Fiftypsychologicalandpsychiatr

　　标题：Fiftypsychologicalandpsychiatrictermstoavoid：alistofinaccurate，misleading，misused，ambiguous，andlogicallyconfusedwordsandphrases
　　source：journal。frontiersin。ScottO。Lilienfeld，KatherynC。Sauvign，StevenJayLynn，RobinL。Cautin，RobertD。LatzmanandIrwinD。Waldman
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　　AmbiguousTerms
　　（35）Comorbidity。Thisterm，whichhasbecomeubiquitousinpublicationsontherelationsbetweentwoormorementaldisorders（appearinginapproximately444，000citationsinGoogleScholar），referstotheoverlapbetweentwodiagnoses，suchasmajordepressionandgeneralizedanxietydisorder。Asimilarterm，“dualdiagnosis，”whichhasacquiredconsiderablecurrencyinthesubstanceabuseliteratureinparticular，referstothesimultaneouspresenceofamentaldisorder，suchasschizophrenia，andasubstanceabusedisorder，suchasalcoholism（Dixon，1999）。Someauthorshavetakenthecomorbidityconceptfurther，extendingitto“trimorbidity”（Corneliusetal。，2001）or“quatromorbidity”（Newmanetal。，1998）。
　　Nevertheless，“comorbidity”canmeantwoquitedifferentthings。Itcanrefertoeitherthe（a）covariation（orcorrelation）betweentwodiagnoseswithinasampleorthepopulationor（b）cooccurrencebetweentwodiagnoseswithinanindividual（Lilienfeldetal。，1994；KruegerandMarkon，2006）。ThefirstmeaningreferstotheextenttowhichConditionAandBforexample，thereissubstantialcovariationbetweenASPDandBPD（Beckeretal。，2014）。ThesecondmeaningisaconditionalprobabilityreferringtotheproportionofindividualswithConditionAwhomeetdiagnosticcriteriaforConditionB。Forexample，inthecaseofthelattermeaning，researchersmightnotethat45ofpatientswithASPDalsomeetdiagnosticcriteriaforBPD。Thedifferencebetweenthesetwomeaningsishardlytrivial，becausetheytendtobedifferentiallyinfluencedbybaserates（prevalences）。Ifthebaseratesofoneormoreconditionschange，thecovariationbetweenthemwillnotnecessarilybeaffectedbutthelevelofcooccurrencealmostalwayswillbe（Lilienfeldetal。，1994）。Moreover，dependingonthebaseratesofthediagnosesinasample，twoconditionsmaydisplaylittleornocovariationbutsubstantialcooccurrence。Forexample，althoughASPDandmajordepressiontypicallydisplayonlymodestcovariation（GoodwinandHamilton，2003），theratesofcooccurrencebetweenASPDandmajordepressioninananalysisconditionedonmajordepression（thatis，theratesofASPDamongpeoplewithmajordepression）wouldbeextremelyhighinaprisonsample，becausemostprisoninmatesmeetcriteriaforASPD（FlintStevens，1993）。Hence，thelevelsofcomorbiditywouldprobablybenegligibleinthefirstcasebuthighinthesecond。Ifauthorselecttousetheterm“comorbidity，”theyshouldthereforebeexplicitaboutwhichmeaning（covariationorcooccurrence）theyintend。
　　Someauthors（Lilienfeldetal。，1994）havefurtherquestionedtheroutineuseofthetermcomorbidityinpsychopathologyresearchgiventhatthisterm，muchlike“dualdiagnosis，”presupposesthattheconditionsinquestionareetiologicallyandpathologicallyseparableentities（butseeRutter，1994；Spitzer，1994，fordemurrals）。Forexample，althoughthehighlevelof“comorbidity”betweenASPDandBPDmayreflectcovariationorcooccurrencebetweentwodistinctconditions，itmayinsteadreflectthefactthatthecurrentdiagnosticsystemisattachingdifferentnamestoslightlydifferentmanifestationsofashareddiathesis，therebyfallingpreytoajanglefallacy。Totakeanadmittedlyextremeexample，howlikelyisitthataparticipantinapublishedstudywhosimultaneouslymetdiagnosticcriteriaforall10DSMpersonalitydisorders（seeLilienfeldetal。，2013）genuinelypossessed10distinctdisordersatthesametime？Criticsoftheexpansiveapplicationofthetermcomorbiditytodescriptivepsychopathologycontendthatthesediagnosticconundrumsarebestexplainedbyaflaweddiagnosticsystemthatisattachingdifferentnamestohighlyoverlappingconstructs。
