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Theoretical Medicine and Bioethics

, Volume 33, Issue 5, pp 343–357 | Cite as

On the nature of mental disorder: towards an objectivist account

  • Panagiotis OulisEmail author
Article
  • 475 Downloads

Abstract

According to the predominant view within contemporary philosophy of psychiatry, mental disorders involve essentially personal and societal values, and thus, the concept of mental disorder cannot, even in principle, be elucidated in a thoroughly objective manner. Several arguments have been adduced in support of this impossibility thesis. My critical examination of two master arguments advanced to this effect by Derek Bolton and Jerome Wakefield, respectively, raises serious doubts about their soundness. Furthermore, I articulate an alternative, thoroughly objective, though in part normative, framework for the elucidation of the concept of mental disorder. The concepts of mental dysfunction and impairment of basic psychological capacities to satisfy one’s basic needs are the building blocks of this framework. I provide an argument for the objective harmfulness of genuine mental disorders as patterns of mental dysfunctions with objectively negative biotic values, as well as a formally correct definition of the concept of mental disorder. Contrary to the received view, this objective framework allows for the possibility of genuine mental disorders due to adverse social conditions, as well as for quasi-universal mental disorders. I conclude that overall, the project of providing an objective account of the concept of mental disorder is far from impossible, and moreover, that it is, at least in principle, feasible.

Keywords

Derek Bolton Jerome Wakefield Nature of mental disorder Objective harmfulness Societal values 

References

  1. 1.
    Bolton, D. 2008. What is mental disorder? An essay in philosophy, science, and values. Oxford: Oxford University Press.Google Scholar
  2. 2.
    Adams, F., and K. Aizawa. 2008. The bounds of cognition. Chichester: Wiley-Blackwell.Google Scholar
  3. 3.
    Baumeister, R.F. 2005. The cultural animal: Human nature, meaning and social life. Oxford: Oxford University Press.Google Scholar
  4. 4.
    Wakefield, J.C. 1992. The concept of mental disorder: On the boundary between biological facts and social values. American Psychologist 47: 373–388.CrossRefGoogle Scholar
  5. 5.
    Wakefield, J.C. 1992. Disorder as harmful dysfunction: a conceptual critic of DSM-III-R’s definition of mental disorder. Psychological Review 99: 232–247.CrossRefGoogle Scholar
  6. 6.
    Wakefield, J.C. 2006. Fait et valeur dans le concept de trouble mental: le trouble en tant que dysfonction prejudiciable. Philosophiques 33: 37–64.CrossRefGoogle Scholar
  7. 7.
    Wakefield, J.C. 2007. The concept of mental disorder: diagnostic implications of the harmful dysfunction analysis. World Psychiatry 6: 149–156.Google Scholar
  8. 8.
    Dohrenwend, B.P., ed. 1998. Adversity, stress and psychopathology. New York: Oxford University Press.Google Scholar
  9. 9.
    Muntaner, C., C. Borrell, and H. Chung. 2008. Class exploitation and psychiatric disorders: From status syndrome to capitalist syndrome. In Liberatory psychiatry, ed. C. Cohen and S. Timini, 136–146. Cambridge: Cambridge University Press.Google Scholar
  10. 10.
    Lennox, J.G. 1995. Health as an objective value. Journal of Medicine and Philosophy 20: 499–511.Google Scholar
  11. 11.
    Mahner, M., and M. Bunge. 1997. Foundations of bio-philosophy. New York: Springer.Google Scholar
  12. 12.
    Deci, E.L., and R.M. Ryan. 2000. The “what” and “why” of goal pursuits: Human needs and the self-determination of behavior. Psychological Inquiry 11: 227–268.CrossRefGoogle Scholar
  13. 13.
    Graham, G. 2010. The disordered mind: An introduction to philosophy of mind and mental illness. London: Routledge.Google Scholar
  14. 14.
    Thagard, P. 2010. The brain and the meaning of life. Princeton: Princeton University Press.Google Scholar
  15. 15.
    Schramme, T. 2010. Can we define mental disorder by using the criterion of mental dysfunction? Theoretical Medicine and Bioethics 31: 35–47.CrossRefGoogle Scholar
  16. 16.
    National Institute of Mental Health. 2011. Research Domain Criteria (RDoC). Draft 3.1, June. Bethesda: NIMH.Google Scholar
  17. 17.
    Schwartz, P.H. 2007. Defining dysfunction: Natural selection, design and drawing a line. Philosophy of Science 74: 364–385.CrossRefGoogle Scholar
  18. 18.
    Boorse, C. 2011. Concepts of health and disease. In Philosophy of medicine, ed. F. Gifford, 13–64. Amsterdam: Elsevier.CrossRefGoogle Scholar
  19. 19.
    American Psychiatric Association. 2000. Diagnostic and statistical manual of mental disorders: Text revision, 4th ed. Washington, DC: APA.Google Scholar
  20. 20.
    Kutchins, H., and S. Kirk. 1997. Making us crazy. DSM: The psychiatric bible and the creation of mental disorders. New York: Free Press.Google Scholar
  21. 21.
    Schramme, T. 2003. Psychische Krankheit aus philosophischer Sicht. Giessen: Psychosozial Verlag.Google Scholar
  22. 22.
    Sadler, J.Z. 2005. Values and psychiatric diagnosis. Oxford: Oxford University Press.Google Scholar
  23. 23.
    Boorse, C. 1997. A rebuttal on health. In What is disease? ed. J.M. Humber and R.F. Almeder, 1–134. Totowa, NJ: Humana Press.Google Scholar

Copyright information

© Springer Science+Business Media B.V. 2012

Authors and Affiliations

  1. 1.First Department of Psychiatry, Eginition HospitalAthens University Medical SchoolAthensGreece

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