Mental health assessment: Inference, explanation, and coherence

J Eval Clin Pract. 2018 Jun;24(3):649-654. doi: 10.1111/jep.12885. Epub 2018 Jan 30.

Abstract

Mental health professionals such as psychiatrists and psychotherapists assess their patients by identifying disorders that explain their symptoms. This assessment requires an inference to the best explanation that compares different disorders with respect to how well they explain the available evidence. Such comparisons are captured by the theory of explanatory coherence that states 7 principles for evaluating competing hypotheses in the light of evidence. The computational model ECHO shows how explanatory coherence can be efficiently computed. We show the applicability of explanatory coherence to mental health assessment by modelling a case of psychiatric interviewing and a case of psychotherapeutic evaluation. We argue that this approach is more plausible than Bayesian inference and hermeneutic interpretation.

Keywords: assessment; coherence; diagnosis; explanation; inference; psychiatry; psychotherapy.

MeSH terms

  • Diagnosis, Differential*
  • Humans
  • Mental Disorders / diagnosis*
  • Mental Health
  • Models, Theoretical
  • Psychiatry
  • Psychotherapy