Unreliability of Biological Evidence for Psychiatry

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Table of Contents

Introduction
Insufficiency of Diagnostic Manual
Unreliability of Biological Evidence
Conclusion
References

Introduction

Mental health issues are complex and multifaceted phenomena that are manifested under the influence of an array of internal (biological) and external (social and cultural) factors. In the era of celebrating diversity and individualism, clinical addressing of psychiatric conditions cannot be limited to the application of standardized procedures that neglect the context and individual particularities of patients (Shelder, 2019). For years, psychiatry has depended on biological evidence and diagnostic principles presented in manuals for assessing, identifying, and treating mental illnesses, which has triggered disagreements among professionals and academics about the usefulness of psychiatric diagnosis. Some claim the irrelevance and nonreliability of psychiatric diagnosis, which is illustrated by the unprecedented growth of mental illness prevalence in the USA (Oliver et al., 2019). This paper is designed to claim that the limitations of the psychiatric diagnosis on biological factors as the leading cause of psychosis are irrelevant due to the significance of the impact of social and cultural determinants on human mental health. To support this argument, the paper will include a discussion of the insufficiency of the currently used diagnostic manual and the unreliability of biological evidence for mental illnesses’ conceptualization.

Insufficiency of Diagnostic Manual

Since people function in complex social, cultural, and political contexts that influence their emotional involvement and psychological coping capabilities, the standardized approach to diagnosis from the perspectives of biological determinants lacks data sufficiency. In particular, the social context is commonly neglected in the Diagnostic and Statistical Manual of Mental Disorders (DSM), omitting life difficulties that people might find challenging to cope with (Steln, 2017). Similarly, Ryle (2019) states that given the inevitability of social and cultural influences, behavioral and emotional deviations should be considered a norm and not be regarded as a disorder subject to treatment with psychotropic medicines. Indeed, the DSM fails to input the cultural considerations, yet according to Crafa and Nagel (2020), how a person lives influences their behavior; the unity of culture, brain, and behavior implies the necessity of conceptualizing mental health beyond its biological manifestations and causes (Mirza et al., 2019). Thus, such a limited biology-based standardized approach to diagnosing mental illnesses without social and cultural contexts leads to an insufficiency of psychiatric diagnosis.

Indeed, there exist cultural practices that trigger behaviors perceived as pathological. For instance, lesbians, gays, bisexuals, and transgender (LGBT) individuals have a higher prevalence of anxiety disorders, depression, and suicide than the general population (Moleiro, 2018). Different cultures have varying levels of mental illness stigmatization and entail different emotional display patterns (Heuss et al., 2018; Mirza et al., 2019). Making a hasty generalization without understanding beliefs and values is a form of prejudice that might stigmatize populations of psychiatric patients.

Errors in diagnosis, underdiagnosis, and irrelevant treatment prescriptions are the indicators of the insufficiency of psychiatric diagnosis deprived of cultural and social contexts. In particular, the inaccuracy of diagnosing discrete and short-term episodes of mental illnesses is a manifestation of psychiatric diagnosis insufficiency. Indeed, the DSM states that in acute stress disorder, the presenting symptoms should be diagnosed within three months and last for not more than six months (Allsopp et al., 2020). Thus, duration constraints can make it challenging to determine the exact treatment needed for a disorder (Allsopp et al., 2020). For example, suppose a patient presents with signs and symptoms of post-traumatic stress disorder treatment. In that case, they might be wrongly diagnosed and encounter the same symptoms in the future, only complicating (Huda, 2019). Therefore, the diagnosis is inaccurate and leads to errors due to the contextless categorization of mental illnesses and a failure to clearly distinguish between disorders with similar symptoms in their early stages.

The lack of an individual approach implied in the DSM-based diagnosis leads to psychiatrists’ errors and negatively impacts the recovery of patients. Indeed, according to research, mental health specialists often prioritize meeting DSM criteria, assess for severity and not the duration or causes of the condition, and do not devote enough time to interviewing patients to inquire about their personal experience of disease (Allsopp et al., 2019; Paris, 2017). Thus, misdiagnosis is a significant concern that justifies the insufficiency of psychiatric diagnosis as the core for mental illness detection since symptoms are commonly used to justify a diagnosis and not determine a patient’s particular issue.

