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- Kent Bach (1993). Emotional Disorder and Attention. In George Graham (ed.), Philosophical Psychopathology. Cambridge: MIT Press.Some would say that philosophy can contribute more to the occurrence of mental disorder than to the study of it. Thinking too much does have its risks, but so do willful ignorance and selective inattention. Well, what can philosophy contribute? It is not equipped to enumerate the symptoms and varieties of disorder or to identify their diverse causes, much less offer cures (maybe it can do that-personal philosophical therapy is now available in the Netherlands). On the other hand, the scientific study of mental disorder has a long way to go. There is much disagreement and uncertainty about the nature, causes, and treatment of many specific disorders, as is evident from DSM's classification of them in predominantly symptomatic terms. And even if what is reflected in DSM were a consensus rather than a compromise, still this shifts periodically with each new edition. Moreover, it is a notorious fact that many patients who clearly have psychiatric abnormalities do not fit any of the recognized diagnostic categories.1.
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This paper explores the factors that contribute to the degree of a mood disorder patient’s self- insight, defined here as her understanding of the particular contingencies of her life that are responsive to her personal identity, interpersonal relationships, illness symptoms, and the relationship between these three necessary components of her lived experience. I consider three factors: (i) the Diagnostic Statistical Manual of Mental Disorders (DSM), (ii) the DSM culture, and (iii) the cognitive architecture of the self. I argue that the symptom-based descriptions of mood disorders which eliminate the subjective features of the patient’s illness experience, in conjunction with the features of the DSM-culture and the cognitive biases that guide the patient, contribute to the impoverishment of her self-insight. The resulting impoverished self-insight would prevent her from developing resourceful responses to her interpersonal problems. In analyzing how these factors combine to influence the patient’s self-insight, I distinguish the therapeutic impact of receiving a psychiatric diagnosis, which facilitates patient’s clinical treatment, from its reflective impact, how the diagnosis informs the patient’s reflection on who she is, how her mental disorder is expressed, and how her interpersonal relationships proceed. I substantiate my argument by considering a patient’s memoir of psychopathology.
The DSM is the main classification of mental disorders used by psychiatrists in the United States and, increasingly, around the world. Although widely used, the DSM has come in for fierce criticism, with many commentators believing it to be conceptually flawed in a variety of ways. This paper assesses some of these philosophical worries. The first half of the paper asks whether the project of constructing a classification of mental disorders that âcuts nature at the jointsâ makes sense. What is mental disorder? Are types of mental disorder natural kinds (that is, are the distinctions between them objective and of fundamental theoretical importance, as are, say, the distinctions between the chemical elements)? The second half of the paper addresses epistemic worries. Even if types of mental disorder are natural kinds there may be reason to doubt that the DSM will come to reflect their natural structure. In particular, I examine the extent to which the DSM is theory-laden, and look at how it has been shaped by social and financial factors. Ultimately, I conclude that although the DSM is of immense practical importance it is not likely to become the best possible classification of mental disorders.
The DSM-III-R definition of mental disorder is inconsistent with the DSM-III-R definition of paraphilias. The former requires the suffering or increased risk of suffering some harm while the latter allows that deviance, by itself, is sufficient to classify a behavioral syndrome as a paraphilia. This inconsistency is particularly clear when examining the DSM-III-R account of a specific paraphilia, Transvestic Fetishism. The author defends the DSM-III-R definition of mental disorder and argues that the DSM-III-R definition of paraphilias should be changed. He recommends that the diagnostic criteria for specific paraphilias, particularly that for Transvestic Fetishism, be changed to make them consistent with the DSM-III-R definition of mental disorder. Keywords: diagnoses, disease, paraphilia, philosophy, psychiatry CiteULike Connotea Del.icio.us What's this?
During the last years, there has been an
important discussion on the concept of mental disorder.
Several accounts of such a concept have been offered by
theorists, although neither of these accounts seems to
have successfully answered both the question of what
it means for a certain mental condition to be a disorder
and the question of what it means for a certain disorder
to be mental. In this paper, I propose an account of the
concept of mental disorder that, if I am right, provides
satisfactory answers to both of these questions. Furthermore,
this account (unlike other accounts presented in
the literature on the subject) meets the requirements for
achieving a crucial goal underlying the project of sorting
out the concept of mental disorder, namely the goal of
allowing the existence of a dialogue between mental
health professionals of different theoretical orientations.
