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精神疾病的解释模型。

Explanatory models for psychiatric illness.

作者信息

Kendler Kenneth S

机构信息

Virginia Institute of Psychiatric and Behavioral Genetics, Virginia Commonwealth University Medical School, Richmond, VA 23298-0126, USA.

出版信息

Am J Psychiatry. 2008 Jun;165(6):695-702. doi: 10.1176/appi.ajp.2008.07071061. Epub 2008 May 15.

Abstract

How can we best develop explanatory models for psychiatric disorders? Because causal factors have an impact on psychiatric illness both at micro levels and macro levels, both within and outside of the individual, and involving processes best understood from biological, psychological, and sociocultural perspectives, traditional models of science that strive for single broadly applicable explanatory laws are ill suited for our field. Such models are based on the incorrect assumption that psychiatric illnesses can be understood from a single perspective. A more appropriate scientific model for psychiatry emphasizes the understanding of mechanisms, an approach that fits naturally with a multicausal framework and provides a realistic paradigm for scientific progress, that is, understanding mechanisms through decomposition and reassembly. Simple subunits of complicated mechanisms can be usefully studied in isolation. Reassembling these constituent parts into a functioning whole, which is straightforward for simple additive mechanisms, will be far more challenging in psychiatry where causal networks contain multiple nonlinear interactions and causal loops. Our field has long struggled with the interrelationship between biological and psychological explanatory perspectives. Building from the seminal work of the neuronal modeler and philosopher David Marr, the author suggests that biology will implement but not replace psychology within our explanatory systems. The iterative process of interactions between biology and psychology needed to achieve this implementation will deepen our understanding of both classes of processes.

摘要

我们如何才能最好地构建精神疾病的解释模型呢?由于因果因素在微观层面和宏观层面都会对精神疾病产生影响,涉及个体内部和外部,且涉及从生物学、心理学和社会文化角度才能最好理解的过程,因此,追求单一广泛适用的解释性定律的传统科学模型并不适合我们这个领域。这类模型基于一种错误的假设,即精神疾病可以从单一角度去理解。对精神病学而言,一种更合适的科学模型强调对机制的理解,这种方法自然地契合多因果框架,并为科学进步提供了一个现实的范式,即通过分解和重新组装来理解机制。复杂机制的简单亚单位可以单独进行有效研究。将这些组成部分重新组装成一个功能整体,对于简单的加法机制来说很直接,但在精神病学中则要困难得多,因为因果网络包含多个非线性相互作用和因果循环。我们这个领域长期以来一直在努力应对生物学和心理学解释视角之间的相互关系。基于神经元建模者兼哲学家大卫·马尔的开创性工作,作者认为在我们的解释系统中,生物学将起到实施作用,但不会取代心理学。实现这种实施所需的生物学与心理学之间的迭代互动过程,将加深我们对这两类过程的理解。

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