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In Chapter 3 we present the first main part of our case for Causal Mechanism, by discussing in detail apoptosis, a central biological mechanism. We examine how John Kerr and his co-workers first introduced apoptosis in 1972. We then present the most important stages in scientific research regarding apoptosis during the last decades that led to its identification as a central biological mechanism, explaining the shift from morphological descriptions to biochemical descriptions of the mechanism. We generalise the molecular definition of a pathway to arrive at a more general notion of a causal pathway. We also show that several distinctions used by biologists in order to differentiate between causal pathways and identify the genuine biological mechanisms (active vs passive, programmed vs non-programmed, physiological vs accidental) do not correspond to internal features of causal pathways, but concern an external feature, that is, the role those processes play within the organism.
By
Craig Morgan, Section of Social and Cultural Psychiatry Health Service and Population Research, Department Box 33, Institute of Psychiatry De Crespigny Park, London, UK,
Kwame McKenzie, Centre for Addictions and Mental Health University of Toronto, 455 Spadina Av. Toronto, Canada,
Paul Fearon, Section of Epidemiology and Social Psychiatry, Department of Psychological Medicine and Psychiatry, Box 63, Institute of Psychiatry De Crespigny Park, London, UK
This concluding chapter provides an overview and summary of the research presented in the book Society and Psychosis, to suggest directions and challenges for future research and to discuss the implications of this research. In attempting to understand the links between society and psychosis, there is a need to develop conceptual tools that allow the complexities of the social world to be studied. The framework for investigating the impact of society on psychosis provides a means of synthesising information and knowledge, and generating testable hypotheses for future research. The tentative models outlined in the book indicate genuinely integrated theories of psychosis aetiology, in which the epidemiological evidence that psychosis is associated with forms of social adversity is linked through known biological and psychological mechanisms to the development of symptoms. Irrespective of whether social factors are causally related to psychosis, many of those who present to services have significant social needs.
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