We are gratified at the largely positive comments on our essay on the dopamine hypothesis of schizophrenia (DHS) by these two distinguished commentators from the fields of biological psychiatry (Dr. Tamminga) and the philosophy of psychiatry (Dr. Murphy). There is little that they have said with which we disagree. Rather, we want to expand briefly on their commentaries.We found Dr. Tamminga's reactions to be particularly fascinating because she has been an "insider" to the story of the DHS as it has (...) unfolded. She provides substantial insight into the "extra-scientific" reasons for the persistence of the DHS despite its poor empirical record.She validates our impression that the DHS was in its first years of .. (shrink)

R. A. Duff has revived the tradition of “answerability” for crime. In this philosophical and jurisprudential tradition, a person is answerable to the criminal law of a state and the process of that state’s courts only if there is some appropriate relationship between the state and the person. Duff’s great contribution has been to develop the idea of accountability of persons to a state or other polity as a philosophical notion which, he argues, underlies all just implementations of criminal law. (...) Duff has centered his views around the relationship between the citizen and the polity (in today’s world, the state) to which the citizen belongs. His focus has been on insiders, rather than outsiders.This article argues that, in the current world, the relationship among cocitizens, outsiders, and the state is based in part on the moral idea that the state exists to protect citizens from evil acts, specifically those that we call public and criminal wrongs, wherever the acts originate. Outsiders understand this, and understand that states other than their own use criminal law to protect their citizens.Duff’s writings contain an idea which turns out to be very useful in cases of outside acts, even though he does not apply it directly to them. Some states or other entities may have only an incomplete relationship with an accused person (compared with the relationship of citizen and state), but nonetheless may have the moral and political authority to try her for crime. This paper extends this notion to show that such incomplete relationships exist in a great many common cases of outsiders (noncitizens who act outside the territory of a state) who commit crime. These relationships support criminal prosecution of outsiders, so long as we admit that protection of persons from crime is a legitimate goal of the criminal law. (shrink)

Levels of Analysis in Psychopathology draws research from psychiatry, philosophy, and psychology to explore the variety of explanatory approaches for understanding the nature of psychiatric disorders both in practice and research. The fields of psychiatry and clinical psychology incorporates many useful explanatory approaches and this book integrates this range of perspectives and makes suggestions about how to advance etiologic theories, classification, and treatment. The editors have brought together leading thinkers who have been widely published and are well-respected in their area (...) of expertise, including several developers of the Diagnostic and Statistical Manual of Mental Disorders and authors of the US National Institute of Mental Health's Research Domain Criteria Project (RDoC). Each main chapter has a commentary provided by one of the other authors and an introduction written by one of the editors to create an accessible, interdisciplinary dialog. (shrink)

A profession's values - including its ethical values - are reflected in the degree to which its structures are accessible to people with disabilities. The profession expresses its values through the decisions of its members to effectively address barriers to access or to maintain those barriers through action or inaction. What barriers can block access to the field for psychologists and psychology students with disabilities? What barriers can block access for people with disabilities to the services that psychologists provide? This (...) brief editorial notes three major kinds of such barriers. (shrink)

A dual relationship in psychotherapy occurs when the therapist engages in another, significantly different relationship with the patient. The two relationships may be concurrent or sequential. For both sexual and nonsexual dual relationships, men are typically the perpetrators and women are typically the victims. This article presents examples of dual relationships, notes the attention that licensing boards and other agencies devote to this topic, reviews the meager research concerning nonsexual dual relationships, and discusses common strategies that promote both sexual and (...) nonsexual dual relationships. (shrink)

Twelve-step programs such as Alcoholics Anonymous and Narcotics Anonymous invite members to trust that what is said in meetings remains confidential. However, the New York Times, a prominent and influential newspaper, has breached that confidentiality, offering both a precedent and a rationale to other media including newspapers, cable news programs, internet news blogs, and so on. This prominent breach may influence not only other news media but also the trust that 12-step members have in their programs.

Eunapius, pagan historian of the fourth century, wrote a history of the contemporary Roman Empire. Scholars have understood Eunapius'animosity toward Christianity as coloring his judgment and supplying him with a purpose for writing. Though his history did reflect contemporary religious tension, it is primarily shaped by traditional approaches to historiography. Eunapius attempts to analogize and explain human behavior in terms of the natural laws which pervade the history. His message is founded on classical values independent of current concerns; Eunapius inculpates (...) an apparently innocent pagan to prove one point. He was not only participant in the sectarian struggle which divided the Empire; he was also part of a thousand-year-old culture that served to unify it. (shrink)

E. T. Jaynes' resolution of Bertrand's paradox in terms of invariance principles is criticized. An experimental setup is considered which generates general solutions to Bertrand's problem by rotating a line around a point a distancer+d from a circle of radiusr. The general solution obtained is neither translationally nor scale invariant, but depends on the value ofr/d. Only in the limitr/d » 0, when the line is just translating across the circle, is the distribution translationally invariant and scale invariant. In this (...) limiting case the distribution found is just that obtained by Jaynes. (shrink)

Psychiatry has been subject to major changes in the last 150 years. This book explores the forces that have shaped these changes and how they have impacted on the psychiatric profession in this time. The result is a dynamic discussion about the nature of psychiatric disorders, and a book that is compelling reading.

