Comment l'autisme montre que les symptômes, comme les diagnostics psychiatriques, sont « construits » : conséquences méthodologiques et épistémiques

Titre original en anglais : 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: 23/01/2021 Ajout dans AutiHub: 14/09/2026 Type: Article Langue de l’article: Anglais
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  1. Sam Fellowes *

Résumé

Résumé Les critiques préoccupés par le statut épistémologique des diagnostics psychiatriques les décrivent souvent comme étant construits. En revanche, ces critiques considèrent généralement les symptômes comme relativement dépourvus de problèmes épistémologiques. Dans cet article, je montre que les symptômes sont également construits. Pour ce faire, je m'appuie sur la démarcation entre les données et les phénomènes. Je rapporte cette distinction à la psychiatrie en présentant le comportement des individus comme des données et les symptômes comme des phénomènes. Je m'appuie ensuite sur des philosophes qui considèrent les phénomènes comme construits afin de soutenir que les symptômes sont également construits. Plutôt que d'être déjà faits dans le monde, je montre comment les symptômes sont des constructions que nous appliquons au monde. Je le mets en évidence à l'aide d'un exemple historique et décris les contraintes méthodologiques pesant sur la construction des symptômes. Je montre que les problèmes épistémiques associés aux diagnostics psychiatriques s'appliquent également aux symptômes. À la suite de cela, je suggère que les critiques des diagnostics psychiatriques devraient étendre leur critique aux symptômes ou, s'ils continuent de croire que les symptômes sont relativement dépourvus de problèmes épistémologiques, devraient repenser leurs préoccupations concernant les diagnostics psychiatriques.

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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Références citées
134
Avec un DOI
95
Sans DOI, à partir du texte brut de la bibliographie
32
1 / 134 (0,7 %) références citées comprennent au moins une personne identifiée comme autiste.
Références avec données à compléter
8 / 134 (6,0 %)
Références avec noms d’auteurices détectés
132 / 134 (98,5 %)
Sans nom d’auteurice détecté
2
Sans titre structuré
6
Sans identifiant stable
29
Références avec noms bruts d’auteurices restant à vérifier
0
Références avec problème de récupération des métadonnées externes
1
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Noms d’auteurices détectés dans la bibliographie citée
178
À partir du DOI ou de métadonnées externes
178
À partir du texte brut validé de la bibliographie
0
Noms bruts déjà validés
0
Noms bruts restant à vérifier
0
15 / 178 (8,4 %) noms sont associés à un·e auteurice déjà présent·e dans AutiHub. 163 / 178 (91,6 %) noms ne sont pas encore associés.
Noms associés à une personne identifiée comme autiste
1 / 178 (0,6 %)
Calculé sur l’ensemble des noms d’auteurices détectés dans la bibliographie citée. Parmi les noms associés à un·e auteurice déjà présent·e dans AutiHub : 1 / 15 (6,7 %). Personnes distinctes identifiées comme autistes : 1 / 150 (0,7 %).
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