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This 3 page Class Notes was uploaded by Melina Mermigas on Monday February 9, 2015. The Class Notes belongs to HPS0612 at University of Pittsburgh taught by in Spring2015. Since its upload, it has received 88 views.
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Date Created: 02/09/15
February 2 2015 Symptoms vs disease stances Review there is a set of symptoms that define the disease or there is an underlying cause that is uniform If you have all the conditions on the list you have the disease 0 If this is how you are thinking you can t raise the question of the accuracy because there is nothing else to define the illness besides this Realist view there is something REAL behind the disease What is known about the causes of schizophrenia The problem the brains of schizophrenics are usually abnormal in several ways 0 This makes it difficult to identify which one of the abnormalities cause the disease 0 To a considerable extent abnormalities don t seem to be specific to schizophrenia I They are found in schizophrenics but can also be found in other patients with other diseases The Nature of Brain Abnormalities in Schizophrenics frontal cortex temporal lobe cortex enlarged ventricles in these areas as well as inadequate functioning in the hippocampus dorsolateral prefrontal cortex impulse control higher planning 0 one of the things seen in schizophrenics is decreased blood ow to these areas 0 hippocampus and temporal lobe difficulty forming memories 0 lateral temporal neocortical areas abnormal in schizophrenics could be involved in auditory illusions hearing voices I dysfunction in the auditory functioning of the brain 0 Another abnormality the role of dopamine I Disturbed and hyperactive dopaminergic signal transduction Etiology of disease has to do with its cause Nosology branch of medicine that has to do with the classification of diseases Pickard defense to Scasz View Mental Illness is Indeed A Myth Natural Kind Plato s metaphor of cutting nature at the joints The ways of dividing nature so that you segment the world into categories in such a way that they are useful for scientific purpose Theory construction is rooted at the natural kind level makes it easier to make theories Sometimes natural kinds have a hidden nature or essence that lies behind and describes the superficial qualities that exist 0 Ex copper superficial would be shiny underneath more difficult to discover but describe WHY they are there CONNECT TO THE ARTICLE Is natural illness a natural kind Is there a hidden nature to the superficial labels we place on the disease When something is a natural kind Know the kind to which it belongs and you can predict other properties based off of this By contrast there is likely to be true for kinds or properties that are not natural the don t support inductive generalization Relevance to the bio medicine One may similarly ask whether various categories or classifications correspond to natural kinds Thinking of a disease with various symptoms on analogy with the apparent properties of copper o Is there some sort of underlying cause for it that is comparable to a natural kind For some disease this could be plausible Cholera various symptoms but there is a biological underlying cause that answers these symptoms Putnm s example Twin Earth and XYZ 0 Suppose we have another planet that is just like Earth in almost all respects 0 Substance that is found in bodies liquid Supposedly illustrates that whether substance is water is not determined by its superficial characteristics but rather its underlying nature or essence What we learn from this thought experiment is that our concept of water in not determined by the superficial property rather determined by underlying scientific properties such as chemical composition February 4 2015 Now do an analogous Thought Experiment with Schizophrenia We discover brain lesion with is extremely reliable correlated with schizophrenia 0 As characterized by its symptoms Regard the lesion as the underlying nature or essence of schizophrenia Then we encounter someone who has the lesion but not the symptoms Does this person have schizophrenia Pickard is skeptical that attempts to define disease and illness in terms of necessary and sufficient conditions are likely to prove fruitful Too many counterexamples and disease health too complex and protean Pickard Mixes facts and values Scientific status reason to be skeptical o Difficult to distinguish schizophrenia from other mental illness such as bipolar disorder The most candidates for underlying cause or nature for schizophrenia are facts about genes or brain structure Genetics some symptoms seem heritable Having a relative with schizophrenia does increase your chances however twin studies shows environment plays a role Reliability how much agreement among different clinicians in diagnosis or among different diagnostic procedures Exclusion rules and co morbidity gerry manding used to insure uniqueness of diagnosis that would not occur otherwise the carving up of the disease statistical studies seem to indicate a continuum between schizophrenia and bipolar disorder 0 scores do not cluster around two distinct poles Psychotic symptoms in the general and prodrome population Conclusion Pickard suggest that evidence for schizophrenia is NOT a natural kind So far we are unable to find some sort of underlying property whether genetic or biological that contributes to this disease Cluster B Personality disorders narcissistic histrionic borderline and anti social Often look like they involve moral failings or character defects These disorders make it possible to construct scientific explanations of the development of virtue and character Explains why group therapy may work Pickard says that Cluster B PD s involve failures of character of virtue Lack the virtues of patience moderation fairness and generosity trust and humility Issues that pertain to issues of virtue or character
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