Definition of disorder
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Definition of Disorder: A Comprehensive Overview
Introduction to the Concept of Disorder
The term "disorder" is widely used in the fields of medicine and psychiatry, yet its definition remains complex and multifaceted. A disorder generally refers to a condition characterized by a collection of signs and symptoms that are associated with distress or impairment in functioning. This article synthesizes various perspectives on the definition of disorder, particularly focusing on mental disorders, as discussed in multiple research papers.
Harmful Dysfunction: A Core Component
One prominent definition of disorder is the concept of "harmful dysfunction." This approach posits that a disorder is a harmful dysfunction where "harmful" is a value-laden term based on social norms, and "dysfunction" refers to the failure of a mental mechanism to perform its natural function as designed by evolution1. This definition attempts to bridge the gap between scientific facts and social values, making it a comprehensive framework for understanding disorders.
DSM Definitions and Critiques
The Diagnostic and Statistical Manual of Mental Disorders (DSM) has played a crucial role in defining mental disorders. The DSM-III-R, for instance, operationally defines disorder as "statistically unexpectable distress or disability"2. However, this definition has been critiqued for failing to adequately capture the concept of dysfunction, leading to issues in distinguishing disorders from non-disorders2.
Evolution of Definitions
The need for a precise definition of mental disorder has been emphasized for various reasons, including ethical, legal, and financial considerations3. The first formal definition emerged to address challenges in psychiatry, such as the removal of homosexuality from classifications and countering antipsychiatry arguments3. Over time, definitions have evolved, incorporating new insights and addressing previous shortcomings.
Pluralistic and Flexible Definitions
Modern definitions of mental disorder are often pluralistic, including multiple components like harm, dysfunction, impairment, statistical deviation, social values, and treatability6. This pluralistic approach acknowledges that not every disorder will contain all these components, allowing for flexibility and adaptability as societal norms and scientific understanding evolve6.
Medical and Mental Disorders
A proposed definition of mental disorder within the medical model describes it as a subset of medical disorders, characterized by psychological or behavioral symptoms that can only be understood using psychological concepts7. This definition emphasizes the need for operational criteria to provide evidence for both organismic dysfunction and societal recognition of the condition7.
Challenges and Debates
The distinction between normality and psychopathology has long been debated. Definitions provided by DSM-IV and DSM-V aim to help clinicians navigate this distinction, although no definition perfectly specifies the boundaries of mental/psychiatric disorders4 5. The ongoing debate highlights the need for continuous refinement of these definitions to improve their scientific validity and clinical utility.
Conclusion
Defining "disorder" is a complex task that involves balancing scientific facts with social values. The concept of harmful dysfunction offers a robust framework, while the evolving definitions in the DSM reflect the dynamic nature of this field. Modern definitions are pluralistic and flexible, accommodating the diverse manifestations of disorders. As our understanding of mental health continues to grow, so too will the definitions that guide diagnosis and treatment.
Sources and full results
Most relevant research papers on this topic
The concept of mental disorder. On the boundary between biological facts and social values.
Mental disorders are defined as harmful dysfunctions, combining value and scientific components, avoiding problems and preserving insights from other approaches.
Highly CitedDisorder as harmful dysfunction: a conceptual critique of DSM-III-R's definition of mental disorder.
The DSM-III-R's definition of mental disorder as "statistically unexpectable distress or disability" fails to capture the idea of "dysfunction" and leads to validity issues in many of its specific diagnostic criteria.
Highly CitedMental Disorder—The Need for an Accurate Definition
The first formal definition of mental disorder, led by Robert Spitzer, addressed challenges in psychiatry, establishing an evidence-based classification, justifying the removal of homosexuality, and countering antipsychiatry arguments.
What is a mental/psychiatric disorder? From DSM-IV to DSM-V
The DSM-V proposes changes to the definition of mental disorder, aiming for a more scientifically valid and clinically useful definition.
Very Rigorous JournalHighly CitedDefining ‘mental disorder’ in DSM-V
The definition of mental disorder in the DSM-V should be revised to better distinguish between normal distress and disorder, and to better guide clinicians in identifying legitimate diagnoses in 'not otherwise specified' cases.
Very Rigorous Journal