Expanding the notion of mechanism to further understanding of biopsychosocial disorders? Depression and medically-unexplained pain as cases in point

Evidence-Based Medicine has little consideration for mechanisms and philosophers of science and medicine have recently made pleas to increase the place of mechanisms in the medical evidence hierarchy. However, in this debate the notions of mechanisms seem to be limited to 'mechanistic processes' and 'complex-systems mechanisms,' understood as 'componential causal systems'. I believe that this will not do full justice to how mechanisms are used in biological, psychological and social sciences and, consequently, in a more biopsychosocial approach to medicine. Here, I propose, following (Kuorikoski, 2009), to pay more attention to 'abstract forms of interaction' mechanisms. The present work scrutinized review articles on depression and medically unexplained pain, which are considered to be of multifactorial pathogenesis, for their use of mechanisms. In review articles on these disorders there seemed to be a range of uses between more 'abstract forms of interaction' and 'componential causal system' mechanisms. I therefore propose to expand the notions of mechanisms considered in medicine to include that of more 'abstract forms of interaction' to better explain and manage biopsychosocial disorders.

Mechanisms in psychology: The road towards unity?

The focus of this special issue of Theory & Psychology is on explanatory mechanisms in psychology, especially on problems of particular prominence for psychological science such as theoretical integration and unification. Proponents of the framework of mechanistic explanation claim, in short, that satisfactory explanations in psychology and related fields are causal. They stress the importance of explaining phenomena by describing mechanisms that are responsible for them, in particular by elucidating how the organization of component parts and operations in mechanisms gives rise to phenomena in certain conditions. We hope for cross-pollination between philosophical approaches to explanation and experimental psychology, which could offer methodological guidance, in particular where mechanism discovery and theoretical integration are at issue. Contributions in this issue pertain to theoretical integration and unification of psychology as well as the growing importance of causal mechanistic explanations in psychological science.