critiques of the DSM
for genuine science to occur as opposed to pseuddoscience...
- the kind has to be a real/genuine kind in order to proide a launching point for further knowledge -- to be used in theories and models to explain and predict various phenomena -- its only thru an accurate description of the kinds essential conditions an distignusihing them from accompanying conditions that u can further scientific knowleddge --knowing what concept x refersto is necessary infurthering scientifc knowlddge - polytheticconcepts cant provide a further jumping off point for scientific knowlge
what are the genus and species of Dissociative identity disorder in DSM 5
- theyve ideiftied the genus as the disociative disorers an the speicies (differential) as involving two essential conditions: essential condition #1 --• the presence of two or more distinct personality states or an experience of possession which is not part of a broadly accepted cultural or religious practice (A) essential conition#2 - recurrent episodes of amnesia (B) **every case of a is the same because it has these two features --> these are what it is
a scientific definition is not the description of...(6)
1--the condditions or process or procudres that caused the kind eg. DID - a genuine kind of disorer cuz it has essential definiing coniditons - but to provie these iefnitng conditions is not to say what caused them 2 -- the sings/symptoms of x are not x - eg.the signsof water are not water (likea plant gorwing - are not water)(the symtpms of a gneuine mentaldisorder are not the disorer because they are signs OF the disorder) 3--the effects or consequencesof the disorer eg.if the effects ofmy mental instability is u giing away feeling like crap -the way u go away feeling is not my mental disorder (x causes them but its not x itself) 4 --the functional purpose of x - u can talk aboit th functionof a shoebut ur not saying what a shoe is - the function of a fshoe is ifferent to what a shoe is 5--the measurement of x - to describe the essential defining features isnt to say anythign about the measurement of x 6 -the scientific is not scientific classification ---> these are often confused in psychology
sceintific defintions are not...(3)
1. operational ddefinfitons - these arnt real defintions -- this is a big problem for psychology because were always taught to operationalize our variables -- the standdardd takeon what an operationalis - its either spelling out what the investigaro must do to measure or maniuplate it or its a manual of instructions to the investigator - usually nothing more than a desrition of a proceddure - the description of a procedure is not a descriptionof the kinds essential feature 2.osetnsive - ostention is pointing to an example of soemthing -- by pointing to something u are not defining it (saying- here is a n exmapleof _but its not sayign hwat ____ is) 3.a descirotion of....6 4.polythetic some diagnositc criteria are polythetic eg.ptsd rewuires one of 5 symptoms -> one patient will come in havign 3 and one will come in havign 4 --> the number of symptoms (any one of 5) is a relatively arbitrary constraint - polythtic criteria is understanddable as a clinician but when they are this is not a definition
messages from last class (2) (standard classical view of scientific definition)
1.any genuine ki of x that is out there in the world is necessarily monothetic-- has a unique setof essential or ddefining features necessarily then these conditions are present wherever the genuine kind is tobe found without those essential or defining features - the kind (ddisorder)would be another didsorder or it wouldnt be a genuine disorderat all 2. we have some concepts throughout the sciences which pruport to refer to a genuine kind - when these cincepts dont each have a unique set of essential features -they do not refer to a genuine kind at all and the concept may simply function as a linguistic markerin every day language but its not refering to a genuine kind -- such concepts are polythetic
1. Stating what the kind/disorder is...
Identifying the signs and symptoms of the disorder
-->in answering the scientific question what is y? ur best anwser is...
Y is Y1 orY2 orY3 orY4 = a disjucntive predicate-->cant rest science on this as a disjucntive predicate it dpesnt refer to a genuine kind
a polythetic concept - Y may consist of....
Y may consist of A or B or C or D, or it may not -- no one feature is essential -this is the case for some diagnoses in the dsm (eg. GAD)
4. Scientific definition is not..
a clinical ddiagnosis an operational ddefinition or classification
3. Monothetic criteria of a genuine kind/disorder are not...
are not the same as polythetic criteria
What do scientific definitions define?
at their most basic - the scientific efintion is an answer to the question "what is it" or whta kin dof thing is it -- theifnition istelf states • what-it-is-to-be that kind/type of thing - shes going ot refer to the type of thing as kind x - x could be a .... - a kind of substance - a kind of process (eg. extinction learning) - a kind of behaviour (eg. vigilance test performance) - a type of cognition (eg. remmebering) - a kind of emotion (eg. fear) - a type of effect/phenomenon (eg. confirmation bias) - a psychological disorder
why does she say that the dissociative team has IN EFFECT created a scientific defintion for Dissociative identity disorder
because across the dsm 5 theres nothign syteematic about their definitions -->in some cases there is noscientific defintion --> very patchy in quality
the thinking of the psycholgicist negage in this debate 10 yrs ago was that the polythetic cirteria must....
