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Valores, desacuerdo y clasificación psiquiátrica

Yafeng Wang
Institute of Philosophy, Chinese Academy of Sciences

Publicado 2025-03-05

Palabras clave

  • Values,
  • Value-Laden,
  • Expert Disagreement,
  • Value Conflict,
  • Psychiatric Classification
  • Valores,
  • Carga valorativa,
  • Desacuerdo entre expertos,
  • Conflicto de valores,
  • Clasificación psiquiátrica

Resumen

Se ha argumentado que los valores no epistémicos tienen roles legítimos en la clasificación de los trastornos psiquiátricos. Esta visión acerca de los valores en la clasificación psiquiátrica plantea preguntas sobre hasta qué punto los desacuerdos entre expertos sobre la clasificación psiquiátrica están alimentados por desacuerdos en torno a valores y hasta qué punto estos desacuerdos podrían resolverse. Este artículo aborda estas preguntas argumentando dos tesis. Primero, una fuente importante de desacuerdos sobre la clasificación psiquiátrica es fáctica y concierne a las consecuencias sociales que tendrá dicha clasificación. Este tipo de desacuerdo puede afrontarse mediante investigación empírica, aunque obtener y evaluar evidencia empírica relevante a menudo requiere colaboración interdisciplinar. Segundo, también existe un tipo de desacuerdo sobre juicios de valor; a saber, desacuerdos sobre cuáles deberían ser los objetivos prioritarios de la clasificación psiquiátrica. Para abordar este tipo de desacuerdo en torno a valores es útil desarrollar diferentes sistemas de clasificación psiquiátrica, cada uno dirigido a satisfacer un subconjunto diferente de objetivos de las partes involucradas.

