I don't disagree with you, but it does seem like you're using "do the meds work" as the key criteria of whether its a trait or an illness. But I guess I don't understand why that matters, apart from "how should we socially judge this person?" There are a large number of mental and physical illnesses that can be improved (by the judgement…
I don't disagree with you, but it does seem like you're using "do the meds work" as the key criteria of whether its a trait or an illness. But I guess I don't understand why that matters, apart from "how should we socially judge this person?" There are a large number of mental and physical illnesses that can be improved (by the judgement of the patient) by a wide range/combination of meds, actions, choices, etc...
If I have schizophrenia and I treat it without meds and I get better, that doesn't prove you wrong. If I treat it exclusively with meds and get better, that doesn't prove Caplan wrong. Because it doesn't matter to me! What matters is: "by my standards and accounting for the cost of treatment, did I get better?" If you want to say "schizophrenia that you can treat without meds doesn't count" then I am 100% fine with that - but I think you (and Caplan) are fighting over definitions instead of reality.
"Do the meds work" isn't a good criterion for whether something is a disease because 1) many illnesses are untreatable, and 2) you can use drugs to stop non-disease behaviors and preferences easily (chemical castration of homosexuals).
Agreed, with the addition that may also be an indication that determining if something is a disease or not isn't that helpful (where I define helpful as "helps make the patient better of).
In my example, the key criteria was "is there an associated common pathway model?"
Whether the meds work or not cannot tell us about whether a trait is real, but it can lend evidence to the idea if we see that there is a treatment effect and it is not heterogeneous (ex: https://jamanetwork.com/journals/jamapsychiatry/article-abstract/2776610). Homogeneous treatment effects are unrealistic for many traits because treatment is generally not targeted at the etiology of a disease comprehensively, so this can only be used to provide positive, not negative evidence wrt whether a psychiatric diagnosis tags an actual trait.
The concerns raised by PercyPrior have to do with measurement invariance, which is often tenuous, rather than etiology, which I was concerned with.
I don't disagree with you, but it does seem like you're using "do the meds work" as the key criteria of whether its a trait or an illness. But I guess I don't understand why that matters, apart from "how should we socially judge this person?" There are a large number of mental and physical illnesses that can be improved (by the judgement of the patient) by a wide range/combination of meds, actions, choices, etc...
If I have schizophrenia and I treat it without meds and I get better, that doesn't prove you wrong. If I treat it exclusively with meds and get better, that doesn't prove Caplan wrong. Because it doesn't matter to me! What matters is: "by my standards and accounting for the cost of treatment, did I get better?" If you want to say "schizophrenia that you can treat without meds doesn't count" then I am 100% fine with that - but I think you (and Caplan) are fighting over definitions instead of reality.
"Do the meds work" isn't a good criterion for whether something is a disease because 1) many illnesses are untreatable, and 2) you can use drugs to stop non-disease behaviors and preferences easily (chemical castration of homosexuals).
Agreed, with the addition that may also be an indication that determining if something is a disease or not isn't that helpful (where I define helpful as "helps make the patient better of).
In my example, the key criteria was "is there an associated common pathway model?"
Whether the meds work or not cannot tell us about whether a trait is real, but it can lend evidence to the idea if we see that there is a treatment effect and it is not heterogeneous (ex: https://jamanetwork.com/journals/jamapsychiatry/article-abstract/2776610). Homogeneous treatment effects are unrealistic for many traits because treatment is generally not targeted at the etiology of a disease comprehensively, so this can only be used to provide positive, not negative evidence wrt whether a psychiatric diagnosis tags an actual trait.
The concerns raised by PercyPrior have to do with measurement invariance, which is often tenuous, rather than etiology, which I was concerned with.