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The Texture of the Real: Experimentation and Experience in Schizophrenia

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Abstract

The dominance of the neurosciences in psychiatric research raises questions about the relationship between research practices and the lived experience of mental illness. Here, I use data from a group of researchers focusing on neurocognition in schizophrenia to explore the problem of representation in psychiatric research and the forms that neuroscientific evidence assumes for those who produce it. These researchers grappled with the complexity of schizophrenia not by narrowing disease concepts to biological facts but by referencing measurement techniques to generate new versions of schizophrenia. By linking experimental findings to inchoate concepts of personhood and social experience, I found that they reframed and reinforced cultural values, including that those with schizophrenia are destined to a debased and deficient existence. I argue that cognition has emerged as an essential feature of schizophrenia not only because of its representational utility but also because of the ontological work the concept performs. In closing, I present some implications for the neurobiological and social sciences.

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References

  • Almasy, Laura, et al. 2008 A genome screen for quantitative trait loci influencing schizophrenia and neurocognitive phenotypes. American Journal of Psychiatry 165:1185-1192.

    Article  Google Scholar 

  • Apud, Jose A., and Daniel R. Weinberger 2007 Treatment of cognitive deficits associated with schizophrenia: potential role of catechol-O-methyltransferase inhibitors. CNS Drugs 21(7):535-557.

    Article  Google Scholar 

  • Beaulieu, Anne 2002 Images Are Not the (Only) Truth: Brain Mapping, Visual Knowledge, and Iconoclasm. Science Technology and Human Values 27(1):53-86.

    Article  Google Scholar 

  • Bernard, Claude 1957 An Introduction to the Study of Experimental Medicine. New York: Dover.

    Google Scholar 

  • Biehl, Joao, Byron J. Good, and Arthur Kleinman 2007 Introduction: Rethinking Subjectivity. In Subjectivity: Ethnographic Investigations. J. Biehl, B.J. Good, and A. Kleinman, eds. Pp. 1-23. Berkeley, CA: University of California Press.

    Google Scholar 

  • Bilder, Robert, et al. 2009 Cognitive ontologies for neuropsychiatric phenomics research. Neuropsychiatry 14(4/5):419-450.

    Article  Google Scholar 

  • Bonner-Jackson, Aaron, et al. 2010 Neurocognition in schizophrenia: a 20-year multi-follow-up of the course of processing speed and stored knowledge. Compr Psychiatry 51(5):471-9.

    Article  Google Scholar 

  • Brannigan, Augustine 1997 The postmodern experiment: Science and ontology in experimental social psychology. The British Journal of Sociology 48(4):594-610.

    Article  Google Scholar 

  • Bromley, Elizabeth 2005 A collaborative approach to targeted treatment development for schizophrenia: a qualitative evaluation of the NIMH-MATRICS project. Schizophr Bull 31(4):954-61.

    Article  Google Scholar 

  • Bromley, Elizabeth, et al. 2011 A Video Ethnography Approach to Assessing the Ecological Validity of Neurocognitive and Functional Measures in Severe Mental Illness: Results from a Feasibility Study. Schizophrenia Bulletin. doi:10.1093/schbul/sbr002

  • Buchanan, Robert W., et al. 2005 A summary of the FDA-NIMH-MATRICS workshop on clinical trial design for neurocognitive drugs for schizophrenia. Schizophrenia Bulletin 31(1):5-19.

    Article  Google Scholar 

  • Burdick, Katherine E., et al. 2006 Neurocognition as a Stable Endophenotype in Bipolar Disorder and Schizophrenia. J Nerv Ment Dis 194(4):255-260.

    Article  Google Scholar 

  • Carter, Cameron S. 2006 Re-conceptualizing schizophrenia as a disorder of cognitive and emotional processing: A shot in the arm for translational research. Biol Psychiatry 60(11):1169-70.

    Article  Google Scholar 

  • Corin, Ellen 1990 Facts and Meaning in Psychiatry. An anthropological approach to the lifeworld of schizophrenics. Culture, Medicine & Psychiatry 14:153-188.

