Version 2.2 Structured Psychosocial Stress and Therapeutic Intervention: Toward a Realistic Biological Medicine Rodrick Wallace, Ph.D. The New York State Psychiatric Institute ∗ June 5, 2003 Abstract Using generalized ‘language of thought’ arguments appropriate to interacting cognitive modules, we explore how disease states can inter- act with medical treatment, including, but not limited to, drug ther- apy. The feedback between treatment and response creates a kind of idiotypic ‘hall of mirrors’ generating a pattern of ‘efficacy’, ‘treatment failure’, and ‘adverse reactions’ which will, from a Rate Distortion per- spective, embody a distorted image of externally-imposed structured psychosocial stress. This analysis, unlike current pharmacogenetics, does not either reify ‘race’ or blame the victim by using genetic struc- ture to place the locus-of-control within a group or individual. Rather, it suggests that a comparatively simple series of questions to identify longitudinal and cross-sectional stressors may provide more effective guidance for specification of individual medical therapy than compli- cated genotyping strategies of dubious meaning. These latter are likely ∗Address correspondence to R. Wallace, PISCS Inc., 549 W. 123 St., Suite 16F, New York, NY, 10027. Telephone (212) 865-4766,
[email protected]. Affiliation is for identification only. This material has been submitted for publication and is protected by copyright. 1 to be both very expensive and utterly blind to the impact of struc- tured psychosocial stress – a euphemism