Brief Comments From a Psychiatric Nosologist Weary From His Own Attempts to Define Mental Disorder: Why Ossorio's Definition Muddles and Wakefield's “Harmful Dysfunction” Illuminates the Issues

1997 ◽  
Vol 4 (3) ◽  
pp. 259-261 ◽  
Author(s):  
Robert L. Spitzer
Keyword(s):  
Mental Disorder ◽  
Harmful Dysfunction

Integrating competence and psychopathology: Pathways toward a comprehensive science of adaptation in development

2000 ◽  
Vol 12 (3) ◽  
pp. 529-550 ◽  
Author(s):  
ANN S. MASTEN ◽  
W. JOHN CURTIS
Keyword(s):  
Risk Factors ◽  
Mental Disorder ◽  
Behavioral Problems ◽  
Emotional And Behavioral Problems ◽  
Developmental Tasks ◽  
Harmful Dysfunction ◽  
Complex Models ◽  
Potential Benefits ◽  
Dsm Iv

This paper examines the conceptual and empirical connections between competence and psychopathology, two historically rich traditions for the study of adaptation in development, and what might be gained from their integration. Historical roots of these two traditions are reviewed, then overlaps in their definition are considered, with a focus on the ways in which judgments about competence enter into the nosology of mental disorders. DSM-IV is analyzed from the perspective of competence, and the debate about “harmful dysfunction” in defining mental disorder is discussed in relation to competence. Different models explaining the empirical associations of competence and psychopathology are delineated, and illustrative empirical evidence is provided. Potential explanations include confounded concepts and methods, symptoms undermining the effectiveness of adaptation in the environment, failures in age-salient developmental tasks leading to emotional and behavioral problems, transactional influences, shared vulnerability or risk factors producing both kinds of difficulties, and more complex models. The potential benefits of integrating competence and psychopathology as two major approaches to adaptation are discussed in regard to theory, classification of mental disorder, research, and intervention.

When is development disordered? Developmental psychopathology and the harmful dysfunction analysis of mental disorder

1997 ◽  
Vol 9 (2) ◽  
pp. 269-290 ◽  
Author(s):  
JEROME C. WAKEFIELD
Keyword(s):  
Mental Disorders ◽  
Mental Disorder ◽  
Predictive Validity ◽  
Conceptual Understanding ◽  
Developmental Psychopathology ◽  
Social Values ◽  
Distinctive Features ◽  
Harmful Dysfunction ◽  
Internal Mechanism ◽  
Is Development

One goal of developmental psychopathology is to understand the origins and course of mental disorders. I argue that pursuit of this goal requires a valid conceptual understanding of disorder and that this understanding can be provided by the “harmful dysfunction” analysis of the concept of disorder. The harmful dysfunction analysis holds that a disorder is a condition that is both harmful according to social values and caused by an internal dysfunction, that is, by a failure of an internal mechanism to perform a function for which it was naturally selected. This analysis explains why many of the distinctive features of developmental psychopathology are appropriate to the study of disorder. It is argued that the harmful dysfunction analysis is a necessary supplement to other proposed criteria for disorder, such as developmental deviation or predictive validity.

Neurodiversity, Autism, and Psychiatric Disability

2020 ◽  
pp. 499-521
Author(s):  
Jerome C. Wakefield ◽  
David Wasserman ◽  
Jordan A. Conrad
Keyword(s):  
Mental Disorder ◽  
Autistic Disorder ◽  
Psychiatric Diagnosis ◽  
Normal Variation ◽  
Philosophy Of Psychiatry ◽  
Disability Theory ◽  
Harmful Dysfunction ◽  
Critical Issues ◽  
Diagnosis And Classification ◽  
Psychiatric Conditions

Neurodiversity advocates apply the same kind of critiques to psychiatric conditions such as autism that disability theory has long applied to somatic conditions. Yet these critiques have received little attention from philosophy of psychiatry. Although the arguments of neurodiversity advocates often are undeveloped, they raise critical issues about psychiatric diagnosis and classification. This chapter uses Jerome Wakefield’s “harmful dysfunction analysis” of the concept of mental disorder to reconstruct and evaluate neurodiversity arguments that autism is a normal variation, not a mental disorder. We argue that because of the heterogeneity of “autism,” these arguments are more plausible for some subgroups than others. We find support for a moderate neurodiversity position that objects to psychiatric overreach without denying the reality of some forms of autistic disorder.

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