Natural kinds of mental disorder

Abstract

Are mental disorders (autism, ADHD, schizophrenia) natural kinds or socially constructed categories? What is at stake if either of these views prove to be true? This paper offers a qualified defence for the view that there may be natural kinds of mental disorder, but also that the implications of this claim are generally overestimated. Especially concerns about over-inclusiveness of diagnostic categories and medicalisation of abnormal behaviour are not addressed by the debate. To arrive at these conclusions the paper opens with a discussion of kind formation in science, followed by an analysis of natural kinds. Seven principled and empirically informed objections to the possibility of natural kinds of mental disorder are considered and rejected. The paper ends with a reflection on diagnostics of mental health problems that don’t fall into natural kinds. Despite the defence of the possibility of natural kinds of mental disorder, this is likely to be the majority of cases.

Who benefits from diagnostic labels for developmental disorders?

“…Because of causal heterogeneity, the categories cannot be said to explain the behavioural patterns. 12 , 13 , 14 , 15 It should be noted that this observation is compatible with the fact that for those receiving the diagnosis, the label can be insightful and explanatory. By reducing a multitude of problems and difficulties into one or two traits – a concentration deficit, or hyperreactivity to sensory stimulation – labels can help them more easily grasp the challenges they face (see Hens and Langenberg 16 for insightful illustrations).…”

“…But for neither category (or their subcategories) has the link between genetics and environmental factors been properly understood, nor have the same neurological differences been found in children similarly classified. Because of causal heterogeneity, the categories cannot be said to explain the behavioural patterns 12–15 . It should be noted that this observation is compatible with the fact that for those receiving the diagnosis, the label can be insightful and explanatory.…”

“…In a scientific context it would, therefore, be best to discard the current diagnostic categories in favour of a more fine-grained, causally informed, and predictively powerful taxonomic system. 12,15,18,19 Such a new taxonomy might distinguish different types of ADHD, depending on the different underlying neurological pathways, 20,21 or different types of ASD, depending on which genetic, environmental, or neurological factors are causally or constitutively involved. 22 There are serious feasibility concerns about this sort of 'neurotyping', given the complexity found at causal levels.…”

Internal and External Crime Hot Spots: From Neural to Micro-Geographical Networks

“…Relatedly, antisocial behaviours are typically diagnosed based on observed symptoms, following a descriptive approach in mental disorder classification that relies less on identifying underlying biological causes or mechanisms (Tsou 2016; Werkhoven 2021). While there may be some overlap between psychiatric and neurological conditions, they do not align neatly (Banner 2013).…”