Wednesday, 22 May 2013

The Neopositivist Structure of the DSM Psychiatric Classification



The Association Crossing Dialogues has recently published a research on the epistemology of psychiatry. Its title is: “Neopositivism and the DSM psychiatric classification. An epistemological history. Part 1: Theoretical comparison”. The paper has been published in the prestigious international journal “History of Psychiatry”, 2013, Vol. 24(2), pp.166-179.
The following is the abstract:
Recent research suggests that the DSM psychiatric classification is in a paradigmatic crisis and that the DSM-5 will be unable to overcome it. One possible reason is that the DSM is based on a neopositivist epistemology which is inadequate for the present-day needs of psychopathology. However, in which sense is the DSM a neopositivist system? This paper will explore the theoretical similarities between the DSM structure and the neopositivist basic assumptions. It is shown that the DSM has the following neopositivist features: (a) a sharp distinction between scientific and non-scientific diagnoses; (b) the exclusion of the latter as nonsensical; (c) the faith on the existence of a purely observable basis (the description of reliable symptoms); (d) the introduction of the operative diagnostic criteria as rules of correspondence linking the observational level to the diagnostic concept.http://hpy.sagepub.com/content/24/2/166.abstract

Tuesday, 12 March 2013

Philosophy of clinical psychopharmacology

This is the abstract of a new paper on the Philosophy of Psychopharmacology. It is an example of the aid of epistemological reflections for the psychiatric practice and research.

Free download clicking here


Abstract
The renewal of the philosophical debate in psychiatry is one exciting news of recent years. However, its use in psychopharmacology may be problematic, ranging from self-confinement into the realm of values (which leaves the evidence-based domain unchallenged) to complete rejection of scientific evidence. In this paper philosophy is conceived as a conceptual audit of clinical psychopharmacology. Its function is to criticise the epistemological and methodological problems of current neopositivist, ingenuously realist and evidence-servant psychiatry from within the scientific stance and with the aim of aiding psychopharmacologists in practicing a more self-aware, critical and possibly useful clinical practice. Three examples are discussed to suggest that psychopharmacological practice needs conceptual clarification. At the diagnostic level it is shown that the crisis of the current diagnostic system and the problem of comorbidity strongly influence psychopharmacological results, new conceptualizations more respondent to the psychopharmacological requirements being needed. Heterogeneity of research samples, lack of specificity of psychotropic drugs, difficult generalizability of results, need of a phenomenological study of drug-induced psychopathological changes are discussed herein. At the methodological level the merits and limits of evidence-based practice are considered, arguing that clinicians should know the best available evidence but that guidelines should not be constrictive (due to several methodological biases and rhetorical tricks of which the clinician should be aware, sometimes respondent to extra-scientific, economical requests). At the epistemological level it is shown that the clinical stance is shaped by implicit philosophical beliefs about the mind/body problem (reductionism, dualism, interactionism, pragmatism), and that philosophy can aid physicians to be more aware of their beliefs in order to choose the most useful view and to practice coherently. In conclusion, psychopharmacologists already use methodological audit (e.g. statistical audit); similarly, conceptual clarification is needed in both research planning/evaluation and everyday psychopharmacological practice.

Tuesday, 19 February 2013

Basic course of Transcultural Psychopathology

The first edition will take place in Rome on march 23, 2013. It is open to those operating in this field. The course is organized by Massimiliano Aragona and Francesco Colosimo on behalf of the Crossing Dialogues Association

1913-2013 One undred years of General Psychopathology

On February 27, 2013 (8,00 pm) the Roman Circle of Psychopathology will celebrate the centenary of the first edition of Karl Jaspers' General Psychopathology. The event is co-organized with Crossing Dialogues

Wednesday, 19 December 2012

Dialogues in Philosophy, Mental and Neuro Sciences 2012 Number 5, Issue 2



The second issue of the fifth volume of the open access journal Dialogues in Philosophy, Mental and Neuro Sciences has been published. In the first article of this issue (Psychosis and Intersubjective Epistemology), HH. Maung claims that delusions and hallucinations present a challenge to traditional epistemology. Against the traditional objective realism that assumes that there is a mind-independent objective world of which people gain knowledge through experience, the author proposes an intersubjective account of psychosis, which avoids this sceptical attack on objective certainty by considering reality not at the level of an objective mind-independent world, but at the level of peoples' shared experiences. This intersubjective hypothesis is developed further, with reference to Husserl's concept of multiple lifeworlds, into a relativistic account.

