The Definition of a "Mental Disorder"

                Before going any further with this article, I feel it is important to give the definition of “Mental Disorder” per the “Diagnostic and Statistical Manual Of Mental Disorders” as written by the American Psychiatric Association.

Definition: Although this volume is titled the Diagnostic and Statistical Manual Of Mental Disorders, the term mental disorder unfortunately implies a distinction between “mental” disorders and “physical” disorders that is a reductionistic anachronism of mind/body dualism. A compelling literature documents that there is much “physical” in “mental” disorders and much “mental” in “physical” disorders. The problem raised by the term “mental” disorders has been much clearer than its solution, and unfortunately, the term persist in the title of DSM-IV because we have not found an appropriate substitute.

                Moreover, although this manual provides a classification of mental disorders, it must be admitted that no definition adequately specifies precise boundaries for the concept of “mental disorder.”  

                Ok, so we start off a study and an article with no real or agreed upon definition for the subject to be studied or written about. But these are peoples lives and individual freedoms we are talking about here. Decisions are being made everyday by parents whether to allow treatment on their children, based on a condition “mental disorder” that can’t be defined by the profession that originated it.

                Lets give the American Psychiatric Association a break and just assume they are simply not very good with defining their own words.   Maybe if we have a look at how they define and determine what a “mental disorder” IS, that should clear up any doubt that they are the experts in the field of “mental disorders”, and know what they are doing!

                The first "mental disorder " to have a look at is Attention Deficit/Hyperactivity Disorder.

From the American Psychiatric Association's book Diagnostic and Statistical Manual of Mental Disorders (DSM-IV)

“ Although most individuals have symptoms of both inattention and hyperactivity-impulsivity, there are some individuals in whom one or the other pattern is predominant.” (pg. 80) The book goes on to list three subtypes of ADHD. A contradiction is found in the Prevalence (.....) section when it is stated “The prevalence of Attention-Deficit/Hyperactivity Disorder is estimated at 3%-5% in school-age children. Data on prevalence in adolescence and adulthood are limited.” (pg. 82)

*From the Associated Laboratory findings section: “ There are no laboratory tests that have been established as diagnostic in the clinical assessment of Attention-Deficit/Hyperactivity Disorder.” (pg. 81)

Here is more on what is looked for in determining if a child has ADHD. “It is very unusual for an individual to display the same level of dysfunction in all settings or within the same setting at all times. Symptoms typically worsen in situations that require sustained attention or mental effort or that lack intrinsic appeal or novelty (e.g., listening to classroom teachers, doing class assignments, listening to or reading lengthy materials, or working on monotonous, repetitive tasks), Signs of the disorder may be minimal or absent when the person is under very strict control, in a novel setting, is engaged in especially interesting activities, in a one-to-one situation (e.g., the clinician’s office), or while the person experiences frequent rewards for appropriate behavior.” (pg. 79/80)

What about other testing that has shown, after 5 years, children that had been diagnosed with ADHD (that were not given drugs or therapy to treat ADHD) tested to be on the same level or hyperactivity scale as the “normal” children. Did ADHD simply vanish?

Here is DSM-IV’s statements. “As children mature, symptoms usually become less conspicuous. By late childhood and early adolescence, signs of excessive gross motor activity (e.g., excessive running and climbing, not remaining seated) are less common, and hyperactivity symptoms may be confined to fidgetiness or an inner feeling of jitteriness or restlessness.” (pg. 81)  

Has the American Psychiatric Association missed it all together? This author thinks so.

From an APA quote earlier on this page: “It is very unusual for an individual to display the same level of dysfunction in all settings or within the same setting at all times.

SOLUTION: Locate where the child does not manifest dysfunction and allow them to learn from that area. 

Symptoms typically worsen in situations that require sustained attention or mental effort or that lack intrinsic appeal or novelty (e.g., listening to classroom teachers, doing class assignments, listening to or reading lengthy materials, or working on monotonous, repetitive tasks),  

SOLUTION: Do not give the child material that requires sustained attention at this stage. If a text lacks intrinsic appeal to the child, give them something to read that does. Example, if you have a child that loves baseball, allow that child to read books about baseball that are written at the proper level. The idea is to learn how to read and understand what you have just read.  

 Signs of the disorder may be minimal or absent when the person is under very strict control, in a novel setting, is engaged in especially interesting activities, in a one-to-one situation (e.g., the clinician’s office), or while the person experiences frequent rewards for appropriate behavior.” (pg. 79/80)

SOLUTION: Use good control with the child. (Good control does not mean beating, drugging, electro shock or harshness.) 

If frequent rewards for appropriate behavior works, do more of it.

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