Deeper than Symptoms: Heterogeneity as a Challenge to Network Models in Psychiatry

Abstract

According to the Network Models account (NM), mental disorders arise from the interplay among symptoms in a network structure. Crucially, some versions of NM rest on the idea that symptoms should be taken as the causally relevant unit of analysis in the study of mental disorders. In this paper we offer some reasons to resist such an idea, by arguing that the exclusive focus on symptoms and their connections fails to provide us with the appropriate level of analysis to understand mental disorders. Drawing on evidence from cultural psychiatry and medical anthropology, we show that heterogeneity raises serious issues for NM. Through the discussion of three significant cases, we suggest that some versions of NM risk missing out on crucial aspects of the person’s pathology. Proponents of NM should therefore amend their account so as to make it more responsive to different aspects of heterogeneity.