In the second article, entitled “Pseudohallucinations: a critical review”, A. Sanati discusses a contentious phenomenon in clinical psychopathology: the pseudohallucinations. In a well developed historical account of the development of the concept, Sanati contributes to the discussion in clinical psychopathology by showing that while the pseudohallucinations’ location and the patient's insight into them are not able to distinguish pseudohallucinations from hallucinations, the quality of the perception is a better guide in this distinction.
To download this paper:

The third article is a new idea by A. Zoumpouli. She discusses the major contribution of the father of psychopathology, Karl Jaspers: i.e., the concept of “static understanding”. In this paper entitled “A contemporary approach to Jaspers' static understanding” Zoumpouli suggests that Japers' static understanding prefigures two main types of empathy emerging from contemporary scientific research in neuroscience and social psychology, namely "automatic emotional empathy" and "cognitive empathy".

The other “new idea” is by E. Gluskin, an expert of physics and complex systems. In a paper entitled “An argument regarding the nature of hooligan behaviour” the author transposes some ideas of the physicist Erwin Schrödinger to the debate about the hooligan behaviour, which is explained as a natural human response to the improper (in its content or form) "informational feeding" that does not allow one to normally treat ("digest") the received information.

Finally, two dialogues by A. Rudnick and D. Trafimow respectively discuss the problem of psychiatric comorbidity and that of the epistemological distinction between science and mysticism. The links to download these contributions are, respectively,
http://www.crossingdialogues.com/Ms-D12-03.htm and http://www.crossingdialogues.com/Ms-D12-02.htm

Tuesday, 27 November 2012

CRP - 6th series of lessons "New ways of reading Psichopathology"

The new series of lessons hold by the CRP (Roman Club of Psychopathology) start once again.
Even this year the association Crossing Dialogues gives its contribution in organizing the lessons giving its cultural and logistic support. Other member contributing to the organization are:
  1. the clinic of mental and nervous disorders of the University "La Sapienza" which makes available the room B (thank you to Prof. Maurizio Inghilleri for his contribution);
  2. the SITCC Lazio
  3. the section of Philosophy of Psychiatry of the European Psychiatric Association (Chair: Prof. Giovanni Stanghellini).
Following tradition, the lessons are hold on Mondays evening once a month and they are completely free.
Even this year the treated topics will widely move between different fields of psychopathology, from hermeneutics and phenomenology to classic psychopathology, cognitive sciences and constructivist psychotherapy.

Friday, 22 June 2012

Dialogues in Philosophy, Mental and Neuro Sciences 2012, Vol.5, Issue 1


The new issue of Dialogues in Philosophy, Mental and Neuro Sciences is online. As usual articles written from different perspectives enrich the interdisciplinary dialogue in Philosophy of Psychopathology.

Jakovljevic & Crnčevic present the most comprehensive article ever published on the epistemological implications of psychiatric comorbidity. The following is the abstract of their “Comorbidity as an epistemological challenge to modern psychiatry”: In spite of a considerable progress in comorbidity research and huge literature on it, this phenomenon is one of the greatest epistemological, research and clinical challenges to contemporary psychiatry and medicine. Mental disorders are very often comorbidly expressed, both among themselves and with various sorts of somatic diseases and illnesses. Therefore, comorbidity studies have been expected to be an impetus to research on the validity of current diagnostic systems as well as on establishing more effective and efficient treatment within the frame of person centered transdisciplinary psychiatry and integrative medicine. This review focuses first on conceptual chaos and different connotations, then on transdisciplinary perspectives of comorbidity and multimorbidity. The authors compiled an extensive set of various views and perspectives, dilemmas and controversies, in order to evaluate what we know and what we don't about comorbidity, what comorbidity is and what comorbidity is not, what are facts and what are non-facts on comorbidity and multimorbidity.
The entire article can be read directly at: http://www.crossingdialogues.com/Ms-A12-07.pdf