    Google Scholar 

  • Corin, Ellen 2007 The ‘other’ of culture in psychosis: the ex-centricity of the subject. In Subjectivity: Ethnographic Investigations. J. Biehl, B.J. Good, and A. Kleinman, eds. Berkeley: University of California Press.

    Google Scholar 

  • Corrigan, Patrick W., and Amy C. Watson 2004 At issue: Stop the stigma: Call mental illness a brain disease. Schizophr Bull 30(3):477-479.

    Article  Google Scholar 

  • Craddock, Nick, and Michael J. Owen 2005 The beginning of the end for the Kraepelinian dichotomy. British Journal of Psychiatry 186:364-366.

    Article  Google Scholar 

  • Delawalla, Zainab, John G. Csernansky, and Deanna M. Barch 2008 Prefrontal Cortex Function in Nonpsychotic Siblings of Individuals with Schizophrenia. Biol Psychiatry 63(5):490-97.

    Article  Google Scholar 

  • Desjarlais, Robert 1994 Struggling along: the possibilities for experience among the homeless mentally ill. American Anthropologist 96(4):886-901.

    Article  Google Scholar 

  • Desjarlais, Robert 1997 Shelter Blues: Sanity and Selfhood among the Homeless. Philadelphia: University of Pennsylvania Press.

    Google Scholar 

  • Devereux, George 1978 Cultural thought models in primitive and modern psychiatric theories. In Ethnopsychoanalysis: Psychoanalysis and Anthropology as Complementary Frames of Reference. G. Devereux, ed. Pp. 265-296. Berkeley: University of California Press.

    Google Scholar 

  • Dumit, Joseph 2003 Picturing Personhood: Brain Scans and Biomedical Identity. Princeton, NJ: Princeton University Press.

    Google Scholar 

  • Durkheim, Emile 1951 Suicide: A Study in Sociology. New York, NY: The Free Press.

    Google Scholar 

  • Duster, Troy 2006 Comparative perspective and competing explanations: Taking on the newly configured reductionist challenge to sociology. American Sociological Review 71:1-15.

    Article  Google Scholar 

  • Eisenberger, Naomi I., et al. 2007 Understanding genetic risk for aggression: Clues from the brain’s response to social exclusion. Biological Psychiatry 61(9):1100-1108.

    Article  Google Scholar 

  • Engelke, Matthew 2009 The Objects of Evidence. Malden, MA: Blackwell Publishing.

  • Fabian, Johannes 1995 Ethnographic Misunderstanding and the Perils of Context. American Anthropologist 97(1):41–50.

    Article  Google Scholar 

  • Fischer, Michael M.J. 2008 Four genealogies for a recombinant anthropology of science and technology. Cultural Anthropology 22(4):539–615.

    Article  Google Scholar 

  • Fleck, Ludwik 1979 Genesis and development of a scientific fact. Chicago and London: University of Chicago Press.

    Google Scholar 

  • Fortun, Michael 2008 Promising Genomics: Iceland and deCODE Genetics in a world of speculation. Berkeley: University of California Press.

    Google Scholar 

  • Fullwiley, Duana 2008 The biologistical construction of race: ‘Admixture’ technology and the new genetic medicine Social Studies of Science 38(5):695-735.

    Article  Google Scholar 

  • Gaines, Atwood D. 1992 From DSM I to III-R; Voices of self, mastery and the Other: A cultural constructivist reading of U.S. psychiatric classification. Social Science & Medicine 35(1):3-24.

    Article  Google Scholar 

  • Gard, David E., et al. 2006 Anticipatory and consummatory components of the experience of pleasure: A scale development study. Journal of Research in Personality 40(6):1086-1102.

    Article  Google Scholar 

  • Geertz, Clifford 1973 The Interpretation of Cultures: Selected Essays. New York, NY: Basic Books.

    Google Scholar 

  • Gigerenzer, Gerd 1991 From tools to theories: A heuristic of discovery in cognitive psychology. Psychological Review 98:254-267.