To achieve this goal, the account herein proposed is not
based in any particular theoretical framework, but in
both ordinary and technical theory-neutral concepts. In
the last part of the paper, I argue that it follows from
most accounts of the concept of mental disorder that
the disciplines concerned with explaining some mental
disorders are not branches of medicine, and that the
treatment of some mental disorders is not a matter of
medical intervention.
The mental disorder concept has not been paid due attention to. The aim of this paper is twofold: first, to assess how much space has been given to the mental disorder concept in textbooks of psychiatry, and second, to show in how many domains both within and beyond psychiatry the mental disorder concept plays a key role. A number of textbooks written in English, German, French, Spanish, and Italian, selected as examples, have been scanned so as to see if there is a chapter dealing with mental disorder, in particular with its definition. Also, the fields in which the mental disorder plays a major role have been identified, and the reasons why the concept of mental disorder is relevant for them have been explored. There is no chapter dealing with the definition of mental disorder in some textbooks of psychiatry in English, German, French, Spanish, and Italian that have been selected as examples. Yet there are numerous domains, directly or indirectly related to psychiatry, in which the mental disorder concept is a substantial element. The results show that the concept of mental disorder should be kept high on psychiatric agenda and given due space in textbooks of psychiatry accordingly.
Conceiving mental disorder -- Disorder of mental disorder -- On being skeptical about mental disorder -- Seeking norms for mental disorder -- An original position -- Addiction and responsibility for self -- Reality lost and found -- Minding the missing me.
It is now generally agreed that we have to rely on value judgments to distinguish mental disorders from other conditions, but it is not quite clear how. To clarify this, we need to know more than to what extent attributions of disorder are dependent on values. We also have to know (1) what kind of evaluations we have to rely on to identify the class of mental disorder; (2) whether attributions of disorder contain any implicit reference to some specific evaluative standard; and (3) whether the concept of mental disorder is value laden in the definitional or in the epistemic sense. I will argue that the evaluations we have to rely on are mainly considerations of harm, but that we also need to rely on other evaluations; that there should be no references to specific evaluative standards; and that even though mental disorders are necessarily undesirable, "mental disorder" may well be a descriptive phrase.
A link between mental disorder and freedom is clearly present in the introduction of the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV). It mentions “an important loss of freedom” as one of the possible defining features of mental disorder. Meanwhile, it remains unclear how “an important loss of freedom” should be understood. In order to get a clearer view on the relationship between mental disorder and (a loss of) freedom, in this article, I will explore the link between mental disorder and free will. I examine two domains in which a connection between mental disorder and free will is present: the philosophy of free will and forensic psychiatry. As it turns out, philosophers of free will frequently refer to mental disorders as conditions that compromise free will and reduce moral responsibility. In addition, in forensic psychiatry, the rationale for the assessment of criminal responsibility is often explained by referring to the fact that mental disorders can compromise free will. Yet, in both domains, it remains unclear in what way free will is compromised by mental disorders. Based on the philosophical debate, I discuss three senses of free will and explore their relevance to mental disorders. I conclude that in order to further clarify the relationship between free will and mental disorder, the accounts of people who have actually experienced the impact of a mental disorder should be included in future research.
A new diagnostic system for organic psychiatry is presented. We first define "organic psychiatry", and then give the theoretical basis for conceiving organic psychiatric disorders in terms of hypothetical psychopathogenetic processes, HPP:s. Such hypothetical disorders are not strictly identical to the clusters of symptoms in which they typically manifest themselves, since the symptoms may be concealed or modified by intervening factors in non typical circumstances and/or in the simultaneous presence of several disorders. The six basic disorders in our system are Astheno Emotional Disorder (AED), Somnolence Sopor Coma Disorder (SSCD), Hallucination Coenestopathy Depersonalisation Disorder (HCDD), Confusional Disorder (CD), Emotional Motivational Blunting Disorder (EMD) and Korsakoff's Amnestic Disorder (KAD). We describe their usual etiologies, their typical symptoms and course, and some forms of interaction between them.
The field of philosophical psychopathology is basically the philosophical study of mental disorders such as schizophrenia, bipolar disorder, depression, autism, as well as more specific symptoms and signs such as Capgras’ delusion (the delusion that your spouse, for example, is an impostor) or the anarchic hand sign (where your hand seems to act on its own intentions). This simple epithet covers a multitude of approaches: how can philosophy help to explain mental disorder? What does mental disorder tell us about consciousness, cognition, emotion and ‘self’? What does the study of mental disorder tell us about phenomenology? What does philosophical phenomenology tell us about mental disorder? What do mental disorders tell us about reasoning, rationality and belief formation? What are the particular ethical aspects of mental disorder and its treatment? If philosophical..
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