The abduction of disorder in psychiatry.

Abstract

The evolutionary cornerstone of J. C. Wakefield's (1999) harmful dysfunction thesis is a faulty assumption of comparability between mental and biological processes that overlooks the unique plasticity and openness of the brain's functioning design. This omission leads Wakefield to an idealized concept of natural mental functions, illusory interpretations of mental disorders as harmful dysfunctions, and exaggerated claims for the validity of his explanatory and stipulative proposals. The authors argue that there are numerous ways in which evolutionarily intact mental and psychological processes, combined with striking discontinuities within and between evolutionary and contemporary social/cultural environments, may cause nondysfunction variants of many widely accepted major mental disorders. These examples undermine many of Wakefield's arguments for adopting a harmful dysfunction concept of mental disorder.

Hebephilia as Mental Disorder? A Historical, Cross-Cultural, Sociological, Cross-Species, Non-Clinical Empirical, and Evolutionary Review

“…Next, for background, we review aspects of the HD approach, including terms andconcepts,which will be used throughout this article. Wakefield (1992bWakefield ( , 1999aWakefield ( , 2007 criticized the traditional ''pure values approach,''often formulated in Roschian terms and seeing disorder as the failure to adjust to contemporary social norms and values (e.g., Houts, 2001;Kirmayer & Young, 1999;Lilienfeld & Marino, 1995Richters & Hinshaw, 1999), as having poor conceptual validity. For example, according to the norms and values of the antebellum South, slaves who tried to escape were mentally disordered, and according to Soviet values, political dissidents were mentally disordered.…”

“…5 Dataonextantorhistoricallow-tech,small-scalesocietiesreflecttoagreat degree (much more so than the modern West) the hunter-gatherer existence in the EEA, and as such are especially useful for inferring human nature, as Arch Sex Behav (2012) 41:797-829 801 adaptation or exaptation) may be currently less than optimal, no longer useful, or outright harmful. When a designed mechanism performs sub-optimally or entails harmful consequences when activated and expressed in a novel or hostile environment, constituting a mechanism-environment mismatch, various writers have argued that it constitutes a disorder even though there is no underlying dysfunction (e.g., Kirmayer & Young, 1999;Lilienfeld & Marino, 1995Richters & Hinshaw, 1999). Wakefield (1999a, b) argued that this view is erroneous, because it confuses current adjustment with design failure.…”

“…Wakefield'sHDapproach-aswellashiscritics'differingformulations (e.g., Brülde, 2007;Gold & Kirmayer, 2007;Lilienfeld & Marino, 1995Richters & Hinshaw, 1999) and his supporters' additional clarifications (e.g., Klein, 1999;Nesse, 2007;Spitzer,1999)-providesasignificantfoundationfordebatingthe mental disorder attribution of any condition or disposition, including hebephilia. None of the many points, ideas, or arguments in these debates or from any other sources appeared in the Blanchard et al (2009) study.…”

Concepts of Disease: Their Relevance for Psychiatric Diagnosis and Classification

“…An ongoing discussion in the conceptual analysis literature [e.g., Brülde, 2003;Fulford, 1989Fulford, , 2001Kendell, 2001;Lilienfeld and Marino, 1999;Richter and Hinshaw, 1999;Sadler, 1999;Wakefi eld, 1992Wakefi eld, , 1999 has exposed the intricacies of the concept of mental disorder currently in use in psychiatric nosology, and illustrates the diffi culties at arriving at a defi nition that satisfactorily responds to all possible scenarios where psychiatric intervention is relevant. Psychiatry confronts diffi culties delineating the boundaries between disorder and nondisorder, and between physical and mental domains, conceived by some as the 'hardware' and the 'software' of brain functioning [Wakefi eld and First, 2003].…”

“…This analysis proposes that mental disorder is the consequence of two conditions: (a) the malfunctioning of an internal, identifi able and teleological psychological mechanism (e.g., cognitive, motivational, behavioral or emotional) in the individual person and (b) harm (in terms of impairment and distress) that results from such dysfunction. Although Wakefi eld's conception has been criticized in the conceptual analysis literature [Fulford, 2001;Lilienfeld and Marino 1999;Richter and Hinshaw, 1999;Sadler, 1999], it has been largely maintained in preliminary discussions preparatory for the development of DSM-V [Wakefi eld and First, 2003].…”