I think we broadly agree, but I can't go as far as agreeing with this: "If you want to trust a diagnostic test of a mental state, ultimately, at some point, you will also have needed to trust the self-reporting of that mental state."
I think it's true we can generally trust people's self reports. But we all know that's not always true. There's the classic comedy staple:
A: You sound upset.
B: I AM NOT UPSET!
But there's more subtlety there, too. Anybody who deals with children has had the experience of understanding what the child is feeling better than said child does. And I remember being on the other side of that as a kid. People would ask me how I was doing, and I would self-report whatever answer I thought they wanted, not my actual state, which was often mysterious to me.
And although that has lessened as I grow older, I still can look back on key moments as an adult where I thought I was feeling one thing but, upon later reflection, realize it was something else.
So I think the best we can do is to come up with a series of external tests that correlate well with self-reporting and with each other. With that, yes, I think we can tell people, "No, you're not really depressed." For example, in the months after I lost my mom to a brain tumor, I thought that I was depressed. I went to see a therapist and she said, "No, you're mourning an important loss. It's supposed to be like this." And she was right.
I think it's true we can generally trust people's self reports. But we all know that's not always true. There's the classic comedy staple:
A: You sound upset. B: I AM NOT UPSET!
But there's more subtlety there, too. Anybody who deals with children has had the experience of understanding what the child is feeling better than said child does. And I remember being on the other side of that as a kid. People would ask me how I was doing, and I would self-report whatever answer I thought they wanted, not my actual state, which was often mysterious to me.
And although that has lessened as I grow older, I still can look back on key moments as an adult where I thought I was feeling one thing but, upon later reflection, realize it was something else.
So I think the best we can do is to come up with a series of external tests that correlate well with self-reporting and with each other. With that, yes, I think we can tell people, "No, you're not really depressed." For example, in the months after I lost my mom to a brain tumor, I thought that I was depressed. I went to see a therapist and she said, "No, you're mourning an important loss. It's supposed to be like this." And she was right.