Some ‘naturalist’ accounts of disease employ a biostatistical account of dysfunction, whilst others use a ‘selected effect’ account. Several recent authors have argued that the biostatistical account offers the best hope for a naturalist account of disease. We show that the selected effect account survives the criticisms levelled by these authors relatively unscathed, and has significant advantages over the BST. Moreover, unlike the BST, it has a strong theoretical rationale and can provide substantive reasons to decide difficult cases. This (...) is illustrated by showing how life-history theory clarifies the status of so-called diseases of old age. The selected effect account of function deserves a more prominent place in the philosophy of medicine than it currently occupies. _1_ Introduction _2_ Biostatistical and Selected Effect Accounts of Function _3_ Objections to the Selected Effect Account _3.1_ Boorse _3.2_ Kingma _3.3_ Hausman _3.4_ Murphy and Woolfolk _4_ Problems for the Biostatistical Account _4.1_ Schwartz _5_ Analysis versus Explication _6_ Explicating Dysfunction: Life History Theory and Senescence _7_ Conclusion. (shrink)

Accounts of the concepts of function and dysfunction have not adequately explained what factors determine the line between low‐normal function and dysfunction. I call the challenge of doing so the line‐drawing problem. Previous approaches emphasize facts involving the action of natural selection (Wakefield 1992a, 1999a, 1999b) or the statistical distribution of levels of functioning in the current population (Boorse 1977, 1997). I point out limitations of these two approaches and present a solution to the line‐drawing problem that builds (...) on the second one. (shrink)

Naturalistic accounts of mental disorder aim to identify an objective basis for attributions of mental disorder. This goal is important for demarcating genuine mental disorders from artificial or socially constructed disorders. The articulation of a demarcation criterion provides a means for assuring that attributions of 'mental disorder' are not merely pathologizing different forms of social deviance. The most influential naturalistic and hybrid definitions of mental disorder identify biological dysfunction as the objective basis of mental disorders: genuine mental...

Despite many authors in psychiatry endorsing a naturalist view of the mind, many still consider that mental dysfunctions cannot be reduced to brain dysfunctions. This paper investigates the main reasons for this view. Some arguments rely on the analogy that the mind is like software while the brain is like hardware. The analogy suggests that just as software can malfunction independently of hardware malfunctions, similarly the mind can malfunction independently of any brain malfunction. This view has been critically examined in (...) recent literature. However, other less discussed reasons suggest that mental dysfunctions cannot be reduced to brain dysfunctions because mental dysfunctions are appropri- ately ascribed at the level of intentional mental states, while brain dysfunctions are solely related to abnormalities in anatomy and physiological processes. This paper questions why such a view would be upheld. The discussion is framed within the interface problem in the philosophy of cognitive science, which concerns the relationship between personal and subpersonal levels of explanation. The paper examines the view that an autonomist perspective on the personal/ subpersonal distinction could justify the separation of mental dysfunctions, described in intentional terms, from brain dysfunctions, described in anatomical or physiological terms. Ultimately, the paper argues that the autonomist view cannot be upheld in psychiatry and, consequently, does not provide a principled justification for rejecting the reduction of mental dysfunctions to brain dysfunctions. (shrink)

This paper criticizes Jerome Wakefield’s harmful dysfunction analysis of disorder by arguing that the conceptual linkage it establishes between the medical concepts of health and disorder and the prudential notions of well-being and harm makes the account inapplicable to nonsentient organisms, such as plants, fungi, and many invertebrate animals. Drawing on a previous formulation of this criticism by Christopher Boorse, and noting that Wakefield could avoid it if he adopted a partly biofunction-based account of interests like that often advocated (...) in the field of environmental ethics, I argue that integrating such an account of interests into the HDA would generate serious concerns. Specifically, it would make dysfunction sufficient for disorder and so reestablish between dysfunction and disorder precisely the kind of sufficiency relation that harm-requiring accounts of disorder strive to avoid; blur the line between the HDA’s dysfunction and harm components and, in so doing, deprive the HDA of its alleged main advantage over monistic dysfunction-based accounts of disorders like Boorse’s; and tie the HDA to an understanding of harm that is in itself problematic. I argue that these three concerns, and the dilemmas they generate, rob the HDA of much of its prima facie appeal, ultimately indicating that a satisfactory account of disorder should most likely eschew all references to prudential notions of well-being and harm. (shrink)

Scientists, philosophers, and even the lay public commonly accept that schizophrenia stems from a biological or internal ‘dysfunction.’ However, this assessment is typically accompanied neither by well-defined criteria for determining that something is dysfunctional nor empirical evidence that schizophrenia satisfies those criteria. In the following, a concept of biological function is developed and applied to a neurobiological model of schizophrenia. It concludes that current evidence does not warrant the claim that schizophrenia stems from a biological dysfunction, and, in (...) fact, that unusual neural structures associated with schizophrenia may have functional or adaptive significance. The fact that current evidence is ambivalent between these two possibilities (dysfunction versus adaptive function) implies that schizophrenia researchers should be much more cautious in using the ‘dysfunction’ label than they currently are. This has implications for both psychiatric treatment as well as public perception of mental disorders. (shrink)

