The Monoamine Hypothesis, Placebos and Problems of Theory Construction in Psychology, Medicine, and Psychiatry :: Psychological Medical Psychiatric Essays

The Monoamine Hypothesis, Placebos and Problems of Theory Construction in Psychology, Medicine, and PsychiatryABSTRACT Can there be scientific theories in psychology, medicine or psychiatry? I approach this question through an in-depth analysis of a ordinary experiment for clinical belief involving the monoamine hypothesis, drug action, and placebos. I begin my discussion with a reconstruction of Adolph Grnbaums conceptual analysis of placebo, and then use his pattern of intentional placebo to discuss a typical experiment using the monoamine hypothesis, two drugs and a placebo. I focus on the theoretical aspects of the experiment, especially on the notion of causal explanation. I then stand five conceptual and methodo ordered problems for theory construction. These problems focus on questions of the causal efficacy of placebos and drugs ad hoc versus ceteris paribus explanations in biomedicine and psychology and the falsifiability of the monoamine hypothesis. I conclude by pointi ng break the need for further, rigorous philosophical analysis concerning the possibility of theory construction in psychology, medicine, or psychiatry. I. IntroductionCan there ever be scientific theories in psychology, medicine, or psychiatry? I argue that one approach to answering this question consists of investigating the nature of such purported theories and I focus on the monoamine hypothesis of clinical depression. (1) By a careful examination of a typical experiment involving the action of drugs and placebos for the cure of clinical depression-an experiment founded upon the monoamine hypothesis-I raise a number of methodological and conceptual problems that may lead one to conclude that rigorous scientific theories in these three disciplines may never be forthcoming, or at least that the state of scientific research in these areas is still in very rudimentary shape and in need of much logical and philosophical analysis. In addition, because no such biomedical theories may be forthcoming, I also undercut Adolf Grnbaums analysis of the concept of a placebo, an analysis that makes the interpretation of placebo relative to a biomedical theory in the first place.I begin in plane section 2 by discussing Grnbaums detailed analysis of what a placebo is. I then use his idea of a generic intentional Placebo and discuss one of many similar experiments concerning the phenomenon of clinical depression, experiments that use the monoamine hypothesis and the notion of a generic intentional placebo. This experiment is described in section 3. In section 4 I analyze the results of this study and in section 5 I offer concluding remarks.