The authors discuss some of the conceptual issues that must be considered in using and understanding psychiatric classification. DSM-IV is a practical and common sense nosology of psychiatric disorders that is intended to improve communication in clinical practice and in research studies. DSM-IV has no philosophic pretensions but does raise many philosphical questions. This paper describes the development of DSM-IV and the way in which it addresses a number of philosophic issues: nominalism vs. realism, epistemology in science, the mind/body dichotomy, (...) the definition of mental disorders, and dimensional vs. categorical classification. (shrink)

Moral considerations do not appear to play a large role in discussions of the DSM-IV personality disorders and debates about their empirical validity. Yet philosophical analysis reveals that the Cluster B personality disorders, in particular, may in fact be moral rather than clinical conditions. This finding has serious consequences for how they should be treated and by whom.

In this paper the role of incomprehensibility in the conceptualization of the DSM-IV definition of delusion is discussed. According to the analysis, the conceptual dependence of DSM-IV definition of delusion on incomprehensibility is manifested in several ways and infested with ambiguity. Definition of bizarre delusions is contradictory and gives room for two incompatible readings. Also the definition of delusion manifests internal inconsistencies and its tendency to account for delusions in terms of misinterpretation is bound to miss the content of the (...) traditional comprehension of delusionality. It is suggested that the ambiguities in defining delusions has to do with the question whether psychiatric practice is better accounted for in terms of the grammar of incorrectness or of incomprehensibility. (shrink)

The DSM-III, DSM-IV, DSM-IV-TR and ICD-10 have judiciously minimized discussion of etiologies to distance clinical psychiatry from Freudian psychoanalysis. With this goal mostly achieved, discussion of etiological factors should be reintroduced into the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. A research agenda for the DSM-V advocated the "development of a pathophysiologically based classification system". The author critically reviews the neuroevolutionary literature on stress-induced and fear circuitry disorders and related amygdala-driven, species-atypical fear behaviors of clinical severity in adult (...) humans. Over 30 empirically testable/falsifiable predictions are presented. It is noted that in DSM-IV-TR and ICD-10, the classification of stress and fear circuitry disorders is neither mode-of-acquisition-based nor brain-evolution-based. For example, snake phobia and dog phobia are clustered together. Similarly, research on blood-injection-injury-type-specific phobia clusters two fears different in their innateness: 1) an arguably ontogenetic memory-trace-overconsolidation-based fear and 2) a hardwired fear of the sight of one's blood or a sharp object penetrating one's skin. Genetic architecture-charting of fear-circuitry-related traits has been challenging. Various, non-phenotype-based architectures can serve as targets for research. In this article, the author will propose one such alternative genetic architecture. This article was inspired by the following: A) Nesse's "Smoke-Detector Principle", B) the increasing suspicion that the "smooth" rather than "lumpy" distribution of complex psychiatric phenotypes may in some cases be accounted for by oligogenic transmission, and C) insights from the initial sequence of the chimpanzee genome and comparison with the human genome by the Chimpanzee Sequencing and Analysis Consortium published in late 2005. Neuroevolutionary insights relevant to fear circuitry symptoms that primarily emerge overconsolidationally are presented. Also introduced is a human-evolution-based principle for clustering innate fear traits. The "Neuroevolutionary Time-depth Principle" of innate fears proposed in this article may be useful in the development of a neuroevolution-based taxonomic re-clustering of stress-triggered and fear-circuitry disorders in DSM-V. Four broad clusters of evolved fear circuits are proposed based on their time-depths: 1) Mesozoic circuits hardwired by wild-type alleles driven to fixation by Mesozoic selective sweeps; 2) Cenozoic circuits relevant to many specific phobias; 3) mid Paleolithic and upper Paleolithic circuits ; 4) Neolithic circuits. More importantly, the author presents evolutionary perspectives on warzone-related PTSD, Combat-Stress Reaction, Combat-related Stress, Operational-Stress, and other deployment-stress-induced symptoms. The Neuroevolutionary Time-depth Principle presented in this article may help explain the dissimilar stress-resilience levels following different types of acute threat to survival of oneself or one's progency. PTSD rates following exposure to lethal inter-group violence are usually 5-10 times higher than rates following large-scale natural disasters such as forest fires, floods, hurricanes, volcanic eruptions, and earthquakes. The author predicts that both intentionally-caused large-scale bioevent-disasters, as well as natural bioevents such as SARS and avian flu pandemics will be an exception and are likely to be followed by PTSD rates approaching those that follow warzone exposure. During bioevents, Amygdala-driven and locus-coeruleus-driven epidemic pseudosomatic symptoms may be an order of magnitude more common than infection-caused cytokine-driven symptoms. Implications for the red cross and FEMA are discussed. It is also argued that hospital phobia as well as dog phobia, bird phobia and bat phobia require re-taxonomization in DSM-V in a new "overconsolidational disorders" category anchored around PTSD. The overconsolidational spectrum category may be conceptualized as straddling the fear circuitry spectrum disorders and the affective spectrum disorders categories, and may be a category for which Pitman's secondary prevention propranolol regimen may be specifically indicated as a "morning after pill" intervention. Predictions are presented regarding obsessive-compulsive disorder and "culture-bound" acute anxiety symptoms. Also discussed are insights relevant to pseudoneurological symptoms and to the forthcoming Dissociative-Conversive disorders category in DSM-V, including what the author terms fright-triggered acute pseudo-localized symptoms. Speculations based on studies of the human abnormal-spindle-like, microcephaly-associated gene, the microcephaly primary autosomal recessive gene, and the forkhead box p2 gene are made and incorporated into what is termed "The pre-FOXP2 Hypothesis of Blood-Injection-Injury Phobia." Finally, the author argues for a non-reductionistic fusion of "distal neurobiology" with clinical "proximal neurobiology," utilizing neurological heuristics. It is noted that the value of re-clustering fear traits based on behavioral ethology, human-phylogenomics-derived endophenotypes and on ontogenomics can be confirmed or disconfirmed using epidemiological or twin studies and psychiatric genomics. (shrink)

