I have another place where I write long essays, and I need to have a discussion of realizm versus nominalism as a form of epistemology. I am a realist: I consider there is an external world that we deal with. In research we look at fragments and our findings lead to theories that can be proven or disproven by other data. We do not know with perfection: we are not God.

And as we are not God, the scientific method helps us deal with our astimagtism and myopia, as Bruce Charlton notes.

But most explanations are partial and biased and highly precise – such as the statistical models and measurements so beloved by bureaucrats and pseudo-scientists. They are like tiny, sharp pictures of tiny, broken pieces of reality – with an implicit denial that anything else in reality matters apart from a single tiny sharp picture of a detached fragment.

Because the partial fragment is sharply seen, it is – in practice, although denied in theory – regarded as the only thing known, the only thing of importance. This is normal and usual in recent generations in philosophy, science, in management… in all modern institutions; and indeed the legalism (‘Phariseeism’) of ancient religions is another expression of the same phenomenon.

(So much ‘logic’ – and mathematics as applied to actual situations – has exactly this falsehood; the units of reasoning are apparently precise but actual broken fragments of arbitrarily-defined real-world significance.)

Instead, we can adopt a very simple idea of ‘the whole thing’ – with a clear accompanying comprehension that it is only a blurry and imprecise vision of totality, with exceptions.

I think Bruce isbeing quite optimistic, almost Panglossian. He forgets that without a clear gold standard test, we tend to consider our diagnostic criteria as real. They are not the condition: they are teliable markers to differetiate wone condition from aonther. The DSM 5 is a guess as to what is there: we do not have a confimatory test akin to neurofibrillary tangles on brian biopsy for Alzheimer’s Disorder or the finding of the spirochaete for Genergel Paresis of teh Ismane.

And this leads to erros. Consider this week’s JAMA psychiatry. Adult ADHD remains controversial: I do not see this as much as antisocpail disorderm but methylphenidate has a reasonable price on the street here. The clinical description is different from childhood ADHD, and childhood ADHD is controvesial enough. So when I read these finings I doubt the assmution of the paper.

The weighted (to adjust for oversampling) prevalence of DSM-5/ACDS adult ADHD was 6.5% in the NCS-R sample, 9.2% in the managed care sample, and 8.2% in the pooled combination of the 2 samples. The unweighted prevalence was 37.0% in the NCS-R sample (n?=?44 of DSM-5/ACDS cases), 23.4% in the managed care sample (n?=?51), and 57.7% in the NYU Langone sample (n?=?173). Of the respondents who met DSM-5 criteria for adult ADHD, 123 were male (45.9%); mean (SD) age was 33.1 (11.4) years.

That is not the crippling lack of intattention that I would want to see to reach for a prescription pad. That is twice the rate of serious mental disorder funded by the New Zealand State.

This is the stigmata of the intelligent. The only reason that I don’; get up and leave in meetings is that I reading something else on my phone and paying partial attention.

The threshold, as is common in the work of Kessler and his project, are too low. THere is no disability and distress. There is nothing to cure. Being bored is not a disease.

This is setting criteria, testing that you can measure them reliably, and then making a category error: that reliable mearuement equals disorder.

ANd now I better go and mark some essays.