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El. knyga: Philosophical Issues in Psychiatry II: Nosology, II [Oxford Medicine Online E-books]

Edited by (Professor of psychiatry), Edited by (Rachel Brown Banks Distinguished Professor of Psychiatry, Professor of Human Genetics, and Director of the Virginia Institute of Psychiatric and Behavioral Genetics at the Virginia Commonwealth University, USA)
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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.

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.
List of Contributors
xi
Introduction xiii
Part I The basics: the definition of psychiatric illness and rules for classification
Chapter 1 Classification and causal mechanisms: a deflationary approach to the classification problem
6(15)
Derek Bolton
Introduction
3(9)
Kenneth S. Kendler
Comments: The National Institute of Mental Health Research Domain Criteria (RDoC) project: moving towards a neuroscience-based diagnostic classification in psychiatry
12(9)
Michael B. First
Chapter 2 Progress and the calibration of scientific constructs: the role of comparative validity
21(21)
Peter Zachar
Introduction
19(16)
Kenneth S. Kendler
Comments: Progress and the calibration of scientific constructs: a new look at validity
35(7)
Rachel Cooper
Chapter 3 Taking disease seriously: beyond "pragmatic" nosology
42(19)
S. Nassir Ghaemi
Introduction
41(13)
Josef Parnas
Comments: What is psychiatric disease? A commentary on Dr Ghaemi's paper
54(7)
Derek Bolton
Chapter 4 Is psychiatric classification a good thing?
61(16)
Rachel Cooper
Introduction
59(12)
Kenneth S. Kendler
Comments: Diagnoses as labels
71(6)
S. Nassir Ghaemi
Part II The historical development of modern psychiatric diagnoses
Chapter 5 The nosological entity in psychiatry: a historical illusion or a moving target?
77(24)
Assen Jablensky
Introduction
75(20)
Josef Parnas
Comments: The Kraepelinian pipe organ model (for a more dimensional) DSM-5 classification
95(6)
Darrel A. Regier
Chapter 6 The 19th-century nosology of alienism: history and epistemology
101(26)
German E. Berrios
Introduction
99(19)
Kenneth S. Kendler
Comments: The nature of the psychiatric object and classification
118(9)
Josef Parnas
Chapter 7 The development of DSM-III from a historical/conceptual perspective
127(18)
Michael B. First
Introduction
125(16)
Kenneth S. Kendler
Comments: Evaluating DSM-III: structure, process and outcomes
141(4)
Harold Alan Pincus
Chapter 8 DSM-IV: context, concepts and controversies
145(24)
Harold Alan Pincus
Introduction
143(18)
Kenneth S. Kendler
Comments: DSM-IV: some critical remarks
161(8)
Mario Maj
Part III The problem of validity
Chapter 9 A philosophical overview of the problems of validity for psychiatric disorders
169(30)
Kenneth F. Schaffner
Introduction
167(23)
Josef Parnas
Comments: Validity, utility and reality: explicating Schaffner's pragmatism
190(9)
Peter Zachar
Chapter 10 Structural validity and the classification of mental disorders
199(22)
Robert F. Krueger
Nicholas R. Eaton
Introduction
197(16)
Kenneth S. Kendler
Comments: Seeing sense in psychiatric diagnoses
213(8)
Paul R. McHugh
Part IV Application to major depression and schizophrenia
Chapter 11 When does depression become a mental disorder?
221(16)
Mario Maj
Introduction
219(10)
Josef Parnas
Comments: A sea of distress
229(8)
Josef Parnas
Chapter 12 DSM-IV and the founding prototype of schizophrenia: are we regressing to a pre-Kraepelinian nosology?
237(32)
Josef Parnas
Introduction
235(25)
Assen Jablensky
Comments: Phenomenology, nosology and prototypes
260(9)
Kenneth S. Kendler
Part V The way(s) forward
Chapter 13 Rendering mental disorders intelligible: addressing psychiatry's urgent challenge
269(16)
Paul R. McHugh
Introduction
267(13)
Josef Parnas
Comments: A search for coherence
280(5)
Assen Jablensky
Chapter 14 Diagnostic threshold considerations for DSM-5
285(20)
Darrel A. Regier
Introduction
283(15)
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
298(7)
Robert F. Krueger
Chapter 15 Epistemic iteration as a historical model for psychiatric nosology: promises and limitations
305(26)
Kenneth S. Kendler
Introduction
303(20)
Josef Parnas
Comments: Coherentist approaches to scientific progress in psychiatry: comments on Kendler
323(8)
Kenneth F. Schaffner
Index 331
The major focus of Kenneth Kendler's research is in the genetics of psychiatric and substance abuse disorders. Two major methodologies are used in this research. The first involves large population based twin samples. In these twins the aggregate role of genetic and environmental factors is addressed. The aim is to understand how these factors interact and correlate, and how, through development, the vulnerability to psychiatric illness and drug abuse is expressed. Samples have been taken from the Virginia Adult Twin Study of Psychiatric and Substance Use Disorders as well as Norway, Sweden and Holland. Kendler's work has focused on a wide range of disorders including major depression, anxiety disorders, eating disorders, externalizing behaviors, alcoholism, and drug abuse. He has also worked towards understanding the genetic and environmental sources of comorbidity of psychiatric and substance use disorders.

Josef Parnas' main research interests comprise epidemiology and pathogenesis of schizophrenia, including longitudinal prospective studies of children at risk, genetic studies, and psychopathology of schizophrenia, addressed both on a theoretical level and through empirical research. Parnas, also trained as a medical doctor, has always been working at the interface between philosophy and psychiatry with a special emphasis on the psychiatric phenomenology. Over the last two decades he has been pioneering research on anomalies of self-experience in schizophrenia. He is a co-founder of the Center for Subjectivity Research at the University of Copenhagen, an interdisciplinary research institute, integrating philosophy of mind, phenomenology, psychopathology and cognitive science.