Biological Psychiatry: Biological Psychiatry 2V Set - Hardcover

Hardcover

ISBN 10: 0471491985 ISBN 13: 9780471491989

Publisher: Wiley–Blackwell, 2002

Synopsis

Biological psychiatry, sometimes called psychiatric neuroscience, concerns itself with scientific research and clinical observation of psychopathologies. Incredible advances in molecular biology, genomics, pharmacology and neuroscience mean that more is known about the biological basis of behaviour and mental illness than ever before. This translates directly to improved diagnoses and disease management as well as better–targeted therapeutics. In fact, biological psychiatric research focuses on psychopharmacological interventions derived from biochemical hypotheses of mental disorders. Biological Psychiatry covers basic principles and then delves deeper into various disorders. Structured to follow the organisation of the DSM–IV, psychiatry′s primary diagnostic and classification guide, the contributions explore functional neuroanatomy, imaging and neuropsychology and pharmacotherapeutic possibilities for depressive, anxiety and mood disorders, substance abuse and eating disorders, schizophrenia and psychotic disorders, and cognitive and personality disorders. The world′s leading psychiatrists, neurologists, neuroscientists, pharmacologists have contributed to this important work, the most comprehensive ever compiled.

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Review

"...A strong point to the volume is its truly international authorship. The book is an excellent companion to psychopharmacology volumes". (Psychotherapy & Psychosomatics, July/August 2003)

Excerpt. © Reprinted by permission. All rights reserved.

Chapter 1 – Conceptual Issues
German E. Berrios and Ivana S. Markova

Born as a by-product of the nineteenth-century movement to organize society on a scientific basis, psychiatry was charged with the construction and enactment of normative views of madness. (Literature on social and clinical history of psychiatry is large; for scholarly papers on both, see the journal History of Psychiatry (started 1990).) Under the protection of medicine and the economic practices following the Industrial Revolution, psychiatrists developed representations of mental disease together with the professional and institutional apparatus to enjoin them. Since its construction, the modalities of psychiatry have been many. For example, there is the group called biological psychiatry, organic psychiatry, neuropsychiatry and behavioural neurology, which seem to share the foundational claims (FCcs) that: (1) mental disorder is a disorder of the brain; (2) reasons are not good enough as causes of mental disorder; and (3) biological psychiatry and its congeners have the patrimony of scientific truth. These four congeners are man-made and there is nothing in nature to suggest real differences between them; indeed, any differences that might be suggested are bound to be historical in origin. To avoid confusion, the term ‘biological psychiatry’ will be used in this chapter as a proxy for the other three congeners. Since the seventeenth century, versions of what might be called biological psychiatry have come in and out of fashion; the reasons for these cycles are unclear.

FOUNDATIONAL CLAIMS AND THE ‘TECHNOLOGY ALIBI’
FCs are unproven and unprovable propositions used to start off the narrative of science. Chosen by ‘experts’, FCs escape audit and are unchallengeable. The view that mental disorders are ‘caused’ by changes in the physical conformation of the brain is a typical foundational claim; that ‘reasons’ cannot constitute efficient causes for the generation of mental disorder is another. Since the nineteenth century, and every time it has failed to deliver, biological psychiatry has used the excuse that ongoing technologies are not sensitive enough to identify the organic causes of all mental disorders and reassured the expecting public that future techniques will do so: we call this the ‘technology alibi’.

Foundational Claim 1: Mental Disorders as Brain Disorders
Meanings for this FC range from the broad assertion that all psychological activity must have brain representation to the narrow assertion that specific brain lesion l is a necessary and sufficient cause for presence of specific mental disorder m (more on this later). Similar claims were made during the middle of the seventeenth century, e.g. by Thomas Willis in 1685 (see Vinchon and Vie, 1928).

The claims that the body (brain) houses the human soul (or mind) and that changes (lesions) in the conformation or constitution of the body (brain) cause mental disorder (i.e. FC 1) are historically independent, and their relationship is asymmetrical; indeed, the belief that brain disease causes mind disease is not logically dependent on the belief that the mind resides in the brain (because the former could be plausibly held without the second being true).

The claim that the body (brain) must house the human soul (or mind) follows from the materialist assumption that at the time the world came into being, there was only matter (Lange, 1957). Thinkers of this persuasion need to explain, however, where ‘mind phenomena’ come from, particularly if a highly configured model of the latter is entertained. Materialist thinkers make use of two types of matter: Plain matter is constituted by homogeneous units of analysis (atoms, fields, strings) and cannot explain mind configurations; these then are assumed to come from outside (cultural context). Baroque matter may be constituted by atoms of different shapes and sizes moving at different rates, or may include dynamic and hidden qualities (Cappelletti, 1979). For example, Cabanis (1802) (although overtly a materialist) held a baroque view of matter and hence was able to account for complex aspects of the mind without resorting to any external agencies.

Foundational Claim 2: Causes and Reasons
Causes and reasons are forms of accounting for the existence and/or origin of objects, tokens, episodes, processes and behaviours. Although etymologically different, they have overlapping semantic fields (i.e. are used as synonyms) and similar epistemic power (capacity to explain actions). Causes are used in the natural sciences; reasons are used in the social sciences (which, in the past, included psychology). What about psychiatry?

Causes
What we have said above suggests that to ask for the cause of a mental disorder is already to opt for a particular model of explanation (Berrios, 2000a), as equally cogent would be to ask for a reason, based on the view that people may do things, including ‘talking and behaving crazy’, for reasons better known to themselves. Reason in this sense needs not be construed in material or mechanical terms but may remain expressed in the language of folk psychology. Even more radically, it could be said that mental disorders are not effects at all, that they do not follow either causes or reasons, and that they are just ‘givens’, i.e. they have been there from the beginning of time. In a world keen on looking for the causes of all things, this latter view may sound strange, but it is not unintelligible and it simply reflects the ontology of preformationism, a view of biology predominant in the eighteenth century.

It could be argued that reasons are just a subtype of cause. This claim muddles the issue further. It is true that the Latin causa meant reason, motive, inducement, but it also meant occasion and opportunity. It translated the Greek aitia and aition (stems of the medical term aetiology)...

Edition details

• Publisher: Wiley–Blackwell
• Publication date: 2002
• Language: English
• ISBN 10: 0471491985
• ISBN 13: 9780471491989
• Binding: Hardcover
• Edition number: 2
• Number of pages: 1486
• Editor: D′haenen Hugo, Den Boer Johan A., Willner P.