This multidisciplinary collection explores three key concepts underpinning psychiatry -- explanation, phenomenology, and nosology -- and their continuing relevance in an age of neuroimaging and genetic analysis. An introduction by Kenneth S. Kendler lays out the philosophical grounding of psychiatric practice. The first section addresses the concept of explanation, from the difficulties in describing complex behavior to the categorization of psychological and biological causality. In the second section, contributors discuss experience, including the complex and vexing issue of how self-agency (...) and free will affect mental health. The third and final section examines the organizational difficulties in psychiatric nosology and the instability of the existing diagnostic system. Each chapter has both an introduction by the editors and a concluding comment by another of the book's contributors. Contributors: John Campbell, Ph.D.; Thomas Fuchs, M.D., Ph.D.; Shaun Gallagher, Ph.D.; Kenneth S. Kendler, M.D.; Sandra D. Mitchell, Ph.D.; Dominic P. Murphy, Ph.D.; Josef Parnas, M.D., Dr.Med.Sci.; Louis A. Sass, Ph.D.; Kenneth F. Schaffner, M.D., Ph.D.; James F. Woodward, Ph.D.; Peter Zachar, Ph.D. (shrink)

The revisions of both DSM-IV and ICD-10 have again focused the interest of the field of psychiatry and clinical psychology on the questions of nosology. This book reviews issues within psychiatric nosology from clinical, historical and particularly philosophical perspectives. It brings together an interdisciplinary group of distinguished authors.

Ethical theories grounded in utilitarianism suggest that social welfare is improved when agents seek to maximize others' welfare in addition to their own (i.e., are altruistic). However, I use a simple game-theoretic model to demonstrate two shortcomings of this argument. First, altruistic preferences can generate coordination problems where none exist for selfish agents. Second, when agents care somewhat about others' utility but weight their own more highly, total social welfare may be lower than with selfish agents even in the absence (...) of coordination problems. (Published Online April 18 2006) Correspondence:c1 105 St. George St., Toronto, Ontario M5S 3E6; kenneth[email protected]. Footnotes1 I thank Adam Brandenburger and Mara Lederman for helpful comments. (shrink)

The book attempts to develop an account of simplicity in terms of testability, and to use this account to provide an adequate characterization of induction, one immune to the class of problems suggested by Nelson Goodman. It is then shown that the past success of induction, thus characterized, constitutes evidence for its future success. A qualitative measure of confirmation is developed, and this measure - along with the considerations of simplicity - is used to provide an account of the consilience (...) of inductions, and also an inductivist account of the structure and progress of scientific theory. An appendix extends the treatment of simplicity to statistical distributions and provides a reasonable interpretation of the maximum entropy principle. Thus, this book is an attempt to characterize induction in terms of a well-defined notion of simplicity and to use that characterization as a basis of an account of empirical, and in particular, scientific reasoning. (shrink)

Psychotherapy holds out the promise of help for people who are hurting and in need. It can save lives and change lives. In therapy, clients can find their strengths and sense of hope. They can change course toward a more meaningful and healthy life. They can confront loss, tragedy, hopelessness, and the end of life in ways that do not leave them numb or paralyzed. They can discover what brings them joy and what sustains them through hard times. They can (...) begin to trust, or to trust more wisely. They can learn new behaviors in therapy and how to teach themselves new behaviors after therapy ends. They can question what they always believed was a given. They can find out what matters most to them, and how to stop wasting time. They can become happier, or at least less miserable. They can become better able, as Freud noted, to love and to work. They can learn how to accept and love themselves just as they are and accept others who are different from them. Our ethics acknowledge and affirm our profession's responsibilities. This book was written to help strengthen, deepen, and inform ethical awareness and the sense of personal ethical responsibility. Its job is to help you hold onto the ideals-including ethical ideals-that called you into the profession to begin with, to help you develop and fulfill those ideals. There will be so much-trust us on this-that tends to dull ethical awareness, to make ethics drift out of focus, to create barriers between you and your ideals, to replace ethics with pseudo-ethics and ethics placebos. Fatigue, endless paperwork, unrealistic expectations, illness, family crises, not being able to make ends meet, burn out, threats of job loss, insurance coverage that doesn't come close to meeting the needs of our clients, biases that have not been addressed, and so many other forces can pressure us into cutting ethical corners. This book is intended to help you develop a strong and healthy resistance to such forces, to help you weather them without losing your ethical awareness and ideals. (shrink)

This essay selectively reviews, from an historical and philosophical perspective, the dopamine (DA) hypothesis of schizophrenia (DHS; Table 1 lists the abbreviations used in this essay). Our goal is not to adjudicate the validity of the theory—although we arrive at a generally skeptical conclusion—but to focus on the process whereby the DHS has evolved over time and been evaluated. Since its inception, the DHS has been the most prominent etiologic theory in psychiatry and is still referred to widely in current (...) textbooks (e.g., Buchanan and Carpenter, Jr. 2005, 1336; Cohen 2003, 225; Gazzaniga 2004, 1257;Kandel et al. 2000, 1200). Understanding its origins and evolution should help to clarify the nature of modern .. (shrink)

The general consensus is that reform of medical malpractice law should be part of the health care system's overhaul. Medical malpractice litigation results in the expenditure of tens of billions annually, largely paid out of health care insurance funds and mostly paid to defendants' and plaintiffs' lawyers. By all accounts, this tort law regime ill serves the basic deterrence and compensation goals of civil liability. The causes and magnitude of these failings are disputed, and many typical reform proposals sidestep the (...) basic problems and may do more harm than good. In contrast, we advance a straightforward way to improve both deterrence and compensation. Essentially, the proposal is to remove current legal limitations on the scope of insurance subrogation that bar private and public health care insurers from “buying” the whole of their insureds' potential medical malpractice claims in exchange for lower premiums and taxes and expanded insurance coverage. Our proposal’s benefits accrue regardless of the cause and magnitude of the failings of malpractice law or the further reforms that might be adopted. (shrink)

Psychiatry has long struggled with the nature of its diagnoses. This book brings together established experts in the wide range of disciplines that have an interest in psychiatric nosology. The contributors include philosophers, psychologists, psychiatrists, historians and representatives of the efforts of DSM-III, DSM-IV and DSM-V.