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Causality and PsychopathologyFinding the Determinants of Disorders and their Cures$
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Patrick Shrout, Katherine Keyes, and Katherine Ornstein

Print publication date: 2011

Print ISBN-13: 9780199754649

Published to Oxford Scholarship Online: November 2020

DOI: 10.1093/oso/9780199754649.001.0001

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Causal Thinking in Psychiatry: A Genetic and Manipulationist Perspective

Causal Thinking in Psychiatry: A Genetic and Manipulationist Perspective

4 (p.66) Causal Thinking in Psychiatry: A Genetic and Manipulationist Perspective
Causality and Psychopathology

Kenneth S. Kindler

Oxford University Press

A large and daunting philosophical literature exists on the nature and meaning of causality. Add to that the extensive discussions in the statistical literature about what it means to claim that C causes E, and it can be overwhelming for the scientists, who, after all, are typically just seeking guidelines about how to conduct and analyze their research. Add to this mix the inherent problems in psychiatry—which examines an extraordinarily wide array of potential causal processes from molecules to minds and societies, some of which permit experimental manipulation but many of which do not—and you can readily see the sense of frustration and, indeed, futility with which this issue might be addressed. In the first section of this chapter, I reflect on two rather practical aspects of causal inference that I have confronted in my research career in psychiatric genetics. The first of these is what philosophers call a ‘‘brute fact’’ of our world—the unidirectional causal relationship between variation in genomic DNA and phenotype. The second is the co-twin–control method—a nice example of trying to use twins as a ‘‘natural experiment’’ to clarify causal processes when controlled trials are infeasible. In the second section, I briefly outline and advocate for a particular approach to causal inference developed by Jim Woodward (2003) that I term ‘‘interventionism.’’ I argue that this approach is especially well suited to the needs of our unusual field of psychiatry. I often teach students that it is almost too easy in psychiatric research to show that putative risk factors correlate with outcomes. It is much harder to determine if that relationship is a causal one. Indeed, assuming that for practical or ethical reasons a randomized trial of exposure to the risk factor is not feasible, one must rely on observational data. In these instances, it can be ‘‘damn near impossible’’ to confidently infer causation. However, in this mire of casual uncertainty, it is interesting to note that one relationship stands out in its causal clarity: the relationship between variation in germline DNA (gDNA) and phenotypes.

Keywords:   Co-twin–control method, Deductive-nomological approach to causation, Inheritance, Intervention model (IM), Major depression, Structural equation modeling

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