Are mental disorders the same as brain disorders? Maybe not!

I am currently reading an excellent paper that will be published in Behavioral and Brain Sciences soon. It raises some very important issues with popular conceptions of mental illness.

Brain disorders? Not really… Why network structures block reductionism in psychopathology research

These two figures capture some of the key points:

Here is the abstract:

“In the past decades, reductionism has dominated both research directions and funding policies in clinical psychology and psychiatry. However, the intense search for the biological basis of mental disorders has not resulted in conclusive reductionist explanations of psychopathology. Recently, network models have been proposed as an alternative framework for the analysis of mental disorders, in which mental disorders arise from the causal interplay between symptoms. In this paper, we show that this conceptualization can help understand why reductionist approaches in psychiatry and clinical psychology are on the wrong track. First, symptom networks preclude the identification of a common cause of symptomatology with a neurobiological condition, because in symptom networks there is no such common cause. Second, symptom network relations depend on the content of mental states and as such feature intentionality. Third, the strength of network relations is highly likely to partially depend on cultural and historical contexts as well as external mechanisms in the environment. Taken together, these properties suggest that, if mental disorders are indeed networks of causally related symptoms, reductionist accounts cannot achieve the level of success associated with reductionist disease models in modern medicine. As an alternative strategy, we propose to interpret network structures in terms of D. C. Dennett’s (1987) notion of real patterns, and suggest that, instead of being reducible to a biological basis, mental disorders feature biological and psychological factors that are deeply intertwined in feedback loops. This suggests that neither psychological nor biological levels can claim causal or explanatory priority, and that a holistic research strategy is necessary for progress in the study of mental disorders.”

Behavioral and Brain Sciences is one of the premier journals for “big thinking” in cognitive science and neuroscience, so it’s great to see these ideas there.


Fifty terms to avoid in psychology and psychiatry?

The excellent blog Mind Hacks shared a recent Frontiers in Psychology paper entitled “Fifty psychological and psychiatric terms to avoid: a list of inaccurate, misleading, misused, ambiguous, and logically confused words and phrases”.

As mentioned in the Mind Hacks post, the advice in this article may not always be spot-on, but it’s still worth reading. Here are some excerpts:

(7) Chemical imbalance. Thanks in part to the success of direct-to-consumer marketing campaigns by drug companies, the notion that major depression and allied disorders are caused by a “chemical imbalance” of neurotransmitters, such as serotonin and norepinephrine, has become a virtual truism in the eyes of the public […] Nevertheless, the evidence for the chemical imbalance model is at best slim […]  There is no known “optimal” level of neurotransmitters in the brain, so it is unclear what would constitute an “imbalance.” Nor is there evidence for an optimal ratio among different neurotransmitter levels.”

“(9) Genetically determined. Few if any psychological capacities are genetically “determined”; at most, they are genetically influenced. Even schizophrenia, which is among the most heritable of all mental disorders, appears to have a heritability of between 70 and 90% as estimated by twin designs”

“(12) Hard-wired. The term “hard-wired” has become enormously popular in press accounts and academic writings in reference to human psychological capacities that are presumed by some scholars to be partially innate, such as religion, cognitive biases, prejudice, or aggression. For example, one author team reported that males are more sensitive than females to negative news stories and conjectured that males may be “hard wired for negative news” […] Nevertheless, growing data on neural plasticity suggest that, with the possible exception of inborn reflexes, remarkably few psychological capacities in humans are genuinely hard-wired, that is, inflexible in their behavioral expression”

“(27) The scientific method. Many science textbooks, including those in psychology, present science as a monolithic “method.” Most often, they describe this method as a hypothetical-deductive recipe, in which scientists begin with an overarching theory, deduce hypotheses (predictions) from that theory, test these hypotheses, and examine the fit between data and theory. If the data are inconsistent with the theory, the theory is modified or abandoned. It’s a nice story, but it rarely works this way”

“(42) Personality type. Although typologies have a lengthy history in personality psychology harkening back to the writings of the Roman physician Galen and later, Swiss psychiatrist Carl Jung, the assertion that personality traits fall into distinct categories (e.g., introvert vs. extravert) has received minimal scientific support. Taxometric studies consistently suggest that normal-range personality traits, such as extraversion and impulsivity, are underpinned by dimensions rather than taxa, that is, categories in nature”

Lilienfeld, S. O., Sauvigné, K. C., Lynn, S. J., Cautin, R. L., Latzman, R. D., & Waldman, I. D. (2015). Fifty psychological and psychiatric terms to avoid: a list of inaccurate, misleading, misused, ambiguous, and logically confused words and phrases. Frontiers in Psychology, 6, 1100.