The Medicalization of Deviant Behavior

Our discussion of DSM shows us clearly that the categories of deviant behavior voted on from time to time reflect social and political conventions. Depending on the disorder, the sociopolitical role played by diagnoses is either great or small, but the application of a diagnosis is always, to a greater or lesser degree, embracing political and social values. Diagnostic labels define what limits of difference society can tolerate.

Whenever a culture decides that it will define a set of behaviors as "sick" rather than "immoral" or unwitting, it is enacting a social value that favors illness over the view that such destructive or unusual behavior is volitional. Armed with this view of behavior as illness, we can justify forced hospitalization, prison, or "protective care."

Consider, however, that unlike medical diagnoses, most mental and behavioral diagnoses cannot be defined separately from their behaviors. Regardless of whatever may be happening in one's chemistry or physiology, if behavior is not disordered, there is no condition. With few exceptions, the diagnosis is only a restatement of the symptoms, not a determination of their cause. Unlike physical medicine where a diagnosis such as hypertension can still be asymptomatic, there is no mental health condition that can exist without symptoms. You can't be depressed or have a major depression without some of the following behavioral symptoms:

Loss of social interest such as decreasing social activities

Sadness

Change of appetite

Change in sexual interest

Altered sleep patterns

Slowing of mental processes

Feelings of worthlessness and helplessness

Conclusion and Findings

The same holds true for all other mental health or psychiatric diagnoses. They cannot and do not exist apart from their manifestations in a person's complaints or behaviors. In medicine, the condition is not dependent on the symptom. The symptom only assists in making the diagnosis; it does not determine it. You may have no gastric distress or other manifest symptoms, but still have an ulcer. Many people, unfortunately, have cancer long before they have symptoms. But we define mental illnesses by subjective reports and overt behaviors. By definition, the symptoms must be present.

The identification of psychiatric disorders always involves a social judgment and often implies a political agenda as...

The definition that behavior constitutes a "problem" for clinical purposes hinges both on what society desires; a social judgment; and what is disruptive of the political order and values; the political agenda. It is less concerned with what is true than with what values it supports and maintains. Research, though also influenced by political forces, is less driven by them than are clinical judgments. Because research methods are less culture specific and are, by their nature, open to replication, the findings may be more likely to be reasonably objective and free from politics. But research needs funding, and political forces and our culture influence such funding decisions.
Notes

Weist MD, Evans SW, Lever NA, eds. Handbook of School Mental Health: Advancing Practice and Research. New York, NY: Kluwer Academic/Plenum Publishers; 2003: 149-162.

Seligman, L. Selecting effective treatments: A comprehensive guide to treating mental disorders (Rev. ed.). (San Francisco: Jossey-Bass; 2009).

Seligman, 3

Seligman, 21

US Census Bureau. Current population survey, (October 2009).

Robinson K, ed. Advances in School-Based Mental Health Interventions. (Kingston, NJ: Civic Research Institute; 2004).

Weist, 152

American Psychiatric Association. Diagnostic and statistical manual of mental disorders (4th ed., text rev.). (Washington, DC: Author. 2008).

Robinson, 84

Seligman, 44

Weist, 173

Robinson, 12

American Psychiatric Association. 4

Weist, 153

Bibliography

American Psychiatric Association. Diagnostic and statistical manual of mental disorders (4th ed., text rev.). (Washington, DC: Author. 2008).

Robinson K, ed. Advances in School-Based Mental Health Interventions. (Kingston, NJ: Civic Research Institute; 2004).

Seligman, L. Selecting effective treatments: A comprehensive guide to treating mental disorders (Rev. ed.). (San Francisco: Jossey-Bass; 2009).

US Census Bureau. Current population survey, (October 2009).

Weist MD, Evans SW, Lever NA, eds. Handbook of School Mental Health: Advancing Practice and Research. (New York, NY: Kluwer Academic/Plenum Publishers; 2003). 149-162.

Weist MD, Proescher E, Prodente C, Ambrose MG, Waxman R. Mental health, health, and education staff working together in schools. Child Adolesc Psychiatr Clin N. Am. (2001;10:33-43).