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Article ID: CBB581473081

Expanding the notion of mechanism to further understanding of biopsychosocial disorders? Depression and medically-unexplained pain as cases in point (2024)

Konsman, Jan Pieter (Author)

Studies in History and Philosophy of Science
Volume: 103
Pages: 123-136
Publication date: 2024
Language: English

DOI: 10.1016/j.shpsa.2023.12.002

URI: https://www.sciencedirect.com/science/article/pii/S0039368123001693

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Mental disorders and diseases Causality Pain Social sciences Psychology Biology Philosophy of medicine Philosophy of science Depression Mechanism Evidence-based medicine

Evidence-Based Medicine has little consideration for mechanisms and philosophers of science and medicine have recently made pleas to increase the place of mechanisms in the medical evidence hierarchy. However, in this debate the notions of mechanisms seem to be limited to ‘mechanistic processes’ and ‘complex-systems mechanisms,’ understood as ‘componential causal systems’. I believe that this will not do full justice to how mechanisms are used in biological, psychological and social sciences and, consequently, in a more biopsychosocial approach to medicine. Here, I propose, following (Kuorikoski, 2009), to pay more attention to ‘abstract forms of interaction’ mechanisms. The present work scrutinized review articles on depression and medically unexplained pain, which are considered to be of multifactorial pathogenesis, for their use of mechanisms. In review articles on these disorders there seemed to be a range of uses between more ‘abstract forms of interaction’ and ‘componential causal system’ mechanisms. I therefore propose to expand the notions of mechanisms considered in medicine to include that of more ‘abstract forms of interaction’ to better explain and manage biopsychosocial disorders.

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