Defining a Mental Disorder
The definition of the concept of a "mental disorder," fundamental to the mental health field, has been an important and controversial issue in psychology. Labeling a person's behavior abnormal, effects the way they are viewed and view themselves, and determines the recommendations for treatment. Since the term describes such a broad range of illnesses, it is difficult to come up with a definition that is adequately inclusive and consistent. J.C. Wakefield (1992) made a compelling argument that defined a mental disorder as a "harmful dysfunction." However, the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders (as cited in Emery & Oltmanns, 1998) provides a more complete definition that includes the different characteristics of mental disorders, while excluding certain conditions that could lead to behavior that may be misconstrued as evidence of a mental disorder. Specifically, the DSM -IV (as cited in Emery & Oltmanns, 1998) requires that present distress, disability, or a significantly increased risk of suffering death, pain, disability, or an important loss of freedom must charac
Wakefield, J.C. (1992). On the boundary between biological facts and social values. American Psychologist, 47, 373-388. Accurately picking out mental disorders, as the difference between anorexia nervosa and religious fasting shows, relies on judgement. The specific definitional guidelines described in the DSM-IV provide a procedure for analysis, and therefore are only as good as their application within a culture. However, the DSM-IV (as cited in Emery & Oltmanns, 1998) requires that a syndrome must not be merely an expectable and culturally sanctioned response to a particular event, deviant behavior, or a conflict between the individual and society. Likewise, Wakefield believed that harmfulness should be judged by the standards of a person's culture, but lacks specifications for that critical judgement. Along with A. Kleinman (1988), he criticized the inadequate consideration of cultural differences in the DSM's previous editions. These conditions for exclusion are essential in accounting for differences in what is considered "normal behavior" cross-culturally, and indicate the difficulty in deciding wh
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