Seed | Redefining Mental Illness

Gary Larson

Last week, psychology graduate student (and Research Blogging Psychology / Neuroscience Editor) Jason Goldman held ... an online forum inviting some of the top psychology and neuroscience bloggers to weigh in on the question “What Is Mental Illness?”

British psychologist and editor Christian Jarrett answered the question by citing an editorial published in January in Psychological Medicine. The editorial’s writers, led by Dan Stein, argued that a “mental disorder” has five primary factors: It’s a behavior or pattern occurring in an individual, causing clinically significant distress or impairment, reflecting an underlying physical dysfunction, and is not primarily the result of social deviance or conflicts with society. It’s also not just a response to a stressful event like a friend or family member’s death, where it’s normal to expect someone to appear “depressed” or otherwise disturbed for a period of time. Stein’s team is part of the working group for the DSM-V, so clearly their arguments will carry significant weight in forming the new definition.

One of the biggest changes in their proposed definition is the statement that a mental disorder “reflects an underlying psychobiological dysfunction.” They are, in essence, saying that there is nothing truly “mental” about these disorders—the disorders are a result of physical problems in the brain. This is a huge acknowledgment for a field that once thrived on such vacuous concepts as the “id” and the “superego.” The anonymous neuroscience blogger “Neurocritic” suggests that these specific, neurological underpinnings are the best way to describe mental illnesses. Neurocritic cites a new effort by the US National Institute for Mental Health (NIMH) to define disorders based not only on their symptoms, but across several domains, including genes, neural structures, and behaviors. Using this line of reasoning, traditional definitions of mental disorders are flawed because they fail to address the mechanism of the illness. Doctors don’t define a broken leg as “unable to walk,” so why should psychiatrists define a mental disorder solely based on the behavioral symptoms?

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