Epistemology of mental disorders: A transversal perspective from naturalistic and constructivist metaphysics and the pragmatic approach

Jorge Romero-Castillo

doi:10.24310/escpsi.18.2.2025.20821

Autores/as

Jorge Romero-Castillo Universidad de Málaga España https://orcid.org/0000-0001-8366-6606

DOI:

https://doi.org/10.24310/escpsi.18.2.2025.20821

Palabras clave:

psicología clínica, enfermedad, trastornos mentales, ontología, filosofía de la medicina, psiquiatría

Resumen

¿Podemos afirmar que las nosologías actuales para los trastornos mentales son correctas? En este artículo, presento una minuciosa revisión epistemológica relacionada con los trastornos mentales y su conceptualización desde tres posiciones de la filosofía de la mente. Primero, abordo el enfoque naturalista, profundizando en la visión eliminativista de Szasz, la explicación bioestadística de Boorse y el modelo de disfunción dañina de Wakefield, a la vez que destaco las críticas generales dirigidas a este enfoque. En segundo lugar, analizo el enfoque constructivista y los argumentos propuestos para criticar y oponerse a la perspectiva naturalista, señalando también sus debilidades. En tercer lugar, expongo el enfoque pragmático, cuyas consideraciones ayudan a trascender la dialéctica y las confrontaciones entre el reduccionismo naturalista y el constructivismo sociocultural. Finalmente, resumo las principales conclusiones y respondo directamente a la pregunta principal de este artículo.

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Aftab, A. (2017). Mental disorders and naturalism. American Journal of Psychiatry Residents' Journal, 11(3), 10–12. https://doi.org/10.1176/appi.ajp-rj.2016.110304

Agich, G. J. (1997). Toward a pragmatic theory of disease. In James M. Humber & Robert F. Almeder (Eds.), What is disease? (pp. 219–246). Humana Press.

American Psychiatric Association [APA]. (2013). Diagnostic and Statistical Manual of mental disorders, 5th Edition (DSM-5). American Psychiatric Association Publishing.

Ash, M. G. (1980). Academic politics in the history of science: Experimental psychology in Germany, 1879–1941. Central European History, 13(3), 255–286.

Banner, N. F. (2013). Mental disorders are not brain disorders. Journal of Evaluation in Clinical Practice, 19(3), 509–513. https://doi.org/10.1111/jep.12048

Benning, T. B. (2016). No such thing as mental illness? Critical reflections on the major ideas and legacy of Thomas Szasz. BJPsych Bulletin, 40(6), 292–295. https://doi.org/10.1192/pb.bp.115.053249

Binney, N. (2024). Reference-Class Problems Are Real: Health-Adjusted Reference Classes and Low Bone Mineral Density. The Journal of Medicine and Philosophy: A Forum for Bioethics and Philosophy of Medicine, 49(2), 128–146, https://doi.org/10.1093/jmp/jhae005

Bingham, R. & Banner, N. (2014). The definition of mental disorder: evolving but dysfunctional? Journal of Medical Ethics, 40(8), 537–542. https://doi.org/10.1136/medethics-2013-101661

Boorse, C. (1977). Health as a theoretical concept. Philosophy of Science, 44(4), 542–573. https://doi.org/10.1086/288768

Brendel, D. H. (2003). Reductionism, eclecticism, and pragmatism in psychiatry: the dialectic of clinical explanation. The Journal of medicine and philosophy, 28(5-6), 563–580. https://doi.org/10.1076/jmep.28.5.563.18814

Cooper, R. (2002). Disease. Studies in History and Philosophy of Biological and Biomedical Sciences, 33(2), 263–282. https://doi.org/10.1016/S0039-3681(02)00018-3

Doust, J., Walker, M. J., & Rogers, W. A. (2017). Current dilemmas in defining the boundaries of disease. Journal of Medicine and Philosophy, 42(4), 350–366. https://doi.org/10.1093/jmp/jhx009

Engel, G. L. (1977). The need for a new medical model: a challenge for biomedicine. Science, 196(4286), 129–136. https://doi.org/10.1126/ciencia.847460

Gagné-Julien, A. M. (2021). Defending Social Objectivity for “Mental Disorder”. Philosophy, Psychiatry, & Psychology, 28(4), 381–384. https://doi.org/10.1353/ppp.2021.0058

Ghaemi, S. N. (2009). The rise and fall of the biopsychosocial model. The British Journal of Psychiatry, 195(1), 3–4. https://doi.org/10.1192/bjp.bp.109.063859

Graham, G. (2010). The disordered mind: An introduction to philosophy of mind and mental illness. Routledge.

Hershenov, D. B. (2020). A naturalist response to Kingma’s critique of naturalist accounts of disease. Theoretical Medicine and Bioethics 41, 83–97. https://doi.org/10.1007/s11017-020-09526-9

Hofmann, B. (2002). On the triad disease, illness and sickness. The Journal of medicine and philosophy, 27(6), 651–673. https://doi.org/10.1076/jmep.27.6.651.13793

Hollon, S. D., Stewart, M. O., & Strunk, D. (2006). Enduring effects for cognitive behavior therapy in the treatment of depression and anxiety. Annu. Rev. Psychol., 57(1), 285–315. https://doi.org/10.1146/annurev.psych.57.102904.190044

Insel, T., Cuthbert, B., Garvey, M., Heinssen, R., Pine, D. S., Quinn, K. J., Sanislow, C., & Wang, P. (2010). Research Domain Criteria (RDoC): Toward a new classification framework for research on mental disorders. American Journal of Psychiatry, 167(7), 748–751. https://doi.org/10.1176/appi.ajp.2010.09091379