Unlike other medical fields, psychiatry is characterized by overlapping diagnoses, making it unhelpful to identify a specific illness. For instance, the symptoms of depression and bipolar are presented as almost similar, especially during the maniac stages (Silveira & Rockman, 2021). Similar experiences occur in several diagnostic categories. For example, major depressive disorder and bipolar are closely related in terms of their presentation and can be included in the symptoms of schizoaffective (Allsopp et al., 2019). Hallucination is a possible symptom of depression but is present in other disorders like schizophrenia and other psychosis (Ryle, 2019). The implication is that there are many diagnostic categories where the specific criteria for diagnosing one condition can still be used in explaining a different mental health issue.

The evidence on the unhelpfulness of psychiatric diagnosis shows a need for change in practice. Adopting alternative diagnosis models while refining the DSM practice is essential since the DSM is prone to misdiagnosis and overdiagnosis (Fritscher, 2020; Huprich, 2018). Moreover, more evidence links social context to troubling behaviors and psychological distress (Cromby, 2021). Several frameworks can help to integrate the biographic data, social context, and beliefs that influence mental health outcomes.

One such approach is the Power Threat Meaning framework (PTM), which prioritizes contextualization and personalization of mental illness diagnoses. In particular, this framework includes a set of questions that should be asked when diagnosing a specific case of illness from the perspective of three core concepts, namely power, threat, and meaning (The British Psychological Society, 2018). Firstly, a patient is asked to reflect on the different types of power, including social, political, ideological, and others, that have impacted their mental state. Secondly, they are asked to discuss how those factors impacted the person; thirdly, one should reflect on the meaning of those situations and experiences to the patient (The British Psychological Society, 2018). Based on these data, the patient is guided on the analysis of how they overcame the issue, what their strength is, and how this whole experience might be helpful in the future. In such a manner, this alternative diagnosis approach allows for setting one’s mental problem in the context of the patient’s life and personality particularities, allowing for more sustainable recovery and less stigmatization.

Unreliability of Biological Evidence

Biological evidence is an unreliable source of information for psychiatrists when they are identifying the cause of a client’s abnormal behavior due to its failure to contextualize the causes and manifestations of an illness. There exists a discrepancy between what the lab experiments indicate on the biological basis for mental illness and the objective particularities of patients’ conditions. Diagnosing theories used by mental health specialists are shaped by developments in laboratories and clinics (Harrington, 2020). Little concern about the epidemiology or developmental stages of the patient, which are vital in medicine, leads to bias (Thapar & Riglin, 2020). It is never apparent whether the symptoms came as a result of the mental disorder or psychosis. Sigmund Freud, widely regarded as the father of psychiatry, cautioned against the genetic predisposition to psychosis (Dalzell, 2018). Specifically, after his study with Daniel Paul Schreber, he concluded that the subjective biographical provided a better explanation for psychosis than the objective-biological (Dalzell 2018). Thus, given that the only way to diagnose psychosis is through the signs that the patient presents without etiology, the diagnosis is of no use.

There is still a struggle to make psychiatry a biological problem to lay down the groundwork for enhancing clinical practice. For example, Waters et al. (2018) found that long-term sleep deprivation might lead to hallucinations, a significant indicator for diagnosing an array of psychiatric conditions, including schizophrenia. Thus, a patient reporting hallucinating episodes might be wrongfully diagnosed with schizophrenia due to the lack of contextualization of the onset of their disorder (Diaconescu et al., 2019). Similarly, environmental factors such as trauma or living with emotionally unstable parents can precipitate a person to start presenting symptoms of psychosis (Konstantopoulou, 2021). Specialists claim that biographical data is better for identifying a person’s psychological disturbances than standardized biological evidence utilization (Dalzell, 2018; Gislason et al., 2021). Therefore, there is rarely biological epidemiology that can explain a psychotic episode to the full extent, leaving room for misinterpretation and misdiagnosis.

When applied in psychiatrist practice, biology fails to explain what is normal functioning for a given pathology resulting in more comorbidities of mental disorders. In particular, the unification of biological predeterminants of mental conditions does not indicate the cause of psychosis. Bornovalova et al. (2020) state that functional neural imaging is notoriously plagued, and biological substrates cannot account for psychosis. Thus, it is essential to understand psychopathology regarding variations of normality. For instance, knowing the variations in what is normal prevents pathologizing individual differences and shows how the process of adapting to new circumstances may cause a vicious cycle leading to psychopathology. Therefore, when treating mental illness with medications, pharmacologists target the symptoms of illnesses and fail to address their causes, which lie within the context of social and cultural settings (Arivazhahan et al., 2021; Mills & Strawn, 2020). Thus, mere reliance on biological evidence does not allow for the effective treatment of mental disorders, which justifies its limited capacity.

