Search

Advocates for the psychological construction of emotion view themselves as articulating a non-essentialist alternative to basic emotion theory's essentialist notion of affect programs. Psychological constructionists have also argued that holding essentialist assumptions about emotions engenders misconceptions about the psychological constructionist viewpoint. If so, it is important to understand what psychological constructionists mean by “essentialism” and “non-essentialism.” To advance the debate, I take a deeper dive into non-essentialism, comparing the non-essentialist views of the early empiricists with those of the psychological constructionists, focusing on the theories of James Russell and Lisa Barrett. Using Lakatos’ notion of scientific research programs, I also describe how Russell's and Barrett's views have evolved into different and potentially competing research programs under the psychological constructionist banner.

The initial plans for the DSM-5 revision envisioned a paradigm shift away from traditional diagnostic categories. However, plans for a major move from descriptive to etiologic diagnoses were quickly abandoned as infeasible. Support was much broader for adding dimensional/spectrum constructs to the categorical diagnoses, although this was interpreted in various ways. Delegation of substantial autonomy to work groups with modest central coordination was seen as problematic by some work groups and positively by others. Controversies emerged around the standards for diagnostic change, and the degree to which the same standards should be used across diagnostic groups. The Summit Group was given the final task of trying to forge a consensus among the various review groups. We conclude with thoughts about the difficulty of trying to revise an entire manual all at once and the desirability of developing clear rules for change at the outset of such a diagnostic project.

Philosophers discuss Jerome Wakefield's influential view of mental disorder as “harmful dysfunction,” with detailed responses from Wakefield himself. One of the most pressing theoretical problems of psychiatry is the definition of mental disorder. Jerome Wakefield's proposal that mental disorder is “harmful dysfunction” has been both influential and widely debated; philosophers have been notably skeptical about it. This volume provides the first book-length collection of responses by philosophers to Wakefield's harmful dysfunction analysis (HDA), offering a survey of philosophical critiques as well as extensive and detailed replies by Wakefield himself. HDA is offered as a definition of mental disorder, but it is also the outcome of a method—conceptual analysis—and contributors first take up HDA's methodology, considering such topics as HDA's influences on the DSM, empirical support for HDA, and clinical practice. They go on to discuss HDA's ultimate goal, the demarcation between normal and abnormal; the dysfunction component of the analysis, addressing issues that include developmental plasticity, autism and neurodiversity, and the science of salience; and the harmful component, examining harmless dysfunction, normal variation, medicalization, and other questions. Wakefield offers substantive responses to each chapter. The open access edition of this book was made possible by generous funding from Arcadia – a charitable fund of Lisbet Rausing and Peter Baldwin. Contributors Rachel Cooper, Andreas De Block, Steeves Demazeux, Leen De Vreese, Luc Faucher, Denis Forest, Justin Garson, Philip Gerrans, Harold Kincaid, Maël Lemoine, Dominic Murphy, Jonathan Sholll, Tim Thornton, Jerome Wakefield, Peter Zachar

This article narrates a consensus history of the proposal to include diagnostic criteria for a psychosis risk syndrome in the DSM-5, in part, to document what happened, but also to potentially help focus future efforts at clinically useful early detection. The purpose of diagnosing a risk state would be to slow and ideally prevent the development of the full disorder. Concerns about diagnosing a psychosis risk state included a high false positive rate, potentially harmful use of anti-psychotic medication with people who would not transition to psychosis, and stigmatization. Others argued that educating professionals about what ‘risk’ entails could reduce inappropriate treatments. During the revision, the proposal shifted from diagnosing risk to emphasizing current clinical need associated with attenuated psychotic symptoms. Within the community of researchers who studied psychosis risk, people disagreed about whether risk and/or attenuated symptoms should be an official DSM-5 diagnosis. Once it became clear that the DSM-5 field trials did not include enough cases to establish the reliability of the proposed criteria, everyone agreed that the criteria should be put in a section on conditions for further study rather the main section of the DSM-5. We close with recommendations about some practical benchmarks that should be met for including criteria for early detection in the classification system.

Commentary on Standards and Guidelines for the Development of Diagnostic Nomenclatures and Alternatives in Mental Health Research and Practice.

Beginning with the Diagnostic and Statistical Manual of Mental Disorders (3rd ed.; DSM-III), depressive episodes following the loss of a loved one were considered to represent normal grief if they did not include certain severe symptoms or if they lasted less than 2 months. This was called the bereavement exclusion rule. A debate about whether to eliminate the bereavement exclusion became a hotly contested issue during the DSM-5 revision process. The debate involved disagreements about which research studies were most relevant to assessing the validity of the bereavement exclusion rule, different value commitments regarding the distinction between normal and abnormal, and contrasting philosophical assumptions about the nature of psychiatric disorder. Based on a review of the arguments offered in academic journals, the blogosphere, and in the mass media, and on interviews with active participants in the debate, this article narrates a consensus history that reflects the diversity of viewpoints promoted during the debate and the diversity of views on the outcome.

Many scholars believe that psychiatric nosology is undergoing a crisis of confidence. Some of the issues up for debate hark back to the introduction of the natural history approach to classification in the seventeenth century. Natural histories map sameness and difference rather than speculate about causes. In contrast, the natural classification approach aspires to carve nature at the joints by demarcating classifications by causes. Natural classifications are more ideal scientifically, but speculation about causality has had a poor track record in psychiatric nosology. A natural classification of psychiatric disorders may have the added burden of requiring normative assumptions in addition to the discovery of fact. In the natural classification tradition, the epistemic iteration perspective, the Research Domain Criteria (RDoC) initiative, and dimensional models offer different views about the criteria of naturalness (or validity). Also in this tradition, some thinkers believe that causes can be empirically indexed by latent variable models, especially if the latent variables are moderately heritable, but these assumptions may be neither statistically nor genetically warranted.

We have developed a renewable, scalable and transgene free human blood-brain barrier model, composed of brain endothelial cells (BECs), generated from human amniotic fluid derived induced pluripotent stem cells (AF-iPSC), which can also give rise to syngeneic neural cells of the neurovascular unit. These AF-iPSC-derived BECs (i-BEC) exhibited high transendothelial electrical resistance (up to 1500 Ω cm2) inducible by astrocyte-derived molecular cues and retinoic acid treatment, polarized expression of functional efflux transporters and receptor mediated transcytosis triggered by antibodies against specific receptors. In vitro human BBB models enable pre-clinical screening of central nervous system (CNS)-targeting drugs and are of particular importance for assessing species-specific/selective transport mechanisms. This i-BEC human BBB model discriminates species-selective antibody- mediated transcytosis mechanisms, is predictive of in vivo CNS exposure of rodent cross-reactive antibodies and can be implemented into pre-clinical CNS drug discovery and development processes.