AAP 2026 CONFERENCE

Psychiatry faces profound challenges a quarter of the way into the twenty-first century. Most notably, there are various philosophical disputes pertaining to a) dimensional vs. categorical models of mental disorder, b) the status of psychiatric kinds, c) states vs. traits as the central constructs of psychiatry, and d) the language of “mental disorder” vs. “mental variation.” Furthermore, these ontological disputes are accompanied by methodological disputes regarding which causal factors are most relevant to formulating generalizations about particular mental disorders. Meanwhile, the DSM faces both a validity crisis and a comorbidity crisis. These problems have motivated some in the field to formulate new research traditions– such as RDoC and HiTOP– which offer distinct and novel approaches to the subject matter of psychiatry. The central claim that I advance here is that contemporary psychiatry approximates a pre-paradigmatic Kuhnian science. I take Kuhn’s theory of scientific practice and change as an idealized model– one which abstracts away from the details of particular episodes in the histories of particular sciences, but which nevertheless presents an “ideal type” for how scientific progress often occurs. Two alternative explanations that I will address here are 1) the Human Science Explanation and 2) the Medical Science Explanation.