In the conclusion to this multi-part article I first review the discussions carried out around the six essential questions in psychiatric diagnosis – the position taken by Allen Frances on each question, the commentaries on the respective question along with Frances’ responses to the commentaries, and my own view of the multiple discussions. In this review I emphasize that the core question is the first – what is the nature of psychiatric illness – and that in some manner all further (...) questions follow from the first. Following this review I attempt to move the discussion forward, addressing the first question from the perspectives of natural kind analysis and complexity analysis. This reflection leads toward a view of psychiatric disorders – and future nosologies – as far more complex and uncertain than we have imagined. (shrink)

In face of the multiple controversies surrounding the DSM process in general and the development of DSM-5 in particular, we have organized a discussion around what we consider six essential questions in further work on the DSM. The six questions involve: 1) the nature of a mental disorder; 2) the definition of mental disorder; 3) the issue of whether, in the current state of psychiatric science, DSM-5 should assume a cautious, conservative posture or an assertive, transformative posture; 4) the role (...) of pragmatic considerations in the construction of DSM-5; 5) the issue of utility of the DSM – whether DSM-III and IV have been designed more for clinicians or researchers, and how this conflict should be dealt with in the new manual; and 6) the possibility and advisability, given all the problems with DSM-III and IV, of designing a different diagnostic system. Part 1 of this article took up the first two questions. Part 2 took up the second two questions. Part 3 now deals with Questions 5 & 6. Question 5 confronts the issue of utility, whether the manual design of DSM-III and IV favors clinicians or researchers, and what that means for DSM-5. Our final question, Question 6, takes up a concluding issue, whether the acknowledged problems with the earlier DSMs warrants a significant overhaul of DSM-5 and future manuals. As in Parts 1 & 2 of this article, the general introduction, as well as the introductions and conclusions for the specific questions, are written by James Phillips, and the responses to commentaries are written by Allen Frances. (shrink)

In face of the multiple controversies surrounding the DSM process in general and the development of DSM-5 in particular, we have organized a discussion around what we consider six essential questions in further work on the DSM. The six questions involve: 1) the nature of a mental disorder; 2) the definition of mental disorder; 3) the issue of whether, in the current state of psychiatric science, DSM-5 should assume a cautious, conservative posture or an assertive, transformative posture; 4) the role (...) of pragmatic considerations in the construction of DSM-5; 5) the issue of utility of the DSM - whether DSM-III and IV have been designed more for clinicians or researchers, and how this conflict should be dealt with in the new manual; and 6) the possibility and advisability, given all the problems with DSM-III and IV, of designing a different diagnostic system. Part I of this article will take up the first two questions. With the first question, invited commentators express a range of opinion regarding the nature of psychiatric disorders, loosely divided into a realist position that the diagnostic categories represent real diseases that we can accurately name and know with our perceptual abilities, a middle, nominalist position that psychiatric disorders do exist in the real world but that our diagnostic categories are constructs that may or may not accurately represent the disorders out there, and finally a purely constructivist position that the diagnostic categories are simply constructs with no evidence of psychiatric disorders in the real world. The second question again offers a range of opinion as to how we should define a mental or psychiatric disorder, including the possibility that we should not try to formulate a definition. The general introduction, as well as the introductions and conclusions for the specific questions, are written by James Phillips, and the responses to commentaries are written by Allen Frances. (shrink)

In face of the multiple controversies surrounding the DSM process in general and the development of DSM-5 in particular, we have organized a discussion around what we consider six essential questions in further work on the DSM. The six questions involve: 1) the nature of a mental disorder; 2) the definition of mental disorder; 3) the issue of whether, in the current state of psychiatric science, DSM-5 should assume a cautious, conservative posture or an assertive, transformative posture; 4) the role (...) of pragmatic considerations in the construction of DSM-5; 5) the issue of utility of the DSM - whether DSM-III and IV have been designed more for clinicians or researchers, and how this conflict should be dealt with in the new manual; and 6) the possibility and advisability, given all the problems with DSM-III and IV, of designing a different diagnostic system. Part I of this article took up the first two questions. Part II will take up the second two questions. Question 3 deals with the question as to whether DSM-V should assume a conservative or assertive posture in making changes from DSM-IV. That question in turn breaks down into discussion of diagnoses that depend on, and aim toward, empirical, scientific validation, and diagnoses that are more value-laden and less amenable to scientific validation. Question 4 takes up the role of pragmatic consideration in a psychiatric nosology, whether the purely empirical considerations need to be tempered by considerations of practical consequence. As in Part 1 of this article, the general introduction, as well as the introductions and conclusions for the specific questions, are written by James Phillips, and the responses to commentaries are written by Allen Frances. (shrink)