constitute the concept of dispsiative identity ddisordder - of coursethey wont because polytehtic criteria cant consitite it as a real kin - not logically possible - the cirteria arnt desciribing and circumsribing what it is - its the monothetci criteria that oes the job of identifiying what the disorder is
genus species distinction -- what kind of thing is water? -- what is the genus --what is the species? -- calcium would be a ....
eg. water - a kind of substance --> genus is substance -- but what kind of subtance is it- how can we ddefiretniate water by other types of substance -we do that by identifyng its essential features (an atom of oxygen that binds with 2 atoms of hydrogen -- its essential features; if u remove either of those molecules u dont have water) Differentia: one oxygen atom two hydrogen atoms = the species Accompanying feature: calcium --> in many smaples of water well also find calcium but we can remove the calcium an u still have water so its not a defining features its an accompanying feature on every signle sampleof water there is one unique set of features (hydrogen and oxygen) in ever single sample of water NECESSARILY
2. The kind/disorder itself is not..4
if its a genuine disorder its not the same as the: diangositc crietai (the signs/symtpoms), the behvaioural effects of the disorder orits signs/symptoms, the phenomenology of the disdorer (how it feels to be depressed), the causes of the disorder, a partiular case of the disorder or an indicual(it is something generalthat somepeoplearethe barrers of)
lets assum ameila has been corretly diagnosed with DID - what is she?
it can be temoting to think of her as a particular case of DID - she is the BARER of this kindd of disorder NOT an instance or a case or example of the disorder to classify this particular case of this disorder as amember of the classof theddisorer requires knwoing what a id IS WHIHC REQUIRES KNOWING THE ESSENTIAL EFINITING CONDITIONS ARE
when u have a unique set of features NECESSARILY present in every example of the kind -- we call it a ______ kind --we call water then a _____ because it has these essential features
monothetic kind --a unique set of features the concept of water is therefore a monothetic concept- because it has these essential features
1. Stating what the kind/disorder is____________
not the same as iddentifying the signs an symptoms of that disorder if the sings/symtpoims it cannot be the disorder and the DSM needs to be vwery clear about the signs/symtpims of x and x
most diagnostic criteria are...
polythetic -- some patients come in with this symtpoms but not this ect -- the diagnositc crietia o not define the disorer - they dont say what the concept of a disoicateive identiy --the diagnositic crietia are distinct from the monothetic defining conditions
a ceitnfic definition can only be of a ...
real kind - a monothetic concept
what is the genus -- species distinction
relative terms rather like parent - offspirng --> one can be a parent at the same time as being an offpring -- one can be a genus at the same time as being a species ---genus is the more inclusive/general term and speicies is more specifc - they are relatvie terms
"The individual disorder definitions that constitute the operationalized sets of diagnostic criteria provide the core of DSM-5 for clinical and research purposes" (DSM-5, p. 10).
she saidd wtf -- would it matter if it was just beigng used for iagnositc purposes - no but they are asayign that its a scientific and clincial document
how are scientific defintions ifferent from scientific classifications
something that humans do all the time- according to our knowlegde an nees andd interests --> the otuocme of my interest in alcohol is that i classify all the alcohol at hpme into classes; gine,wine and everythign esle - this classification is based on my interests and needs in the scientifc contexts an otutcome of classifciationnwill be a collection of thjngs (a class) that are classifie according to the kins of thing that they are -> that is according to the kinds essenital features -its possible to have a clasification based on the functionof things but FREWUENTYL a sicentific classification is based on the way tuings ARE not theyir function/causes ect - but on the kinds essential features so this kind of scientifc classififcation DEPENDS ON scientfic defintions - u cant classify untilu know wht kindofthing it is -->because it depends on scientifc defintion it cannot BE sicentific defintion ex.class of DID disorders isjust every case of disosiative identity - each case is a member of that class -- it ddoesnt consits of every person with DID but it consists of every case of did --> the person is not the case - if the scientific context reuqires us to be more precise wecouldclassify the whwre and when condditions eg.the class ofddid in austrlaia between 2015-2019 inclusive (a specification of the class)
what is the tension in the DSM
tension between the science and the clincial work of diagnosis and treatment
"... a too-rigid categorical system [i.e., the disorders as discrete qualitative categories] does not capture clinical experience or important scientific observations" (DSM-5, p. 5).probelm?
thats their justifucation for using diagnositc polythetic criteria --these are approariate for treatment and diagnisis but no0t for creating a scientific classifciation ***they are conflating the clinical task with the scientific task
What is scientific definition? --introduced by...developed by... -- in a nutshell, to provide a scientific defeintion is to ....