Citas

  1. Aarseth, E., Bean, A. M., Boonen, H., Carras, M. C., Coulson, M., Das, D.,...van Rooij , A. J. (2017). Scholars’ open debate paper on the World Health Organization ICD-11 gaming disorder proposal. Journal of Behavioral Addictions, 6(3), 267-270. https://doi.org/10.1556/2006.5.2016.088
  2. Aftab, A., Banicki, K., Ruffalo, L. M., & Frances, A. (2024). Psychiatric dianogsis: A clinical guide to navigating diagnostic pluralism. The Journal of Nervous and Mental Disease, 212(8), 445-454.
  3. Biddle, J. B. (2016). Inductive risk, epistemic risk, and overdiagnosis of disease. Perspectives on Science, 24(2), 192-205. https://doi.org/10.1162/POSC_a_00200
  4. Biddle, J. B., & Kukla, R. (2017). The geography of epistemic risk. In K. C. Elliott, & T. Richards, Exploring inductive risk: Case studies of values in science (pp. 215-237). New York: Oxford University Press. https://doi.org/10.1093/acprof:oso/9780190467715.003.0011
  5. Billieux, J., King, D. L., Higuchi, S., Achab, S., Bowden-Jones, H., Hao, W., ....Poznyak, V. (2017). Functional impairment matters in the screening and diagnosis of gaming disorder. Journal of Behavioral Addictions, 6(3), 285-289. https://doi.org/10.1556/2006.6.2017.036
  6. Brewis, A., & Wutich, A. (2019). Lazy, crazy, and disgusting: Stigma and the undoing of global health. Johns Hopkins University Press.
  7. Brink, W. v. (2017). ICD-11 gaming disorder: Needed and just in time or dangerous and much too early? Journal of Behavioral Addictions, 6(3), 290–292. https://doi.org/10.1556/2006.6.2017.040
  8. Brown, M. J. (2020). Science and moral imagination: A new ideal for values in science. University of Pittsburgh Press.
  9. Carpenter, W. T. (2013). RDoC and DSM-5: What’s the fuss? Schizophrenia Bulletin, 39(5), 945-946. https://doi.org/10.1093/schbul/sbt101
  10. Casey, B., Craddock, N., Cuthbert, B. N., Hyman, S. E., Lee, F. S., & Ressler, K. J. (2013). DSM5 and RDoC: Progress in psychiatry research? Nature Rviews: Neuroscience, 14, 810-814. https://doi.org/10.1038/nrn3621
  11. Cohen, S. (2011). Folk devils and moral panics. Routledge.
  12. Cooper, R. (2005). Classifying madness: A philosophical examination of the Diagnostic and Statistical Manual of Mental Disorders. Springer.
  13. Cooper, R. (2007). Psychiatry and philosophy of science. Acumen.
  14. Cooper, R. (2012). Is psychiatric classification a good thing? In S. K. Kendler & J. Parnas, Philosophical Issues in Psychiatry II: Nosology (pp. 61-70). Oxford University Press. https://doi.org/10.1093/med/9780199642205.003.0011
  15. Cooper, R. (2016). First do no harm? What role should considerations of potential harm play in revising the DSM? Philosophy, Psychiatry, & Psychology, 23(2), 103-113. https://dx.doi.org/10.1353/ppp.2016.0010
  16. Cooper, R. (2017). Understanding the DSM-5: Stasis and change. History of Psychiatry, 29(1), 49-65. https://doi.org/10.1177/0957154X17741783
  17. Corrigan, P. W., Roe, D., & Tsang, H. W. (2011). Challenging the stigma of mental illness: Lessons for therapists and advocates. John Wiley & Sons. https://onlinelibrary.wiley.com/doi/book/10.1002/9780470977507
  18. Cuypers, V., & Reydon, T. A. (2023). An oak is an oak, or not? Understanding and dealing with confusion and disagreement in biological classification. Biology & Philosophy(38), 1-20. https://doi.org/10.1007/s10539-023-09925-x
  19. Cuypers, V., Reydon, T. A., & Artois, T. (2022). Deceiving insects, deceiving taxonomists? Making theoretical sense of taxonomic disagreement in the European orchid genus Ophrys. Perspectives in Plant Ecology, Evolution and Systematics, 56(125686). https://doi.org/10.1016/j.ppees.2022.125686
  20. Douglas, H. (2000). Inductive risk and values in science. Philosophy of Science, 67, 559-579. https://doi.org/10.1086/392855
  21. Etchells, P. (2019). Lost in a good game: Why we play video games and what they can do for us. Icon Books.
  22. First, M. B. (2012). The National Institute of Mental Health Research Domain Criteria (RDoC) project: Moving towards a neuroscience-based diagnostic classification in psychiatry. In K. S. Kendler, & J. Parnas, Philosophical Issues in Psychiatry II: Nosology (pp. 12-18). Oxford University Press. https://doi.org/10.1093/med/9780199642205.003.0003
  23. Fulford, B., Thornton, T., & Graham, G. (2006). Oxford textbook of philosophy of psychiatry. Oxford University Press. https://doi.org/10.1093/oso/9780198526940.001.0001
