Laukaityte, U.
University of California, Berkeley
There are good grounds to believe there is a false positives problem in psychiatry, which leads to undertreatment of patients who are in urgent need of psychiatric intervention as a result of overtreatment of patients that would fare similarly well without it. Diagnostic inflation could potentially be tackled by reforming its classificatory and diagnostic practices in line with the strong interpretation of the medical model. The Research Domain Criteria (RDoC) project is a step in the right direction. However, I suggest that having a computational cognitive model that spans the neurophysiological and the experiential levels of a disorder has a better chance of differentiating between essential and correlational mechanisms (i.e. realising and contributing causal factors respectively). Just such a model is offered by the predictive processing framework. The possibility of providing mechanistic cognitive accounts for various mental illnesses has been explored by cognitive neuropsychiatry, yet none of the theories seem to have the unificatory potential that predictive processing promises. Furthermore, this is not a reductionist proposal about the causes of psychiatric conditions, as the model is able to accommodate a range of interacting factors (genetic, neurophysiological, social, etc.) that invariably underlie aetiology. Rather, the claim is that whatever the combination of causal factors in any given case, together they should conspire to affect the neurophysiology such that the relevant neural markers are in place and it is these that should guide a more scientific psychiatry. A number of interesting corollaries fall out from analysing the issue within predictive processing. For instance, I will introduce the possibility of and potential mechanisms behind psychosomatic mental illness by analogy with the predictive processing account of functional motor and sensory symptoms (historically known as hysteria). I hypothesise that psychosomatic mental illness could currently be contributing to the overdiagnosis and overtreatment phenomena in psychiatry.