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1. does it exist independtly of ehatever anyone categorises it as such ?(e.g. increase in autism prevelence)
2. does it have an essence? ( e.g. specific neurobioloigcal dysfucntion )
3. how useful is it? does it help us acheve our classificatory goals? ( how peactical is the autism spectrum as a construct?)

essentialist view

social constructivis view

pragmatic view

mechanistic view

dominant view

exists whether ir not we recognizes it

has an essence that explains all its properties ( symptoms F1 F5)

emphasis on a single, well defined etiological agent

one baseline explanation explains all symptoms

1. we differ to much for one model to explain all variability
2. single and simple causal agent does not fit (not diverse and flexible enough )
3. we would need a model classification tht is flexible enough to explain all etiology and

variability

1. not enough scientific data

psychiatric diosrders are constructed by society and culture

no biological essence ( e.g. homosxuality in DSM II : an ego dystonic mental disorder...)

1. cultures have differences between themselves so then how can the same problems be the same all over the globe
2. ignores the genetic component , physiological and psychological factors that are ofthen shared among particular cases
3. relativism then we can just chage the disorders by changing the society

essentialist and social constructivist are about the first two dimensions ( exist independently and having an essence)

instrumentalist approach → third dimension

essentialist and social constructivist are about the first two dimensions ( exist independently and having an essence)

'realness' does not matter if we can integrate the disease category with well tested theories in genetics , physiology and cognitive science and cure the disorder

clasification proceeds by determining ehich categories best help us meet scientific and proffesional goals

1. does not get sidetracked into debates about metahysics
2. gives NO clar advice about how classification should be built
3. scientific and proffesional goals ( reliable testing , prognsotication, treatment, identification og genetic risk ) may change
4. what counts as a good classification may change as well

an explanation of a phenomenon or system in terms of its *components*, the components *operations* and theis *causal organization*

e.g. mechanistic expalantion of chemical neurotransmission

appeals to components ( e.g. ions and neurotansmitters)

and operations ( e.g. depolariizng and diffusing )

organized (together so they can preserve a signal across the space between cells )

Kendler invented the MPC model "mechanistic property cluster" model of mental disorder

focus on complex and multi level causal mechanisms that produce, undelie and sustain psychiatric syndromes

they cluster toghether beacuse of developmental evolutionarand physiological causal mechisms that ensure these properties instantiated togeher

may span several levels and include interconnected sympotms

individual symptoms interact to sustain th eother sympotpms characterisitc of the disorder

result = the disorder will appear more or less stable set of traits

are psychiatric disorders structurally and functionally decomposable ?

if they are functionally but not structurally decomposable network approach might be a viable alternative

1. functional decomposition
2. structural decomposition

**( organization )**

"decomposition involves developing a model of a system's behaviour by indentifing discrete component parts and their linear or wak non linear interactions"

**(components and operations)**

"localization that involves mapping those discrete components and interactions onto features of a physical system "

ignored in early stages of reseach

whole phenomenon is localized in a single part of the mechaism

network model consists of

1. nodes ( elements of the network )
2. edges ( connections between nodes )

many real world networks are so called " small world" networks ( Watts Strogatz)

most nodes are not neighbours, but can be reached form every other node by a small number of steps

Rathknopf (2015) Kostic (2020) ; network models ( distinct explanation )

1. network science approaches complexity head on
2. network science is particulary helpful in explaiing porperties of non decomposable sysems "

e.g. " betweenness" : measure of centrality in a graph based on shortest paths

compress what appears at firt to be hoplessly complex patterns of interaction into meaning variables

veriables considerable explanatory power

psychiatric disorders are networks of causally interacting symptoms

networkd can potentially also include relevant non symptom factors ( e.g. environemntal factors)

mental disorders are not just brain disorders

appeal to extended network structures as well as extended mechanisms

depends more on correlation which can give us an expectation of what will happen but not a medical solution

we can tell when a storm is coming and why but not what to do about it

the boundry problem : perhaps gambling machines , roulette tables abd casinos are also counterintuitive of gambling disorers

problem for both mechaistic and network approaches

recognises the potential relevance of many different cuaes ( no single essence expains everything we need to know)