  24. Galanis, C., Delfabbro, P., & King, D. (2021). Stigma-related arguments against gaming disorder: A call for research. Addiction, 116, 2921-2926. https://doi.org/10.1111/add.15561
  25. Ghaemi, N. (2012). Taking disease seriously: Beyond “pragmatic” nosology. In K. S. Kendler, & J. Parnas, Philosophical Issues in Psychiatry II: Nosology (pp. 42-53). Oxford University Press. https://doi.org/10.1093/med/9780199642205.003.0008
  26. Griffiths, M. D. (2016). Gaming addition and internet gaming disorder. In R. Kowert, & T. Quandt, The video game debate: Unravelling the physical, social, and psychological effects of digital games (pp. 74-93). Routledge.
  27. Griffiths, M. D., Kuss, D. J., Lopez-Fernandez, O., & Pontes, H. M. (2017). Problematic gaming exists and is an example of disordered gaming. Journal of Behavioral Addictions, 6(3), 296–301. https://akjournals.com/view/journals/2006/6/3/article-p296.xml
  28. Hempel, C. (1965). Science and human values. In C. Hempel, Aspects of scientific explanation and other essays in the philosophy of science (pp. 81-98). The Free Press.
  29. Higuchi, S., Nakayama, H., Mihara, S., Maezono, M., Kitayuguchi, T., & Hashimoto, T. (2017). Inclusion of gaming disorder criteria in ICD-11: A clinical perspective in favor. Journal of Behavioral Addictions, 6(3), 293-295. https://doi.org/10.1556/2006.6.2017.049
  30. Horwitz, A. V. (2021). DSM: A history of psychiatry’s bible. Johns Hopkins University Press.
  31. Janzik, R., Wehden, L.-O., Reer, F., & Quandt, T. (2020). Gaming addiction—underdefined, overestimated? In M. Groen, N. Kiel, A. Tillmann, & A. Weßel, Games and ethics: Theoretical and empirical approaches to ethical questions in digital game cultures (pp. 47-59). Springer. https://doi.org/10.1007/978-3-658-28175-5_4
  32. Király, O., & Demetrovics, Z. (2017). Inclusion of gaming disorder in ICD has more advantages than disadvantages. Journal of Behavioral Addictions, 6(3), 280-284. https://doi.org/10.1556/2006.6.2017.046
  33. Kostko, A. (2019). Inductive risks and psychiatric classification. In Ş. Tekin, & R. Bluhm, The Bloomsbury companion to philosophy of psychiatry (pp. 197-215). Bloomsbury Academic.
  34. Kukla, B. (2019). Infertility, epistemic risk, and disease definition. Synthese, 196, 4409-4428. https://doi.org/10.1007/s11229-017-1405-0
  35. Kuss, D. J., Griffiths, M. D., & Pontes, H. M. (2017). Chaos and confusion in DSM-5 diagnosis of internet gaming disorder: Issues, concerns, and recommendations for clarity in the field. Journal of Behavioral Addictions, 6(2), 103-109. https://doi.org/10.1556/2006.5.2016.062
  36. Kuss, D. J., Griffiths, M. D., & Pontes, H. M. (2017). DSM-5 diagnosis of internet gaming disorder: Some ways forward in overcoming issues and concerns in the gaming studies field. Journal of Behavioral Addictions, 6(2), 133-141. https://doi.org/10.1556/2006.6.2017.032
  37. Lee, S.-Y., Cho, H., & Lee, H. K. (2017). Balancing between prejudice and fact for gaming disorder: Does the existence of alcohol use disorder stigmatize healthy drinkers or impede scientific research? Journal of Behavioral Addictions, 6(3), 302-305. https://doi.org/10.1556/2006.6.2017.047
  38. Lusk, G., & Elliott, K. C. (2022). Non-epistemic values and scientific assessment: An adequacy-for-purpose view. European Journal for Philosophy of Science, 12(35), 1-22. https://doi.org/10.1007/s13194-022-00458-w
  39. Müller, K. W., & Wölfling, K. (2017). Both sides of the story: Addiction is not a pastime activity. Journal of Behavioral Addictions, 6(2), 118-120. https://doi.org/10.1556/2006.6.2017.038
  40. Nemeroff, C. B., Weinberger, D., Rutter, M., MacMillan, H. L., Bryant, R. A., Wessely, S.,... Lysaker, P. (2013). DSM-5: A collection of psychiatrist views on the changes, controversies, and future directions. BMC Medicine, 11(202). https://doi.org/10.1186/1741-7015-11-202
  41. NIH. (2024, 9 7). Impact of the DSM-IV to DSM-5 Changes on the National Survey on Drug Use and Health. https://www.ncbi.nlm.nih.gov/books/NBK519704/table/ch3.t22/
  42. Petry, N. M., & O’Brien, C. P. (2013). Internet gaming disorder and the DSM-5. Addiction, 1186-1187. https://doi.org/10.1111/add.12162
  43. Petry, N. M., Rehbein, F., Gentile, D. A., Lemmens, J. S., Rumpf, H.-J., Mößle, T.,... O’Brien, C. P. (2014). Moving internet gaming disorder forward: A reply. Addiction, 109, 1412-1413. https://doi.org/10.1111/add.12653
