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Crossing the Threshold: An Epigenetic Alternative to Dimensional Accounts of Mental Disorders

Serpico, Davide and Petrolini, Valentina (2023) Crossing the Threshold: An Epigenetic Alternative to Dimensional Accounts of Mental Disorders. British Journal for the Philosophy of Science. ISSN 1464-3537

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Abstract

Recent trends in psychiatry involve a transition from categorical to dimensional frameworks, in which the boundary between health and pathology is understood as a difference in degree rather than as a difference in kind. A major tenet of dimensional approaches is that no qualitative distinction can be made between health and pathology. As a consequence, these approaches tend to characterize such a threshold as pragmatic or conventional in nature. However, dimensional approaches to psychopathology raise several epistemological and ontological issues. First, we review major sources of evidence usually recruited in support of the dimensional trend (focusing on clinical observation and biological data), and we show that these are connected to different conceptualizations of how dimensional traits extend across health and pathology. Second, we criticize two unquestioned assumptions that stand at the core of the dimensional trend: a) that there is continuity from health to pathology at the symptomatic level; b) that such continuity reflects an underlying continuity in the genetic liability for pathological conditions. Third, we argue against the idea of a conventional threshold by showing that such a view implies a linear relationship between the genotype and the phenotype. Fourth, drawing on epigenetics and developmental biology, we offer a characterization of mental disorders as stable and dynamic constellations of multi-level variables that differ qualitatively from ‘healthy states’. We conclude by showing that our account has several theoretical advantages over both categorical and dimensional approaches. Notably, it provides crucial insights into psychological development over time and individual differences, with major implications in terms of intervention and clinical decision-making.


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Item Type: Published Article or Volume
Creators:
CreatorsEmailORCID
Serpico, Davide0000-0003-3997-3056
Petrolini, Valentina0000-0001-7666-2391
Keywords: Dimensions; Categories; Continuity thesis; Threshold; Health & Pathology; Behavioral Genetics; Epigenetic landscape; Epigenetics
Subjects: Specific Sciences > Biology > Developmental Biology
Specific Sciences > Biology > Molecular Biology/Genetics
Specific Sciences > Psychology > Developmental Psychology
Specific Sciences > Medicine > Health and Disease
Specific Sciences > Medicine > Psychiatry
Depositing User: Dr. Davide Serpico
Date Deposited: 22 Apr 2023 12:29
Last Modified: 22 Apr 2023 12:29
Item ID: 22008
Journal or Publication Title: British Journal for the Philosophy of Science
Official URL: https://www.journals.uchicago.edu/doi/10.1086/7251...
DOI or Unique Handle: https://doi.org/10.1086/725188
Subjects: Specific Sciences > Biology > Developmental Biology
Specific Sciences > Biology > Molecular Biology/Genetics
Specific Sciences > Psychology > Developmental Psychology
Specific Sciences > Medicine > Health and Disease
Specific Sciences > Medicine > Psychiatry
Date: April 2023
ISSN: 1464-3537
URI: https://philsci-archive-dev.library.pitt.edu/id/eprint/22008

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