Posted by Chairman_MAO on March 7, 2006, at 14:40:46
In reply to Re: oh, posted by linkadge on March 7, 2006, at 13:16:40
Dr. Kramer is not familiar with basic scientific epistemology, then. One is only allowed to make a positive scientific knowledge-claim regarding causal relations insofar as one is able to reason deductively from empirically validated propositions. Deductive reasoning entails making the claim that the conclusion could not be satisfied without the premeses being true. This is the spirit in which double-blind, placebo controlled studies are held as the most valuable evidence. Without a control group one can only reason inductively at best, and there are no firm rules for inductive reasoning. Dr. Kramer is conflating correlation with causation.
There has not been one cause of end-stage syphilis that does not feature a certain anatomical lesion detectable upon post-mortem examination. Indeed, a pathologist has no greater certainty that an individual's _behavior_ was due to syphilis than the presence of that lesion. The behavior is a symptom, not a cause. In the case of depression, Kramer is begging the question by treating the behavior as a symptom and then pointing to something which is merely a correlate with the symptom as a cause, e.g. low 5-HIAA levels. There are no data that I am aware of which shows that low 5-HIAA levels are anything but a CORRELATE of being depressed. That is, every conscious state has a complex neurobiological substrate; some folks who displayed depressive behavior turn out to have low 5-HIAA levels, some don't. In "real diseases", there is always an underlying set of pathologies without which the disease is not present. It would be absurd to say that someone who has low 5-HIAA levels and never claimed to be depressed nor acted depressed was depressed. There is no identified sine qua non of any mental illness; otherwise--as in neurosyphilis, Alzheimer's dementia, etc.--the behavior would be reclassified as symptoms of a neurological disorder. The psychiatric slight-of-hand involves taking what is considered to be the de facto pathology--such as drug addiction or depression-- and ascribing it to an underlying cause (it used to be demons, then humours, now it's biological, in keeping with the popular ideology of the time) which in reality is not a cause at all, but simply a correlate of the beahvior which is deemed pathological.Below a certain density of dopaminergic neurons in the substantia nigra (MNs) WILL PRODUCE Parkinson's disease symptomology. There is no case in which there is 90% loss of MNs does not exhibit Parkinsonism that I am aware of. The link between hypothyroidism and mood is a CORRELATE; supraphysiological doses of T4 have an antidepressant effect in many people with "normal" levels. This does not indicate a pathology per se, only a hormonal influence on one's affective state.
I will agree with Kramer only insofar as there is no evidence that rules out psychobiological pathology. Certainly it is likely that some people diagnosed with many different mental illnesses have some heretofore unrecognized neurobiological abberation. However, many people without so-called "mental illnesses" do as well. The problem with psychiatric reasoning is that the beahvior is used to infer the abberation, which the psychiatrist in turn appeals to when asked about the cause of the disorder. This is called begging the question, and it is the antithesis of sound scientific reasoning.
This problem is further confounded by the entire medical notion of the norm. What is "normal"? The "normal" range of testosterone concentration, for instance, is so broad that many men who screen as normal exhibit symptoms of hypogonadism. Surely this is in part because of receptor insensitivity as well as things we have yet to or--here's the rub--never will be able to quantify. Despite the claims made to the contrary, there is no notion in neuroscience of what a "chemical imbalance" would even look like.
That does not mean such a thing does not exist. However, most people choose scientific theories based upon a synergy of two fundamental principles: (1) (Bayes' Theorem) which involves evaluating the likelihood of hypotheses given the weight of various pieces of evidence. (2) Occam's Razor, which states that the simplest plausible explanation of a phenomenon is likely to be the correct one. Biopsychiatric sophistry violates both of these principles some if not most (or all) of the time.See:
http://www.szasz.com/manifesto.html
http://en.wikipedia.org/wiki/Bayesianism
http://www.peele.net/lib/blues.html
http://www.eliofrattaroli.com/main.asp
poster:Chairman_MAO
thread:613775
URL: http://www.dr-bob.org/babble/20060304/msgs/617077.html