　　（36）Interaction。AsOlweus（1977）observedinthecontextofthepersonsituationdebate，theterm“interaction”hasmultiplemeanings，someofthemlogicallyincompatible。Forexample，thefamiliarphrase“genesandenvironmentinteractforDisorderX”canmeananyoneoffourthings：（a）genesandenvironmentarebothinvolvedinthecausesofDisorderX；（b）therelationbetweengenesandenvironmentsarebidirectional，becausegenesinfluencetheenvironmentstowhichpeopleareexposed（bymeansofgeneenvironmentcorrelations），andenvironmentsinfluencewhichgenesareactivatedorinactivated（bymeansofepigeneticprocesses）；（c）or（d）thestatisticaleffectsofgenesdependonpeople’senvironments，andthestatisticaleffectsofenvironmentsdependonpeople’sgenes。Onlymeaning（d）referstoastatisticalinteractioninthestandardmultipleregressionoranalysisofvariancesense。
　　Twopointsareworthnotinghere。First，psychologistsroutinelyconfusemeanings（a）and（d）。Forexample，whenresearcherswritethat“Allreasonablescholarstodayagreethatgenesandenvironmentinteracttodeterminecomplexcognitiveoutcomes”（Batesetal。，1998，p。195），somereadersmayassumethattheyarereferringtothestandardstatisticalmeaningoftheterm“interaction，”（McClellandandJudd，1993），i。e。，amultiplicativeratherthanadditiverelationbetweenvariables，suchasthatbetweengeneticandenvironmentalinfluences。Instead，inthiscasetheauthorsappeartobesayingonlythatbothgenesandenvironmentplayaroleincognitiveoutcomes，ascenariothatdoesnotrequireamultiplicativerelationbetweengenesandenvironment。Second，meanings（c）and（d）arelogicallyincompatible，becauseiftheeffectsofgenesandenvironmentarenotseparable，thenclearlytheycannotbedistinguishedinstatisticaldesigns。Thebottomline：whenauthorsusetheterm“interaction，”theyshouldbeexplicitaboutwhichofthefourmeaningstheyintend。
　　（37）Medicalmodel。Althoughmanyauthorswhoinvoketheterm“medicalmodel”presumethatitreferstoasingleconceptualization（e。g。，MannandHimelein，2008），itdoesnot。Someauthorsinsistthatthetermissovagueandunhelpfulthatwearebetteroffwithoutit（Meehl，1995）。Amongotherthings，ithasbeenwieldedbyvariousauthorstomean（a）（b）anemphasisonunderlying“disease”（c）（d）（e）（f）or（g）thebeliefthatmentallyillindividualswhoengageinirresponsiblebehaviorarenotfullyresponsibleforsuchbehavior（seeBlaney，1975，2015，fordiscussions）。Similarsemanticandconceptualambiguitiesbedeviltheterm“diseasemodel”whenappliedtoaddictionsandmostotherpsychologicalconditions（e。g。，Graham，2013）。
　　（38）Reductionism。Theremaybenogreaterinsultinpsychologicalcirclesthantobrandacolleaguea“reductionist。”Indeed，merelyaccusingafellowfacultymemberof“beingreductionistic”isoftenaneffectiveconversationstopperatcocktailparties。Thenegativeconnotationattachedtothistermneglectsthepoint，overlookedbymanyauthors（e。g。，Harris，2015），that“reductionism”isnotoneapproach。Robinson（1995）delineatedmultipleformsofreductionism，including（a）nominalisticreduction，i。e。，reductionatthelevelofnames（“Abrainstructurecalledtheamygdalaplaysakeyroleinfearprocessing”）；（b）nomologicalreduction，i。e。，reductionatthelevelofscientificexplanation（“Theperceptionofedgesismediatedinpartbyfeaturedetectioncellsinthevisualcortex”）；and（c）ontologicalreduction，i。e。，reductionbyeliminatingimmaterialentities（“Neuroscientificdatastronglysuggestthatthereisnoimmaterialsoul”）。
　　Morebroadly，wecandifferentiatebetweentwoquitedifferentbrandsofreductionism：constitutiveandeliminative，thelattertermed“greedyreductionism”byDennett（1995）。Theconstitutivereductionistbelievesmerelythateverythingthatis“mental”isultimatelymaterialatsomelevel，andthatthe“mind”iswhatthebrainandrestofthecentralnervoussystemdo。Constitutivereductionists（Robinson，1995），whoappeartocompriseanoverwhelmingmajorityofpsychologistsandneuroscientists，rejectmindbodydualism，theclaimthatthemindisentirelyseparablefromthebrain。Incontrast，eliminativereductionistsgoalargestepfurther（Lilienfeld，2007）。Theycontendthatthe“mind”willeventuallybeexplainedawayentirelybylowerlevelconceptsderivedfromneuroscience，andthatmentalistconcepts，suchasthoughts，motives，andemotions，willultimatelyberenderedsuperfluousbyneuroscientificexplanations。Foreliminativereductionists，thefieldofpsychologywilleventuallybe“gobbledup”byneuroscience。Althoughwedonotattempttoadjudicatethedisputebetweenconstitutiveandeliminativereductionistshere，sufficeittosaythat“reductionism”doesnotcarryasinglemeaninginpsychology。Asaresult，psychologistswhouse“reductionist”asahandytermofopprobriumagainsttheircolleaguesmustbeexplicitaboutwhichformofreductionismtheyareinvoking。