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naraburns  nihil supernum  1yr ago (text post)   32160 thread views

Culture War Roundup for the week of January 23, 2023

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Scott has posted a short article: You Don’t Want a Purely Biological, Apolitical Taxonomy of Mental Disorders.

Takeaway:

if “political correctness” sounds too dismissive, we can rephrase it as: “they want something that doesn’t think about ethics and practicality at all, but which is simultaneously more ethically correct and pragmatically correct than other taxonomies”.

Some of Scott’s best work comes from the tension between categories-as-descriptive and categories-as-prescriptive, so I’m pleased to see him tackling this subject.

He has a couple potentially spicy sentences which have been interspersed with extra letters to ward off journalists. Legends say they aren’t able to remove text without an invitation, preventing context-removal. A handful of commenters immediately proceed to demonstrate why this will do nothing to keep some people from thinking Scott is literally Hitler, but perhaps it will keep them from publishing that? I’m not optimistic this will keep an opportunistic editor from stripping out letters with no direct relevance unless they’re legally required to put “…” in their place.

What's interesting to me is that the statements in question mean the exact same thing in context as they would out of context.

"from N a N biological N point N of N view N, homosexuality N and N pedophilia N are probably N pretty N similar."

"the N relevant N difference N between N homosexuality N and N pedophilia N is N moral N, not N biological."

"So N, should N your N purely N biological N, apolitical N, taxonomy N of N mental N disorders N classify N homosexuality N as N a mental N illness, N or N should N it N refuse N to N classify N pedophilia N as N a N mental N illness?"

"That N means N that N a N purely N biological N apolitical N taxonomy N of N mental N disorders N which N classifies N all N things N with N similar N biological N causes N in N the N same N way N would N also N probably N classify N homosexuality N as N a N mental N disorder."

"Pedophilia N is N worse N than N homosexuality N, not N because N the N biology N necessarily N involves N different N processes N or N brain N regions, N but N because N it’s N important N for N your N sexual N partners N to N be N able N to N consent."

Amazingly, you can just quote all of the “PLEASE DON’T TAKE THIS OUT OF CONTEXT” sentences, in order, and get a perfectly functional 1-paragraph summary of the entire blog post.

I think his intention was to use that as an example of why biological definitions of mental illness were bad, not give the impression of homosexuality being wrong.

Slightly aside from this, is there even such a thing as a biologically defined mental illness? Is there a single mental illness that’s diagnosed with a blood test or some other empirical measurement that doesn’t involve a checklist of symptoms that the patient describes to the physician?

Sure.

There's a whole DSM section for substance abuse disorders. Alcohol/nicotine/opioid withdrawal are real, measurable things.

Or the variety of conditions with a single, specific response. REM Sleep Disorder is measured on a "polysomnograph." Actually, there's a bunch of sleep-specific ones. Elimination disorders like enuresis are also fairly obvious. For something like PTSD I imagine you could objectively measure a panic response.

Does an effective, selective drug count as evidence? Ex. prescribing antipsychotics seems like a rather objective way to measure schizophrenia.

I'd argue that you could count certain behavioral disorders as empirical. It's not a lab test, but if someone compulsively gambles all his money away, he doesn't have to tell the physician it's a disorder. Likewise for the paraphilias.

Plus, at a certain point, it just gets lumped into physical illnesses. Rabies includes anxiety, hallucinations, and fear of water or blowing air on one's face. It's diagnosed with virus isolation. Obviously, it doesn't get counted as a mental illness on account of all the non-mental symptoms.

To the question of an effective drug counting, I would say no. I’m more concerned that there is a physiological symptom from which the supposed mental condition is diagnosable.

I’m not sure that someone having a physiological withdrawal symptom from a substance to which they’re addicted would count either as someone who is not an addict will still experience those.

The sleep disorders seem a better candidate.

I’m more concerned that there is a physiological symptom from which the supposed mental condition is diagnosable.

Things like Down Syndrome, Parkinson's disease, Huntington's disease etc. can be. I'm guessing your asking this question, because you don't really view them as mental illnesses and are gerrymandering the category to only include things not easily physiologically measurable. The DSM doesn't do that and includes these things.

I’m just thinking it through out loud.

My family has a lot of mental illness of the OCD and bipolar type, and those family members insist this is a well understood science and then make claims that seem essentially religious. I’m feeling out the edges of where measurable physiological issue versus vague “chemical imbalance?” meet.

Want to share what those claims are exactly? Hard to know if they’re backed by science or not without actually seeing them.

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