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The Battle to Define Mental Illness (2010)

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31–40 of 106 posts

Re: The Battle to Define Mental Illness (2010)

#31
post #29

Earlier quoted context omitted.

Sure, people are prescribed psychotropic medication for depression. But as more stringent scrutiny has been paid to those, the effect sizes have gone down over time and with more adjustment for publication bias. There's no shortage of demand for psychotherapy services, and head-to-head they are comparable and both in combination fare best. There is no blood test for depression, and if there is, no one uses it in prac…

How familiar are you with factor analysis? I worry that because the best mathematical minds are often not attracted to psychology as a field, that psychologists as a group are somewhat blind to implications of statistical choices and assumptions that they inherit or make.

What would you like to say about factor analysis? Lay it on me

Re: The Battle to Define Mental Illness (2010)

#32

This conundrum reminds me of a thought experiment. You have people use a mental illness as a defense in courts of law. But could you not plausibly define anyone who commits major crimes to be mental ill? Mental illness could also be defined by a person's ability to function in their community and social constructs. But a healthy species, evolutionary speaking, requires these outliers. These deviations from the "norm"…

Sounds like programmers are obsolete because software will become redundant once we've solved everything in hardware :D

A surprising number of people seem to believe this is actually true when they discuss Copilot and ChatGPT!

Re: The Battle to Define Mental Illness (2010)

#33
Even today, we don’t have a definition of “species”, a definition acceptable to biologists working in this domain. What is needed is a theory, and further development of that theory.

Those who quibble about definitions should develop theories and test them, amend them, replace them. All these activities help understand the phenomenon in the question. When people engage in definitional disputes, it shows that intuitions about the phenomenon conflict. That’s all. To settle these issues, one should do science: that is, develop theories, derive consequences, add back ground theories to test these consequences.

Re: The Battle to Define Mental Illness (2010)

#34

This conundrum reminds me of a thought experiment. You have people use a mental illness as a defense in courts of law. But could you not plausibly define anyone who commits major crimes to be mental ill? Mental illness could also be defined by a person's ability to function in their community and social constructs. But a healthy species, evolutionary speaking, requires these outliers. These deviations from the "norm"…

Defining mental illness in terms of deviance from law is actually an insane idea.

Were the opponents to Nazis mentally ill, simply because they did not adhere to Nazi law?

Think about the implications.

Re: The Battle to Define Mental Illness (2010)

#35

This conundrum reminds me of a thought experiment. You have people use a mental illness as a defense in courts of law. But could you not plausibly define anyone who commits major crimes to be mental ill? Mental illness could also be defined by a person's ability to function in their community and social constructs. But a healthy species, evolutionary speaking, requires these outliers. These deviations from the "norm"…

> Mental illness could also be defined by a person's ability to function in their community and social constructs.

No, I think mental illness should be defined relative to a person's capacity to change behaviour volitionally or in response to feedback signals, like a scolding or rehab or imprisonment. People who are mentally ill do not respond to feedback signals like this, they have little volition over their behaviours without significant pharmaceutical or other interventions first. It's like asking someone with Tourette's to stop having verbal tics as compared to someone who just likes swearing. There's a fundamental difference in volitional control and responsiveness to feedback.

Re: The Battle to Define Mental Illness (2010)

#36

Frances's concerns definitely aren't wrong on the whole, but I feel like he's not seeing the forest for the trees. This ultimately isn't just a question of whether this or that DSM revision is helpful. The patterns of the mental health establishment of the 21st century are oddly reminiscent of where physics and chemistry stood ca. the mid-19th century. Legitimate advances are being made, but most of the tools are sti…

> It's not a great situation, and I don't see many signs that it's improving.

I think this is a little too pessimistic on the one hand, and very accurate on the other.

On the accurate side: this discipline took one of the most significant hits from the replication crisis, and was one of the most resistant to acknowledging and changing practices. Everyone should keep pushing for open science and preregistered studies to improve quality of the evidence here.

On the optimistic side, there is one potentially huge change that's just starting to crest as opinions improve and acceptance spreads: psychedelics. MDMA for PTSD was a huge win and indicates a potentially large untapped realm of possibilities for altering cognition in positive ways.