This paper presents the interpersonal variability of harm challenge to Jerome Wakefield’s harmful-dysfunction account (HDA) of disorder. This challenge stems from the seeming fact that what promotes well-being or is harmful to someone varies much more across individuals than what is intuitively healthy or disordered. This makes it at least prima facie difficult to see how judgments about health and disorder could, as harm-requiring accounts of disorder like the HDA maintain, be based on, or closely linked to, judgments about (...) well-being and harm. This interpersonal variability of harm challenge is made salient by the difficulty faced by harm-requiring accounts of disorder in dealing satisfactorily with cases of intuitively disordered conditions that seem harmless because they do not deprive the individuals that they affect of anything that they value (e.g., desired infertility). I argue that this challenge is made more serious for the HDA by some clarifications Wakefield has recently made on harm. In recent publications, Wakefield dissociates himself from the sheer cultural-relativist view of harm attributed to him by some critics based on his linkage of harm to social values, and adopts a more qualified social-values-based view of harm that leaves room for criticism of the values endorsed by members of a cultural group at a given time. I show how Wakefield’s qualified view makes it more difficult for the HDA to deal with the interpersonal variability of harm challenge, at least when applied to a Western cultural context where a high value is placed on autonomy and individual choice. (shrink)

Counterfactual thinking—the capacity to reflect on what would, could, or should have been if events had transpired differently—is a pervasive, yet seemingly paradoxical human tendency. On the one hand, counterfactual thoughts can be comforting and inspiring (Carroll & Shepperd, Chapter 28), but on the other they can be anxiety provoking and depressing (Zeelenberg & Pieters, Chapter 27). Likewise, such thoughts can illuminate pathways toward better future outcomes (Wong, Galinsky, & Kray, Chapter 11), yet they can also promote confusion and lead (...) us astray (Sanna, Schwarz, & Kennedy, Chapter 13). The first part of this chapter focuses on work that supports the prevailing Zeitgeist in the counterfactual thinking literature: Counterfactual thinking is beneficial. The second part of the chapter, however, strikes a more cautionary tone by reviewing work that describes some deleterious consequences of counterfactual thinking. We conclude by offering a tentative reconciliation of these conflicting perspectives and suggesting directions for future research. (shrink)

According to Jerome Wakefield’s harmful dysfunction account, a mental disorder must involve an objective dysfunction couched in evolutionary terms. However, selected effects functions are indeterminate because (i) the same trait can be both selectively advantageous and disadvantageous, and (ii) the functional activity of a trait can be assessed according to conflicting norms, given the trait’s place in a hierarchy of functions. Therefore, there may be a dysfunction that can be described in multiple empirically adequate ways. The choices (...) involved in these cases are value-laden. Some cases of addiction may fit this mold, involving indeterminacy that invites opposing value judgments. (shrink)

One way in which bioethicists can benefit the medical community is by clarifying the concept of disorder. Since insurance companies refer to the DSM for whether a patient should receive assistance, one must consider the consequences of one’s concept of disorder for who should be provided with care. I offer a refinement of Jerome Wakefield’s hybrid concept of disorder, the harmful dysfunction analysis. I criticize both the factual component and the value component of Wakefield’s account and suggest how they (...) might be improved. I propose that the factual component should be statistical variation analyzed in multilevel and chronological compilations of physiological data. I propose that the value component should prioritize the individual’s authority regarding the experience of suffering from a physiological condition. My account preserves the insight of using a factual and a value component while avoiding the problems that Wakefield’s original account faces. (shrink)

This treatise proposes a comprehensive diagnostic framework for Social Media Syndrome (SMS), conceptualized as a constellation of psychological, cognitive, and behavioral disturbances arising from moderate to excessive social media engagement. Drawing upon empirical research in neuropsychology, developmental psychology, and clinical psychology, alongside theoretical frameworks from Jungian depth psychology and psychodynamic theory, this paper examines the mechanisms through which social media platforms induce pathological states. The analysis integrates three domains of dysfunction: (a) affective dysregulation encompassing anxiety, depression, and mood instability; (...) (b) cognitive impairment, including attention fragmentation, reduced executive function, and diminished critical thinking capacity; and (c) identity pathology characterized by persona proliferation, false self-development, and individuation arrest. Central to this framework is the dopaminergic reward system's hijacking through variable-ratio reinforcement schedules, social comparison mechanisms, and the externalization of self-worth to quantified metrics. This paper argues that SMS represents a novel form of psychopathology warranting clinical recognition, distinct from but related to internet addiction disorder. Proposed diagnostic criteria, theoretical grounding in the False Self-Persona Proliferation Framework, and intervention recommendations are presented. The treatise concludes that SMS constitutes a structural assault on ego coherence and individuation, requiring multi-level intervention across individual, cultural, and technological domains. (shrink)

High blood pressure is an important component of pre-eclampsia. The underlying mechanism of development of hypertension in pre-eclampsia is complicated and still remains obscure. Several theories have been advanced including endothelial dysfunction, uteroplacental insufficiency leading to generalized vasoconstriction, increased cardiac output, and sympathetic hyperactivity. Increased blood flow and pressure are thought to lead to capillary dilatation, which damages end-organ sites, leading to hypertension, proteinuria and edema. Additional theories have been put forward based on epidemiological research, implicating immunological and genetic (...) factors. None of these theories have been substantiated. Based on a review of literature this paper postulates that the initiating event for the development of preeclampsia is intermittent hypoxia associated with irregular breathing during sleep, hypoapnea, apnea,inadequate respiratory excursions during the waking hours and inadequate cardiopulmonary synchronization (abnormal sympatho-vagal balance). (shrink)

