ReviewMolecular psychiatry2012
Levels of explanation in psychiatric and substance use disorders: implications for the development of an etiologically based nosology.
Review in Molecular psychiatry, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 43 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
43 citing papers in PubMed.
- Beyond DSM Categories: Criteria for Biologically Valid Disease Axes in Psychiatry.Journal of clinical medicine · 2026Review
- The many-to-many problem of endophenotypes in psychiatry - a biological perspective.Molecular psychiatry · 2026Review
- How the brain structures the boundaries of psychiatric discourse.Frontiers in psychology · 2026Article
- 'Impaired in life': Analyzing people's accounts of depression in Ethiopia - Implications for a cultural-eco social approach to global mental health.The International journal of social psychiatry · 2025Article
- Neuroimaging Biomarkers in Addiction.medRxiv : the preprint server for health sciences · 2024Article
- Evidence-Based Assessment of Substance Use Disorder.Assessment · 2024Review
- Development of a revised version of the transdiagnostic skills scale (T2S-R).Frontiers in psychology · 2024Article
- (Mis)understanding alcohol use disorder: Making the case for a public health first approach.Drug and alcohol dependence · 2023Article
- Prospective associations between cannabis use and depressive symptoms across adolescence and early adulthood.Psychiatry research · 2023Article
- Relating psychiatric symptoms and self-regulation during the COVID-19 crisis.Translational psychiatry · 2022Article
- Is addiction a brain disease? A plea for agnosticism and heterogeneity.Psychopharmacology · 2022Review
- Klerman's "credo" reconsidered: neo-Kraepelinianism, Spitzer's views, and what we can learn from the past.World psychiatry : official journal of the World Psychiatric Association (WPA) · 2022Article
- How does the 'environment' come to the person? The 'ecology of the person' and addiction.World journal of psychiatry · 2021Review
- The meaning of significant mean group differences for biomarker discovery.PLoS computational biology · 2021Article
- Computational approaches and machine learning for individual-level treatment predictions.Psychopharmacology · 2021Review
- Addressing the context and consequences of substance use, misuse, and dependence: A global imperative.PLoS medicine · 2019Article
- A new conception and subsequent taxonomy of clinical psychological problems.BMC psychology · 2019Article
- Non-Medical Use of Prescription Stimulants for Treatment of Attention Disorders by University Students: Characteristics and Associations.Medical science monitor : international medical journal of experimental and clinical research · 2019Article
- Psychiatric genetics and the structure of psychopathology.Molecular psychiatry · 2019Review
- Psychotherapy and Genetic Neuroscience: An Emerging Dialog.Frontiers in genetics · 2018Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
1 author.
Funding
Abstract
The soft medical model for psychiatric illness, which was operationalized in DSM-III, defines psychiatric disorders as syndromes with shared symptoms, signs, course of illness and response to treatment. Many in our field want to move to a hard medical model based on etiological mechanisms. This essay explores the feasibility of this move and asks whether psychiatric disorders have the needed single clear level of explanation for an etiologically based nosology. I propose seven criteria for a good explanation: (i) strength, (ii) causal confidence, (iii) generalizability, (iv) specificity, (v) manipulability, (vi) proximity and (vii) generativity. Applying them to cystic fibrosis, a gene-level approach to etiology performs well across the board. By contrast, a detailed review of alcohol dependence and a briefer review of major depression suggests that psychiatric disorders have multiple explanatory perspectives no one of which can be privileged over others using scientific data alone. Therefore, a move toward an etiologically based diagnostic system cannot assume that one level of explanation will stand out as the obvious candidate on which to base the nosology. This leaves two options. Either a hard medical model will be implemented that will require a consensus about a preferred level of explanation which must reflect value judgments as well as science. To take this approach, we need to agree on what we most want from our explanations. Alternatively, we will need to move away from the traditional hard medical model that requires that we ground our diagnoses in single biological essences, and focus instead on fuzzy, cross-level mechanisms, which may more realistically capture the true nature of psychiatric disorders.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.