A philosophical analysis of the neuroscientific conception of autistic traits: contributions from Georges Canguilhem’s biological normativity

Clara Castañares Biochemistry. Doctoral student in Neuroscience. Scholar, Consejo Nacional de Investigaciones Científicas y Técnicas, Instituto Ferreyra Instituto de Investigación Médica Mercedes y Martín Ferreyra, Universidad Nacional de Córdoba; Córdoba, Argentina. image/svg+xml , Luis Bagatolli Doctor in Chemistry. Principal Investigator, Consejo Nacional de Investigaciones Científicas y Técnicas. Director interino, Instituto Ferreyra Instituto de Investigación Médica Mercedes y Martín Ferreyra, Universidad Nacional de Córdoba; Córdoba, Argentina. image/svg+xml , Guillermo Folguera Biologist. Philosopher. Independent researcher, Consejo Nacional de Investigaciones Científicas y Técnicas. Profesor, Universidad de Buenos Aires; Ciudad Autónoma de Buenos Aires, Argentina. image/svg+xml
Received: 14 September 2021, Accepted: 1 December 2021, Published: 20 December 2021 Open Access
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Abstract


Taking Georges Canguilhem’s 1943 book The normal and the pathological as a starting point, this article explores the ways in which the neurosciences define, validate, and legitimize the existence of autistic traits as a subclinical expression of autism. The general hypothesis is that different assumptions based on a naturalistic perspective of health and disease have become consolidated in the specialized literature. Such assumptions include that behaviors should be explained strictly in biological terms, that there is an objective and statistical parameter of normality, and that individuals’ behaviors can be analyzed independently of their context. Based on some aspects of Canguilhem’s arguments regarding health, normality, and normativity, we analyze the ways in which the neurosciences assign a quasi-pathological quality to the descriptive notion of autistic traits. It is possible to conclude that this process involves certain assumptions taken in an aprioristic and uncritical manner, which inhibits the discussion of key aspects associated with the nature of autism and that end up pathologizing differences between people.

Full-text of the article is available for this language: Español.


References


1. Verhoeff B. Autism’s anatomy: A dissection of the structure and development of a psychiatric concept. Groningen: University of Groningen; 2015.

2. Kendler K, Parnas J. Philosophical issues in psychiatry II: Nosology. Oxford: Oxford University Press; 2017.

3. Verhoeff B. Normaal of pathologisch? - De visie van arts en filosoof Georges Canguilhem (1904-1995). Tijdschrift Voor Psychiatrie. 2010;52(9):639-647.

4. Margree V. Normal and abnormal: Georges Canguilhem and the question of mental pathology. Philosophy, Psychiatry, & Psychology. 2002;9(4):299-312.

5. Ferreyra JA, Castorina JA. El aplicacionismo de las neurociencias en el campo de la salud mental. Investigaciones en Psicología. 2017;22(2):25-36.

6. Bloise L, Arias C, Folguera G. Problematizando a la neurociencia cognitiva: biologicismo, patologización y narrativas para el control social. I Jornadas de Fundamentos y Aplicaciones de la Interdisciplina [Internet]. 2021 [citado 12 nov 2021]. Disponible en: https://tinyurl.com/2p83jxwm.

7. Lavagnino NJ, Barbero S, Folguera G. Caracterización, alcances y dificultades de las “bases biológicas” del Trastorno por Déficit de Atención e Hiperactividad (TDAH). Un enfoque desde la Filosofía de la Biología. Physis: Revista de Saúde Coletiva. 2018;28(1):1-32.

8. Bracken P, Thomas P, Timimi S, Asen E, Behr G, Beuster C, et al. Psychiatry beyond the current paradigm. British Journal of Psychiatry. 2012;201(6):430-434.

9. Richards G, Kenny R, Griffiths S, Allison C, Mosse D, Holt R, et al. Autistic traits in adults who have attempted suicide. Molecular Autism. 2019;10(1):4-13.

10. Fornaro M, Sassi T, Novello S, Anastasia A, Fusco A, Senatore I, et al. Prominent autistic traits and subthreshold bipolar/mixed features of depression in severe anorexia nervosa. Brazilian Journal of Psychiatry. 2020;42(2):153-161.

11. Loureiro D, Machado A, Silva T, Veigas T, Ramalheira C, Cerejeira J. Higher autistic traits among criminals, but no link to psychopathy: Findings from a high-security prison in Portugal. Journal of Autism and Developmental Disorders. 2018;48(9):3010-3020.

12. Constantino JN, Todd RD. Autistic traits in the general population: A twin study. Archives of General Psychiatry. 2003;60(5):524-530.

13. Zhao X, Shi W, Li X, Li W, Li C. Autistic traits and negative emotions in the general population during COVID-19: Mediating roles of the behavioural immune system and COVID-19 risk perception. Psychiatry Research. 2021;300:113918.

14. Happé F, Frith U. Annual Research Review: Looking back to look forward – changes in the concept of autism and implications for future research. Journal of Child Psycholofy and Psychiatry. 2020;61(3):218-232.

15. Caponi S. Georges Canguilhem: del cuerpo subjetivo a la localización cerebral. Salud Colectiva. 2010;6(2):149-161.

16. Neves TI, Porcaro LA, Curvo DR. Saúde é colocar-se em risco: normatividade vital em Georges Canguilhem. Saude e Sociedade. 2017;26(3):626-637.

17. Caponi S. An epistemological analysis of the diagnosis of depression. Interface - Comunicação Saúde Educação. 2009;13(29):327-338.