    Article  Google Scholar 

  • Gilbert, G. Nigel, and Michael Mulkay 1984 Opening Pandora’s Box: A Sociological Analysis of Scientists’ Discourse. New York: Cambridge University Press.

  • Gold, Ian, and Lauren Olin 2009 From Descartes to Desipramine: Psychopharmacology and the Self. Transcultural Psychiatry 46:38-59.

    Article  Google Scholar 

  • Good, Byron J. 1997 Studying mental illness in context: Local, global, or universal? Ethos 25(2):230-248.

    Article  Google Scholar 

  • Goodwin, Charles 1994 Professional Vision. American Anthropologist 96(3):606-633.

    Article  Google Scholar 

  • Green, Michael F. 1996 What are the functional consequences of neurocognitive deficits in schizophrenia? Am J Psychiatry 153(3):321-30.

    Google Scholar 

  • Green, Michael F., Robert S. Kern, and Robert K. Heaton 2004 Longitudinal studies of cognition and functional outcome in schizophrenia: implications for MATRICS. Schizophr Res 72(1):41-51.

    Article  Google Scholar 

  • Hall, John R. 1990 Epistemology and sociohistorical inquiry. Annual Review of Sociology 16:329-51.

    Article  Google Scholar 

  • Hartmann, Martin 2010 Against first nature: critical theory and neuroscience. In Critical neuroscience S. Choudhury and J. Slaby, eds. Oxford: Wiley-Blackwell.

    Google Scholar 

  • Healy, David 2004 Shaping the Intimate: Influences on the Experience of Everyday Nerves. Social Studies of Science 34:219-245.

    Article  Google Scholar 

  • Hedgecoe, Adam 2001 Schizophrenia and the narrative of enlightened geneticization. Social Studies of Science 31:875-911.

    Article  Google Scholar 

  • Herskovits, Elizabeth 1995 Struggling over subjectivity: debates about the “self” and Alzheimer’s Disease. Medical Anthropology Quarterly 9(2):146-164.

    Article  Google Scholar 

  • Hess, David J. 1997 Science Studies: An Advanced Introduction. New York, NY: NYU press.

    Google Scholar 

  • Hogle, Linda F. 2010 Characterizing Human Embryonic Stem Cells: Biological and Social Markers of Identity. Medical Anthropology Quarterly 24(4):433-50.

    Article  Google Scholar 

  • Holden, Constance 2010 Proposed Revisions to Psychiatry’s Canon Unveiled. Science 327:770-1.

    Google Scholar 

  • Insel, Thomas R., and Philip S. Wang 2010 Rethinking Mental Illness. Journal of the American Medical Association 303(19):1970-1971.

    Article  Google Scholar 

  • Jablensky, Assen, and Norman Sartorius 2008 What did the WHO studies really find? Schizophrenia Bulletin 34(2):253–255.

    Article  Google Scholar 

  • Kee, Kimmy S., et al. 2009 Emotional intelligence in schizophrenia. Schizophrenia Research 107:61-68.

    Article  Google Scholar 

  • Keefe, Richard S., et al. 2006 The schizophrenia cognition rating scale: an interview-based assessment and its relationship to cognition, real-world functioning, and functional capacity. Am J Psychiatry 163(3):426-32.

    Article  Google Scholar 

  • Keller, Evelyn Fox 2010 The Mirage of a Space Between Nature and Nurture. Durham & London: Duke University Press.

  • Kerr, Anne, Sarah Cunningham-Burley, and Amanda Amos 1997 The new genetics: Professionals’ discursive boundaries. The Sociological Review 45(2):279-303.

    Article  Google Scholar 

  • Kerr, Catherine 2002 Translating ‘mind-in-body’: two models of patient experience underlying a randomized controlled trial of qigong. Culture, Medicine and Psychiatry 26:419-447.

    Article  Google Scholar 

  • Kilts, Clinton D., et al. 2003 Dissociable Neural Pathways Are Involved in the Recognition of Emotion in Static and Dynamic Facial Expressions. NeuroImage 18:156 –168.

