Abstract
Although clinicians and researchers working in the field of autism are generally not concerned with philosophical categories of kinds, a model for understanding the nature of autism is important for guiding research and clinical practice. Contemporary research in the field of autism is guided by the depiction of autism as a scientific object that can be identified with systematic neuroscientific investigation. This image of autism is compatible with a permissive account of natural kinds: the mechanistic property cluster (MPC) account of natural kinds, recently proposed as the model for understanding psychiatric disorders. Despite the heterogeneity, multicausality and fuzzy boundaries that complicate autism research, a permissive account of natural kinds (MPC kinds) provides prescriptive guidance for the investigation of objective causal mechanisms that should inform nosologists in their attempt to carve autism’s boundaries at its natural joints. However, this essay will argue that a mechanistic model of autism is limited since it disregards the way in which autism relates to ideas about what kind of behavior is abnormal. As historical studies and definitions of autism show, normative issues concerning disability, impairment and societal needs have been and still are inextricably linked to how we recognize and understand autism. The current search for autism’s unity in neurobiological mechanisms ignores the values, social norms and various perspectives on mental pathology that play a significant role in 'the thing called autism’. Autism research needs to engage with these issues in order to achieve more success in the effort to become clinically valuable.
Highlights
A fundamental question in the philosophy of psychiatry is: What kind of things are psychiatric disorders? This issue is being discussed extensively in a philosophically oriented literature, but there is still no consensus as to the best answer
Can psychiatric disorders best be conceived of as; objects that exist in nature independent of psychiatric classifications; scientifically constructed tools or instruments that help to achieve important goals; or maybe as kinds that are brought into being by societies and cultures through the practice of classifying human behavior as distinct kinds?
Understandings and practices in the field of autism, I will argue, are compatible with a permissive account of natural kinds, namely the mechanistic property cluster (MPC) account of natural kinds recently proposed by Kendler, Zachar and Craver [5] as the model for understanding psychiatric disorders in general
Summary
A fundamental question in the philosophy of psychiatry is: What kind of things are psychiatric disorders? This issue is being discussed extensively in a philosophically oriented literature, but there is still no consensus as to the best answer. The historically and culturally variable boundaries of ‘impairment of social interaction’ or ‘a lack of ability to understand and use the rules governing social behaviour’— considered essential features of autism—are clearly not set by causal mechanisms This issue of setting the boundaries of autism is not just a matter of demarcating a coherent cluster of signs and symptoms, it is a matter of demarcating normality from pathology. The separation of the two demarcation problems in different criteria is compatible with an MPC model of psychiatric kinds, in which a behavioral or psychological syndrome or pattern (cluster) reflects underlying (psychobiological) mechanisms Whether it ‘deserves clinical attention’ (criterion B) can be approached as a separate issue. This may be close to impossible, but it is better to expose and explore this difficulty than to artificially restrict mental disorder to that which is ‘in an individual’ while ignoring societal aspects
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