There's also hope that neuroscience can start to supplant at least parts of psychology in a few decades.

Re: The Battle to Define Mental Illness (2010)

#37
post #33

Even today, we don’t have a definition of “species”, a definition acceptable to biologists working in this domain. What is needed is a theory, and further development of that theory. Those who quibble about definitions should develop theories and test them, amend them, replace them. All these activities help understand the phenomenon in the question. When people engage in definitional disputes, it shows that intuitio…

Do we even have a definition of of biology or biologist that’s acceptable to the vast majority?

e.g. some of the very small viruses, viruses and similar structures seem pretty close to chemistry.

Re: The Battle to Define Mental Illness (2010)

#38

This conundrum reminds me of a thought experiment. You have people use a mental illness as a defense in courts of law. But could you not plausibly define anyone who commits major crimes to be mental ill? Mental illness could also be defined by a person's ability to function in their community and social constructs. But a healthy species, evolutionary speaking, requires these outliers. These deviations from the "norm"…

>But could you not plausibly define anyone who commits major crimes to be mental ill?

Yes, and it makes punishment in the manners we do it [US] frankly unconsciable for being torturous. What else do you call forcing a man to sit in a concrete and iron box for ten years involuntarily, if he would willingly expatriate instead? Imprisonment should become optional with expatriation. It is assinine that we take away passports from criminals; you should be wanting them to depart for good! Throwing a man in a box completely involuntarily and without any reachable alternative recourse except to wait it out, in lieu of just seizing all assets and kicking them out permanently if they so choose as the prison-alternative, is assuaging what internet trolls would call... your booty-blastedness for him giving you a really bad time.

Re: The Battle to Define Mental Illness (2010)

#39

This conundrum reminds me of a thought experiment. You have people use a mental illness as a defense in courts of law. But could you not plausibly define anyone who commits major crimes to be mental ill? Mental illness could also be defined by a person's ability to function in their community and social constructs. But a healthy species, evolutionary speaking, requires these outliers. These deviations from the "norm"…

> Mental illness could also be defined by a person's ability to function in their community and social constructs. No, I think mental illness should be defined relative to a person's capacity to change behaviour volitionally or in response to feedback signals, like a scolding or rehab or imprisonment. People who are mentally ill do not respond to feedback signals like this, they have little volition over their behavi…

> No, I think mental illness should be defined relative to a person's capacity to change behaviour volitionally or in response to feedback signals, like a scolding or rehab or imprisonment. People who are mentally ill do not respond to feedback signals like this, they have little volition over their behaviours without significant pharmaceutical or other interventions first.

Yeah, this is exactly what someone without mental illness will never understand. Awareness is not static. It ebbs and flows. Sometimes I know that I'm saying/doing something but completely unaware of what it is. I have to ask someone else about my actions/words once I regain awareness. However, I do hold a full time position and can respond to feedback signals depending on the day. I was told growing up to think of consequences of my actions before doing it. Yeah right, for that to happen I need to understand what I'm doing let alone think through the consequences. Pharmaceutical or other interventions aren't a silver bullet to all mental illness issues. Yes, they do help and curb some symptoms but you can't predict when someone will have an episode. And they come with their own side effects. Their effectiveness also depends on the person being treated. Not everyone with depression responds equally well to anti-depressants. It's much more complicated than you think.

Re: The Battle to Define Mental Illness (2010)

#40

Frances's concerns definitely aren't wrong on the whole, but I feel like he's not seeing the forest for the trees. This ultimately isn't just a question of whether this or that DSM revision is helpful. The patterns of the mental health establishment of the 21st century are oddly reminiscent of where physics and chemistry stood ca. the mid-19th century. Legitimate advances are being made, but most of the tools are sti…

> The patterns of the mental health establishment of the 21st century are oddly reminiscent of where physics and chemistry stood ca. the mid-19th century. Legitimate advances are being made, but most of the tools are still unreliable and many of the theories still fairly reek of superstition and magical thinking.

Ah this is also my stance. There are lots of good will in this subject, but trusting it is like trusting surgeons in 19th century. There may be no other option, but sometimes it's better to leave the bullet in your chest rather than letting it be infected by doctors with dirty hands.

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