Parkinson’s disease is a common movement disorder associated primarily with oxidative stress-mediated degeneration of dopaminergic neurons. Earlier studies showed that Sorghum bicolor-based supplement (SbS) exhibited antioxidant and neuroprotective activities and might likely rescue the death of dopaminergic neurons in Parkinson’s disease. This study examined the effect of SbS on rotenone-induced Parkinsonian-like motor deficits in rats and the involvement of oxidative stress and pro-inflammatory cytokines. Rats were divided into six groups and treated orally with sunflower oil (vehicle-control), rotenone (2.5 mg/kg) alone (...) or in combination with each dose of SbS (50, 100, and 200 mg/kg) and levodopa-carbidopa (10 mg/kg) on an alternate day for 28 days. The changes in motor functions were evaluated on day 28 and the brain concentrations of oxidative stress biomarkers and pro-inflammatory cytokines (tumor necrosis factor-alpha and interleukin-6) were determined. Rotenone caused motor deficits by impaired locomotor activity in the open field test and induced catalepsy in the bar test, which were attenuated by SbS. Rats pretreated with SbS had reduced brain levels of malondialdehyde, nitrite, and pro-inflammatory cytokines compared to rotenone controls. SbS mitigated rotenone-induced depletion of reduced glutathione and antioxidant enzymes in the rat brain. The results suggest that SbS ameliorated rotenone-induced Parkinsonian-like motor dysfunctions by reducing neuronal oxidative stress and pro-inflammatory cytokines in rats. (shrink)

This chapter examines how different kinds of images have been deployed in disparate medical contexts to render long-term fatigue—an elusive and quintessentially intangible pathological physical and mental condition—visually communicable and epistemically explorable in the mid-twentieth and early ­ twenty-first centuries. First, by focusing on two disparate case studies, we intend to perform in-depth analyses of select context-specific uses of images in mediating the production and dissemination of biomedical knowledge of fatigue in different historical contexts. Second, through such an unusual juxtaposition (...) of two mutually independent case studies, each written by a separate author, we want to exemplify the heterogeneity of context-specific functions that diverse images have fulfilled in the medical discourse on fatigue. To achieve this twofold aim, we selected two case studies from different historical periods and medical contexts, characterized by different conceptual framings of fatigue and the use of different types of images, whose separate analyses necessitated employing two different methodological approaches. (shrink)

Abstract This paper explores the metaphor of politics as a game of basketball in which both players and referees repeatedly violate the rules, resulting in a descent into chaos comparable to mixed martial arts (MMA). The analogy serves as a framework to analyze how systemic corruption, weak institutions, and moral decay erode democratic governance. Drawing on real-world examples from multiple political systems, this paper argues that the violation of ethical and institutional rules in politics undermines public trust, polarizes societies, and (...) destabilizes governance. It concludes by proposing a return to integrity, accountability, and adherence to the universal law of balance as foundational principles for restoring harmony in governance. -/- . (shrink)

Psychiatric conditions are commonly regarded as mental disorders or dysfunctions of the mind. Yet there is a wealth of historical theorizing about the mind that conceives of these conditions as, in some sense, a matter of design rather than dysfunction. This intellectual legacy is the topic of Justin Garson’s penetrating study, Madness: A Philosophical Exploration (2022). In this paper, I interpret Garson’s book as a genealogy (in the Foucauldian sense) of the “anti-tradition” that he labels “madness-as-design”. I argue that (...) viewing the intellectual legacy that Garson analyzes through this genealogical lens has two benefits. First, it encourages us to identify other instances of madness-as-design (or madness-by-design), particularly those with an overtly political dimension, such as psychiatric conditions in a colonial context. Second, it should lead us to question the category of madness itself, which turns out to be radically disjointed, particularly since it cannot be unified under the rubric of disorder or dysfunction. (shrink)

Artefacts do not always do what they are supposed to, due to a variety of reasons, including manufacturing problems, poor maintenance, and normal wear-and-tear. Since software is an artefact, it should be subject to malfunctioning in the same sense in which other artefacts can malfunction. Yet, whether software is on a par with other artefacts when it comes to malfunctioning crucially depends on the abstraction used in the analysis. We distinguish between “negative” and “positive” notions of malfunction. A negative malfunction, (...) or dysfunction, occurs when an artefact token either does not or cannot do what it is supposed to. A positive malfunction, or misfunction, occurs when an artefact token may do what is supposed to but, at least occasionally, it also yields some unintended and undesirable effects. We argue that software, understood as type, may misfunction in some limited sense, but cannot dysfunction. Accordingly, one should distinguish software from other technical artefacts, in view of their design that makes dysfunction impossible for the former, while possible for the latter. (shrink)

How do people understand the concepts of mental health and disorder? The objective of this paper is to examine the impact of several factors on people’s judgments about whether a condition constitutes a mental disorder or a healthy state. Specifically, this study examines the impact of the source of the condition, its outcome, individual valuation (i.e., the value the individual attaches to the condition), and group valuation (i.e., the value the relevant group attaches to the condition). While we find that (...) people’s health and disorder judgments are driven by perceived dysfunction, we also find that health and disorder judgments are impacted differently by these factors. Health judgements are impacted by outcome and individual valuation, and disorder judgments are impacted by condition source. These results suggest that the folk concept of mental health is positive (i.e., mental health is more than the absence of mental disorder) and normativist (i.e., value judgments play a significant role in determining whether a condition counts as healthy), while the concept of mental disorder aligns with a naturalist perspective, at least to the extent that dysfunction plays an important role in categorizing a condition as a disorder. However, our finding that people’s dysfunction judgments are influenced by individual valuation and outcomes poses a strong challenge to naturalist accounts. To provide access to our supplementary data, an appendix has been included. (shrink)

In this paper, we explore whether a living being can have a medical disorder purely in virtue of its current structure, or whether its historical origins are also relevant. We do so by presenting two dialogues based on the Swampman thought experiment. These dialogues bring out two key points. First, although evolutionary history plays a central role in theoretical accounts of disorder, its relevance is less obvious in everyday medical practice. Second, there may be an asymmetry between somatic and mental (...) disorders: somatic disorders are typically identified by biological dysfunction, while many paradigmatic mental disorders appear to involve violations of rationality. Nevertheless, we suggest that dysfunctions—and thereby historical considerations—still play a role in distinguishing normal from pathological irrationality. Rather than introducing a new theory, this paper tests existing accounts of function and disorder by applying them to an extreme but instructive case. (shrink)

