Each month, the open access team of the University of Groningen Library (UB) puts a recent open access article by UG authors in the spotlight. This publication is highlighted via social media and the library’s newsletter and website.

The article in the spotlight for the month of November 2022 is titled Why mental disorders are brain disorders. And why they are not: ADHD and the challenges of heterogeneity and reification written by Stephan Schleim (Department of Theory & History of Psychology, Faculty of Behavioural and Social Sciences).

Abstract

Scientific attempts to identify biomarkers to reliably diagnose mental disorders have thus far been unsuccessful. This has inspired the Research Domain Criteria (RDoC) approach which decomposes mental disorders into behavioral, emotional, and cognitive domains. This perspective article argues that the search for biomarkers in psychiatry presupposes that the present mental health categories reflect certain (neuro-) biological features, that is, that these categories are reified as biological states or processes. I present two arguments to show that this assumption is very unlikely: First, the heterogeneity (both within and between subjects) of mental disorders is grossly underestimated, which is particularly salient for an example like Attention Deficit/Hyperactivity Disorder (ADHD). Second, even the search for the biological basis of psychologically more basic categories (cognitive and emotional processes) than the symptom descriptions commonly used in mental disorder classifications has thus far been inconclusive. While philosophers have discussed this as the problem of mind-body-reductionism for ages, Turkheimer presented a theoretical framework comparing weak and strong biologism which is more useful for empirical research. This perspective article concludes that mental disorders are brain disorders in the sense of weak, but not strong biologism. This has important implications for psychiatric research: The search for reliable biomarkers for mental disorder categories we know is unlikely to ever be successful. This implies that biology is not the suitable taxonomic basis for psychiatry, but also psychology at large.

We asked author Stephan Schleim a few questions about the article:

How did you select the journal in which to publish? Why did you choose Frontiers in Psychiatry? 

I know the Frontiers journals almost since their inception. My very first publication there was a coincidence: I had been invited to a meeting on the social impact of neuroscience at Cambridge University in March 2009, when I was just finishing my PhD. The organizers wanted to publish the proceedings as a “Research Topic” in Frontiers in Human Neuroscience, comparable to a special issue in other journals. The host kindly paid the fees for us and the paper was published just before the end of that year, which also shows you how fast it can go. It has actually become my most frequently cited article and now has 24,000 accesses on the Frontiers site, which makes it one of the most popular 3% of all their papers (i.e., of almost 300,000 articles by now).

The new publication you now selected is again part of a Research Topic. This time I was invited by Laura Batstra, a developmental psychologist and professor at the Pedagogics Institute, who wanted to collect critical perspectives on psychiatry, together with other scholars. As I had a couple of unpublished ideas about that topic, I did not hesitate long to submit an abstract and later the manuscript.

What I like about the Frontiers journals generally is the constructive dialogue with the editors and peer reviewers, whose names will also be published along with the article. This increases the transparency of the scientific publication process. I think, by the way, that the peer review reports should also be made available, to improve accountability and trust in science. The Frontiers website and system is so advanced that it sometimes feels like chatting with each other. This speeds up things enormously. The downside is that the editors start urging you to respond very soon. If you have a busy schedule (and who hasn’t?) or the revision is complex, that’s simply not feasible.

Finally, it’s also great to know that once your article is published, everyone around the world has free access to it. “Publication” and “to publish” are derived from Latin publicare, which means to make something public. The public (in its role as taxpayer) also pays for our work. So why should we restrict access to its fruits?

To publish your article open access, Frontiers charged an article processing charge (APC) of US$ 1,850. How did you pay for this, and what do you think of such a fee?

I know that for some that’s a lot of money. And this was just for a shorter “B Type Article” (max. 3,000 words). Longer articles are more expensive. But Frontiers also has agreements with many universities (unfortunately not ours) to offer discounts and as far as I know you can apply for a reduction or even a waiver for the whole amount, like when you are from a poor country. That way scholars from richer countries (such as the Netherlands) support scientists elsewhere.