    Article  Google Scholar 

  • Kondo, Dorinne 1986 Dissolution and Reconstitution of Self: Implications for Anthropological Epistemology. Cultural Anthropology 1(1):74-88.

    Article  Google Scholar 

  • Lakoff, Andrew 2005 Pharmaceutical Reason: Knowledge and Value in Global Psychiatry. Cambridge University Press, UK.

    Book  Google Scholar 

  • Lampland, Martha, and Susan L. Star, eds. 2009 Standards and Their Stories: How Quantifying, Classifying, and Formalizing Practices Shape Everyday Life. Ithaca, NY: Cornell University Press.

    Google Scholar 

  • Langlitz, Nicolas 2010 The persistence of the subjective in neuropsychopharmacology: Observations of contemporary hallucinogen research. History of the Human Sciences 23:37-57.

    Article  Google Scholar 

  • Langwick, Stacey A. 2008 Articulate(d) Bodies: Traditional Medicine in a Tanzanian Hospital. American Ethnologist 35(3):428-439.

    Article  Google Scholar 

  • Latour, Bruno 1987 Science in Action: How to Follow Scientists and Engineers Through Society. Cambridge, MA: Harvard University Press.

    Google Scholar 

  • Latour, Bruno 2008 What is the style of matters of concern: two lectures in empirical philosophy. The Netherlands: Royal Van Gorcum.

    Google Scholar 

  • Law, John 1999 After ANT: complexity, naming and topology. In Actor Network Theory and After. J. Law and J. Hassard, eds. Oxford, UK: Blackwell Publishers.

    Google Scholar 

  • Lindemann, Gesa 2009 From Experimental Interaction to the Brain as the Epistemic Object of Neurobiology. Human Studies 32:153–181.

    Article  Google Scholar 

  • Lock, Margaret and Judith Farquhar, eds. 2007 Beyond the Body Proper: Reading the Anthropology of Material Life. Durham, NC: Duke University Press.

    Google Scholar 

  • Lovell, Anne 1997 ‘The City is My Mother’: Narratives of Schizophrenia and Homelessness. American Anthropologist 2:355-68.

    Article  Google Scholar 

  • Lynch, Michael E. 1982 Technical work and critical inquiry: Investigations in a scientific laboratory. Social Studies of Science 12(4):499-533.

    Article  Google Scholar 

  • Marder, Stephen R., Wayne Fenton, and Kenneth Youens 2004 Schizophrenia, IX: Cognition in schizophrenia–the MATRICS initiative. Am J Psychiatry 161(1):25.

    Article  Google Scholar 

  • Mol, Annemarie 2002 The body multiple: ontology in medical practice. Durham, NC: Duke University Press.

    Google Scholar 

  • Ochs, Elinor, and Sally Jacoby 1997 Down to the wire: the cultural clock of physicists and the discourse of consensus. Language in Society 26(4):479-505.

    Article  Google Scholar 

  • Pickering, Andy 1993 The mangle of practice: agency and emergence in the sociology of science. American Journal of Sociology 99(3):559-589.

    Article  Google Scholar 

  • Pickering, Andy 1994 After representation: Science studies in the performative idiom. PSA: Proceedings of the Biennial Meeting of the Philosophy of Science Association 2:413-419.

    Google Scholar 

  • Pickersgill, Martyn 2009 Between soma and society: Neuroscience and the ontology of psychopathy. BioSocieties (4):45–60.

  • Pinch, Trevor J., and Wiebe E. Bijker 1984 The social construction of facts and artefacts: Or how the sociology of science and the sociology of technology might benefit each other. Social Studies of Science 14:399-441.

    Article  Google Scholar 

  • Prouteau, Anne, et al. 2005 Cognitive predictors of psychosocial functioning outcome in schizophrenia: a follow-up study of subjects participating in a rehabilitation program. Schizophr Res 77(2-3):343-53.

    Article  Google Scholar 

  • Rabelo, Mariam, and Iara Souza 2003 Temporality and experience: on the meaning of nervoso in the trajectory of urban working-class women in northeast Brazil. Ethnography 4(3):333-361.

