Seminar on History and Philosophy of Science

Abstract: Over the past few decades there have been increasingly common claims that psychiatry is in a "crisis" (Hyman 2013; Morgan 2015; Poland and Tekin 2017). These claims often target the lack of known causal etiologies for psychiatric disorders and suggest that they are "among the most intractable enigmas in medicine" (Sullivan, Daly, and O'Donovan 2012, 537). The intractable nature of these disorders is often associated with their "causal complexity," but it is not always clear exactly what is meant by this (Poland and Tekin 2017, 5). While scientists use a variety of terms to refer to causal complexity (e.g. multifactorial causality, multicausality, heterogeneous causation, and systemic causation), they often fail to define these terms and they can use them inconsistently. In the philosophical literature, causal complexity is frequently acknowledged and discussed, but this literature lacks a clear taxon-omy of types of complexity and how they relate to medicine and explanations of psychiatric disease.
These points raise a number of questions. First, how should we understand causal com-plexity in this domain? Second, how does causal complexity challenge scientific efforts to understand and explain these diseases? In this talk, I address these questions by providing an analysis of causal complexity. I argue that there are at least two main types of causal complexity present in psychiatry that challenge efforts to understand and explain disease. My analysis clarifies (1) what these types of causal complexity are, (2) how they challenge efforts to understand and explain these disorders, and (3) how scientists are working to over-come these challenges. A key feature of this analysis is that these types of complexity arise when diseases fail to meet an accepted model of disease causation that figures in modern medical theory.