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Defining Mental Disorder

Jerome Wakefield and His Critics

Author Harold Kincaid, Peter Zachar, Dominic Murphy

Edited by Luc Faucher, Denis Forest

Paperback

$110.00 US

| $143.00 CAN

The MIT Press

On sale Oct 28, 2025 | 640 Pages | 9780262055796

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Nonfiction > Psychology
Nonfiction > Wellness

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Philosophers discuss Jerome Wakefield's influential view of mental disorder as “harmful dysfunction,” with detailed responses from Wakefield himself.

One of the most pressing theoretical problems of psychiatry is the definition of mental disorder. Jerome Wakefield's proposal that mental disorder is “harmful dysfunction” has been both influential and widely debated; philosophers have been notably skeptical about it. This volume provides the first book-length collection of responses by philosophers to Wakefield's harmful dysfunction analysis (HDA), offering a survey of philosophical critiques as well as extensive and detailed replies by Wakefield himself.

HDA is offered as a definition of mental disorder, but it is also the outcome of a method—conceptual analysis—and contributors first take up HDA's methodology, considering such topics as HDA's influences on the DSM, empirical support for HDA, and clinical practice. They go on to discuss HDA's ultimate goal, the demarcation between normal and abnormal; the dysfunction component of the analysis, addressing issues that include developmental plasticity, autism and neurodiversity, and the science of salience; and the harmful component, examining harmless dysfunction, normal variation, medicalization, and other questions. Wakefield offers substantive responses to each chapter.

The open access edition of this book was made possible by generous funding from Arcadia – a charitable fund of Lisbet Rausing and Peter Baldwin.

Contributors
Rachel Cooper, Andreas De Block, Steeves Demazeux, Leen De Vreese, Luc Faucher, Denis Forest, Justin Garson, Philip Gerrans, Harold Kincaid, Maël Lemoine, Dominic Murphy, Jonathan Sholll, Tim Thornton, Jerome Wakefield, Peter Zachar

Luc Faucher is Professor in the Philosophy Department at the at the University of Québec in Montréal.

Denis Forest is Professor of Philosophy of Science in the Department of Philosophy at Paris 1 Panthéon-Sorbonne and Member of the IHPST (Institute of History and Philosophy of Science and Technique), Paris.

Harold Kincaid is Professor in the School of Economics and Director of the Research Unit in Behavioural Economics and Neuroeconomics at the University of Cape Town. He is the coeditor of Distributed Cognition and the Will: Individual Volition and Social Context and What Is Addiction? (both published by the MIT Press).

Peter Zachar is Professor in the Department of Psychology at Auburn University Montgomery. He is the author of Psychological Concepts and Biological Psychiatry: A Philosophical Analysis.

Dominic Murphy is Senior Lecturer in the Unit for History and Philosophy of Science at the University of Sydney.

Philip Gerrans is Professor of Philosophy at the University of Adelaide.

Harold Kincaid View titles by Harold Kincaid

Peter Zachar View titles by Peter Zachar

Dominic Murphy View titles by Dominic Murphy

Introduction ix
Denis Forest and Luc Faucher
Wakefield Critiques: Introductory Comments xxix
Jerome Wakefield
I On Conceptual Analysis
1 DSM in the Light of HDA (and Conversely) 3
Steeves Demazeux
2 From Ribot and Dupré to Spitzer and RDoC: Does the Harmful Dysfunction Analysis Possess Historical Explanatory Power? Reply to Steeves Demazeux 27
Jerome Wakefield
3 Facts, Facts, Facts: HD Analysis Goes Factual 47
Luc Faucher
4 Do the Empirical Facts Support the Harmful Dysfunction Analysis? Reply to Luc Faucher 71
Jerome Wakefield
5 Against the Disorder/Nondisorder Dichotomy 97
Leen De Vreese
6 Do Clinicians Understand the Harmful Dysfunction Analysis of Mental Disorder? Reply to Leen De Vreese 109
Jerome Wakefield
7 Doing without “Disorder” in the Study of Psychopathology 123
Harold Kincaid
8 Quinian Qualms, or Does Psychiatry Really Need the Harmful Dysfunction Analysis? Reply to Harold Kincaid 133
Jerome Wakefield
II The Demarcation Problem
9 Psychiatric Disorders and the Imperfect Community: A Nominalist HDA 157
Peter Zachar
10 Can a Nonessentialist Neo-Empiricist Analysis of Mental Disorder Replace the Harmful Dysfunction Analysis? Reply to Peter Zachar 177
Jerome Wakefield
III The Dysfunction Component
11 Is the Dysfunction Component of the “Harmful Dysfunction Analysis” Stipulative? 199
Maël Lemoine
12 Is the Harmful Dysfunction Analysis Descriptive or Stipulative, and Is the HDA or BST the Better Naturalist Account of Dysfunction? Reply to Maël Lemoine 213
Jerome Wakefield
13 Function and Dysfunction 251
Dominic Murphy
14 Can Causal Role Functions Yield Objective Judgments of Medical Dysfunction and Replace the Harmful Dysfunction Analysis’s Evolutionary Component? Reply to Dominic Murphy 267
Jerome Wakefield
15 Do the Works of Carl Craver or Marcel Weber Explain How Causal Role Functions Can Provide Objective Medical Judgments of Dysfunction? Supplementary Reply to Dominic Murphy 317
Jerome Wakefield
16 The Developmental Plasticity Challenge to Wakefield’s View 335
Justin Garson
17 Does Developmental Plasticity Pose a Challenge to the Harmful Dysfunction Analysis? Reply to Justin Garson 353
Jerome Wakefield
18 Biological Function Hierarchies and Indeterminacy of Dysfunction: Supplementary Reply to Justin Garson 385
Jerome Wakefield
19 Harmful Dysfunction and the Science of Salience: Adaptations and Adaptationism 397
Philip Gerrans
20 Are Cognitive Neuroscience and the Harmful Dysfunction Analysis Competitors or Allies? Reply to Philip Gerrans 415
Jerome Wakefield
21 Autistic Spectrum, Normal Variation, and Harmful Dysfunction
Denis Forest 433
22 Do the Challenges of Autism and Neurodiversity Pose an Objection to the Harmful Dysfunction Analysis? Reply to Denis Forest 449
Jerome Wakefield
23 Naturalism and Dysfunction 469
Tim Thornton
24 Is Indeterminacy of Biological Function an Objection to the Harmful Dysfunction Analysis? Reply to Tim Thornton 485
Jerome Wakefield
IV The Harmful Component
25 Harmless Dysfunctions and the Problem of Normal Variation
Andreas De Block and Jonathan Sholl 495
26 Can the Harmful Dysfunction Analysis Distinguish Problematic Normal Variation from Disorder? Reply to Andreas De Block and Jonathan Sholl 511
Jerome Wakefield
27 On Harm 537
Rachel Cooper
28 Must Social Values Play a Role in the Harm Component of the Harmful Dysfunction Analysis? Reply to Rachel Cooper 553
Jerome Wakefield
29 Are There Naturally Selected Disorders? Supplementary Reply to Rachel Cooper 577
Jerome Wakefield
Contributors 593
Index 595