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Psychiatric diagnoses are not mental process: Wittgenstein on conceptual confusion

Rosenman, Stephen; Nasti, Julian

Description

Background: Empirical explanation and treatment repeatedly fail for psychiatric diagnoses. Diagnosis is mired in conceptual confusion that is illuminated by Ludwig Wittgensteins later critique of philosophy (Philosophical Investigations). This paper examines conceptual confusions in the foundation of psychiatric diagnosis from some of Wittgensteins important critical viewpoints. Argument: Diagnostic terms are words whose meanings are given by usages not definitions. Diagnoses, by Wittgensteins...[Show more]

dc.contributor.authorRosenman, Stephen
dc.contributor.authorNasti, Julian
dc.date.accessioned2015-12-10T22:23:42Z
dc.identifier.issn0004-8674
dc.identifier.urihttp://hdl.handle.net/1885/52924
dc.description.abstractBackground: Empirical explanation and treatment repeatedly fail for psychiatric diagnoses. Diagnosis is mired in conceptual confusion that is illuminated by Ludwig Wittgensteins later critique of philosophy (Philosophical Investigations). This paper examines conceptual confusions in the foundation of psychiatric diagnosis from some of Wittgensteins important critical viewpoints. Argument: Diagnostic terms are words whose meanings are given by usages not definitions. Diagnoses, by Wittgensteins analogy with games, have various and evolving usages that are connected by family relationships, and no essence or core phenomenon connects them. Their usages will change according to the demands and contexts in which they are employed. Diagnoses, like many psychological terms, such as reading or understanding, are concepts that refer not to fixed behavioural or mental states but to complex apprehensions of the relationship of a variety of behavioural phenomena with the world. A diagnosis is a sort of concept that cannot be located in or explained by a mental process. Conclusion: A diagnosis is an exercise in language and its usage changes according to the context and the needs it addresses. Diagnoses have important uses but they are irreducibly heterogeneous and cannot be identified with or connected to particular mental processes or even with a unity of phenomena that can be addressed empirically. This makes understandable not only the repeated failure of empirical science to replicate or illuminate genetic, neurophysiologic, psychic or social processes underlying diagnoses but also the emptiness of a succession of explanatory theories and treatment effects that cannot be repeated or stubbornly regress to the mean. Attempts to fix the meanings of diagnoses to allow empirical explanation will and should fail as there is no foundation on which a fixed meaning can be built and it can only be done at the cost of the relevance and usefulness of diagnosis.
dc.publisherSAGE Publications
dc.sourceAustralian and New Zealand Journal of Psychiatry
dc.subjectKeywords: clinical practice; confusion; depression; family; human; mental function; mental health; psychiatric diagnosis; review; Humans; Language; Mental Disorders; Mental Processes; Philosophy; Semantics Diagnosis; mental disorders; philosophy; Wittgenstein
dc.titlePsychiatric diagnoses are not mental process: Wittgenstein on conceptual confusion
dc.typeJournal article
local.description.notesImported from ARIES
local.identifier.citationvolume46
dc.date.issued2012
local.identifier.absfor170110 - Psychological Methodology, Design and Analysis
local.identifier.ariespublicationu4146231xPUB259
local.type.statusPublished Version
local.contributor.affiliationRosenman, Stephen, College of Medicine, Biology and Environment, ANU
local.contributor.affiliationNasti, Julian, Concord Hospital
local.description.embargo2037-12-31
local.bibliographicCitation.issue11
local.bibliographicCitation.startpage1046
local.bibliographicCitation.lastpage1052
local.identifier.doi10.1177/0004867412446090
local.identifier.absseo920209 - Mental Health Services
dc.date.updated2016-02-24T10:37:50Z
local.identifier.scopusID2-s2.0-84873678465
CollectionsANU Research Publications

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