Chapter

A philosophical overview of the problems of validity for psychiatric disorders

Kenneth F. Schaffner

in Philosophical Issues in Psychiatry II

Published on behalf of Oxford University Press

Published in print April 2012 | ISBN: 9780199642205
Published online February 2013 | e-ISBN: 9780191754777 | DOI: http://dx.doi.org/10.1093/med/9780199642205.003.0026

Series: International Perspectives in Philosophy & Psychiatry

A philosophical overview of the problems of validity for psychiatric disorders

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This paper defines and briefly summarizes several concepts of validity, including diagnostic validity and etiopathogenic validity. It then begins to introduce the notion of “clinical validity” via a critique of the work of Kendell and Jablensky, noting that molecular biological investigations find no clear points of rarity in molecular mechanisms that might be relevant to psychiatry. Instead, a Rosch-like prototype form of analysis is proposed, which identifies the most robust categories as prototypes, related to other prototypes by similarity. These prototypes are typically interlevel, and not unilevel and simply reductionistic, a view which it is argued is applicable more generally to psychiatry. For the foreseeable future, such prototypes can also best be confirmed via the clinical validity approach, viewed largely as predictive validity (and utility). Predictive validity can be embedded in a larger philosophical “pragmatic” framework that is a compromise way of addressing the realism–instrumentalism dichotomy—a position I term “conditionalized realism.” With this framework as a backdrop, I look speculatively at how some forms of “structural realism” might assist in facilitating progress in psychiatry, as well as raise the question whether the current constellation of psychiatric disorders might be replaceable by a molecular-based classification system, and how this could possibly occur.

Chapter.  10808 words.  Illustrated.

Subjects: Psychiatry

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