Abstract: This paper is a critical analysis of the concept of mental disorder recently advanced by Jerome Wakefield (1992a, 1992b, 1993, 1996, 1997a, 1997b). Wakefield suggests that mental disorders are most aptly conceived as "harmful dysfunctions" involving two distinct and separable components: 1) the failure of a mechanism in the person to perform a natural function for which the mechanism was designed by natural selection, and 2) a value judgment that the dysfunction is undesirable.

In our critique of the harmful dysfunction formulation, we argue against several of Wakefield's views. The first of these is Wakefield's contention that a malfunction, defined according to his Darwinian view of function, is a necessary ingredient of mental disorder. The second involves a rather dubious set of assumptions about mental mechanisms: how they are to be identified, how scientifically efficacious it is to posit mental mechanisms correlative with mental disorders, and whether the identification of mental mechanisms in the manner Wakefield suggests is truly value-free. We argue that disorders exist in the absence of malfunction. We further argue that Wakefield's approach to investigating the factors underlying mental disorders is scientifically unfruitful and fails his own test of objectivity.


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pp. 241-252
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