[Psychological aspects of "reasonable efforts" for the prediction of mental disorder-related disability]

Current standards by which socio-medical expert opinions are furnished and how they forecast the effects of mental disorder on the individual level of performance are discussed. Expert reports generally focus on assessing how the impact of mental illness can be overcome by reasonable "efforts of volition", using a number of criteria within the scope of psychiatric and psychosomatic models of explanation. The article reasons that prognoses concerning impaired performance due to health problems should to a lesser degree be based on illness-related parameters and analyses which are not subject to will and intention. Instead, it asks for a clear distinction between controlled coping processes on the one hand and psychodynamic defence mechanisms and illness-related processes on the other. Forecasts should take into greater consideration to what extent the effects of mental disorder on individual behaviour can also be attributed to a wide range of deliberate, non-pathological factors. Psychological motivation and action theories should become an integral part of expert reports, as they offer some useful tools for differentiating between those disabilities that are caused by controlled action and others that can be attributed to disorder-related factors.