engleski

The role of harm in diagnosing mental disorders: An explicationist perspective

The notion of harm has been a recurring and a significant notion in the characterization of mental disorder. It is present in eminent diagnostic manuals such as DSM and ICD, as well as in the discussion on mental disorders in philosophy of psychiatry. Recent demotion of harm in the definition of mental disorders in DSM-5 shows a general trend towards reducing the significance of harm when thinking about the nature of mental disorders. In this paper, we defend the relevance of the notion of harm in the characterization of mental disorder against some of these attacks. We approach this paper through the perspective of someone devising a diagnostic manual and ask ourselves what the definition in the manuals should look like. To answer this we use the method of conceptual explication pioneered by Rudolf Carnap. This methodology is akin to the conceptual engineering approaches as it aims to shape the concept according to the relevant theoretical and practical considerations. Through the lens of the explicationist methodology, we defend a two-stage picture of mental disorder that contains an objective, science-based component in terms of biological dysfunction and an evaluative component in terms of harm. Moreover, we focus on the harm component and defend it against some recent attacks by arguing that it not only helps to discriminate what is pathological from the nonpathological but also prevents potential misuses of psychiatric authority.

Harm ; mental disorder ; DSM-IV ; DSM-5 ; explication

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