The “hypervigilance, escape, struggle, tonic immobility” evolutionarily hardwired acute peritraumatic response sequence is important for clinicians to understand. Our commentary supplements the useful article on human tonic immobility (TI) by Marx, Forsyth, Gallup, Fusé and Lexington (2008). A hallmark sign of TI is peritraumatic tachycardia, which others have documented as a major risk factor for subsequent posttraumatic stress disorder (PTSD). TI is evolutionarily highly conserved (uniform across species) and underscores the need for DSM-V planners to consider the inclusion of evolution (...) theory in the reconceptualization of anxiety and PTSD. We discuss the relevance of evolution theory to the DSM-V reconceptualization of acute dissociativeconversion symptoms and of epidemic sociogenic disorder(epidemic “hysteria”). Both are especially in need of attention in light of the increasing threat of terrorism against civilians. We provide other pertinent examples. Finally, evolution theory is not ideology driven (and makes testable predictions regarding etiology in “both directions”). For instance, it predicted the unexpected finding that some disorders conceptualized in DSM-IV-TR as innate phobias are conditioned responses and thus better conceptualized as mild forms of PTSD. Evolution theory may offer a conceptual framework in DSM-V both for treatment and for research on psychopathology. (shrink)

The revisions of both DSM-IV and ICD-10 have again focused the interest of the field of psychiatry and clinical psychology on the questions of nosology. This book reviews issues within psychiatric nosology from clinical, historical and particularly philosophical perspectives. It brings together an interdisciplinary group of distinguished authors.