In this paper, I look into the debate about the status of addiction as a disease. Although addiction is widely regarded as a disease, several authors have put forward reasons for agnosticism or skepticism about the appropriateness of the disease label. Any attempt to address this issue directly is complicated by its relationship to several other contentious issues, both on the side of theories of addiction and on the side of theories of disease. My primary aim in this paper is (...) to identify the major points of contention. My secondary aim is to offer a limited defense of the disease view. The crux of the debate is whether addiction is aptly pictured as the result of psychological dysfunction. The main hurdle for the psychological dysfunction claim is that we currently lack a relatively unified account of the behavioral trait that most strongly suggests dysfunctional processes: the loss of expectable ability to control behavior. I argue that there is a sense in which the dysfunction claim may be warranted even in the absence of a unified causal account. However, this requires assumptions that are to some extent controversial, most notably, the impaired control view of addiction and the acceptability of dysfunction-talk based on personal-level behavioral traits. (shrink)

This paper proposes the Van Gogh Compass, a two-axis model of social orientation that extends the traditional introversion-extroversion spectrum by introducing a perpendicular dimension addressing belonging and categorical transcendence. Building upon the Van Gogh Curve framework (Boether, 2025a), which reconceptualizes cognitive diversity as differentiation rather than pathology, this model integrates Jung's (1921/1923) foundational typology with contemporary developments, including the ambivert concept (Conklin, 1923), Kaminski's (2025) otrovert construct, and the phenomenologically grounded Ubervert (Boether, 2025b). The resulting compass places the ambivert at (...) the center point, with the X-axis spanning introversion to extroversion (energy direction) and the Y-axis spanning otroversion to uberversion (belonging orientation). This reconceptualization applies the Van Gogh Curve's core insight—that statistical deviation represents cognitive specialization rather than deficit—to social orientation, generating the Knowledge Distribution Principle for Social Orientation: meaningful social contribution and authentic connection exist at all positions on both axes. The paper develops diagnostic criteria distinguishing social orientation from social dysfunction, examines evolutionary and phenomenological foundations, and proposes practical implications for clinical practice, education, and organizational design. The Van Gogh Compass offers a non-hierarchical framework honoring the full spectrum of human social possibility. (shrink)

This dissertation aims to develop a program resource for helping and mental health professionals to foster proactive coping and diminish dysfunctional coping from work stressors. Professionals succumb to chronic stressors and secondary traumatic stress due to their vocation, often disregarding self-care. Should this type of resource be implemented, psychological and social resources would be required. The need for proactive coping is a generally accepted concept, but helping and mental health professionals often lack resources, limiting advocacy and resilience. Self-help resources are (...) frequently perceived as self-indulgence, in addition to the concept that professionals provide care, not the clients receiving care. Moreover, victimization by stigmas and emotional contagion surrounds helping and mental health professions. Addressing these concerns by implementing an accessible and advocate-heavy website may mitigate experienced ramifications by increasing retention, psychological well-being, resilience, and support. Most importantly, it may reduce maladaptive behaviors and standardize professional self-care. (shrink)

In this thesis, I offer a novel, overarching account of the cognitive architecture, evolution, and disorders of the capacity for low mood. First, I offer novel arguments for the propitiousness theory, according to which the proper function of the low mood system (LMS) is to limit resource expenditure in unpropitious circumstances. Following this, I develop an original account of the intentional content of low mood, according to which low mood has the following indicative-imperative content: Good events are, on average, less (...) likely to occur than bad events & Limit [the subject’s] resource expenditure! Next, I argue that the LMS takes input from numerous sensory, interoceptive, and affective systems, but that higher cognition can only effect low mood indirectly—namely, by triggering low-mood-inducing emotions. Finally, I argue that (a) disorders are necessarily constituted by dysfunctional systems (systems that fail to carry out their proper function), (b) most cases of depression (severe, long-lasting low moods) are activations of properly functioning LMSs, and therefore (c) most cases of depression are not in fact disorders. (shrink)

In view of the publication of the DSM-V researchers were asked to discuss the theoretical implications of the definition of mental disorders. The reasons for the use, in the DSM-III, of the term disorder instead of disease are considered. The analysis of these reasons clarifies the distinction between the general definition of disorder and its implicit, technical meaning which arises from concrete use in DSM disorders. The characteristics and limits of this technical meaning are discussed and contrasted to alternative definitions, (...) like Wakefield’s harmful/dysfunction analysis. It is shown that Wakefield’s analysis faces internal theoretical problems in addition to practical limits for its acceptance in the DSM-V. In particular, it is shown that: a) the term dysfunction is not purely factual but intrinsically normative/evaluative; b) it is difficult to clarify what dysfunctions are in the psychiatric context (the dysfunctional mechanism involved being unknown in most cases and the use of evolutionary theory being even more problematic); c) the use of conceptual analysis and commonsense intuition to define dysfunctions leaves unsatisfied empiricists; d) it is unlikely that the authors of the DSM-V will accept Wakefield’s suggestion to revise the diagnostic criteria of any single DSM disorder in accordance with his analysis, because this is an excessively extensive change and also because this would probably reduce DSM reliability. In conclusion, it is pointed up in which sense DSM mental disorders have to be conceived as constructs, and that this undermines the realistic search for a clear-cut demarcation criterion between what is disorder and what is not. (shrink)

