Mental Disorders

In its introduction, the DSM IV TRoffers a general de?nition of mental disorder using the following criteria: Diagnosis and Treatment Planning 2771. a clinically signi?cant behavioral or psychological syndrome or pattern that occurs in an individual and that is associated with present distress or disability or a signi?cantly increased risk of suffering death, pain, disability, or an important loss of freedom.

Speci?c criteria are provided to help mental health professionals exclude particular symptoms or conditions from being considered mental disorders. The DSM IV TR provides examples and criteria for what should not be considered a mental disorder: . . . this syndrome or pattern must not be merely an expectable and culturally sanctioned response to a particular event, for example, the death of a loved one. Whatever its original cause, it must currently be considered a manifestation of a behavioral, psychological, or biological dysfunction in the individual. Neither deviant behavior nor con?icts that are primarily between the individual and society are mental disorders unless the deviance or con?ict is a symptom of a dysfunction in the individual….

Not surprisingly, signi?cant vagueness in the DSM IV TR general de?nition of mental disorder remains. There is room for debate regarding what constitutes “a clinically signi?cant behavioral or psychological syndrome or pattern.” Further, the manual recognizes that “culturally sanctioned” behavioral responses may not be a mental disorder, but notes the inverse; that is, deviant or culturally unsanctioned behaviors may not, in and of themselves, be considered a mental disorder. This vagueness and subjectivity in de?ning mental disorders is another area where the DSM has received criticism . For example, Szasz states: Which kinds of social deviance are regarded as mental illnesses? The answer is, those that entail personal conduct not conforming to psychiatrically de?ned and enforced rules of mental health. If narcotics avoidance is a rule of mental health, narcotics ingestion will be a sign of mental illness; if even temperedness is a rule of mental health, depression and elation will be signs of mental illness; and so forth.