Schleim Stephan
Theory and History of Psychology, Faculty of Behavioral and Social Sciences, Heymans Institute for Psychological Research, University of Groningen, Groningen, Netherlands.
Front Psychiatry. 2022 Aug 22;13:943049. doi: 10.3389/fpsyt.2022.943049. eCollection 2022.
Scientific attempts to identify biomarkers to reliably diagnose mental disorders have thus far been unsuccessful. This has inspired the Research Domain Criteria (RDoC) approach which decomposes mental disorders into behavioral, emotional, and cognitive domains. This perspective article argues that the search for biomarkers in psychiatry presupposes that the present mental health categories reflect certain (neuro-) biological features, that is, that these categories are as biological states or processes. I present two arguments to show that this assumption is very unlikely: First, the (both within and between subjects) of mental disorders is grossly underestimated, which is particularly salient for an example like Attention Deficit/Hyperactivity Disorder (ADHD). Second, even the search for the biological basis of (cognitive and emotional processes) than the symptom descriptions commonly used in mental disorder classifications has thus far been inconclusive. While philosophers have discussed this as the problem of mind-body-reductionism for ages, Turkheimer presented a theoretical framework comparing weak and strong biologism which is more useful for empirical research. This perspective article concludes that mental disorders are brain disorders in the sense of , but not biologism. This has important implications for psychiatric research: The search for reliable biomarkers for mental disorder categories we know is unlikely to ever be successful. This implies that biology is not the suitable taxonomic basis for psychiatry, but also psychology at large.
迄今为止，通过科学手段识别能够可靠诊断精神障碍的生物标志物的尝试均未成功。这激发了研究领域标准（RDoC）方法的产生，该方法将精神障碍分解为行为、情感和认知领域。这篇观点文章认为，在精神病学中寻找生物标志物的前提是，当前的心理健康类别反映了某些（神经）生物学特征，也就是说，这些类别是作为生物学状态或过程存在的。我提出两个论据来表明这种假设极不可能成立：第一，精神障碍的（个体内部和个体之间的）变异性被严重低估了，这在注意力缺陷多动障碍（ADHD）这样的例子中尤为明显。第二，即使是寻找比精神障碍分类中常用的症状描述更能反映（认知和情感过程）生物学基础的研究，迄今为止也尚无定论。虽然哲学家们长期以来一直将此作为身心还原论的问题进行讨论，但图尔肯海默提出了一个比较弱生物主义和强生物主义的理论框架，这对实证研究更有用。这篇观点文章的结论是，从某种意义上说，精神障碍是脑部疾病，但并非强生物主义所认为的那样。这对精神病学研究具有重要意义：寻找我们已知的精神障碍类别的可靠生物标志物不太可能成功。这意味着生物学并非精神病学，乃至整个心理学合适的分类基础。