We recognize today's deep neural network (DNN) models of language behaviors as engineering achievements. However, what we know intuitively and scientifically about language shows that what DNNs are and how they are trained on bare texts, makes them poor models of mind and brain for language organization, as it interacts with infant biology, maturation, experience, unique principles, and natural law.

We characterize a type of functional explanation that addresses why a homologous trait originating deep in the evolutionary history of a group remains widespread and largely unchanged across the group’s lineages. We argue that biologists regularly provide this type of explanation when they attribute conserved functions to phenotypic and genetic traits. The concept of conserved function applies broadly to many biological domains, and we illustrate its importance using examples of molecular sequence alignments at the intersection of evolution and cell biology. (...) We use these examples to show how the study of conserved functions can integrate knowledge of a trait’s causal effects on fitness and its history of natural selection without invoking adaptation. We also show how conserved function provides a novel basis for addressing objections against evolutionary functions raised by Robert Cummins. (shrink)

Quine takes physics to be the ultimate arbiter of what there is. [AL 1/29/2004].

As etiologic concepts of diseases gradually changed from humoral to microbial in the 19th century, syphilis presented particularly great challenges to doctors and scientists. Was “syphilis” merely a synonym for “venereal disease,” and did all manifestations attributed to it have the same cause? The discovery in 1879 of the gonococcus by Albert L. Neisser , and of the cause of chancroid, or soft chancre, in 1890 by Augusto Ducrey , established that venereal disease and syphilis were not synonymous, but syphilis (...) continued to mystify investigators. Symptoms could disappear for years and then—in most but not all persons—reappear with entirely different “tertiary” manifestations. .. (shrink)

We show that certain classes of modules have universal models with respect to pure embeddings: Let R be a ring, T a first‐order theory with an infinite model extending the theory of R‐modules and (where ⩽pp stands for “pure submodule”). Assume has the joint embedding and amalgamation properties. If or, then has a universal model of cardinality λ. As a special case, we get a recent result of Shelah [28, 1.2] concerning the existence of universal reduced torsion‐free abelian groups with (...) respect to pure embeddings.We begin the study of limit models for classes of R‐modules with joint embedding and amalgamation. We show that limit models with chains of long cofinality are pure‐injective and we characterize limit models with chains of countable cofinality. This can be used to answer [18, Question 4.25].As this paper is aimed at model theorists and algebraists an effort was made to provide the background for both. (shrink)

As fundamental researchers in the neuroethology of efference copy, we were stimulated by Grush's bold and original synthesis. In the following critique, we draw attention to ways in which it might be tested in the future, we point out an avoidable conceptual error concerning emulation that Grush seems to share with other workers in the field, and we raise questions about the neural correlates of Grush's schemata that might be probed by neurophysiologists.

At a time of COVID-19 pandemic, universal basic income (UBI) has been presented as a potential public health ‘upstream intervention’. Research indicates a possible impact on health by reducing poverty, fostering health-promoting behaviour and ameliorating biopsychosocial pathways to health. This novel case for UBI as a public health measure is starting to receive attention from a range of political positions and organisations. However, discussion of the ethical underpinnings of UBI as a public health policy is sparse. This is depriving policymakers (...) of clear perspectives about the reasons for, restrictions to and potential for the policy’s design and implementation. In this article, we note prospective pathways to impact on health in order to assess fit with Rawlsian, capabilities and perfectionist approaches to public health policy. We suggest that Raz’ pluralist perfectionist approach may fit most comfortably with the prospective pathways to impact, which has implications for allocation of resources. (shrink)