Since 2016, there has been an explosion of academic work and journalism that fixes its subject matter using the terms ‘fake news’ and ‘post-truth’. In this paper, I argue that this terminology is not up to scratch, and that academics and journalists ought to completely stop using the terms ‘fake news’ and ‘post-truth’. I set out three arguments for abandonment. First, that ‘fake news’ and ‘post-truth’ do not have stable public meanings, entailing that they are either nonsense, context-sensitive, or contested. (...) Secondly, that these terms are unnecessary, because we already have a rich vocabulary for thinking about epistemic dysfunction. Thirdly, I observe that ‘fake news’ and ‘post-truth’ have propagandistic uses, meaning that using them legitimates anti-democratic propaganda, and runs the risk of smuggling bad ideology into conversations. (shrink)

This paper defines wokeism as the systemic escalation of epistemic injustice emerg- ing during the so-called “Great Awokening” (mid-2010s) and persisting through 2025. Drawing on Miranda Fricker’s foundational analysis of testimonial injustice and hermeneu- tical injustice, we develop and prove two further categories: credibility injustice, where entire legally defined categories are subjected to structural credibility deficits by in- stitutional fiat, and definitional injustice, where those categories are reconstituted as pathologies so that all possible testimony is excluded by definition. The preliminaries (...) establish the framework through Aristotelian syllogistic form (Barbara), Aquinas’s definition of truth (adaequatio intellectus ad rem), and a set- theoretic formulation of Fricker’s and our own categories. We formalize the unfalsi- fiability criterion P (T ) = 1 ⇐⇒ ∀E, E ⇒ Conf irm(T ) and prove the Illegitimacy Trigger, P (T ) = 1 ⇒ IASE(E) = 1, identifying when an epistemic instrument be- comes self-sealing and thus illegitimate. A further formalization, Pathological Attri- bution (PA), captures how attributes such as “privilege,” “fragility,” or “supremacy” are attached irreducibly to legal child and human being ”white” categories of race, rendering credibility permanently discounted regardless of individual testimony with no legal due process. Fricker herself warned of the “prejudicial dysfunction in the economy of credibility” (2007, p. 28). We extend this insight by showing how testimonial injustice metastasizes into hermeneutical injustice, and through definitional capture becomes credibility and definitional injustice. The impossibility of restoring credibility is not a flaw of the theory, but evidence of systemic closure itself. Wokeism, on this account, is best understood as an epistemic fracture: public epistemics grounded in testimony and empirical reality versus academic epistemics grounded in redefinition and unfalsifiable constructs. This fracture institutionalizes new and distinctively Frickerian injustices. DOI: 10.63968/post-bio-ai-epistemics.v1n2.011. (shrink)

This paper argues that proper functions are proximal functions. In other words, it rejects the notion that there are distal biological functions – strictly speaking, distal functions are not functions at all, but simply beneficial effects normally associated with a trait performing its function. Once we rule out distal functions, two further positions become available: dysfunctions are simply failures of proper function, and pathological conditions are dysfunctions. Although elegant and seemingly intuitive, this simple view has had surprisingly little uptake in (...) the literature. Indeed, our position departs from that of almost every theorist who has engaged with the issue at any depth. We start by presenting three arguments for the position that proper functions are proximal: one from the specificity of functions, one from their relation to intervention, and one from their relation to pathology. We then consider two case studies evidencing the trouble that accepting distal functions causes for philosophical reflection on the nature of pathological conditions. Finally, we anticipate and respond to three objections: that there can be failure of function without dysfunction; that our account is unacceptably revisionary in respect of normal function-talk; and that our thesis over-generalises from a narrow set of cases. (shrink)

This chapter defends the thesis that feeling conviction is sufficient for belief: if you feel conviction that p, then you believe that p. I begin with a neutral characterization of belief in terms of its normative profile: belief is a state that is subject to certain distinctive norms of rationality. The main argument of the chapter is that feelings of conviction are beliefs because they are subject to the same norms of rationality that govern our beliefs. Functionalists often deny that (...) feelings of conviction constitute beliefs when they play dysfunctional causal roles, as in cases of mad belief or delusion or implicit bias, but this only serves to obscure the kind of irrationality involved in such cases. These are dysfunctional beliefs, rather than non-doxastic states, or "in-between" cases. (shrink)

Jonathan Y. Tsou examines and defends positions on central issues in philosophy of psychiatry. The positions defended assume a naturalistic and realist perspective and are framed against skeptical perspectives on biological psychiatry. Issues addressed include the reality of mental disorders; mechanistic and disease explanations of abnormal behavior; definitions of mental disorder; natural and artificial kinds in psychiatry; biological essentialism and the projectability of psychiatric categories; looping effects and the stability of mental disorders; psychiatric classification; and the validity of the DSM's (...) diagnostic categories. The main argument defended by Tsou is that genuine mental disorders are biological kinds with harmful effects. This argument opposes the dogma that mental disorders are necessarily diseases that result from biological dysfunction. Tsou contends that the broader ideal of biological kinds offers a more promising and empirically ascertainable naturalistic standard for assessing the reality of mental disorders and the validity of psychiatric categories. (shrink)

We argue that the notion of "mental institutions"-discussed in recent debates about extended cognition-can help better understand the origin and character of social impairments in autism, and also help illuminate the extent to which some mechanisms of autistic dysfunction extend across both internal and external factors (i.e., they do not just reside within an individual's head). After providing some conceptual background, we discuss the connection between mental institutions and embodied habits of mind. We then discuss the significance of our (...) view for understanding autistic habits of mind and consider why these embodied habits are sometimes a poor fit with neurotypical mental institutions. We conclude by considering how these insights highlight the two-way, extended nature of social impairments in autism, and how this extended picture might assist in constructing more inclusive mental institutions and intervention strategies. (shrink)