Another aspect that validates the unreliability of biological evidence for mental illness diagnosis is that laboratory tests for psychiatrists lack specificity and sensitivity to the underlying physiological characteristics that can be measured using biomarkers. The search for specific genetic characteristics has only associated some genes with a few mental illnesses (Saaty, 2019). However, most of such research on messenger Ribonucleic acid (mRNA) is useless and fails to give sufficient causes for particular disorders or symptoms (Yang et al., 2019). Recognizing the complexity of the diverse genome regulation over lifespan calls for more research on epigenetics.

Psychiatric practices sometimes rely on observing neurons in the brain to establish the basis for the biological cause of psychosis. However, research indicates that neural responses may vary across individuals based on their social-cultural differences (Hall et al., 2020). Moreover, other factors, including affective state, intentions, and tacit values, can interfere with a person’s neural responses. The biological reality is that neural circuits are nested in a complex system that can only be grasped by understanding the entire brain network (Bornovalova et al., 2020). This finding implies that the results from a patient of a given context may not be generalizable to others with similar disorders (Saaty, 2019). Similar symptoms can have different causes, changing implications, and dynamics for clinical prognosis and management.

Conclusion

In conclusion, using DSM and other diagnostic manuals is unhelpful as they cause people to be labeled as having a disease of the mind without a biological basis. The psychiatrists focus on checking if the client’s symptoms are a match for the criteria given for anxiety, schizophrenia, or any other disease. Often, there is little examination of the client’s developmental issues, trauma experience, or culture. Yet, the diagnosis is given without an etiology that proves the symptoms are a sign of illness. Moreover, biological treatments have multiple uses and are originally for managing neuroleptic conditions. The laboratory searches have no specificity needed to prove a biological. The arguments presented in the paper imply that psychiatrists should dismiss the diagnostic manual and reliance on biological evidence in their practice and continue research that will help understand individual differences while differentiating normal from abnormal.

References

Allsopp, K., Read, J., Corcoran, R., & Kinderman, P. (2019). Heterogeneity in psychiatric diagnostic classification. Psychiatry Research, 279, 15-22. Web.

Arivazhahan, A. (2021). Drug therapy of psychosis and mania. Introduction to Basics of Pharmacology and Toxicology, 1(1), 179-192. Web.

Bornovalova, M. A., Choate, A. M., Fatimah, H., Petersen, K. J., & Wiernik, B. M. (2020). Appropriate use of Bifactor analysis in psychopathology research: Appreciating benefits and limitations. Biological Psychiatry, 88(1), 18-27. Web.

The British Psychological Society. (2018). The power threat meaning framework: Guided discussion. Web.

Crafa, D., & Nagel, S. K. (2020). Traces of culture: The feedback loop between behavior, brain, and disorder. Web.

Cromby, J. (2020). Meaning in the power threat meaning framework. Journal of Constructivist Psychology, 35(1), 41-53. Web.

Cromby, J. (2021). The power threat meaning framework. The Palgrave Encyclopedia of Critical Perspectives on Mental Health, 1-11. Web.

Dalzell, T. G. (2018). Disposition to psychosis in Freud’s Schreber text. Freud’s Schreber Between Psychiatry and Psychoanalysis, 3(5), 27-66. Web.

Diaconescu, A. O., Hauke, D. J., & Borgwardt, S. (2019). Models of persecutory delusions: A mechanistic insight into the early stages of psychosis. Molecular Psychiatry, 24(9), 1258-1267. Web.

Fritscher, L. (2020). Advantages and Disadvantages of the Diagnostic Statistical Manual. Verywell Mind. Web.

Gislason, M. K., Kennedy, A. M., & Witham, S. M. (2021). The interplay between social and ecological determinants of mental health for children and youth in the climate crisis. International Journal of Environmental Research and Public Health, 18(9), 4573. Web.

Hall, G. N., Berkman, E., Zane, N., Leong, F., Hwang, W., Nezu, A. M., Nezu, C. M., Hong, J. J., Chu, J. P., & Huang, E. (2020). Reducing mental health disparities by increasing the personal relevance of interventions. Web.