1. takes into account th eporbabilistic repationship between relevant causal features and the cluster of overt symptoms
2. same cluster of symptoms may arise form different etiological, undelying or sustainin mechanisms in different cases

1. a behavioural or psychological syndorme or pattern that occurs in an individual
2. refelcts and undelying psychobiological dysfunction
3. the consequences of which are clinically significant distress (a painful symptom) or disability (impairemnt in one or more important areas of functioning )
4. must not be mearly and expected response to common stressors and losses ( e.g loss of loved one) or culturally sanctiones response to a partiuclar event ( e.g. trance states in religious rituals)
5. must not be primarly a result of social deviance or conflicts with soicety

### Self illness ambiguity

people with menatal ilness often have problems in distinguishing thier 'self' form their mental illness

feeling insecure about who you are, which essential characteristics belong to you, which triats, values, toughts and actions represent you best

ambiguity about whwere the self ends and the disease begins, charterized by questions like " what is mine and what belongs to my disorder"

1. agency
2. idendity
3. trajectory
4. history
5. perspective

am I in control or is my mental illness in control?

distinguishing self and other based on who you are or based on th emental ilness

sense of purpose and future based on you or the menatl illness

are who you are due to you or the illness

unique viewpoint becasue who you are or because you mental illness

self ambiguity is a common phenomenon → all kinds of life events may result in self ambiguity

clinical psychology, social psychology and sociology ; the extend to which peple feel " themseves" my fluctuate in a daily basis

over 91% participants did not feel like themselves or felt less like themselves every two months

1. people who had multiple jobs ot transition across jobs frequently may not feel like themselves in some work related contexts
2. authentic slef expirince and certianty about onself might fluctuate for sport fans depending on the chevmnt of their team
3. getting marries or becoming a parent might significantly affect whether and to what extent we feel like outselves
4. a particular life event in romatic breakup might expirinceambiguity regarding who they are→ migh even drastically change appearence or even lifestyle and values

priemrly results : self ambigurity in Agency, Identity and Trajectory

MS porgression related to more self ilness ambiguity and loss of self

take in consideration a multilayer network approach

1. reification
2. first person authority
3. group membership

mental disorders as entities or things ehich cause patient's symptoms → insead of reffering to the cluster of sympotms itelf

if patient also conciev this selves as things , they often struggle with how the two things are related to each other

self is the cuase of their depression or is it the result?

may question whether it is thei self or their diorde that is 'in change'

how we make sense of our expirinces, if they are unreliable and cannot be trusted ? lack of baseline

relying on knowledge and expertise of the 'experts' i.e clinicians or researchers

to what extend do you trust the expert's judhgemtn ? e.g. feeling autistic vs being autistic

who has the final say about slef illness relation the patient or the expert?

people rely on other people

use social cotexts to 'test' erther their new self 'fits'

other people can function as obstacles in the process of self resolving SIA

e.g. by being somone with autism you ener a gorup of people with autism so it would be complicated to change as they are your frinds

psychiatric classification systems are contex insensitive

being sad due to an event in your life vs a symptom of depression

psychoatric classification systems are also charaterized by hypo

the abstact form individual's life story ( development, history, biological events, risk factor )

people belive the descriptions apply specifically to them , tespite the fact that they apply to everyone

psychiatric classification descriptions are genral, lack detail and provinde no room for particula contingecies

when exposed to these, people attribute thier problems to suggested symptoms, underminding other, more peornal aspects of their lives

a "first peron laguage' is ebst to use when communicating about mental illness

person with schizophernia NOT schizophrenic perosn

some consider FP to be stigmatizing itself