Largely due to the cultural and political shift of the Enlightenment, Western societies in the eighteenth century emerged from sectarian conflict and embraced a more religiously moderate path. In nine original essays, leading scholars ask whether exporting the Enlightenment solution is possible—or even desirable—today. Contributors begin by revisiting the Enlightenment's restructuring of the West, examining its ongoing encounters with Protestant and Catholic Christianity, Judaism, Islam, and Hinduism. While acknowledging the necessity of the Enlightenment emphasis on toleration and peaceful religious coexistence, (...) these scholars nevertheless have grave misgivings about the Enlightenment's spiritually thin secularism. The authors ultimately upend both the claim that the West's experience offers a ready-made template for the world to follow and the belief that the West's achievements are to be ignored, despised, or discarded. (shrink)

Juxtaposing the ecological insights of Arne Naess and Eihei Dōgen, Deane Curtin maintains that Dōgen’s metaphysical conception of sentience subsumes and corrects Naess’s ecologi­cal Self and its problem of limits. However, an alternative reading of Dōgen, one which deemphasizes the ontological status of the natural world in favor of how we epistemically view it, revitalizes Naess’s question of limits and enables us to reappropriate the problem as our problem. This line of thinking forces us to rethink how we relate to (...) the natural world. (shrink)

In developing the concept of assemblages, Gilles Deleuze draws at least some inspiration from Gilbert Simondon’s concept of information. While his acknowledgement of Simondon’s influence is almost entirely positive, Deleuze explicitly distances himself from the concept of information in order to avoid its link to the field of cybernetics. However, a Deleuzian informational ontology could instead be leveraged as an alternative to cybernetics. Drawing on the Spinozan link between the work of Deleuze and Simondon, it is possible to develop a (...) hybrid informational ontology. This system can not only offer a different approach to information, data and technology than the essentialist concept of information embraced by cybernetics, but also aligns well with recent research in the biological sciences that has disrupted a long-held concept of individuals as entirely separate and autonomous. Shifting away from the Platonic Form to a Deleuzian/simondonian in-formation furthers the post-human project aimed at understanding processes of subjectivation at multiple scales, including the micro and macro. (shrink)

Havstad and Smith (2019) argue that Lakatos’ “methodology of scientific research programs” (MSRP) is a promising philosophical framework for explaining the perceived empirical success of the hypothesis that birds are maniraptoran theropod dinosaurs, and the perceived empirical failures or stagnation of alternatives to that hypothesis. These conclusions are rejected: Havstad and Smith’s account of the alternative “research programs” inadequately characterizes criticism of the hypothesis that birds are maniraptoran theropods and they neither offer sufficient modifications to MSRP to correct its known (...) difficulties in deriving logically or empirically satisfactory criteria for the assessment and preferential selection of “research programs” from historiographical data, nor proposals to mitigate its tendency to promote confirmation bias and dogmatism. Independent flight loss, an important problem in systematic ornithology with implications for the origin of birds, provides a supplementary demonstration of how the application of MSRP in the present context would tend systematically to mislead investigations of the evolutionary history of birds by promoting an uncritical perspective. Given these difficulties, MSRP is an unacceptable philosophical framework for evaluating alternative hypotheses for the origin of birds. (shrink)

Ch. 1. Obshta teorii︠a︡ na pravoto -- ch. 2. Filosofii︠a︡ na pravoto.

The paper deals with visions of Kyiv in the writings of Russian and Ukrainian émigré writers during the interwar period. The city became a focal point of intensive intellectual debate whose participants regarded Kyiv not only as a place of a recent battleground but also as a sacral place and a highly symbolic image. Within the methodological framework of ethnic symbolism, this study attempts to explain how this physical/symbolic dichotomy was used to reinforce continuing claims for historical origin and cultural (...) heritage, thus serving the contemporary purpose of national identity and political legitimacy. It also deploys the concept of displacement as a complex process of negotiation between homeland and hostland within an émigré community — whose sense of loss and identity crisis creates additional impetus, though in different forms, for exploiting historical narratives. (shrink)

Thomas Szasz wrote over thirty books and several hundred articles, replete with mordant criticism of psychiatry. His works made him arguably one of the world's most recognized psychiatrists, albeit one of the most controversial. This book critically examines the legacy of a man who challenged the very concept of mental illness.