18. Greco M. Between social and organic norms: reading Canguilhem and ‘somatization’. Economy and Society. 1998;27(2-3):234-248.

19. Buchanan A. Georges Canguilhem and the diagnosis of personality disorder. The Journal of the American Academy of Psychiatry and the Law. 2007;35(2):148-151.

20. Hens K. The many meanings of autism: conceptual and ethical reflections. Developmental Medicine & Child Neurology. 2019;61(9):1025-1029.

21. Lord C, Brugha TS, Charman T, Cusack J, Dumas G, Frazier T, et al. Autism spectrum disorder. Nature Reviews Disease Primers. 2020;6(1):5.

22. Nadesan MH. Constructing Autism: Unravelling the ‘truth’ and understanding the social. Constructing Autism. New York: Routledge; 2005.

23. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 5th ed. Washington: American Psychiatric Association; 2013.

24. Chown N. Are the “autistic traits” and “broader autism phenotype” concepts real or mythical? Autism Policy and Practice. 2019;2(1):46-63.

25. Dawson G, Webb S, Schellenberg GD, Dager S, Friedman S, Aylward E, et al. Defining the broader phenotype of autism: Genetic, brain, and behavioral perspectives. Development and Psychopathology. 2002;14(3):581-611.

26. Maxwell CR, Parish-Morris J, Hsin O, Bush JC, Schultz RT. The broad autism phenotype predicts child functioning in autism spectrum disorders. Journal of Neurodevelopmental Disorders. 2013;5:25.

27. Bralten J, Van Hulzen KJ, Martens MB, Galesloot TE, Arias Vasquez A, Kiemeney LA, et al. Autism spectrum disorders and autistic traits share genetics and biology. Molecular Psychiatry. 2018;23(5):1205-1212.

28. Churchard A, Ryder M, Greenhill A, Mandy W. The prevalence of autistic traits in a homeless population. Autism. 2019;23(3):665-676.

29. Golding J, Ellis G, Gregory S, Birmingham K, Iles-Caven Y, Rai D, et al. Grand-maternal smoking in pregnancy and grandchild’s autistic traits and diagnosed autism. Scientific Reports. 2017;7:46179.

30. Işik Ü, Çokünlü Y, Şimşek F, Demirel B, Kiliç F, Demirdaş A, et al. Autistic traits in men with substance use disorder. The Journal of Nervous and Mental Disease. 2020;208(6):505-509.

31. Warrier V, Greenberg DM, Weir E, Buckingham C, Smith P, Lai MC, et al. Elevated rates of autism, other neurodevelopmental and psychiatric diagnoses, and autistic traits in transgender and gender-diverse individuals. Nature Communications. 2020;11:3959.

32. O’Reilly H, Ni Y, Johnson S, Wolke D, Marlow N. Extremely preterm birth and autistic traits in young adulthood: the EPICure study. Molecular Autism. 2021;12:30.

33. Baron-Cohen S, Hoekstra rasgos autistas, Knickmeyer R, Wheelwright S. The Autism-Spectrum Quotient (AQ)—Adolescent Version. Journal of Autism and Developmental Disorders. 2006;36(3):343-350.

34. Wing L, Gould J. Severe impairments of social interaction and associated abnormalities in children: epidemiology and classification. Journal of Autism and Developmental Disorders. 1979;9(1):11-29.

35. Whitehouse AJ, Hickey M, Ronald A. Are autistic traits in the general population stable across development? PLoS One. 2011;6(8):e23029.

36. Mottron L, Bzdok D. Autism spectrum heterogeneity: fact or artifact? Molecular Psychiatry. 2020;25:3178-3185.

37. Gaudenzi P. Normal e patológico no naturalismo e no normativismo em saúde: a controvérsia entre Boorse e Nordenfelt. Physis: Revista de Saúde Coletiva. 2016;26(3):747-767.

38. Rose N. Neuroscience and the future for mental health? Epidemiology and Psychiatric Sciences. 2016;25(2):95-100.

39. Canguilhem G. Lo normal y lo patológico. Buenos Aires: Siglo XXI Editores; 1971.

40. London E. The role of the neurobiologist in redefining the diagnosis of autism. Brain Pathology. 2007;17(4):408-411.

41. von Ehrenstein OS, Ling C, Cui X, Cockburn M, Park AS, Yu F, et al. Prenatal and infant exposure to ambient pesticides and autism spectrum disorder in children: population based case-control study. BMJ. 2019;364:l962.

42. Gindis B. Institutional autism in children adopted internationally: Myth or reality? International Journal of Special Education. 2008;23(3):118-123.

43. Rutter M, Andersen Wood L, Beckett C, Bredenkamp D, Castle J, Groothues C, et al. Quasi autistic patterns following severe early global privation. Journal of Child Psychology and Psychiatry, and Allied Disciplines. 1999;40(4):537-549.

44. Hull L, Lai MC, Baron-Cohen S, Allison C, Smith P, Petrides K V., et al. Gender differences in self-reported camouflaging in autistic and non-autistic adults. Autism. 2020;24(2):352-563.

45. de Leeuw A, Happé F, Hoekstra RA. A conceptual framework for understanding the cultural and contextual factors on Autism across the globe. Autism Research. 2020;13(7):1029-1050.

46. Happé F, Frith U. The beautiful otherness of the autistic mind. Philosophical Transactions of the Royal Society of London: Series B, Biological Sciences. 2009;364(1522):1345-1350.

47. Lefève C. La relation médecin-malade chez Georges Canguilhem. Dialogue. 2013;52(4):695-723.