In my case, funds were not a problem, as this was part of an NWO project and I had also specified publication fees in the budget. For some academics, such costs are difficult to cover and some accuse Frontiers of being too expensive. But we should understand that the scientific publication system, on the side of the publishers, always was about money – even profits. As far as I know the libraries have to sign non-disclosure agreements to keep their contracts with the old-fashioned publishers secret. So don’t criticize Frontiers or similar publishers, if you aren’t critical of how the old system worked as well. In the past, scientists may even have had to sign such strict contracts prohibiting them to use their own papers for educational purposes!

Good work has its price. And someone has to pay for that. Whether a single publication fee or ongoing subscription costs, for the old-fashioned journals and publishers, is better or cheaper is an ongoing debate. Frontiers makes transparent how it uses the money. If somebody convinced me of their misuse, I’d stop publishing there.

You are quite active in outreach activities. Do you consider it important for academics to engage in dissemination activities and participate in public debate? If so, why?

I have already explained the “making public” idea of science. For me it just makes no sense to receive public funds and then build a wall around the knowledge I gather. I also want the university to be as open and inclusive as possible. It should be a place for creative minds to meet, develop innovative ideas, and improve our understanding and ideally the world as well, though the latter is unpredictable and can sometimes take a long time.

We should also not forget that we are a governmental institution. The government, because of its privilege to tax people and companies, is virtually the only actor in a capitalistic system which doesn’t need to make profit to survive. This gives us precious freedom to explore new ways of communication, education, and research.

But I would not force any colleague to engage with the public. For me it is fun. I grew up as digital communication and the internet evolved. I spent countless hours discussing with people all over the world, sometimes just for the sake of discussing. Then I was fortunate to pursue a PhD in neuroscience when that research was hyped in the media. In 2007, the German publisher Spektrum der Wissenschaft (a daughter of Scientific American) invited me to join their new science blog platform, now called SciLogs. Writing these 415 essays so far – without a salary – was a great training opportunity. And the 32,000 comments just on my blog make it an interactive educational project that now receives more than 1,000 daily accesses.

That’s one of the great things about knowledge and education: You can share it – and afterward everyone is only richer, nobody lost anything. We so often complain about polarization in society. But how can we depolarize society when hiding in the ivory tower, far away from the public? Just recently I had a reader who used racist vocabulary. Instead of blocking him right away, I explained it to him. He understood. And then adapted his language. We should not forget that the vast majority of society, unlike us privileged few, doesn’t spend most of their time in an education environment, surrounded by so many intelligent people.

Lastly I would also like to thank the Psychological Institute for explicitly endorsing the staff’s public engagement as real work and not just the time spent in the lab, office, or on scientific meetings. I remember days when colleagues thought that those interacting with the public couldn’t be good scientists. This has changed mostly, I think.

Could you reflect on your experiences with open access and open science in general?

Generally, they are very positive. It can also happen that you get unfair or bad peer reviews in open access journals. But because they usually work faster, you at least lose less time. In recent years, also in response to various scandals and fostered by new digital technology, we have already improved a lot. But I think we can still do better: Make all protocols, peer reviews, articles, and data publicly accessible.

As long as I can afford it, I don’t want to feed the old and closed publication system anymore. Soon my first open access book will be published, on mental health and substance use, which summarizes my NWO project. I’m curious about its international impact, as it will also be my first book in English. 

Useful links:

Funder policies: Most research funding organizations require publications resulting from publicly funded grants to be published open access. Most funders allow article processing charges to be paid from grant money, although conditions apply. See this support page for more information about funder policies.

Stephan Schleim’s personal website 

Citation:

Schleim S (2022) Why mental disorders are brain disorders. And why they are not: ADHD and the challenges of heterogeneity and reification. Front. Psychiatry 13:943049. doi: 10.3389/fpsyt.2022.943049 

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