SPECIFIC ETIOLOGY AND OTHER FORMS OF STRONG INFLUENCE - SOME QUANTITATIVE MEANINGS
SPECIFIC ETIOLOGY AND OTHER FORMS OF STRONG INFLUENCE - SOME QUANTITATIVE MEANINGS
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DOI：
10.1093/jmp/2.1.33
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发表时间：
1977-01-01
影响因子：
1.6
通讯作者：
MEEHL, PE
中科院分区：
文献类型：
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作者：
MEEHL, PE
近年来出现了一些具有重大道德、法律和政策重要性的问题，促使哲学界倾向于寻求澄清“疾病”和“疾病实体”的含义。例如，关于“精神疾病”是否正确称呼的争议（例如，参见 Ausubel 1961；Szasz 1961）以及非自愿民事承诺的相关问题（Livermore，Malmquist 和 Meehl 1968）或对刑事指控的精神错乱辩护（Livermore 和 Meehl 1967；Goldstein 1967；一般参见 Brooks 1974；Miller 等人，2016 年）。 1976）。当前关于遗传和社会学习因素在精神分裂症病因中的作用的学术争议的解决（参见 Gottesman 和 Shields，正在出版，以及其中引用的参考文献）似乎仅部分取决于进一步的事实；它还取决于（在我看来，越来越多地）分类学（类型学、“实体”类）概念与推测的经验因果解释之间关系的方法论澄清。行为矫正传统中的一些临床医生认为（非常错误地）他们强大的技术方法与精神病学疾病分类学不相容，并且（甚至更错误地）用疾病实体术语解释行为倾向在某种程度上是前科学的、同义反复的或循环的。另一个例子是，人们对批评科赫的病因学立场及其历史替代方案（Penn 和 Dworkin 1976）重新产生了兴趣，以及当前对疾病的生态学、经济学和社会学的重视。对这些问题（尤其是遗传精神病理学中的混乱）的反思使我相信，特定病因学的有些模糊概念是我们当代困惑的原因之一，并且值得努力梳理和形式化它的一些组成部分和种类。不言而喻，我并不认为解决上述问题是一项努力；我
In recent years several issues, some of great moral, legal, and policy importance, have arisen which impel the philosophically inclined to seek clarification about the meaning of" disease" and" disease entity." Examples are the controversy over whether" mental illness" is properly so called (see, eg, Ausubel 1961; Szasz 1961) and the related questions of involuntary civil commitment (Livermore, Malmquist, and Meehl 1968) or the insanity defense to a criminal charge (Livermore and Meehl 1967; Goldstein 1967; see generally Brooks 1974; Miller et al. 1976). Resolution of current scholarly dispute concerning roles of genetic and social learning factors in the causation of schizophrenia (see Gottesman and Shields, in press, and references cited therein) appears to hinge only partly on getting further facts; it also hinges (in my view, increasingly) on methodological clarification of the relation between a taxonomic (typological," entity"-like) concept and conjectured empirical causal explanations of it. Some clinicians in the behavior-modification tradition believe (quite wrongly) that their powerful technological approach is incompatible with psychiatric nosology and (even more wrongly) that explanation of behavior dispositions in disease-entity terms is somehow prescientific, tautologous, or circular. Revival of interest in criticizing Koch's etiological position and its historical alternatives (Penn and Dworkin 1976) and the related current emphasis upon the ecology, economics, and sociology of disease is another example. Reflection upon these matters (especially the confusions in genetic psychopathology) persuades me that the somewhat fuzzy notion of specific etiology is one cause of our contemporary puzzlement and that an effort to tease apart and formalize some of its components and varieties would be worthwhile. It goes without saying that I so not see such an endeavor as solving the list of problems above; I