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Reconsidering harm in psychiatric manuals within an explicationist framework.

Mia Biturajac1, Marko Jurjako2

  • 1Department of Philosophy, Faculty of Humanities and Social Sciences in Rijeka, University of Rijeka, Sveučilišna Avenija 4, Rijeka, Croatia.

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Harm is crucial for defining mental disorders, distinguishing pathology from normal experience. This paper defends harm

Keywords:
DSM-5DysfunctionExplicationHarmMental disorder

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Area of Science:

  • Philosophy of Psychiatry
  • Psychopathology
  • Medical Ethics

Background:

  • The concept of harm is central to defining mental disorders in diagnostic manuals like the Diagnostic and Statistical Manual of Mental Disorders (DSM) and the International Classification of Diseases (ICD).
  • Recent revisions, particularly in DSM-5, have seen a trend towards diminishing the significance of harm in the conceptualization of mental disorders.
  • This shift raises concerns about the accurate characterization of psychopathology and the potential for misapplication of psychiatric authority.

Purpose of the Study:

  • To defend the continued relevance of the notion of harm in characterizing mental disorders.
  • To address the recent trend of reducing harm's significance in psychiatric nosology.
  • To explore the philosophical underpinnings of harm in the context of mental health.

Main Methods:

  • Utilizing conceptual explication, a philosophical method pioneered by Rudolf Carnap.
  • Analyzing the role of harm in existing diagnostic frameworks (DSM, ICD).
  • Engaging with philosophical discussions on mental disorder and psychiatric authority.

Main Results:

  • The notion of harm remains essential for differentiating pathological conditions from non-pathological variations in human experience.
  • Excluding or minimizing harm risks an imprecise understanding of mental disorders.
  • Maintaining the concept of harm acts as a safeguard against potential overreach or misuse of psychiatric power.

Conclusions:

  • The concept of harm is indispensable for a robust and accurate definition of mental disorder.
  • Conceptual explication supports the integration of harm into psychiatric nosology.
  • Preserving the role of harm is vital for both clinical accuracy and ethical psychiatric practice.