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Free keywords:
autism; dialectical misattunement; social interaction; intersubjectivity; cultural historical activity theory; enactivism; predictive processing / coding; active inference; dialectical approach; Vygotsky; Bayes
Abstract:
Drawing on socio-cultural theories and Bayesian accounts of brain function, in this article we construe
psychiatric conditions as disorders of social interaction, to fully account for their complexity and
dynamicity across levels of description and temporal scales. After an introduction of the theoretical
underpinnings of our integrative approach, we take Autism Spectrum Conditions (ASC) as a paradigm
example and discuss how neurocognitive hypotheses can be translated into a Bayesian formulation, i.e.
in terms of predictive processing and active inference. We then argue that consideration of individuals
(even within a Bayesian framework) will not be enough for a comprehensive understanding of
psychiatric conditions and consequently put forward the dialectical misattunement hypothesis, which
views psychopathology, not merely as disordered function within single brains, but as a dynamic
interpersonal mismatch that encompasses various levels of description. Moving from a mere
comparison of groups, i.e. ‘healthy’ persons versus ‘patients’, to a fine-grained analysis of social
interactions within dyads and groups of individuals will open new avenues and may allow to avoid an
overly neurocentric scope in psychiatric research, as well as help to reduce social exclusion.
