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Mental Disorders: Scientific Concepts or Value

Judgments? It is true that many forms of abnormal behavior are normative concepts based on value judgments. Most mental disorders are negative conditions that justify social concerns, but defining them in terms of pure value judgments allows classifying many socially disapproved behaviors as disorders when they clearly are not.

Incarcerated Soviet dissidents, ‘‘childhood masturbation disorder,’’ drapetomania (slaves running away from their masters), or other socially deviant behavior, which violated social norms of the time or a particular culture, are clearly not disorders. In spite of Houts and Follette’s  claim that abnormal behavior is, first and foremost, a social judgment, this cannot and should not be the case because this means that disorders can become a method of social control associated with repression of unpopular behavior, as was done in Russia. Recent controversies about ‘‘self-defeating personalities’’ and homosexuality  clearly illustrate this problem. Similarly, if disorder is defined as a ‘‘dysfunction’’ in purely scientific terms, there are serious limitations. For example, a person in our culture who hears voices that others do not is assumed to have a disorder of cognitive processing.

But, what about prophets, saints, and holy men who hear voices in other cultures or subcultures. Are they suffering from mental disorders? The point is that some internal malfunctions do not cause harm to the individual nor do they cause harm to others. Thus, to consider the dysfunction a mental disorder it must be harmful to the individual or society. A hybrid definition where the behavior represents both a dysfunction (i.e., a scientific concept) and harm (i.e., a value concept) is necessary to label a condition as a mental disorder. Both components are necessary, and neither is sufficient alone.

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