Mental disorders are not brain disorders
Mental disorders are not brain disorders
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DOI：
10.1111/jep.12048
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发表时间：
2013-06-01
影响因子：
2.4
通讯作者：
Banner, Natalie F.
中科院分区：
文献类型：
--
作者：
Banner, Natalie F.
随着神经科学和遗传学的进步揭示了大脑结构、功能和精神障碍症状之间的复杂联系，有人呼吁重新配置精神病分类，将精神障碍概念化为大脑障碍。在本文中，我认为这种观点是错误的，我们识别精神障碍的水平是，也应该是，人，而不是大脑。这并不是要否定物理主义，或者说精神领域在某种程度上与物理领域不同，而是要表明精神障碍中出问题的地方是在人的层面上挑选出来的：它们的特点是违反了认识、理性、评价、情感、社会和道德规范。然而，随着我们对大脑的科学理解的进步，使大脑结构或功能中确定的神经生物学差异成为病理学指标的是它与人的这些行为的关联。与其将精神病学崩溃为生物医学，生物医学可能会受益于更接近精神病学的专业知识，因为它能够在关注人的同时，在他们的环境中容纳社会，心理和生物学解释。
As advances in neuroscience and genetics reveal complex associations between brain structures, functions and symptoms of mental disorders, there have been calls for psychiatric classifications to be reconfigured, to conceptualize mental disorders as disorders of the brain. In this paper, I argue that this view is mistaken, and that the level at which we identify mental disorders is, and should be, the person, not the brain. This is not to deny physicalism or argue that the mental realm is somehow distinct from the physical, but rather to suggest the things that are going wrong' in mental disorder are picked out at the person-level: they are characterized by breaches in epistemic, rational, evaluative, emotional, social and moral norms. However, as our scientific understanding of the brain becomes advanced, what makes an identified neurobiological difference in brain structure or functioning indicative of pathology is its association with these behaviours at the person-level. Instead of collapsing psychiatry into biomedicine, biomedicine may benefit from drawing closer to the expertise of psychiatry, as it is able to accommodate social, psychological and biological explanations while focusing on the person, within their environment.