  44. Petry, N. M., Rehbein, F., Gentile, D. A., Lemmens, J. S., Rumpf, H.-J., Mößle, T.,... O’Brien, C. (2014). An international consensus for assessing internet gaming disorder using the new DSM-5 approach. Addiction, 109(9), 1399-1406. https://doi.org/10.1111/add.12457
  45. Petry, N. M., Rehbein, F., Ko, C.-H., & O’Brien, C. P. (2015). Internet gaming disorder in the DSM-5. Current Psychiatry Reports, 17, 72. https://doi.org/10.1007/s11920-015-0610-0
  46. Pierre, J. M. (2013). Overdiagnosis, underdiagnosis, synthesis: A dialectic for psychiatry and the DSM. In J. Paris, & J. Phillips, Making the DSM-5: Concepts and controversies (pp. 105-124). Springer. https://doi.org/10.1007/978-1-4614-6504-1_8
  47. Rudner, R. (1952). The scientist qua scientist makes value judgments. Philosophy of Science, 20, 1-6. https://www.jstor.org/stable/185617
  48. Rumpf, H.-J., Achab, S., Billieux, J., Bowden-Jones, H., Carragher, N., Demetrovics, Z.,... Poznyak, V. (2018). Including gaming disorder in the ICD-11: The need to do so from a clinical and public health perspective. Journal of Behavioral Addictions, 7(3), 556-561. https://doi.org/10.1556/2006.7.2018.59
  49. Sadler, J. Z. (2013). Considering the economy of DSM alternatives. In J. Paris, & J. Phillips, Making the DSM: Concepts and controversies (pp. 21-38). Springer. https://doi.org/10.1007/978-1-4614-6504-1_2
  50. Saunders, J. B., Hao, W., Long, J., King, D. L., Mann, K., Fauth-Bühler, M.,... Poznyak, V. (2017). Gaming disorder: Its delineation as an important condition for diagnosis, management, and prevention. Journal of Behavioral Addictions, 6(3), 271-279. https://doi.org/10.1556/2006.6.2017.039
  51. Shadloo, B., Farnam, R., Amin-Esmaeili, M., Hamzehzadeh, M., Rafiemanesh, H., Jobehdar, M. M.,... Rahimi-Movaghar, A. (2017). Inclusion of gaming disorder in the diagnostic classifications and promotion of public health response. Journal of Behavioral Addictions, 6(3), 310-312. https://doi.org/10.1556/2006.6.2017.048
  52. Singh, M. (2024, May 6). Why we’re turning psychiatric labels into identities. Retrieved from The New Yorker: https://www.newyorker.com/magazine/2024/05/13/why-were-turning-psychiatric-labels-into-identities
  53. Starcevic, V. (2017). Internet gaming disorder: Inadequate diagnostic criteria wrapped in a constraining conceptual model. Journal of Behavioral Addictions, 6(2), 110-113. https://doi.org/10.1556/2006.6.2017.012
  54. Steel, D. (2009). Epistemic values and the argument from inductive risk. Philosophy of Science, 77, 14-34. https://doi.org/10.1086/650206
  55. van Rooij, A. J., & Kardefelt-Winther, D. (2017). Lost in the chaos: Flawed literature should not generate new disorders. Journal of Behavioral Addictions, 6(2), 128-132. https://doi.org/10.1556/2006.6.2017.015
  56. van Rooij, A. J., Ferguson, C. J., Carras, M. C., Kardefelt-Winther, D., Shi, J., Aarseth, E.,... Przybylski, A. K. (2018). A weak scientific basis for gaming disorder: Let us err on the side of caution. Journal of Behavioral Addictions, 7(1), 1-9. https://doi.org/10.1556/2006.7.2018.19
  57. Wakefield, J. C. (1992). The concept of mental disorder: On the boundary between biological facts and social values. American Psychologist, 47(3), 373-388. https://psycnet.apa.org/doi/10.1037/0003-066X.47.3.373
  58. Wakefield, J. C. (2015). DSM-5, psychiatric epidemiology and the false positives problem. Epidemiology and Psychiatric Sciences, 24, 188-196. https://doi.org/10.1017/S2045796015000116
  59. Werkhoven, S., Anderson, J. H., & Robeyns, I. A. (2022). Who benefits from diagnostic labels for developmental disorders? Developmental Medicine & Child Neurology, 64(8), 944-949. https://doi.org/10.1111/dmcn.15177
  60. WHO. (2020). Addictive behaviors: Gaming disorder. https://www.who.int/news-room/questions-and-answers/item/addictive-behaviours-gaming-disorder
  61. Widiger, T. A., & Samuel, D. B. (2005). Diagnostic categories or dimensions? A question for the Diagnostic Statistical Manual of Mental Disorders-fifth edition. Journal of Abnormal Psychology, 114(4), 494-504. https://psycnet.apa.org/doi/10.1037/0021-843X.114.4.494
  62. Zachar, P. (2002). The practical kinds model as a pragmatist theory of classification. Philosophy, Psychiatry, and Psychology, 9(3), 219-227. https://dx.doi.org/10.1353/ppp.2003.0051