Just finished my keynote at @conference_2021 on "Mental health: studying systems instead of syndromes". You can find slides & new preprint here: osf.io/bm6r5/. Really enjoyed making a completely new presentation from scratch.
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The first barrier to progress I talk about is diagnostic literalism and its consequences: while many of us don't believe in MDD or schizophrenia as "natural disease units" in the world, case-control research in our field is often carried out in that way.
I discuss some historical evidence on how arbitrary many of the categories and thresholds we have today in DSM-5 were, and that DSM-5 may look quite different today if minor things had gone differently.
This means diagnostic categories are not natural kinds.
But our field is not alone in having failed its ambitious mission to identify natural kinds: many nosologies are somewhat arbitrary (e.g. biological species, emotions, threshold for high blood pressure). That doesn't make these things less "real" or important.
The second barrier I talk about is reductionism, using the prominent example of biological reductionism. Reductionism is a useful heuristic tool, but has limited value in complex systems such as mental disorders.
Both barriers interact with each other in a vicious cycle: somewhat arbitrary diagnostic categories are reified because we identify (e.g. biological) correlates.
Moving forward, conceptualizing and studying mental disorders as complex systems offer many new opportunities because there is a rich field of complexity science with many theories and methods that may prove to be useful for mental research.
I discuss some features we can study from this perspective, such as emergence, early warning systems, phase transitions, stable states, and so on.
Thanks to @conference_2021 for inviting me to give a keynote; slides osf.io/bm6r5/.
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