About this Research Topic
In recent years, the need to rediscover the importance of intuition and clinical judgement has been invoked from many scholars and clinicians as a possible way out of the current crisis of psychiatric nosography. The approach of statistical manuals and standardized interviews, being based on the implicit, but strong philosophical assumptions of behaviorism and physicalist ontology, has progressively downsized the contribution of subjectivity (of both the patient and the clinician) in the clinical process.
Conversely, we are currently experiencing a paradigm shift towards a second-person perspective in the field of social neuroscience, while new developments in computational psychiatry may contribute to sharpening the definition of psychopathological phenotypes by modeling time, context, and interactive phenomena.
Further, in the current philosophical debate, there has been a lively discussion concerning the epistemological status of intuitions, emotions, and “atmospheric feelings” and their specific role in knowledge acquisition and justification. Based on these premises, maybe the time has come to call for rethinking the whole concept of diagnostic and clinical reasoning in Psychiatry and Psychology.
But how should we define clinical judgement? In a broad sense, clinical judgement may be considered as fusion of knowledge and experience deriving from the variable contribution of personal sensitivity, theoretical knowledge, and repeated exposure to different clinical pictures in different contexts. How do all those elements precisely interact and intertwine in contributing to psychiatric and psychological evaluation, though? And what role exactly do intuitions, emotions, and “atmospheric feelings” play in diagnostic reasoning? How does the clinician’s behavior, emotional condition, and personal attitude affect the patient’s disposition toward the clinical encounter, the diagnostic process, and the person of the clinician herself?
Following the most recent contributions of both phenomenological psychiatry, placing great emphasis on the role of interactive phenomena in the clinical situation, and social neuroscience, with their paradigm shift towards a second-person perspective, we believe that diagnostic and clinical reasoning should be reconceptualized as a social interaction process (i.e. as a process of mutual responsiveness).
Also, being the social interactional dynamics as constitutive for the psychiatric disorders itself, the factual knowledge on psychiatric nosology becomes deeply entrenched with the pre-factual, emotional, holistic, and sensuality-based attunement with the patient’s situation, where diagnostic intuition becomes a product of a shared sense-making process.
Finally, we critically stress two aspects: on the one hand it seems that in order to address the complex issue of diagnosis in psychopathology disciplines like philosophy of psychiatry and philosophy of mind have to expand their underlying theory by considering the growing developments of both second-person neuroscientific research and computational methods, and, on the other hand, that those developments may also help filling the gap between classical conceptual framework of intuitive knowledge and the most recent neurobiological models of the “social brain”.
This issue of Frontiers in Psychology would like to collect papers aiming to investigate the philosophical premises and the theoretical framework for diagnostic and clinical reasoning in Psychiatry and Psychology, starting from a concretely full-fledged inter-subjective perspective and exploring the nature and the role of intuitions, emotions and “atmospheric” feelings in diagnostic reasoning and clinical judgement.
Topics of interest may include, but may be not limited to:
• An exploration of the epistemological status of intuitions and emotions (How do they work in general, and in clinical reasoning in particular? How do they interact with analytic thinking?);
• A more-in-depth investigation on the role of intuitions, emotions and “atmospheric” feelings in the development of a “good” clinical judgement (i.e., How can these faculties be developed? How can they be taught?);
• What can be said about diagnostic and clinical thinking by second-person neuroscientific approaches?
• The question of diagnostics as a medical art: how is this art of developing an intuitive knowledge of the patient or the clinical picture also taught, for example, in the training of clinicians?
• Considering mental health problems as dynamic and context dependent phenomena, is it possible to combine computational and second-person neuroscientific approaches to sharpen psychopathological phenotyping?
• Is it possible for computational models to also include the clinician’s subjective experience (e.g., intuitions) in order to refine the definition of psychopathological dimensions?
• Problem cases: when intuition is deceptive and there is a clash between empirical findings and gut feelings. What are the reasons for deceptive intuitions and how do we manage them? Can social interaction models contribute to addressing the problem of misleading intuition?