Kelly, B. D., Bracken, P., Cavendish, H., Crumlish, N., MacSuibhne, S., Szasz, T., & Thornton, T. (2010). The Myth of Mental Illness: 50 years after publication: What does it mean today? Irish journal of psychological medicine, 27(1), 35–43. https://doi.org/10.1017/S0790966700000902

Kendler, K. S. (2005). Toward a philosophical structure for psychiatry. American Journal of Psychiatry, 162(3), 433–440. https://doi.org/10.1176/appi.ajp.162.3.433

Kendler, K. S. (2016). The nature of psychiatric disorders. World Psychiatry, 15(1), 5–12. https://doi.org/10.1002/wps.20292

Kingma, E. (2013). Naturalist accounts of mental disorder. In Bill KWM. Fulford, Martin Davies, Richard Gipps, George Graham, John Z. Sadler, Giovanni Stanghellini, & Tim Thornton (Eds.), The Oxford handbook of philosophy and psychiatry (pp. 363–384). Oxford University Press. https://doi.org/10.1093/oxfordhb/9780199579563.001.0001

Kirmayer, L. J., & Gold, I. (2011). Re‐socializing psychiatry: Critical neuroscience and the limits of reductionism. In S. Choudhury, & J. Slaby (Eds.), Critical neuroscience: A handbook of the social and cultural contexts of neuroscience (pp. 305–330). Wiley-Blackwell.

Klein, D. F. (1978). A proposed definition of mental illness. In Robert L. Spitzer & Donald F. Klein (Eds.), Critical issues in psychiatric diagnosis (pp. 41–71). Raven Press.

Kuhn, T. S. (1992). The trouble with the historical philosophy of science: Robert and Maurine Rothschild Distinguished Lecture. Cambridge: Department of the History of Science, Harvard University.

Laudan, L. (1981). A confutation of convergent realism. Philosophy of science, 48(1), 19–49.

Moynihan, R., & Henry, D. (2006). The fight against disease mongering: generating knowledge for action. PLoS medicine, 3(4): e191. https://doi.org/10.1371/journal.pmed.0030191

Müller, U., Fletcher, P. C., & Steinberg, H. (2006). The origin of pharmacopsychology: Emil Kraepelin’s experiments in Leipzig, Dorpat and Heidelberg (1882–1892). Psychopharmacology, 184, 131-138. https://doi.org/10.1007/s00213-005-0239-5

Nakao, M., Shirotsuki, K., & Sugaya, N. (2021). Cognitive–behavioral therapy for management of mental health and stress-related disorders: Recent advances in techniques and technologies. BioPsychoSocial medicine, 15(1): 16. https://doi.org/10.1186/s13030-021-00219-w

Nesse, R. M. (2005). Evolutionary psychology and mental health. En D. M. Buss (Ed.), The Handbook of Evolutionary Psychology (pp. 903–927). John Wiley & Sons.

Parnas, J., & Gallagher, S. (2015). Phenomenology and the interpretation of psychopathological experience. In L. J. Kirmayer, R. Lemelson, & C. A. Cummings (Eds.), Revisioning Psychiatry: Integrating Biological, Clinical and Cultural Perspectives (pp. 65–80). Cambridge University Press.

Pérez-Álvarez, M., Sass, L. A., & García-Montes, J. M. (2008). More Aristotle, less DSM: The ontology of mental disorders in constructivist perspective. Philosophy, psychiatry, & psychology, 15(3), 211–225. https://doi.org/10.1353/ppp.0.0192

Rashed, M. A. (2020). More things in heaven and earth: Spirit possession, mental disorder, and intentionality. Journal of Medical Humanities, 41, 363–378. https://doi.org/10.1007/s10912-018-9519-z

Saborido, C. (2020). Filosofía de la medicina. Tecnos.

Stein, D. J., Phillips, K. A., Bolton, D., Fulford, B. KWM., Sadler, J. Z., & Kendler, K. S. (2010). What is a mental/psychiatric disorder? From DSM-IV to DSM-V. Psychological medicine, 40(11), 1759–1765. https://doi.org/10.1017/S0033291709992261

Szasz, T. S. (1960). The myth of mental illness. American Psychologist, 15, 113–118. https://doi.org/10.1037/h0046535

Thakker, J., Ward, T., & Strongman, K. T. (1999). Mental disorder and cross-cultural psychology: A constructivist perspective. Clinical Psychology Review, 19(7), 843–874. https://doi.org/10.1016/S0272-7358(98)00077-4

Thornton, T. (2007). Essential Philosophy of Psychiatry. Oxford University Press.

Van Riel, R. (2016). What is constructionism in psychiatry? From social causes to psychiatric classification. Frontiers in Psychiatry, 7: 57. https://doi.org/10.3389/fpsyt.2016.00057

Wakefield, J. C. (1992). The concept of mental disorder: on the boundary between biological facts and social values. American psychologist, 47(3): 373. https://doi.org/10.1037//0003-066x.47.3.373

Wakefield, J. C. (2000). Spandrels, vestigial organs, and such: reply to Murphy & Woolfolk’s “the harmful dysfunction analysis of mental disorder”. Philosophy, Psychiatry, & Psychology, 7, 253–269.

Wakefield, J. C. (2007). The concept of mental disorder: diagnostic implications of the harmful dysfunction analysis. World Psychiatry, 6(3), 149–156.

Zachar, P. (2014). A metaphysics of psychopathology. MIT press.

Zachar, P. (2015). Psychiatric disorders: natural kinds made by the world or practical kinds made by us? World Psychiatry, 14(3), 288–290. https://doi.org/10.1002/wps.20240

Zachar, P., & Kendler, K. S. (2007). Psychiatric disorders: A conceptual taxonomy. American Journal of Psychiatry, 164(4), 557–565. https://doi.org/10.1176/ajp.2007.164.4.557