Doctors without ‘Disorders’

2020 ◽  
Vol 94 (1) ◽  
pp. 163-184 ◽  
Author(s):  
Lisa Bortolotti

Abstract On one influential view, the problems that should attract medical attention involve a disorder, because the goals of medical practice are to prevent and treat disorders. Based on this view, if there are no mental disorders then the status of psychiatry as a medical field is challenged. In this paper, I observe that it is often difficult to establish whether the problems that attract medical attention involve a disorder, and argue that none of the notions of disorder proposed so far offers a successful demarcation criterion between medical and non-medical problems. As an illustration, I consider why delusions are considered pathological and whether they attract medical attention in virtue of being pathological, where ‘pathological’ stands for ‘being caused by a disorder’. Although there are several promising answers to what makes delusions pathological, available accounts of the pathological nature of delusions fail to distinguish delusions from other irrational beliefs that are not typically thought of as pathological; and cannot explain why delusions typically attract medical attention whereas other irrational beliefs do not.

2007 ◽  
pp. 5-27 ◽  
Author(s):  
J. Searle

The author claims that an institution is any collectively accepted system of rules (procedures, practices) that enable us to create institutional facts. These rules typically have the form of X counts as Y in C, where an object, person, or state of affairs X is assigned a special status, the Y status, such that the new status enables the person or object to perform functions that it could not perform solely in virtue of its physical structure, but requires as a necessary condition the assignment of the status. The creation of an institutional fact is, thus, the collective assignment of a status function. The typical point of the creation of institutional facts by assigning status functions is to create deontic powers. So typically when we assign a status function Y to some object or person X we have created a situation in which we accept that a person S who stands in the appropriate relation to X is such that (S has power (S does A)). The whole analysis then gives us a systematic set of relationships between collective intentionality, the assignment of function, the assignment of status functions, constitutive rules, institutional facts, and deontic powers.


2012 ◽  
Vol 18 (3) ◽  
pp. 219-232 ◽  
Author(s):  
Nancy Wolff ◽  
Jing Shi ◽  
Nicole Fabrikant ◽  
Brooke E. Schumann

Author(s):  
Mansour Abdulshafea ◽  
Abdul Hakim Rhouma ◽  
Nadeem Gire ◽  
Ali AlMadhoob ◽  
Usman Arshad ◽  
...  

Abstract Introduction There has been a global increase in the prevalence of common mental disorders (CMD), particularly in conflict hotspots. The limited amount of resources is one of the key barriers to effective treatment within Low- and Middle-income countries (LAMICs). The lack of service provision for mental health disorders in LAMICs has resulted in limited opportunities to conduct mental health research. Libya is a North African country that has suffered from ongoing conflict with the current political unrest in Libya further impacting the mental health of the population. Main text The aim of this review is to conduct a synthesis of evidence regarding the estimated prevalence and associated risk factors of CMD in Libya. A search was completed in the academic databases; PubMed, Medline, EMBASE, PsychINFO, CINHAL, and the Institute for Development, Research, Advocacy and Applied Care (IDRAAC) from inception to March 2020. Only studies that investigated prevalence and associated risk factors of CMD in Libya were included. A total of 219 studies were identified of which 15 met the inclusion criteria for the review. There were (n = 3) papers investigated the prevalence of depression, (n = 4) studies were focused on stress-related disorders and the remaining papers looked at both anxiety and depression. Statistically, sample sizes of the included studies ranged from (n = 41–13,031) for the prevalence studies (mean = 1188.6, median = 233). Conclusion The status of Libya as a conflict hotspot has led to a reduced level of epidemiological data on mental health, with a vital need to conduct research in CMD. Libya requires better clinical governance which can allow for more scientific research into CMD and enabling the Libyan government to develop evidence-based policy initiatives for CMD.


Author(s):  
Paula Byrne ◽  
Órla O’Donovan ◽  
Susan M Smith ◽  
John Cullinan

There has been a notable increase in the use of statins in people without cardiovascular disease but who may be at risk in the future. The majority of statin users now fall into this category but little research has focused exclusively on this group. Debate has ensued regarding medicating asymptomatic people, and processes described variously as medicalisation, biomedicalisation and pharmaceuticalisation are used to explain how this happens. These overlapping and interrelated processes require issues to be ‘problemised’ as medical problems requiring medical solutions given the prevailing understandings of health, risk and disease. However, current understandings of risk and disease are not simply the result of technological and scientific advances, they are also socially constructed. We interviewed members of the public, GPs and others, and found that rather than high cholesterol being seen as one of several risk factors that contributes to heart disease, it tended to be promoted simplistically to the status of a disease needing treatment of itself. Statins were justified by those taking them as different to ‘unnecessary medicines’. However, some participants demonstrated resistance to statins, worried about over-medicalisation and deviated from accepted practices, indicating a complex ‘muddling through’ in the face of uncertainty.


