On the nature of mental disorder: towards an objectivist account.
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.
First Department of Psychiatry, Eginition Hospital, Athens University Medical School, Vas. Sofias Av. 72-74, 11528 Athens, Greece. oulisp@med.uoa.gr
Panagiotis
P
Oulis
D000223:Adaptation, Psychological; D039721:Diagnostic and Statistical Manual of Mental Disorders; D028663:Ethical Theory; D040821:Human Characteristics; D006801:Humans; D007600:Judgment; D001523:Mental Disorders / Q000175:diagnosis / Q000523:psychology; D011569:Psychiatric Status Rating Scales; D011570:Psychiatry / Q000941:ethics / Q000592:standards / Q000639:trends; D012945:Social Values