Harrington, A. (2020). Mind fixers: psychiatry’s troubled search for the biology of mental illness. W W Norton.

Heuss, S. C., Schwartz, B. J., & Schneeberger, A. R. (2018). Second opinions in psychiatry: A review. Journal of Psychiatric Practice, 24(6), 434-442. Web.

Huda, A. S. (2019). The medical model in mental health: An explanation and evaluation. Oxford University Press, USA.

Huprich, S. K. (2018). Moving beyond categories and dimensions in personality pathology assessment and diagnosis. The British Journal of Psychiatry, 213(6), 685-689. Web.

Jain, S., Kuppili, P. P., Pattanayak, R. D., & Sagar, R. (2017). Ethics in Psychiatric Research: Issues and Recommendations. Indian Journal of Psychological Medicine, 39(5), 558-565. Web.

Konstantopoulou, G. (2021). The beginning of psychosis: Psychological and environmental factors that lead to psychosis and their relationship to biological factors. International Journal Of Medical Science And Clinical Research Studies, 01(09). Web.

Mills, J. A., & Strawn, J. R. (2020). Antidepressant tolerability in pediatric anxiety and obsessive-compulsive disorders: A Bayesian hierarchical modeling meta-analysis. Journal of the American Academy of Child & Adolescent Psychiatry, 59(11), 1240-1251. Web.

Mirza, A., Birtel, M. D., Pyle, M., & Morrison, A. P. (2019). Cultural differences in psychosis: The role of causal beliefs and stigma in white British and south Asians. Journal of Cross-Cultural Psychology, 50(3), 441-459. Web.

Moleiro, C. (2018). Culture and psychopathology: New perspectives on research, practice, and clinical training in a globalized world. Frontiers in Psychiatry, 9(3). Web.

Oliver, D., Reilly, T. J., Baccaredda Boy, O., Petros, N., Davies, C., Borgwardt, S., McGuire, P., & Fusar-Poli, P. (2019). What causes the onset of psychosis in individuals at clinical high risk? A meta-analysis of risk and protective factors. Schizophrenia Bulletin, 46(1), 110-120. Web.

Paris, J. (2017). Overdiagnosis in psychiatry: How modern psychiatry lost its way while creating a diagnosis for almost all of life’s misfortunes (2nd ed.). Oxford University Press, USA.

Radua, J., Ramella-Cravaro, V., Ioannidis, J. P., Reichenberg, A., Phiphopthatsanee, N., Amir, T., Yenn Thoo, H., Oliver, D., Davies, C., Morgan, C., McGuire, P., Murray, R. M., & Fusar-Poli, P. (2018). What causes psychosis? An umbrella review of risk and protective factors. World Psychiatry, 17(1), 49-66. Web.

Ryle, C. A. (2019). Risk and reasoning in clinical diagnosis: process, pitfalls and safeguards. Oxford University Press.

Saaty, T. L. (2019). The brain: Unraveling the mystery of how it works: The neural network process. RWS Publications.

Shelder, J. (2019). A psychiatric diagnosis is not a disease. Psychology Today. Web.

Silveira, J., & Rockman, P. (2021). Managing uncertainty in mental health care. Oxford University Press.

Steele, J. D., & Paulus, M. P. (2019). Pragmatic neuroscience for clinical psychiatry. The British Journal of Psychiatry, 215(01), 404-408. Web.

Steln, S. (2017). Diagnoses: Harmful or helpful? Psychology Today. Web.

Thapar, A., & Riglin, L. (2020). The importance of a developmental perspective in psychiatry: What do recent genetic-epidemiological findings show?Molecular Psychiatry, 25(8), 1631-1639. Web.

The University of Liverpool. (2022). Psychiatric diagnosis ‘is scientifically meaningless. ScienceDaily. Web.

Waters, F., Chiu, V., Atkinson, A., & Blom, J. D. (2018). Severe sleep deprivation causes hallucinations and a gradual progression toward psychosis with increasing time awake. Frontiers in Psychiatry, 9(4). Web.

Yang, Z., Zhou, D., Li, H., Cai, X., Liu, W., Wang, L., Chang, H., Li, M., & Xiao, X. (2019). The genome-wide risk alleles for psychiatric disorders at 3p21.1 show convergent effects on mRNA expression, cognitive function, and mushroom dendritic spine. Molecular Psychiatry, 25(1), 48-66. Web.

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