Key takeaways

  • DSM has expanded over the years, and now 50% of all Americans have at some point in their lives had a mental disorder (Kessler epidemiology).
  • Have we actually discovered more conditions “in nature” or are we simply sub-typing and expanding into everyday life? Blurring the boundary between distress and disorder?
  • An advantage of the current system with specific diagnostic criteria is improved Reliability of diagnosis, and a Lingua Franca despite theoretical differences between clinicians.
  • Social constructivism critique: disorders are affected by clinicians themselves. Also mentioned in Why we need to get better at critiquing psychiatric diagnosis:

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Network approach to psychopathology

  • Symptoms tend to cluster, why?
  • Medical model: they co-occur because of a shared underlying cause, e.g. a latent disorder or brain aberration
  • Axiom of local independence not fulfilled, symptoms are causally connected

The episode with a mental disorder represents the activation of causally linked symptom networks