Anna Smajdor and Joona Räsänen argue that we have good reason to classify pregnancy as a disease. They discuss five accounts of disease and argue that each account either implies that pregnancy is a disease or if it does not, it faces problems. This strategy allows Smajdor and Räsänen to avoid articulating their own account of disease. Consequently, they cannot establish that pregnancyisa disease, only that plausible accounts of disease suggest this. Some readers will dismiss Smajdor and Räsänen’s claims as (...) counterintuitive. By analogy, if a mathematical proof concludes ‘2+2=5’, readers will know—without investigation—that an error occurred. Rather than dismiss Smajdor and Räsänen’s work, however, the easiest way to undermine their argument is to describe at least one plausible account of disease that (1) excludes pregnancy and (2) avoids the problems they raise for it. This is our strategy. We focus on dysfunction accounts of disease. After outlining Smajdor and Räsänen’s main arguments against dysfunction accounts, we explain why pregnancy is not a disease on these accounts. Next, we defend dysfunction accounts against the three problems that Smajdor and Räsänen raise. If successful, then contra Smajdor and Räsänen, at least one plausible account of disease does not imply that pregnancy is a disease. We suspect that defenders of other accounts can respond similarly. Yet, we note that insofar as dysfunction accounts align with the commonsense intuition that pregnancy is not a disease, this, all else being equal, seems like a point in their favour. (shrink)

Meditation often reveals a progressive emergence of inner light phenomena that are poorly understood in cognitive science and frequently dismissed as entoptic noise or hallucinatory artifacts. This study offers a structured phenomenological analysis of endogenous vision in meditation and introduces the concept of the Ultrasubjective Hyperspace (USH), a lawful, internally accessible field of luminous experience that emerges when sensory attenuation and attentional stabilization unlock deeper levels of perception. This paper identifies six developmental phases of luminous perception: (1) reactive flickers, (2) (...) geometric grids, (3) fractalized central luminosity and figural emergence, (4) immersive visionary fields, (5) vortical transport and encounters with luminous beings, and (6) collapse into a unified radiant field. At this final stage, perceptual content dissolves into dimensionless luminosity, marking entry into the Ultrasubjective Hyperspace, a non-dual field where the distinction between seer and seen collapses into self-luminous awareness. Contrary to pathological interpretations, meditation-induced inner light experiences exhibit phenomenological coherence, autonomy, and progressive refinement, distinguishing them from migraine aura and neurological dysfunction. Supported by neurophenomenological literature, these luminous states correspond to mechanisms of sensory deafferentation, homeostatic excitation of the visual cortex, gamma synchrony, and predictive processing dynamics. Rather than visual byproducts, they reveal intrinsic structures of consciousness and invite reconsideration of perception as a generative, internally luminous process. This study reframes inner light as a legitimate domain of contemplative science and positions the Ultrasubjective Hyperspace as a foundational concept for future research on visionary cognition, neurophenomenology, and transpersonal psychology. It also reopens the path of Yoga of Inner Light as a rigorous contemplative discipline grounded in direct experience rather than metaphysical speculation. (shrink)

Theories of function are conventionally divided up into historical and ahistorical ones. Proponents of ahistorical theories often cite the ahistoricity of their accounts as a major virtue. Here, I argue that none of the mainstream “ahistorical” accounts are actually ahistorical. All of them embed, implicitly or explicitly, an appeal to history. In Boorse’s goal-contribution account, history is latent in the idea of statistical-typicality. In the propensity theory, history is implicit in the idea of a species’ natural habitat. In the causal (...) role theory, history is required for making sense of dysfunction. I elaborate some consequences for the functions debate. (shrink)

Identity-protective reasoning---motivated reasoning driven by defending a social identity---is often dismissed as a paradigm of epistemic vice and a key driver of democratic dysfunction. Against this view, I argue that identity-protective reasoning can play a positive epistemic role, both individually and collectively. Collectively, it facilitates an effective division of cognitive labor by enabling groups to test divergent beliefs, serving as an epistemic insurance policy against the possibility that the total evidence is misleading. Individually, it can correct for the distortions (...) that arise from taking ideologically skewed evidence at face value. This is particularly significant for members of marginalized groups, who frequently encounter evidence that diminishes the value of their identities, beliefs, and practices. For them, identity-protective reasoning can counter dominant ideological ignorance and foster resistant standpoint development. While identity-protective reasoning is not without risks, its application from marginalized and counter-hegemonic positions carries epistemic benefits crucial in democracies threatened by elite capture. Against dominant views in contemporary political epistemology and psychology, identity-protective reasoning should be reconceived as a resource to be harnessed and not a problem to be eradicated. (shrink)

Even though the evidence‐based medicine movement (EBM) labels mechanisms a low quality form of evidence, consideration of the mechanisms on which medicine relies, and the distinct roles that mechanisms might play in clinical practice, offers a number of insights into EBM itself. In this paper, I examine the connections between EBM and mechanisms from several angles. I diagnose what went wrong in two examples where mechanistic reasoning failed to generate accurate predictions for how a dysfunctional mechanism would respond to intervention. (...) I then use these examples to explain why we should expect this kind of mechanistic reasoning to fail in systematic ways, by situating these failures in terms of evolved complexity of the causal system(s) in question. I argue that there is still a different role in which mechanisms continue to figure as evidence in EBM: namely, in guiding the application of population‐level recommendations to individual patients. Thus, even though the evidence‐based movement rejects one role in which mechanistic reasoning serves as evidence, there are other evidentiary roles for mechanistic reasoning. This renders plausible the claims of some critics of evidencebased medicine who point to the ineliminable role of clinical experience. Clearly specifying the ways in which mechanisms and mechanistic reasoning can be involved in clinical practice frames the discussion about EBM and clinical experience in more fruitful terms. (shrink)

