Causal explanation in psychiatry – beyond scientism and scepticism

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About this Research Topic

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Background

We have organized a workshop on this research topic that will be held on August 22nd, at the Free University in Amsterdam. More information can be found here:Frontiers in Events

Since psychiatry firmly established itself as a scientific discipline, it has been propelled forward by the hope that the different diagnostic categories distinguished in clinical practice, will turn out to correspond to unique underlying causes. However, so far there is hardly any evidence that the behavioral, cognitive and emotional manifestations of disorders such as major depression or schizophrenia can be traced back to relatively simple, common causal trajectories. Rather, the etiology of almost all mental disorders seems to be multifactorial. Different etiological factors also appear to span different levels of explanation, ranging from the (epi)genetic, neurobiological to the psychological and social level.
Moreover, many psychiatric symptoms are defined in terms of psychological states that have intentional content: patients with delusions for example suffer from beliefs about being spied upon, or about being poisoned. Traditionally, explanations in psychiatry that referred to the content of mental states such as beliefs and emotions were taken to provide hermeneutic insight (‘Verstehen’), which was separated from causal explanation (the domain of 'Erklären'). However, to strictly separate meaning from causation seems problematic in that the content of patients’ beliefs, fears and desires surely seems to be causally relevant to their illness behavior. This raises the question how such mental content could be integrated in causal explanations of mental disorder.
Progress with respect to these fundamental issues has been limited in the past decades. This has led to different responses: clinicians, broadly speaking, tend to be sceptical about the prospects of causal modelling in psychiatry; whereas scientists tend to cling to a reductionist view on mental disorder, according to which true explanation of mental disorder is considered the province of the natural sciences only (biology, genetics, neuroscience). This latter view leans towards a form of scientism, according to which only theoretical knowledge, acquired in a scientific setting, can provide us with real insight into mental disorder.
Psychiatry needs to find a way beyond scepticism and scientism. Progress in psychiatry at least requires the development of new methods and concepts to gain a better insight into the complexity of the causal processes leading to, as well as the role of mental content in the explanation of, mental disorders. In this Research Topic we want to review and discuss novel theoretical and empirical strategies addressing causation and causal explanation in psychiatry.
Some important questions would be: how could the (diachronic) complexity of mental disorders be modelled and empirically investigated? Are traditional nomological theories of causation the best framework for thinking about causation in psychiatry, or should we look at alternatives such as mechanism-based, interventionist or pluralist theories of causation and/or approaches based on complexity theory? How to integrate different levels of explanation in etiological models of mental disorder? Should the content of mental states be integrated in empirical research on mental disorders?
This Research Topic welcomes all types of contributions (reviews, philosophical analyses, original empirical studies, modelling work, discussion pieces) from psychiatry, philosophy, psychology and other relevant disciplines.

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