Definition and Classification II

Question 1

Recap: Any genuine kind of X that is out there in the world (e.g., a genuine psychiatric disorder) is… what?

Answer 1

Necessarily monothetic and has a unique set of essential or defining features/conditions.

Question 2

Recap: without those essential or defining features the kind would…

Answer 2

… not be the kind that it is.

Question 3

Recap: in psychology, we have some disorders that seem to refer to a genuine kind BUT why is this not correct?

Answer 3

Because those disorders do not have unique sets of essential or defining features.

Question 4

Although psychology likes to refer to most disorders as being real things that exist, would are they actually?

Answer 4

In truth, they just function as linguistic markers in everyday language that refer to a polythetic concept.

Question 5

Now we know what a scientific definition IS, what is it not? (6 points).

Answer 5

A scientific definition is not:

1. an operational definition.
2. ostensive.
3. a description of the: a) conditions process/procedures that CAUSED the disorder, b) the signs/symptoms of the disorder, c) the effects or consequences of the disorder.
4. the functional purpose of the disorder.
5. a description of the (so-called) measurement of the disorder.
6. scientific classification.

Question 6

A scientific definition is not an ‘operational definition’, explain what this means.

Answer 6

Well, what an operational definition is depends on who is teaching you. But the standard take is either the steps an investigator must take to measure/manipulate a variable OR a manual of instructions.
But it is not a genuine definition, it is just a description of a procedure.

Question 7

A scientific definition is not ‘ostensive’, explain what this means.

Answer 7

Well, ostensive = ‘to directly demonstrate’ or ‘point to’. Pointing to something is not describing any essential defining features.
Pointing to an example of X is not to define X.

Question 8

A scientific definition is not a description of what three factors? Explain them.

Answer 8

A scientific definition is not a description of:

a. the conditions/processes/procedures that caused X (what caused something should not be included in the definition).
b. the signs/symptoms of X are not X (e.g., oxygen and hydrogen are not water).
c. the effects or consequences of X.

Question 9

The scientific definition of X is not the ‘functional purpose’ of X, explain what this means.

Answer 9

Well, logically, you can talk about the function of a shoe but that is different to what the show actually is.

Question 10

The scientific definition of X, is not the (so-called) ‘measurement’ of X, explain what this means.

Answer 10

Measuring something, or finding the amount of something is NOT what that something is.

Question 11

The scientific definition of X, is not the ‘scientific classification’ of X, explain what this means.

Answer 11

Definition does not equal classification, these concepts are often confused in psychology.

Question 12

Why are ‘definitions’ and ‘classifications’ often confused in psychology?

Answer 12

Well, what is it to classify? We are constantly classifying according to our knowledge, needs and interests (e.g., my interest in alcohol means that I classify gins and wines and forget about the rest). In science, things are classified based on the type of thing they are according to their essential features. Different kinds may be grouped or classed together.
Scientific classification is most often based on what the things ARE (not their function, cause, etc.), so scientific classification depends on scientific definition.

Question 13

What does scientific classification depend on?

Answer 13

It depends on scientific definition because things are classified based on what they ARE, based on their essential and defining features.

Question 14

Why are some mental disorders in the DSM-5 polythetic?

Answer 14

Because they are defined by their diagnostic criteria or symptoms that may or may not be present in each case.

Question 15

In what sense is polythetic criteria of a mental disorder understandable?

Answer 15

For clinicians who need to make a diagnosis. BUT must understand that those criteria are NOT essential defining features and should not be used to construct a scientific system of classification.

Question 16

There is an area of mental health where polythetic mental disorders are useful, but to what other area must they NOT be extrapolated to?

Answer 16

Polythetic mental disorders may help with diagnosis (as they contain symptoms that may/may not be present) but they CANNOT be extrapolated to a scientific system or research as they do not have essential defining features.

Question 17

1. An issue with the DSM-5 is that it states what the disorder is (defines the disorder) by:

Answer 17

identifying the signs and symptoms of the disorder (which are NOT essential defining features).
The DSM-5 must be clear about the difference between a symptom and a definition.

Question 18

The DSM-5 must be clear about the difference between a…

Answer 18

… symptom and a definition.

Question 19

2. According to the 6 points that refer to what a scientific definition IS NOT, the DSM-5 wrongly states that the disorders are what (seven things)?

Answer 19

The DSM-5 wrongly states that disorders are:

a. the diagnostic criteria (signs/symptoms).
b. the behavioural effects of the disorder.
c. the behavioural effects of the sign/symptoms.
d. the phenomenology of the disorder (how it feels to have that disorder).
e. the causes of the disorder.
f. the examples/particular cases of the disorder.
g. the individual as the bearer of the disorder.

Question 20

What is the phenomenology of a disorder?

Answer 20

How it feels to have that disorder.

Question 21

3. The DSM-5 assumes that the diagnosing criteria are monothetic (real things), when actually…

Answer 21

they are polythetic, they may or MAY NOT be present.

Question 22

4. The DSM-5 assumes (what?) three factors are the scientific definitions of a mental disorder…

Answer 22

The DSM-5 assumes that:
a. clinical diagnosis;
b. operational definitions;
c. classifications;
are defining features of a mental disorder.

E.g., a clinical diagnosis is not the scientific definition of a disorder. But a clinical diagnosis is dependant on a separate scientific definition of a mental illness.

Question 23

Respond to this excerpt from the DSM-5: ‘the individual disorder definitions that constitute the operationalised sets of diagnostic criteria provide the core of DSM-5 for clinical and research purposes.’

Answer 23

How can the ‘individual disorder definitions’ be used for both clinical and research purposes?
It would be fine for just clinical purposes but to say the document is both a diagnostic and scientific document is a contradiction.

Question 24

2. Respond to this excerpt from the DSM-5: ‘… a too rigid categorical system (i.e., the disorders as discrete qualitative categories) does not capture clinical experience or important scientific observations.’

Answer 24

‘Categorical systems do not capture scientific observations’? This is the justification for using polythetic diagnostic criteria. Those systems are absolutely appropriate for clinical treatment but not for constructing scientific definitions.
They have conflated the clinical task with the scientific task.

Question 25

3. Respond to this excerpt from the DSM-5: ‘… the boundaries between many disorder “categories” are more fluid over the life course than DSM-4 recognised, and many symptoms assigned to a single disorder may occur… in many other disorders. These findings mean that DSM should accomodate ways to introduce dimensional approaches to mental disorders, including dimensions that cut across current categories.’

Answer 25

While there is a push to use dimensional approaches to diagnosis (because a lot of symptoms or diagnostic criteria appear in many different disorders) this might just indicate that the diagnostic criteria are not being used illegitametely, and are not actually measuring what they are supposed to measure so the symptoms are popping up across the board.

These confusions might not affect diagnosing clinicians but they might affect research… and the problems will get perpetuated and added to. When dimensionality is introduced, the problems in the DSM-5 will expand, like compound interest.

(‘if they change to dimensional, it will be even more of a dog’s breakfast’ - Fiona)

Question 26

What is the problem with dimensionality for diagnosis?

Answer 26

Diagnosing someone based on their symptoms across different disorders may not be so bad for a clinician but for a researcher the problems will get more confusing, added to more and will expand. It will be like compounding interest in the DSM-6.