精神障碍诊断演化中的机制属性簇转向

Shifting towards the Mechanistic Property Cluster in the Evolution of Mental Disorders Diagnosis

当代精神病学的《精神疾病诊断与统计手册》诊断是否符合自然类需求这一哲学问题依然存在争论。本质主义肯定《精神疾病诊断与统计手册》试图找到疾病的某种“本质”是自然类认知实践过程中的关键;机制属性簇理论却认为《精神疾病诊断与统计手册》无法作出刻画疾病“复杂系统”的形而上学承诺。结合疾病诊断演化分析,我们主张基于机制属性簇概念刻画精神障碍自然类。对比本质主义视角下分类困境,机制属性簇理论提供了更具解释力的因果机制概念来刻画精神障碍,并结合最近提出的研究领域标准范式在精神病学科学中践行。基于格伦南机制哲学阐释,精神障碍由机制类解构的必然性也将得以解释。

Whether contemporary psychiatric The Diagnostic and Statistical Manual of Mental Disorders(DSM)diagnoses conform to natural kinds remains a matter of debate.Essentialism affirms that the"essence"of the disease found by DSM is critical to the epistemic practice of natural kinds.However,mechanistic property cluster(MPC)argues that the model cannot describe the"complex system"of diseases.In this study,we advocate characterizing the natural kinds of mental disorder based on the MPC.Compared with the classification dilemma from an essentialist perspective,MPC uses a more explanatory concept of causal mechanism to characterize mental disorders,and has been embodied in scientific practice in combination with the recently proposed paradigm of Research Domain Criteria in psychiatry.Based on Glennan's philosophy of mechanisms,the inevitability of deconstructing psychiatric disorders into mechanistic classes will also be explained.