Brian Earp introduces the reader to the fascinating world of philosophy of mind. The article is entitled “I can't get no (epistemic) satisfaction: Why the hard problem of consciousness entails a hard problem of explanation”. It is an important contribution on the discussion of Chalmers’ famous challenge to cognitive research. In the abstract, Earp writes: Daniel Dennett (1996) has disputed David Chalmers' (1995) assertion that there is a "hard problem of consciousness" worth solving in the philosophy of mind. In this paper I defend Chalmers against Dennett on this point: I argue that there is a hard problem of consciousness, that it is distinct in kind from the so-called easy problems, and that it is vital for the sake of honest and productive research in the cognitive sciences to be clear about the difference.But I have my own rebuke for Chalmers on the point of explanation. Chalmers (1995, 1996) proposes to "solve" the hard problem of consciousness by positing qualia as fundamental features of the universe, alongside such ontological basics as mass and space-time. But this is an inadequate solution: to posit, I will urge, is not to explain. To bolster this view, I borrow from an account of explanation by which it must provide "epistemic satisfaction" to be considered successful (Rowlands, 2001; Campbell, 2009), and show that Chalmers' proposal fails on this account. I conclude that research in the science of consciousness cannot move forward without greater conceptual clarity in the field.
Here is the link, the download is free as usual: http://www.crossingdialogues.com/Ms-A12-04.pdf

In the section New Ideas, Prof. Korf proposes to consider the mind as an emerging configuration of the personal brain. It is a new and very interesting point of view that merits to be widely discussed by neuroscientists and philosophers of mind. This is the abstract: This essay examines the relationship between metabolic brain processes and psycho-physiological activities or mental activity. It is argued that metabolic brain processes, including those involved in the production of energy, proteins and other molecules are restorative and conditional, rather than directly involved in mental activities. This stance suggests that life-time acquired learning and memory is precipitated as a permanent and personal configuration of the brain, that is in principle accessible to neurophysiological examination. Current neuroscience largely ignores implicitly or explicitly the search for new emergent configurations of the brain.

Biological and psychological reflections on Religion are the focus of “Mysticism and Science: Two Products of the Human Imagination”, by Trevors & Saier Jr. In the abstract the authors state: We examine that both science and religion were original products of the human imagination. However, the approaches taken to develop these two explanations of life, were entirely different. The precepts of evolution are well established through the scientific method. This approach has led to the accumulation of immense amounts of evidence for biological evolution, and much scientific progress has been made to understand the pathways taken for the appearance of organisms and their macromolecular constituents. The existence of spiritual beings has not and presumably cannot be documented via a scientific approach, no more than a fairy tale or a myth. However, science, education and knowledge coupled to proper actions are exactly what are needed to make the correct decisions so as to preserve and improve our common, shared biosphere which is currently confronted with two immense problems: human population growth and climate change.
The link for the open access is: http://www.crossingdialogues.com/Ms-C11-01.pdf

Finally, in the section Dialogues David Trafimow comments on the “Descriptive richness and abstract theorizing pertaining to schizophrenic disorders”. The author argues that: a) diagnosis
of clinical disorders is unlikely to work well in the absence of a theory on which the diagnostic
system can be based, and b) at present, there is very little theory concerning schizophrenic disorders. On this basis he argues that good descriptions are not enough and that researchers should
collect rich descriptions of subjective experiences of schizophrenics in the interest of generating
a strong theory.
The link to read his contribution is: http://www.crossingdialogues.com/Ms-D12-01.pdf
Trafimow’s paper is a comment to Gaetano’s contribution that can be downloaded at: http://www.crossingdialogues.com/Ms-A11-02.pdf


Liam Keating - Associative and oppositional thinking

Is there a real difference between the brain hemispheres? Liam Keating discusses this important subject in "Associative and opposi...