Two important issues in the philosophy of medicine are the evaluative issue (whether the concept of disease is value-laden) and the neutrality issue (whether the concept of dysfunction is value-laden). The aim of this study was to empirically examine whether a person’s evaluation of their own condition (i.e., patient evaluation) influences whether their condition is considered to be a disease and dysfunction. With respect to the evaluative issue, we observed, consistent with previous research, that patient evaluation does not (...) influence people’s disease judgments, but it does influence their health judgments. Further, with respect to the neutrality issue, we observed that while patient evaluation does not influence people’s dysfunction judgments in physical conditions, it does influence their dysfunction judgments in mental conditions. Depending on exactly how these results are interpreted they might have potentially significant implications for dominant positions in the literature, particularly for those that claim to account for lay judgments. Progress in the philosophy of medicine might benefit from a shift in focus from the concepts of disease and health to a more detailed examination of the concept of dysfunction. (shrink)

This paper investigates the structural role of social media in either enabling or disabling meaningful judgement. Using the Judgemental Triad—Constructivity, Coherence, and Resonance—we analyze the informational and affective architecture of social media platforms. We argue that while social media appears to amplify communication, it often collapses the structure necessary for judgement: fragmenting coherence, overloading constructibility, and severing resonance. This collapse leads to a paradoxical condition: infinite expression, but no return. We conclude that social media constitutes a systemic environment of judgemental (...) dysfunction. (shrink)

In a recent contribution to conceptual ethics, Joshua Habgood-Coote argues that philosophers should refrain from using the term “fake news,” which is commonly employed in public discussions focusing on the epistemic health of democracies. In this short discussion note, I take issue with this claim, discussing each of the three arguments advanced by Coote to support the conclusion that we should abandon this concept. First, I contend that although “fake news” is a contested concept, there is significant agreement among contemporary (...) philosophers about its key feature. Second, I argue against the claim that “fake news” is an unnecessary concept by underlying that it is not reducible to other terms we customarily use to describe the epistemic dysfunctions of democracies. Lastly, I suggest that using the term “fake news” need not serve propagandistic aims, and that philosophers can use this concept without engaging in epistemic policing, that is, commanding their interlocutors not to believe specific news stories or sources. (shrink)

In their article ‘Is Pregnancy a Disease? A Normative Approach’, Anna Smajdor and Joona Räsänen contend that, on several of the most prominent accounts of disease, pregnancy should be considered a disease. More specifically, of the five accounts they discuss, each renders pregnancy a disease or suffers serious conceptual problems otherwise. They take issue specifically with the dysfunction account of disease and argue that it suffers several theoretical difficulties. In this response, we focus on defending the dysfunction account (...) against their main objections and show why a version of the dysfunction account is viable on account of the indispensability of normativity in biology and medicine. After disarming their main objections to the dysfunction account, we briefly respond to their treatment of the normality of pregnancy and then draw a distinction between adverse symptoms and underlying causes to show why even though pregnancy may have ‘disease-like’ features, it is not a disease. (shrink)

What form must a theory of epistemic injustice take in order to successfully illuminate the epistemic dimensions of struggles that are primarily political? How can such struggles be understood as involving collective struggles for epistemic recognition and self-determination that seek to improve practices of knowledge production and make lives more liveable? In this paper, I argue that currently dominant, Fricker-inspired approaches to theorizing epistemic wrongs and remedies make it difficult, if not impossible, to understand the epistemic dimensions of historic and (...) ongoing political struggles. Recent work in the theory of recognition— particularly the work of critical, feminist, and decolonial theorists—can help to identify and correct the shortcomings of these approaches. I offer a critical appraisal of recent conversation concerning epistemic injustice, focusing on three characteristics of Frickerian frameworks that obscure the epistemic dimensions of political struggles. I propose that a theory of epistemic injustice can better illuminate the epistemic dimensions of such struggles by acknowledging and centering the agency of victims in abusive epistemic relations, by conceptualizing the harms and wrongs of epistemic injustice relationally, and by explaining epistemic injustice as rooted in the oppressive and dysfunctional epistemic norms undergirding actual communities and institutions. (shrink)

A dominant view of guilt and shame is that they have opposing action tendencies: guilt- prone people are more likely to avoid or overcome dysfunctional patterns of behaviour, making amends for past misdoings, whereas shame-prone people are more likely to persist in dysfunctional patterns of behaviour, avoiding responsibility for past misdoings and/or lashing out in defensive aggression. Some have suggested that addiction treatment should make use of these insights, tailoring therapy according to people’s degree of guilt-proneness versus shame-proneness. In this (...) paper, we challenge this dominant view, reviewing empirical findings from others as well as our own to question (1) whether shame and guilt can be so easily disentangled in the experience of people with addiction, and (2) whether shame and guilt have the opposing action tendencies standardly attributed to them. We recommend a shift in theoretical perspective that explains our main finding that both emotions can be either destructive or constructive for recovery, depending on how these emotions are managed. We argue such management depends in turn on a person’s quality of self-blame (retributive or ‘scaffolding’), impacting upon their attitude towards their own agency as someone with fixed and unchanging dispositions (shame and guilt destructive for recovery) or as someone capable of changing themselves (shame and guilt productive for recovery). With an eye to therapeutic intervention, we then explore how this shift in attitude towards the self can be accomplished. Specifically, we discuss empathy-driven affective and narratively-driven cognitive components of a process that allow individuals to move away from the register of retributive self-blame into a register of scaffolding ‘reproach’, thereby enabling them to manage their experiences of both shame and guilt in a more generative way. (shrink)

