During the era of the DSM-IV, the definition of mental disorder was:

“Clinically significant behavioral or psychological or biological syndromes that are associated with present distress, disability, or significant impairment in important areas of functioning”

However, the DSM 5 has added to this definition the following criteria.

  1. “Must draw concern from others in a relational, social, occupational, or a vocational setting that requires a referral for treatment.”
  2. “Must incorporate respect for age, gender, and culture-specific factors and a sensitivity to these factors when making a diagnosis.”
  3. “Diagnostics are guidelines for understanding human behaviors. Diagnostics are not to be considered legal definitions to be used by law enforcement and courts.”

These are three positive additions to the definition of a mental disorder.

Regarding the first, the criterion stated that one’s behavior must draw concern from others. However, the person him or herself need not be concerned. This would apply to persons who are syntonic (or absent of insight), such as someone experiencing a manic episode.

Regarding the second criteria, the DSM 5 task force represented 18 countries and also was 40% composed of persons from outside the United States. Hence, the DSM 5 isn’t a US book, it’s a world book and it includes sensitivities to how human behaviors vary according to circumstances and across cultures.

Lastly, addressing the third criterion, the horse has already left the gate on this one! The DSM was never meant to be a legal or forensic book. However, while it was not intended for such use, the DSM (since it’s first edition) has been used in the justice system since as early as 1962. Then, in 1980 the insurance industry began referring to the DSM. Again, such use is strictly “off label” as the sole focus of the DSM is to help its audience better understand human behaviors.

What do you think about the extended definition of Mental Disorders in the DSM 5?

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