health: Ethical Principles and Best Practices, . pp. 247-268. 2021.
    The application of human right frameworks is an increasingly important part of efforts to accelerate progress in global mental health. Much of this has been driven by several influential legal and policy instruments, most notably the United Nations’ Convention on the Rights of Persons with Disabilities, as well as the World Health Organization’s QualityRights Tool Kit and Mental Health Action Plan. Despite these significant developments, however, much more needs to be done to prevent human right…Read more
  •  31
    The last few years have seen a marked increase of interest in the ethics of psychotherapy. As the field of mental health has recently taken on a new level of prominence, renewed commitment to the ethical analysis of psychiatric and psychological treatment is clearly required. In this review essay, we survey recent work on psychotherapy ethics, taking a critical yet generally sympathetic view of the new literature. There are important considerations that remain neglected or overlooked entirely, i…Read more
  •  25
    In this introduction to the edited volume, we briefly describe some of the current challenges faced by public mental health initiatives, at both the national and global level. We also include several general remarks on interdisciplinary methodology in public mental health ethics, followed by short descriptions of the chapters included in the volume.
  •  22
    There are any number of important but frequently neglected research programs in biomedical ethics. Notable amongst these are projects deeply grounded in the history of philosophy as well as critical treatments of the methodological contours of the field. Fortunately the present volume, Applied Ethics in Mental Health Care: An Interdisciplinary Reader (MIT Press, 2013), edited by Dominic Sisti, Arthur Caplan, and Hila-Rimon-Greenspan, addresses another commonly overlooked topic, that of mental he…Read more
  •  15
    Duration of Untreated Psychosis, Referral Route, and Age of Onset in an Early Intervention in Psychosis Service and a Local CAMHS
    with Judith Regan, Victoria McAllister, Mima Simic, and Katherine Aitchison
    Child and Adolescent Mental Health 13 130-133. 2008.
    Background: The aim of this study was to investigate associations between demographic and clinical variables and duration of untreated psychosis (DUP) in a sample of cases of psychosis across an adult early intervention in psychosis service and a child and adolescent community team. Method: Cross-sectional baseline data for cases of psychosis across the two teams on the caseload at a given time point were collected, including age of onset, gender, ethnicity, referral route, and DUP. Results: The…Read more
  •  14
    'You may kiss the bride, but you may not open your mouth when you do so': Policies concerning sex, marriage and relationships in English forensic psychiatric facilities
    with Peter Bartlett, Nadia Mantovani, Claire Dillon, and Nigel Eastman
    Liverpool Law Review 31 155-176. 2010.
    In 1996, the Royal College of Psychiatrists recommended that all psychiatric facilities in the UK develop policies concerning sexuality and sexual expression for persons contained in those facilities. This paper analyses the prevalence and content of such policies in English forensic psychiatric facilities. While the College recommends an individualised approach to sexual and emotional relationships, most hospitals in fact either prohibit or actively discourage such expression as a matter of pol…Read more
  •  2
    Public Mental Health Ethics
    Lancet Psychiatry 9 (11): 855-856. 2022.
  • Modularity in Cognitive Models of Delusion
    Acta Psychiatrica Scandinavica 114 (s431): 84-85. 2006.
    Recent cognitive models of delusions have attempted to explain why delusions are commonly circumscribed, in that they tend to center on isolated beliefs, and incorrigible, as they often persist in the face of countervailing evidence. In this effort, the suggestion has been made that ‘modularity’ – a concept originating in seminal accounts of the architecture of perceptual and cognitive processes – may help explain delusions. The aim of this paper is to take up this suggestion, critically evaluat…Read more
  • A Neglected Concept – Duration of Untreated Psychosis in Bipolar Patients
    with K. Shivakumar, V. McAllister, and K. Aitchison
    ISBD Global 6 (1): 7. 2005.
    Bipolar affective disorder (BPAD) can be a devastating disorder for both sufferers and their relatives. In addition to the variety of distressing and severe affective symptoms, the consequences of illness onset may be equally debilitating, particularly as the illness may commonly present in early adulthood. As such, the developmental trajectory between late adolescence and early adulthood is commonly interrupted. Relationships with family, friends and partners may deteriorate, employment or stud…Read more
  • Concepts of Coercion: Provisional Lessons from Recent Research
    Philosophical Communications 57 44-45. 2011.
    The topic of coercion has a long and contentious history in both political philosophy and medical ethics. This substantial literature centers on two fundamental questions: What is coercion? And when is it justified? In the context of psychiatry there has been a recent upsurge of interest in coercion, with particular focus on the latter question. For example, a number of research groups have been investigating the relationship between coercion and clinical outcomes. But of course such research re…Read more