Diagnostic criteria as dysfunction indicators: bridging the chasm between the definition of mental disorder and diagnostic criteria for specific disorders

Canadian Journal of Psychiatry. Revue Canadienne De Psychiatrie
Michael First, Jerome C Wakefield

Abstract

According to the introduction to the Diagnostic and Statistical Manual of Mental Disorders (DSM), Fifth Edition, each disorder must satisfy the definition of mental disorder, which requires the presence of both harm and dysfunction. Constructing criteria sets to require harm is relatively straightforward. However, establishing the presence of dysfunction is necessarily inferential because of the lack of knowledge of internal psychological and biological processes and their functions and dysfunctions. Given that virtually every psychiatric symptom characteristic of a DSM disorder can occur under some circumstances in a normally functioning person, diagnostic criteria based on symptoms must be constructed so that the symptoms indicate an internal dysfunction, and are thus inherently pathosuggestive. In this paper, we review strategies used in DSM criteria sets for increasing the pathosuggestiveness of symptoms to ensure that the disorder meets the requirements of the definition of mental disorder. Strategies include the following: requiring a minimum duration and persistence; requiring that the frequency or intensity of a symptom exceed that seen in normal people; requiring disproportionality of symptoms, given the context; requi...Continue Reading

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Citations

Jun 14, 2016·Journal of Racial and Ethnic Health Disparities·Shervin AssariHarold W Neighbors
Sep 16, 2017·Journal of Racial and Ethnic Health Disparities·Shervin Assari
Dec 18, 2013·Canadian Journal of Psychiatry. Revue Canadienne De Psychiatrie·Jerome C Wakefield, Michael B First
Jan 17, 2016·Annual Review of Clinical Psychology·Jerome C Wakefield
Jun 1, 2018·The Journal of Medicine and Philosophy·M Cristina Amoretti, Elisabetta Lalumera
Oct 24, 2018·Brain Sciences·Gorka FragaGonzálezJurgen Tijms
Jul 13, 2014·Systematic Reviews·Megan E McCoolChristian Apfelbacher
Jul 30, 2015·Current Psychiatry Reports·Alan J BudneyLaura M Juliano
Oct 6, 2020·International Review of Psychiatry·Awais Aftab, Mohammed Abouelleil Rashed
Nov 11, 2020·Sexual Medicine·Khaled MadboulySaleh Binsaleh
Feb 18, 2021·Theoretical Medicine and Bioethics·Maria Cristina Amoretti, Elisabetta Lalumera
Apr 13, 2021·Psychological Medicine·Dan J SteinKenneth S Kendler
Jul 18, 2017·Journal of Affective Disorders·R García-VelázquezT H Rosenström

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