The power of words: the evaluative character of psychiatry
Abstract
In psychiatry, one of the main concerns is to recognize when something, be it an emotional state, a behaviour or a personality trait, is to be placed inside the boundaries of ‘normality’, or when it has to be considered a pathological trait, that needs to be cured. Being a medical discipline, psychiatry has one aspiration: to achieve an objective and impersonal view of abnormal behaviour.
Yet, what does it mean, for a discipline that has to deal with human fragility and suffering, to be ‘objective’? Is mental disorder something we can detect in a impartial, neutral way? This paper aims to stress the relevance, for defining and classifying mental disorders, of both a mentalist vocabulary (Banner 2013, Broome, Bortolotti 2009) and the reference to cultural, social, moral and evaluative rules (Olbert, Gala 2015). My claim is that, when it comes to psychiatry, it is very hard to divide the objective and the evaluative component.
References
American Psychiatric Association (APA) (2013), Diagnostic and statistical manual of mental disorders (5th ed.), American Psychiatric Publishing, Arlington.
Banner, N. (2013), «Mental disorders are not brain disorders», in Journal of Evaluation in Clinical Practice, vol. 19, n. 3, pp. 509-513.
Broome, M., Bortolotti, L. (2009), «Mental illness as mental: In defence of psychological realism», Humana Mente, n. 11, pp. 25-43.
Galbraith, N. D., Manktelow, K. I., Chen-Wilson, C. H., Harris, R. A., Nevill, A. (2014), «Different combinations of perceptual, emotional, and cognitive factors predict three different types of delusional ideation during adolescence», in The Journal of nervous and mental disease, vol. 202, n. 9, pp. 668-676.
Galbraith, N. (2021), Delusions and pathologies of belief: making sense of conspiracy beliefs via the psychosis continuum, in Cardella V., Gangemi A., a cura di, Psychopathology and Philosophy of mind. What mental disorders can tell us about our minds, Routledge, London-New York, pp. ??
Graham, G. (2013), The disordered mind: An introduction to philosophy of mind and mental illness, Routledge, London-New York.
Greenberg, G. (2012), «Commentary on The six most essential questions in psychiatric diagnosis: A pluralogue part 1: Conceptual and definitional issues in psychiatric diagnosis», in Phillips et al. (2012), «The six most essential questions in psychiatric diagnosis: A pluralogue part 1: Conceptual and definitional issues in psychiatric diagnosis», in Philosophy, Ethics, and Humanities in Medicine: PEHM, vol. 7, n. 3., (consultato il 25/07/2023), https://doi.org/10.1186/1747-5341-7-3.
Kapur, S., Phillips, A., Insel, T. (2012), «Why has it taken so long for biological psychiatry to develop clinical tests and what to do about it?», in Molecular Psychiatry, n. 17, pp. 1174-1179.
Kelleher, I., Cannon, M. (2011), «Psychotic-like experiences in the general population: characterizing a high-risk group for psychosis», in Psychological medicine, vol. 41, n. 1, pp. 1-6.
Murphy, D. (2006), Psychiatry in the scientific image, MIT Press, Cambridge, MA.
Olbert, C. M., Gala, G. J. (2015), «Supervenience and psychiatry: Are mental disorders brain disorders?», in Journal of Theoretical and Philosophical Psychology, vol. 35, n. 4, pp. 203-219.
Overton, S. L., Medina, S. L. (2008), «The stigma of mental illness», in Journal of Counseling & Development, vol. 86, n. 2, pp. 143-151.
Payne, R. L. (1992), «First person account: my schizophrenia», in Schizophrenia Bulletin, vol. 18, n. 4, pp. 725-728.
Phillips, J., Frances, A., Cerullo, M. A., Chardavoyne, J., Decker, H. S., First, M. B., et al. (2012), «The six most essential questions in psychiatric diagnosis: A pluralogue part 1: Conceptual and definitional issues in psychiatric diagnosis», in Philosophy, Ethics, and Humanities in Medicine: PEHM, vol. 7, n. 3, (consultato il 25/07/2023), https://doi.org/10.1186/1747-5341-7-3.
Piccinini, L. (2021), Ansia, ossessioni e trauma, in Rossi Monti M., a cura di, Manuale di psichiatria per psicologi, Carocci, Roma, pp. 75-124.
Poulton, R., Caspi, A., Moffitt, T. E., Cannon, M., Murray, R., Harrington, H. (2000), «Children's self-reported psychotic symptoms and adult schizophreniform disorder: a 15-year longitudinal study», in Archives of general psychiatry, vol. 57, n. 11, pp. 1053-1058.
Pouncey, C. L. (2005), «Philosophy of psychopathology», in Current Opinion in Psychiatry, vol. 18, pp. 659-663.
Prata, D., Mechelli, A., Kapur, S. (2014), «Clinically meaningful biomarkers for psychosis: A systematic and quantitative review», in Neuroscience and Biobehavioral Reviews, n. 45, pp. 134-141.
Stein, D. J., Phillips, K. A., Bolton, D., Fulford, K. W. M., Sadler, J. Z., Kendler, K. S. (2010), «What is a mental/psychiatric disorder? From DSM-IV to DSM-V», in Psychological Medicine, vol. 40, n. 11, pp. 1759-1765.
van Os, J., Linscott, R. J., Myin-Germeys, I., Delespaul, P., Krabbendam, L. J. P. M. (2009), «A systematic review and meta-analysis of the psychosis continuum: evidence for a psychosis proneness-persistence-impairment model of psychotic disorder», in Psychological medicine, vol. 39, n. 2, p. 179.
Venkatasubramanian, G., Keshavan, M. (2016), «Biomarkers in psychiatry: A critique», in Annals of Neuroscience, n. 23, pp. 3-5.
Weickert, C. S., Weickert, T. W., Pillai, A., Buckley, P. F. (2013), «Biomarkers in schizophrenia: A brief conceptual consideration», in Disease Markers, n. 35., (consultato il 25/07/2023), https://doi.org/10.1155/2013/510402.
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