the classical acocunt of scientific defineiton was introdued by socrates and developed by aristolte -- in a nutshell, to provide a scientific defeintion is to describe the kinds essential or defining conditions/features -- describing a disorders essential features: the charatceristics/features/conidtions wuthout which that kind would not be the kind it is - the kind has them necessarily
what is the implication that some of these diagnositc criteria are polythtic ..
the criteria should not be used din constructing a scientifc system of classicialtion because the cirteria are not definitional -- andd the same cirteria sometimes appear across different didsorders so u can circumsibe/demarcate between one disordder and another so theyre im,portant for diagnositc and treatemnt but not for the basisof SCIENTIFC CLASSIFICATION
what is one reason the dsm want to move to a more dimesnional appraoch?
the same criteria appear across different dddisorers (eg. anxiety in depression) -- becasue they are not the definign conditions --this confusion amoungst clinicians and will make it worse for dsm 6 if they continue
"... the boundaries between many disorder 'categories' are more fluid over the life course than DSM-IV recognized, and many symptoms assigned to a single disorder may occur ... in many other disorders. These findings mean that DSM should accommodate ways to introduce dimensional approaches to mental disorders, including dimensions that cut across current categories" (DSM-5, p. 5).
there is a push to introduce ddimensional approaches to disorddder - its using the fact thatthe same ddiangositc criteria occur across ddifferent disorders to justify using these ddimensional appraoches - she argues that if u use diangositc criteria illigitametyl to circumscribe/efine the disorders ofcourse theres gonna be a problem because yoiull find the sameddiangositc cirteria amoung idfferent disorders --> she says they arnt rawing boundaries accordding to essential ddefining conditions sao of course this is gonna happen she says by using dimensional approahces its gonna be even more of a ogs breakkfast
what is a polythetic concept? what concept in psych odes evidence point to being a polythetic concept? if a concept is polythetic it is not a...
there is no one feature that appears in every single case of the concept some of the researhc inpsych is suggesting that vulnerabiltiy is a polythetic cocnept because allthe researchis suggesting that there is no one single feature or condition that is present in every case/imnstance of vulnerability --> if a concept is polythetic - it is not a real kind - whatever concept y appears to refer to in the world its not real/not a genuine kind - whatever weve conceptualized it has no essential defining condditions - there could be a pattern but its not a genuine kind - might mean we havnt hit the bullseye in terms of whats rlly out there
10 years ago when they were working on dsm 5 -- what was there a call for? what was the one good reason?
there was a call for DAD not to be identifie accoring to these monothetic criteria and the one good reason was clincial an pragmatic not scientifc... what was it? -- this is of no help to clincians in making a diagnosis ---doesnt provide any diagnostic criteria -- if u provide and raise the # of disgnositc criteria you will make diagnosis easier and thereby reducing the # of false negative diagnosese -- argued were gonna miss out on properly diagnosing DAD by not proviing any diagnositc criteria --said we shjould identify dad according to its diagnostic criteria
what is there a debate regarsding the essential features of dad
theres debate whether condition #2 (amnesia) is an essnetial feature or an accompanying feature
what does she say will happen with a dimensional approach
these confusions carry over into the clinical research - get perpetuated and get adedd to
whats wrong with this scenario of the fact that "Y may consist of A or B or C or D, or it may not"? y is giving us a ....
ts contradictory - all it provies is contradictions -- cant rest science on contradictions -->we have a disjunctive predicate (its either this, that , or this or that)
with respect to psychologcal disorders, a scientifc defiition answers the question..
what is it to be that kind of disorder or what kind of disorder is it? (referedd to as kind x) - not operational definitions --> forget these --they arnt defintions - certainly not a scientific one
what are the essential features? these features or conditions are identified as ______ or _______ this involves the .....
what it is in virtue of that makes kind X, X and not kind Y -->the kind's characteristics or features or conditions without which that kind could not be the kind it is, i.e., the kind has them necessarily these features or conditions are identified as essential or necessary involves the genus - species distinction
Implications of the standard account of scientific definition -
what scientific definition is not -- since we know what it is, we cna know what it is not and should not be confused with
what is the issue with the diganositc criteria being polythetic?
where the diganositc criteria is polythetic - it may be good for clincial settings (to make a correct diagnosis) ---but for the purposeof scicne an saying what this disorder it is - its no help at all cuz its not giving u a distinctset of features speocif to that kind -- its not saying what it is and what its not -- not making any categorical distinctions
2. The kind/disorder itself is not...
(a)Diagnostic criteria - signs/symptoms b) Behavioural effects of the disorder c) Behavioural effects of the signs/symptoms c) Phenomenology of the disorder d) The causes of the disorder e) Examples/particular cases of the disorder f) The individual as the bearer of the disorder