How autism shows that symptoms, like psychiatric diagnoses, are 'constructed': methodological and epistemic consequences

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Fellowes, S. (2021). How autism shows that symptoms, like psychiatric diagnoses, are 'constructed': methodological and epistemic consequences. Synthese, 199(1-2), 4499-4522. https://doi.org/10.1007/s11229-020-02988-3

Publication date: 23 Jan 2021 Added to AutiHub: 14 Sep 2026 Type: Article Article language: English
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1 / 1 (100.0%)
  1. Sam Fellowes *

Abstract

Abstract Critics who are concerned over the epistemological status of psychiatric diagnoses often describe them as being constructed. In contrast, those critics usually see symptoms as relatively epistemologically unproblematic. In this paper I show that symptoms are also constructed. To do this I draw upon the demarcation between data and phenomena. I relate this distinction to psychiatry by portraying behaviour of individuals as data and symptoms as phenomena. I then draw upon philosophers who consider phenomena to be constructed to argue that symptoms are also constructed. Rather than being ready made in the world I show how symptoms are constructs we apply to the world. I highlight this with a historical example and describe methodological constraints on symptom construction. I show the epistemic problems with psychiatric diagnoses are also applicable to symptoms. Following this, I suggest that critics of psychiatric diagnoses should extend their criticism to symptoms or, if they still believe symptoms are relatively epistemologically unproblematic, should rethink their concerns over psychiatric diagnoses.

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Cited references
134
With a DOI
95
Without a DOI, from raw bibliography text
32
1 / 134 (0.7%) cited references include at least one author identified as autistic.
References with data to complete
8 / 134 (6.0%)
References with detected author names
132 / 134 (98.5%)
Without detected author names
2
Without a structured title
6
Without a stable identifier
29
References with raw author names still to review
0
References with external metadata lookup issues
1
These indicators apply to cited references displayed on this page, after technical duplicates have been merged. A reference without a DOI can still support author statistics when a title and author names are available.
Author names detected in the cited bibliography
178
From DOI or external metadata
178
From validated raw bibliography text
0
Raw names already validated
0
Raw names still to review
0
15 / 178 (8.4%) names are linked to an author already present in AutiHub. 163 / 178 (91.6%) names are not yet linked.
Names linked to a person identified as autistic
1 / 178 (0.6%)
Calculated across all author names detected in the cited bibliography. Among names linked to an author already present in AutiHub: 1 / 15 (6.7%). Distinct people identified as autistic: 1 / 150 (0.7%).
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