Harmful dysfunction and the search for value neutrality in the definition of mental disorder: response to Wakefield, part 2.

Wakefield's claims to have identified and objective scientific component of mental disorders in the concept of dysfunction are examined in light of previous attempts to state a value free concept of mental disorders. The harmful dysfunction concept of dysfunction is not value free because it confounds cause and purpose in a specious use of evolutionary theory and because evolutionary theory cannot reliably supply standards for when a function is broken. Harmful dysfunction analysis collapses into a value-laden concept of mental disorders and serves the untoward goal of promoting the status quo in the modern DSMs. If the concept of dysfunction were taken seriously and rigorously defined, then it might be possible to separate what is medical from what is not in the domain of mental disorders.