Is the Dysfunction Component of the “Harmful Dysfunction Analysis” Stipulative?

2021 ◽  
pp. 199-212
Author(s):  
Maël Lemoine
Keyword(s):  
Author(s):  
Dane Muckler ◽  
James Stacey Taylor

Abstract Normativism holds that there is a close conceptual link between disease and disvalue. We challenge normativism by advancing an argument against a popular normativist theory, Jerome Wakefield’s harmful dysfunction account. Wakefield maintains that medical disorders are breakdowns (dysfunctions) in evolved mechanisms that cause significant harm to the organism. We argue that Wakefield’s account is not a promising way to distinguish between disease and health because being harmful is neither necessary nor sufficient for a dysfunction to be a disorder. Counterexamples to the harmful dysfunction account are considered, such as mild infections, perceptual deficits, and beneficial illnesses. Then we consider two ways of amending the harmful dysfunction account to address these cases and argue that the proposed amendments raise even more serious problems for this account. These problems apply generally to any normativist theory and raise doubts about the entire normative approach to the philosophy of health and disease.


2000 ◽  
Vol 12 (3) ◽  
pp. 529-550 ◽  
Author(s):  
ANN S. MASTEN ◽  
W. JOHN CURTIS

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.


2021 ◽  
Vol 11 (3) ◽  
Author(s):  
Rosa W. Runhardt

AbstractIf a human subject knows they are being measured, this knowledge may affect their attitudes and behaviour to such an extent that it affects the measurement results as well. This broad range of effects is shared under the term ‘reactivity’. Although reactivity is often seen by methodologists as a problem to overcome, in this paper I argue that some quite extreme reactive changes may be legitimate, as long as we are measuring phenomena that are not simple biological regularities. Legitimate reactivity is reactivity which does not undermine the accuracy of a measure; I show that if such reactivity were corrected for, this would unjustifiably ignore the authority of the research subject. Applying this argument to the measurement of depression, I show that under the most commonly accepted models of depression there is room for legitimate reactivity. In the first part of the paper, I provide an inventory of the different types of reactivity that exist in the literature, as well as the different types of phenomena that one could measure. In the second part, I apply my argument to the measurement of depression with the PHQ-9 survey. I argue that depending on what kind of phenomenon we consider depression to be (a disease, a social construction, a harmful dysfunction, or a practical kind), we will accept different kinds of reactivity. I show that both under the harmful dysfunction model and the practical kinds model, certain reactive changes in measuring depression are best seen as legitimate recharacterizations of the underlying phenomenon, and define what legitimate means in this context. I conclude that in both models, biological aspects constrain characterization, but the models are not so strict that only one concept is acceptable, leaving room for reactivity.


2012 ◽  
Vol 14 (1) ◽  
pp. 61-73 ◽  
Author(s):  
Jon A. Lindstrøm

Critics of attention-deficit/hyperactivity disorder (ADHD) have repeatedly argued that there is no proof for the condition being symptomatic of an organic brain disease and that the current “ADHD epidemic” is an expression of medicalization. To this, the supporters of ADHD can retort that the condition is only defined as a mental disorder and not a physical disease. As such, ADHD needs only be a harmful mental dysfunction, which, like other genuine disorders, can have a complex and obscure etiology. This article argues that such a line of argument fails to save ADHD as a valid diagnostic category. Given the general diagnostic logic of theDSM–IVand how ADHD has been defined in terms of everyday (male) child behaviors, there are compelling grounds to disbelieve that ADHD can be a true medical syndrome united by some type of harmful dysfunction. Indeed, strong logical and empirical reasons will be adduced to show that people may qualify for ADHD diagnosis without suffering from any type of underlying pathology.


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