Autism Spectrum Disorders: A Case Study in Causation and Explanation in Psychiatric Conditions

Abstract

This thesis discusses epistemological and ethical issues in classifi cation and diagnosisof psychiatric conditions, and briefly discusses realism about psychiatric conditions. I use autism spectrum disorder (ASD) as a case study to examine whether the explanatory and predictive power of classi fication and diagnosis could be improved if psychiatry adopts a cause-based framework in place of a symptom-based framework. However, there is signifi cant debate regarding the sort of explanatory pattern that will adequately represent the complex causation involved in psychiatric conditions. I develop a preliminary list of criteria for adequate explanatory patterns in psychiatry, and use these criteria to analyze explanations of ASD. I show that explanatory patterns unable to meet these criteria limit the validity and reliability of diagnosis. However, I argue that an integrated pattern that includes biological, cognitive and social levels of explanation may meet the criteria. Thus, diagnosis of ASD could improve if psychiatry adopted a cause-based framework informed by an intergrated explanation pattern. More accurate diagnosis of ASD may allow earlier access to Intensive Behaviourial Intervention/Applied Behavioural Analysis treatment programs, which may increase the effectiveness of this treatment and reduce the amount of resources individuals with ASD require from governments over their lifespans. Explaining these conditions using an integrated pattern of explanation can further challenge myths regarding the causes of ASD, and may provide support for Canadian lawsuits petitioning for expanded public funding of IBI/ABA programs.