In this paper, I defend a version of the medical model of disability, which defines disability as an enduring biological dysfunction that causes its bearer a significant degree of impairment. We should accept the medical model, I argue, because it succeeds in capturing our judgments about what conditions do and do not qualify as disabilities, because it offers a compelling explanation for what makes a condition count as a disability, and because it justifies why the federal government should spend (...) hundreds of billions of dollars, annually, on aid and accommodations for disabled people. After responding to a pair of objections Elizabeth Barnes has raised against the medical model, I contrast it with Guy Kahane and Julian Savulescu's welfarist account of disability, and with Barnes's own mere-difference view. Both of these accounts face serious challenges, although elements of Barnes's view can—and, in my opinion, should—be adopted by proponents of the medical model. (shrink)

We recently suggested that there are both pragmatic and normative reasons to classify pregnancy as a disease. Several scholars argued against our claims. In this response, we defend the disease view of pregnancy against their criticism. We claim that the dysfunctional account of disease that some of our critics rely on has some counterintuitive results. Furthermore, we claim that our critics assume what needs to be argued that the primary function of our sexual organs is to reproduce. Since only a (...) small percentage of sexual intercourse leads to pregnancy, it is far from obvious that reproduction is the primary biological function of our sexual organs. We also claim that while taking pregnancy itself as a reference class could avoid the conclusion that pregnancy is a disease, the strategy is problematic since it renders the Boorsean approach to disease and health circular and effectively deprives it of any utility in determining whether a particular phenomenon is a disease or not. (shrink)

Psychiatric and neurological disorders have historically provided key insights into the structure-function rela- tionships that subserve human social cognition and behavior, informing the concept of the ‘social brain’. In this review, we take stock of the current status of this concept, retaining a focus on disorders that impact social behavior. We discuss how the social brain, social cognition, and social behavior are interdependent, and emphasize the important role of development and com- pensation. We suggest that the social brain, and its (...) dysfunction and recovery, must be understood not in terms of specific structures, but rather in terms of their interaction in large-scale networks. (shrink)

This paper defines and defends a notion of teleological function which is fit to figure in explanations concerning how organic systems, and the items which compose them, are able to perform certain activities, such as surviving and reproducing or pumping blood. According to this notion, a teleological function of an item (such as the heart) is a typical way in which items of that type contribute to some containing system's ability to do some activity. An account of what it is (...) for an item to contribute to a containing system's ability to perform an activity is provided. I argue that the view acquires its normative status in virtue of the fact that it obeys a function-accident distinction and obeys a function-dysfunction distinction; that the view is ahistorical; and, that its ahistoricity provides it with an advantage over one of its main competitors. (shrink)

The medical model of disability views disabilities as biological dysfunctions of the individual’s body. Historically, this has been unpopular in the literature, but that is at least partly because it has also been associated with objectionable moral or political ideas. As such, it’s not clear that the core view about the nature of disability has received a fair hearing. This paper meets the medical model on its own terms. I argue that there is no available naturalistic account of biological functioning (...) such that disabilities can plausibly be understood as biological dysfunctions. (shrink)

Does a diagnosis of brain dysfunction matter for ascriptions of moral responsibility? This chapter argues that, while knowledge of brain pathology can inform judgments of moral responsibility, its evidential value is currently limited for a number of practical and theoretical reasons. These include the problem of establishing causation from correlational data, drawing inferences about individuals from group data, and the reliance of the interpretation of brain findings on well-established psychological findings. Brain disorders sometimes matter for moral responsibility, however, because (...) they change an individual’s moral psychology in a way that is beyond their control. While control over psychological changes is not an excusing factor, brain disorders can mitigate moral responsibility because they confront individuals with new psychological deficits or urges for which their previous moral education and existing external and internal moral resources have not prepared them. (shrink)

Background: Obstetrics and gynaecology are many and common, where a woman suffers from problems related to pregnancy or her reproductive organs. Any part of her body may be affected due to some symptoms that are completely related to the reproductive organs when she is in a critical period for her, whether in her menstrual cycle, pregnancy, or disease conditions. The bulk of cases of diseases related to women and childbirth are dealt with great care and special care, as all diseases (...) related to women are considered very sensitive diseases due to the presence of the disease in sensitive and not simple places. A gynaecologist is a specialist in all diseases and problems related to the female sexual organs. They perform regular preventive medical exams, such as cervical smear tests and breast exams. It also provides consultations for women of all ages about the problems of contraception, infertility and menopause. Objectives: The objective of this expert system is to help and facilitate women in diagnosing diseases related to their obstetrics and gynaecology, a simple expert system has been designed consisting of ten various common diseases that affect women whether During or without pregnancy, Methods: In this system, the system consists of a list of some common symptoms, the correct diagnosis adopted for these diseases, and how to treat diseases in the correct way with the help of a consultant obstetrician and gynaecologist, Dr. Fathi Muhammad Al-Habibi, and these diseases are: uterine cancer, cervical cancer, Infertility, double uterus, ectopic pregnancy, endometrial cancer, female sexual dysfunction, endometriosis, faecal incontinence, female infertility, CLIPS Expert System language was used to design and implement the proposed expert system. Results: The proposed ten obstetrics and gynaecology diagnostic expert system was evaluated by medical students and they were satisfied with its performance. Conclusions: The proposed expert system is very useful for obstetricians and gynaecologists, patients with reproductive system problems, and recent graduates. (shrink)

In this article we examine obsessive compulsive disorder (OCD). We examine and reject two existing models of this disorder: the Dysfunctional Belief Model and the Inference‐Based Approach. Instead, we propose that the main distinctive characteristic of OCD is a hyperactive sub‐personal signal of being in error, experienced by the individual as uncertainty about his or her intentional actions (including mental actions). This signalling interacts with the anxiety sensitivities of the individual to trigger conscious checking processes, including speculations about possible harms. (...) We examine the implications of this model for the individual's capacity to control his or her thoughts. (shrink)