transdiagnostic processes

[From Bill Powers (2008.10.09.1041 MDT)]

Martin Taylor 2008.10.09.10.21 --

I agree with both you and Jeff Vancouver. Always try to improve the old constructs, but keep a strainer over the drain.

The problem with prescientific constructs is that they are primarily subjective and descriptive: "depression" feels like being pressed down, but of course nothing is pressing down on the person except metaphorically. We have to examine all these traditional constructs with one question in mind: what is wrong with a person who presents these appearances and reports these experiences? If you say a person "has" "schizophrenia," what, exactly, is it that this person does and experiences differently from other people -- and what is wrong with doing and experiencing those things? If a person is "anxious," don't ask what the persion is anxious about, because that assumes that there is a definition of anxiety, which there isn't: there are synonyms, but no definitions. Ask what it is that this person feels and thinks and tries to do unsuccessfully.

In addition to this, remember that a construct of the traditional kind is a dead end as far as explanations are concerned. If you say that a person's problem is that of having low self-esteem, you're saying that low self-esteem is the explanation of the problem. But what is causing the low self-esteem? Is this just a condition you catch, like a cold, or an inherited problem like sickle-cell anemia? Or. much more likely, is it a manifestation of a process that can be traced deeper and farther back in time? The same goes for the current fads in finding neurotransmitters that, because of excesses or deficiencies, cause psychological or physiologial problems. A real explanation has to be traced back to the actual independent variable; you have to ask what is making the level of neurotransmitter too high or too low. And I suspect that if you trace far enough, you will quite often find, instead of an independent variable, one of the variables whose state you were trying to explain. You'll find that the causal chain is a closed loop.

There seems to be a new movement afoot called "transdiagnostic processes", which makes the radical proposal that what goes wrong with people might not be confined to the traditional boundaries of "disorders." In effect, this is a recognition that traditional categories are (in the absence of any fundamental theories) essentially arbitrary and ideosyncratic to the diagnoser. If we were to find that a person who is depressed has some of the same disabilities as a person with schizophrenia and a person with anxiety, that would raise the suspicion that these three categories actually slice through several of the dimensions in which the real problems exist. This would make traditional assessments look similar to trying to explain why some cars ran fast and other ran slowly in a race by analyzing their colors. Yes, blue cars run demonstrably slower than green ones, or perhaps the other way around, p < 0.05, but that is completely irrelevant as an explanation. See Martin's example of explaining why cars bunch up on a road, if you didn't notice the stop light.

So while I can agree with Jeff and Martin that we must be careful not to discard useful aspects of tranditional constructs, we should not get lazy or defensive about them just because they seem important. Other ways of looking at problems may turn out to be much more important.

Best,

Bill P.

[From Bill Powers (2008.10.10.1211 MDT)]

Hi there, funny I have just given a workshop today on the
transdiagnostic approach, along with pct and mol. I began it asking
everyone to tell me their favourite bird which I then classified on
the board. I asked - is it morally acceptable to classify birds - yes.
Is it valid - yes - a robin is still a robin a week later. But how
useful is it if you want to understand how birds fly? You need to know
about control and aerodynamics for that. Or if you find a bird with a
broken wing, does knowing it is a sparrow help you look after it?
maybe a little - dont feed it eagle food - but it classification does
not explain shared mechanisms and how to promote them. Does that help?

Yes, that gets closer to the reasons for the transdiagnostic movement. I think that what we're both saying is that to understand what's wrong with a system, you have to go down a level, not up toward greater abstraction. If the bird's wing is broken, it doesn't help us to understand what is wrong if we say that this exemplar of an avian species is in a State of Impaired Self-ELevation CAPacities -- it has a "siselcap" disorder.

I think that CBT goes a little in this direction, in analyzing a person's problems in concrete terms rather than general concepts. But of course in CBT, the wrong person does the analyzing. I wonder, though, if we aren't overlooking something in thinking that MOL always must go up levels. Goalwise, yes, but perceptionwise, maybe not always. Just conjecturing ...

Best,

Bill P.

ยทยทยท

At 05:54 PM 10/10/2008 +0100, Warren Mansell wrote:

On 10/9/08, Bill Powers <powers_w@frontier.net> wrote:
> [From Bill Powers (2008.10.09.1041 MDT)]
>
> Martin Taylor 2008.10.09.10.21 --
>
> I agree with both you and Jeff Vancouver. Always try to improve the
> old constructs, but keep a strainer over the drain.
>
> The problem with prescientific constructs is that they are primarily
> subjective and descriptive: "depression" feels like being pressed
> down, but of course nothing is pressing down on the person except
> metaphorically. We have to examine all these traditional constructs
> with one question in mind: what is wrong with a person who presents
> these appearances and reports these experiences? If you say a person
> "has" "schizophrenia," what, exactly, is it that this person does and
> experiences differently from other people -- and what is wrong with
> doing and experiencing those things? If a person is "anxious," don't
> ask what the persion is anxious about, because that assumes that
> there is a definition of anxiety, which there isn't: there are
> synonyms, but no definitions. Ask what it is that this person feels
> and thinks and tries to do unsuccessfully.
>
> In addition to this, remember that a construct of the traditional
> kind is a dead end as far as explanations are concerned. If you say
> that a person's problem is that of having low self-esteem, you're
> saying that low self-esteem is the explanation of the problem. But
> what is causing the low self-esteem? Is this just a condition you
> catch, like a cold, or an inherited problem like sickle-cell anemia?
> Or. much more likely, is it a manifestation of a process that can be
> traced deeper and farther back in time? The same goes for the current
> fads in finding neurotransmitters that, because of excesses or
> deficiencies, cause psychological or physiologial problems. A real
> explanation has to be traced back to the actual independent variable;
> you have to ask what is making the level of neurotransmitter too high
> or too low. And I suspect that if you trace far enough, you will
> quite often find, instead of an independent variable, one of the
> variables whose state you were trying to explain. You'll find that
> the causal chain is a closed loop.
>
> There seems to be a new movement afoot called "transdiagnostic
> processes", which makes the radical proposal that what goes wrong
> with people might not be confined to the traditional boundaries of
> "disorders." In effect, this is a recognition that traditional
> categories are (in the absence of any fundamental theories)
> essentially arbitrary and ideosyncratic to the diagnoser. If we were
> to find that a person who is depressed has some of the same
> disabilities as a person with schizophrenia and a person with
> anxiety, that would raise the suspicion that these three categories
> actually slice through several of the dimensions in which the real
> problems exist. This would make traditional assessments look similar
> to trying to explain why some cars ran fast and other ran slowly in a
> race by analyzing their colors. Yes, blue cars run demonstrably
> slower than green ones, or perhaps the other way around, p < 0.05,
> but that is completely irrelevant as an explanation. See Martin's
> example of explaining why cars bunch up on a road, if you didn't
> notice the stop light.
>
> So while I can agree with Jeff and Martin that we must be careful not
> to discard useful aspects of tranditional constructs, we should not
> get lazy or defensive about them just because they seem important.
> Other ways of looking at problems may turn out to be much more important.
>
> Best,
>
> Bill P.
>

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