The ability to effectively prevent smallpox was the greatest medical accomplishment of the first half of the 19th century. From 1838 to 1840, half a century after vaccination was introduced but before it became mandatory in England, data about the general population of England and Wales recorded 70 deaths per million from smallpox; only 180, 900 vaccinations were recorded. In London alone from 1848 to 1852, there were 4, 858 youthful deaths from smallpox, 67% of which occurred during the first (...) five years of life (Simon 1857).In a report to the House of Commons in 1802, Edward Jenner (1749-1823) stated that person-to-person vaccination was a basic principle of his procedure. He gained confidence in it from the case .. (shrink)

Why and how have supply chain codes of conduct diffused among lead firms around the globe? Prior research has drawn on both institutional and stakeholder theories to explain the adoption of codes, but no study has modeled adoption as a temporally dynamic process of diffusion. We propose that the drivers of adoption shift over time, from exclusively nonmarket to eventually market-based mechanisms as well. In an analysis of an original data set of more than 1,800 firms between the years 2006 (...) and 2015, we find that strong nonmarket labor institutions in a firm’s home country are critical to initiating and sustaining the diffusion process. Market mechanisms, such as investor scrutiny and brand risk, emerge as important later. Contrary to prior research, we did not find a significant effect from nongovernmental organization (NGO) pressure. We conclude that markets for corporate social responsibility can and do arise, but only after they are effectuated by nonmarket institutions. (shrink)

Life is a battlefield onto which we are thrown at birth, with only fate and fortune settling upon where we land. Wherever we land, whether it's on the front lines or surrounded by a network of defenses, we are all asking the same question: why are we here? The problem with this question, however, is that we tend to answer it from our own relative positions, and so we all arrive at different conclusions. The many answers we've created have filled (...) the field. They have become banners that are raised high so that we can see and follow them. These banners are always at risk of being toppled though; always at risk of losing their capacity for belief. But then, what if belief is more than a mere by-product of our universal search? What if belief can change the very fabric of this field? That is, what if truth is actually irrelevant, and the only real thing that makes up this battlefield is the belief, and consequently the collective will, which we invest in our answers? (shrink)

Reality is two-fold, composed of the lighted world as revealed in Genesis, and the darker primordiality which preceded it. The illuminated represents that which the human mind can comprehend, manipulate and re-order to its will: a “designed” and mechanical universe of parts. But behind it, in the backspace of reality, remains the darkness. A formless state of pre-creation, the darkness exists as an endless series of intertwining “signatures” – single possibilities waiting to be created in the illuminated forefront of reality. (...) Permitting each and every part of the lighted world to be connected to the rest, it possesses a “design” all of its own. The question is, if we are blind in the dark, how could we ever come to know it? (shrink)

These essays by some of the most prominent figures in linguistics, artificial intelligence, and psychology explore the problems involved in creating a general cognitive science that will treat language, thought, and behavior in an integrated fashion. They address the fundamental questions of the relations between linguistic structures and cognitive processes, between cognitive processes and language behavior, and between language behavior and linguistic structure. Contents: Introduction, Thomas G. Bever (Columbia University), John M. Carroll and Lance A. Miller (IBM Thomas (...) J. Watson Research Center). "Philosophy and "Linguistics: An Outline of Platonist Grammar, Jerrold J. Katz (CUNY). Sense and Reference in a Psychologically Based Semantics, Ray Jackendoff (Brandeis University). Some Thoughts on the Boundaries and Components of Linguistics, Charles J. Fillmore (University of California, Berkeley). Psychology: Approaches to the Study of the Psychology of Language, Walter Kintsch (University of Colorado). Toward An Abstract Performance Grammar, Charles E. Osgood (University of Illinois). Upgrading a Mind, David Premack (University of Pennsylvania). Computational "Models: "Memory, Meaning, and Syntax, Roger Schank (Yale University) and Lawrence Birnbaum (Yale University). Some Inadequate Theories of Human Language Processing, Mitchell P. Marcus (AT&T Bell Laboratories). (shrink)

The tragedies of the past decade have led to an identity crisis among humanitarians. Respecting traditional principles of neutrality and impartiality and operating procedures based on consent has created as many problems as it has solved.

If the Libyan intervention goes well, it will put teeth in the fledgling RtoP doctrine. Yet, if it goes badly, critics will redouble their opposition, and future decisions will be made more difficult. Libya suggests that we can say no more Holocausts, Cambodias, and Rwandas--and occasionally mean it.