Clinicians have proposed different psychological theories to explain mental illness from the perspective of the mind. Some of them are imaginative explanations of facts that have not or can’t be explained neurobiologically. Ultimately such explanations blur the line between cause and effect. Unsurprisingly, the number of psychological theories about a condition is a direct reflection of how little is known about its etiology. When little is known about a condition, theories proliferate, become grouped, and are publicized as new developments. Theories, stemming from this perspective, are difficult to falsify. Are they dogma or scientific explanations? In psychology, the more compelling the description, the more persistent is the underlying presumption. Moreover, psychological explanations have become a fair game for the opinion of anybody who is willing to espouse a trendy name, e.g., refrigerator mothers, catch 22. These theories are not the end of psychoanalytic ruminations but rather represent a return to the same.
One could not argue, however, that only the biological perspective is correct or that it has escaped neuroscientific inquiry unscathed. The lack of reproducible findings has allowed for a proliferation of biological theories. In this regard, neuropathology echoes Dostoyevsky’s unsettling remark that if there is no God, then everything is allowed. If we do not have pathology, we should favorably consider every inquiry and every result. Unfortunately this approach preserved falsehoods by building tale upon tale. Maybe finding pathology for autism is akin to existential horror. Finding pathology would locate the workings of minds in the brain. This approach leads to the astonishing hypothesis that “You, your joys and your sorrows, your memories and ambitions, your sense of personal identity and free will are in fact no more than the behavior of a vast assembly of nerve cells and their associated molecules”. This undermines the human tendency to flatter themselves, to assert their uniqueness. Desmond Morris once said that we tend to think of ourselves as fallen angels, not risen apes.
Core deficits are now defined in terms of information processing impairment. At present, there is enough scientific evidence to accord the status of “theory” to three different psychological conjectures on autism: deficits in theory of mind, executive function, and central coherence. First, deficits in theory of mind can be seen as an exaggeration of gender based differences that are seemingly hard-wired to our brain. Asperger was the first brave soul to suggest that this syndrome was the extreme of the male personality. Simon Baron-Cohen has publicized this theory based on his own pioneering research spanning the spectrum from gossip to aggression, from evolution to everyday life, and from brain sciences to theory of mind. These differences reflect the way we systemize and develop empathy. Second, executive functions have a locus within the prefrontal cortex. Experimental work by Goldman-Rakic indicates that, according to the anatomical area involved, the frontal lobe exhibits different working-memory domains. Visuospatial processing is performed by the dorsolateral prefrontal cortex. Working memory for the features of objects and faces occurs in the more lateral and inferior cortices, while semantic encoding and retrieval involves still more inferior and insular regions. It is easy to envision how a defect in working memory/executive functions can provide for abnormalities in language, thinking, and behavior. Lastly, central coherence is analogous to the binding phenomena studies in neurosciences. Weak central coherence, a pattern typical of autism, is a cognitive style that emphasizes low-level features in lieu of high-level integrative processing. Higher level integrative processing appears to be mediated by the synchronization of neuronal discharges on high- (gamma) frequency EEG. Unsurprisingly, investigators have recently reported a disorder of binding related gamma EEG oscillatory activity I autism.
It is noteworthy that Shakow, working in the 1930’s and 40’s, generated a segmental set theory that seemingly joined both executive functions and central coherence. His theory stated that in order to successfully perform daily activities one needs to break down activities into segments while retaining the big picture or set. In some conditions, the big picture is easily lost. The underlying deficit appears related to hemispheric, rather than global function. The right hemisphere interprets global patterns while the left hemisphere infers details of stimuli.
Without hard evidence in terms of neuropathology psychological theories are too malleable, confluent, and easy to paint themselves into a corner. Most psychological theories offer nothing more than common sense. It has been the failure of psychologists not to pursue their theories with neurobiological techniques. Thus far they all remain unidimensional and only offer the perspective of the people that developed them.