Conversely, we are currently experiencing a paradigm shift towards a second-person perspective in the field of social neuroscience, while new developments in computational psychiatry may contribute to sharpening the definition of psychopathological phenotypes by modeling time, context, and interactive phenomena.
Further, in the current philosophical debate, there has been a lively discussion concerning the epistemological status of intuitions, emotions, and “atmospheric feelings” and their specific role in knowledge acquisition and justification. Based on these premises, maybe the time has come to call for rethinking the whole concept of diagnostic and clinical reasoning in Psychiatry and Psychology.
But how should we define clinical judgement? In a broad sense, clinical judgement may be considered as fusion of knowledge and experience deriving from the variable contribution of personal sensitivity, theoretical knowledge, and repeated exposure to different clinical pictures in different contexts. How do all those elements precisely interact and intertwine in contributing to psychiatric and psychological evaluation, though? And what role exactly do intuitions, emotions, and “atmospheric feelings” play in diagnostic reasoning? How does the clinician’s behavior, emotional condition, and personal attitude affect the patient’s disposition toward the clinical encounter, the diagnostic process, and the person of the clinician herself?
Following the most recent contributions of both phenomenological psychiatry, placing great emphasis on the role of interactive phenomena in the clinical situation, and social neuroscience, with their paradigm shift towards a second-person perspective, we believe that diagnostic and clinical reasoning should be reconceptualized as a social interaction process (i.e. as a process of mutual responsiveness).
Also, being the social interactional dynamics as constitutive for the psychiatric disorders itself, the factual knowledge on psychiatric nosology becomes deeply entrenched with the pre-factual, emotional, holistic, and sensuality-based attunement with the patient’s situation, where diagnostic intuition becomes a product of a shared sense-making process.
Finally, we critically stress two aspects: on the one hand it seems that in order to address the complex issue of diagnosis in psychopathology disciplines like philosophy of psychiatry and philosophy of mind have to expand their underlying theory by considering the growing developments of both second-person neuroscientific research and computational methods, and, on the other hand, that those developments may also help filling the gap between classical conceptual framework of intuitive knowledge and the most recent neurobiological models of the “social brain”.
This issue of Frontiers in Psychology would like to collect papers aiming to investigate the philosophical premises and the theoretical framework for diagnostic and clinical reasoning in Psychiatry and Psychology, starting from a concretely full-fledged inter-subjective perspective and exploring the nature and the role of intuitions, emotions and “atmospheric” feelings in diagnostic reasoning and clinical judgement.
Topics of interest may include, but may be not limited to:
• An exploration of the epistemological status of intuitions and emotions (How do they work in general, and in clinical reasoning in particular? How do they interact with analytic thinking?);
• A more-in-depth investigation on the role of intuitions, emotions and “atmospheric” feelings in the development of a “good” clinical judgement (i.e., How can these faculties be developed? How can they be taught?);
• What can be said about diagnostic and clinical thinking by second-person neuroscientific approaches?
• The question of diagnostics as a medical art: how is this art of developing an intuitive knowledge of the patient or the clinical picture also taught, for example, in the training of clinicians?
• Considering mental health problems as dynamic and context dependent phenomena, is it possible to combine computational and second-person neuroscientific approaches to sharpen psychopathological phenotyping?
• Is it possible for computational models to also include the clinician’s subjective experience (e.g., intuitions) in order to refine the definition of psychopathological dimensions?
• Problem cases: when intuition is deceptive and there is a clash between empirical findings and gut feelings. What are the reasons for deceptive intuitions and how do we manage them? Can social interaction models contribute to addressing the problem of misleading intuition?
Keywords: Diagnosis, Intuition, Cognitive feelings, Emotions, Clinical judgement
Important Note: All contributions to this Research Topic must be within the scope of the section and journal to which they are submitted, as defined in their mission statements. Frontiers reserves the right to guide an out-of-scope manuscript to a more suitable section or journal at any stage of peer review.
