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The DSM-5 Definition of Mental Disorder: Critique and Alternatives

Part of the Essential Clinical Social Work Series book series (ECSWS)

Abstract

The chapter begins by dissecting the definition of mental disorder offered in the latest edition of the diagnostic manual, incisively pointing out its flaws and shortcomings. These flaws are of two kinds. First, there is the DSM’s overreach in what it “counts” as a mental disorder—e.g., enduring conditions with a clear biological etiology such as Down’s syndrome; temporary states caused by events such as alcohol intoxication, dehydration, or fever-induced delirium; and reactions to adverse environmental stressors. For a condition to be categorized as a mental disorder, its etiology ought to be mentally related, not simply represent a condition that adversely effects mental functioning; indeed, distress and dysfunction can be caused by a wide range of factors, not all of which constitute “mental disorders.” Second, there are fundamental errors in logical reasoning found throughout the manual—e.g., the assumption that diagnoses represent natural and coherent syndromes, as well as the pervasive reification and tautological reasoning in how mental disorder is “explained” by the very elements that comprise its definition. Alternatives to the DSM are explored including various forms of “denialism,” symptomatic treatment, and functional behavioral assessment. The chapter concludes with a reflection on the consequences for clinical assessment and treatment of the DSM’s vision of mental disorder and a call for social workers to critically examine its tenets and decide for themselves the model(s) they wish to use.

Keywords

  • Denialism
  • Etiology
  • Syndrome
  • Reification
  • Circular reasoning
  • Symptomatic treatment
  • Functional assessment of behavior

Portions of this chapter previously appeared in Thyer (2014).

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Correspondence to Bruce A. Thyer .

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Thyer, B.A. (2015). The DSM-5 Definition of Mental Disorder: Critique and Alternatives. In: Probst, B. (eds) Critical Thinking in Clinical Assessment and Diagnosis. Essential Clinical Social Work Series. Springer, Cham. https://doi.org/10.1007/978-3-319-17774-8_3

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