Internalizing disorders as shape-shifters: Understanding individual and cultural heterogeneity in the presentation of symptoms
Bibliographic record
Abstract
Contemporary psychopathology is grounded in the assumption that diagnostic categories are characterized by discrete sets of individual symptoms. As such, considerable resources have been invested over the past half-century to identify and refine these sets. There is a counter-tradition, however, that emphasizes symptom heterogeneity, especially for the internalizing disorders. This heterogeneity can be observed both within individual sufferers and across groups of sufferers in different sociocultural contexts. Rather than understanding this heterogeneity as a problem in need of a solution, we argue that variability in symptom presentation is an essential feature of internalizing distress: these disorders are, in their essence, shape-shifters. We begin by describing examples of similarities and differences in internalizing distress across cultural-historical contexts. Then, we address the complex nature of symptoms as physiological, psychological, and cultural phenomena that are experienced, interpreted, remembered, and anticipated, highlighting potential mechanisms of heterogeneity at each level of analysis. As this heterogeneity is not boundless, we also consider constraints that afford more uniform presentations and stabilize historical changes. The literature on the cultural shaping of psychological functioning is recruited throughout to illustrate the ways to conceptualize and study symptom heterogeneity. Understanding these disorders as shape-shifters has the potential to transform our approach to psychopathology, bringing a rapidly-growing literature on individual and cultural-historical variation to the very center of how we conceptualize internalizing distress.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.004 | 0.007 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.002 | 0.001 |
| Science and technology studies | 0.001 | 0.017 |
| Scholarly communication | 0.006 | 0.008 |
| Open science | 0.001 | 0.005 |
| Research integrity | 0.001 | 0.002 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".