    Article  Google Scholar 

  • Rheinberger, Hans-Jörg 1997 Toward a History of Epistemic Things: Synthesizing Proteins in the Test Tube. Palo Alto, CA: Stanford University Press.

    Google Scholar 

  • Rheinberger, Hans-Jörg2005 A Reply to David Bloor: ‘Toward a Sociology of Epistemic Things’. Perspectives on Science 13(3):406-410.

    Article  Google Scholar 

  • Robins, Steven 2006 From ‘Rights’ to ‘Ritual’: AIDS Activism in South Africa. American Anthropologist 108(2):312–323.

    Article  Google Scholar 

  • Sapolsky, Robert M. 2001 Depression, antidepressants, and the shrinking hippocampus. Proceedings of the National Academy of Sciences 989(22):12320-12322.

    Article  Google Scholar 

  • Shapin, Steven 1994 A Social History of Truth: Civility and Science in Seventeenth-Century England. Chicago and London: The University of Chicago Press.

    Google Scholar 

  • Silva, Mary C., Jeanne M. Sorrell, and Christine D. Sorrell 1995 From Carper’s patterns of knowing to ways of being: An ontological philosophical shift in nursing. Advances in Nursing Science 18(1):1-13.

    Google Scholar 

  • Slaby, Jan 2010 Steps towards a Critical Neuroscience. Phenom Cogn Sci 9:397–416.

    Article  Google Scholar 

  • Smyth, Mary M. 2001 Certainty and uncertainty sciences: Marking the boundaries of psychology in introductory textbooks. Social Studies of Science 31(3):389-416.

    Article  Google Scholar 

  • Sparks, Amy, et al. 2010 Social cognition, empathy and functional outcome in schizophrenia. Schizophrenia Research 122(1-3):172-8.

    Article  Google Scholar 

  • Stafford, Charles 2009 Linguistic and cultural variables in the psychology of numeracy. In The Objects of Evidence. M. Engelke, ed. Malden, MA: Blackwell Publishing.

    Google Scholar 

  • Stenberg, Jan H., et al. 2010 Effects of add-on mirtazapine on neurocognition in schizophrenia: a double-blind, randomized, placebo-controlled study. Int J Neuropsychopharmacol 13(4):433-41.

    Article  Google Scholar 

  • Teghtsoonian, Katherine 2009 Depression and mental health in neoliberal times: A critical analysis of policy and discourse. Social Science & Medicine 69:28–35.

    Article  Google Scholar 

  • Timmermans, Stefan, and Steven Epstein 2010 A World of Standards but not a Standard World: Toward a Sociology of Standards and Standardization. Annual Review of Sociology 36:69-89.

    Article  Google Scholar 

  • Verdon, Michael 2010 “The Superorganic,” or Kroeber’s hidden agenda. Philosophy of the Social Sciences 40(3):375-398.

    Article  Google Scholar 

  • Young, Allan 2001 Our traumatic neurosis and its brain. Science in Context 14(4):661–683.

    Article  Google Scholar 

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Acknowledgments

This research was funded by the VA/Robert Wood Johnson Clinical Scholars Program and the Foundation for Psychocultural Research. The author would like to thank Carole Browner, Kim Hopper, Douglas Hollan, Joel T. Braslow, Stephen R. Marder, and Kenneth B. Wells for their invaluable contributions to this research. I am also particularly grateful to anonymous reviewers for their generous and insightful suggestions for improvement.

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  1. Department of Psychiatry and Biobehavioral Sciences, Center for Health Services and Society, University of California, Los Angeles, CA, USA

    Elizabeth Bromley

  2. West Los Angeles VA Healthcare Center, Desert Pacific Mental Illness Research, Education and Clinical Center (MIRECC), Los Angeles, CA, USA

    Elizabeth Bromley

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Correspondence to Elizabeth Bromley.

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Bromley, E. The Texture of the Real: Experimentation and Experience in Schizophrenia. Cult Med Psychiatry 36, 154–174 (2012). https://doi.org/10.1007/s11013-011-9241-z

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