Author(s):  
Faye F. Didymus

The cognitive–behavioral model of psychotherapy holds cognition at the core of psychological problems and disorders. The theoretical foundations of this model imply that dysfunctional thinking is common to all psychiatric disorders, psychological problems, and medical problems with a psychological component, and that changing an individual’s cognition results in causal changes in emotions and behaviors. In addition, when working with the cognitive–behavioral model, practitioners acknowledge that ongoing cognitive formulation is the basis of effective practice; that working with an individual’s beliefs about themselves, the world, and others results in sustained change; and that neurobiological changes occur following cognitive–behavioral therapy (CBT). The cognitive–behavioral model has been successfully applied in many domains (e.g., clinical, occupational, and sport psychology) where interventions are framed around the beliefs that characterize a presenting issue. Cognitive restructuring is one technique for implementing CBT that has been applied in sport and performance psychology. This technique is particularly relevant to performance domains because of the focus on cognitive formulation; the underpinning associations between cognition, emotion, and behavior; and the links between positively valenced emotions and superlative performance. Findings of sport psychology research extend the application of CBT beyond clinical populations and highlight the usefulness of cognitive–behavioral approaches for optimizing experiences of and performance in sport. Some would argue that the first scientifically testable paradigm that was built on the cognitive–behavioral model of psychotherapy, and came chronologically slightly before CBT, is rational emotive behavior theory (REBT). Because both CBT and REBT share cognitive–behavioral roots, they have many similarities in their underpinning assumptions and in the ways that they are applied. REBT, however, focuses on rational and irrational beliefs and the links between an individual’s beliefs and his or her emotions and performance. REBT has a more philosophical focus with motivational theoretical roots when compared to other CBT approaches. Distinguishing features of REBT also lie in the techniques used and, hence, the way in which the underlying principles of the cognitive–behavioral model are applied. Disputing is the applied foundation of REBT and is a method of questioning an individual’s beliefs that generate emotional responses. This technique aims to help an individual recognize and adjust flaws in his or her thinking to work toward a more functional philosophy. Research that has used REBT in sport and performance contexts is sparse but that which does exist highlights the approach as a promising one for optimizing athletes’ beliefs and their emotional, behavioral, and physiological responses.


1988 ◽  
Vol 62 (2) ◽  
pp. 519-522 ◽  
Author(s):  
Ron L. Evans ◽  
Robert D. Hendricks ◽  
Kaye V. Lawrence

To estimate the relationship between mental health problems and use of medical resources, this study compared readmission rates of medical/surgical patients who had a comorbid psychiatric disorder with those who did not. Patients with mental disorders were no more likely to be readmitted for medical problems after their index hospitalization than patients without psychiatric comorbidity. Results may assist in determining whether to include psychiatric variables as risk factors that might predict poor outcome after medical care.


2020 ◽  
Vol 16 (2) ◽  
pp. 79-99
Author(s):  
Valentina Petrolini

Disorders of agency could be described as cases where people encounter difficulties in assessing their own degree of responsibility or involvement with respect to a relevant action or event. These disturbances in one’s sense of agency appear to be meaningfully connected with some mental disorders and with some symptoms in particular—i.e. auditory verbal hallucinations, thought insertion, pathological guilt. A deeper understanding of these experiences may thus contribute to better identification and possibly treatment of people affected by such disorders. In this paper I explore disorders of agency to flesh out their phenomenology in more detail as well as to introduce some theoretical distinctions between them. Specifically, I argue that we may better understand disorders of agency by characterizing them as dimensional. In §1 I explore the cases of Auditory Verbal Hallucinations (AVH) and pathological guilt and I show that they lie at opposite ends of the agency spectrum (i.e. hypoagency versus hyperagency). In §2 I focus on two intermediate cases of hypo- and hyper- agency. These are situations that, despite being very similar to pathological ones, may be successfully distinguished from them in virtue of quantitative factors (e.g. duration, frequency, intensity). I first explore the phenomenon of mind wandering as an example of hypoagency, and I then discuss the phenomenon of false confessions as an example of hyperagency. While cases of hypoagency exemplify situations where people experience their own thoughts, bodies, or actions as something beyond their control, experiences of hyperagency provide an illusory sense of control over actions or events.


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