The Distinction Between Antisociality And Mental Illness

The suggested approach implied in the article below would, within the context of mainstream psychiatry, increase the already huge number (categories) of supposed mental illnesses (and increase the already vast number of psychiatric diagnoses) … which would not be a good thing from the perspective of a new vision for mental health. On the other hand, it would also result in a desirable, less punitive and more effective approach towards antisocial and aggressive behaviours.

However, this conflict of desirable outcomes would disappear if the labelling of mental illnesses (and the associated diagnostic process of psychiatry) were abandoned and replaced by the simple understanding that there are people suffering from psychological and emotional distress whom we can help.

Given this important caveat, the article below raises some interesting questions and perspectives. Written by Prof. Abigail Marsh and published on the Edge website, it begins:

“The scientific studies of mental illness and antisocial behavior continue to occupy largely separate intellectual domains. Although some patterns of persistent antisocial behavior are nominally accorded diagnostic labels such as Antisocial Personality Disorder or Conduct Disorder, the default approach to individuals who engage in persistent antisocial behavior is to view their patterns of behavior through a moral lens (as ‘badness’) rather than through a mental health lens (as ‘madness’).

In some senses this distinction represents progress. As recently as the 19th and early 20th century, individuals affected by all manner of psychopathologies were routinely confined and in some cases punished or even executed. Along with the emergence of the understanding that symptoms of mental illness reflect disease processes, the emphasis has shifted toward a focus on prevention and treatment. However, this shift has not applied equally to all forms of psychopathology. For example, disorders primarily characterized by internalizing symptoms (persistent distress or fear, self-injuring behaviors) versus externalizing symptoms (persistent anger or hostility, antisocial and aggressive behaviors) are strikingly similar in many respects: comparable prevalence; parallel etiologies and risk factors; and similarly detrimental effects on social, educational, and vocational outcomes. But whereas immense scientific resources are aimed at identifying the causes and disease processes of internalizing symptoms and developing therapies for them, the emphasis for externalizing symptoms remains primarily on confinement and punishment, with relatively few resources devoted to identifying causes and disease processes or developing therapies. Comparisons of federal mental health funding, clinical trials, available therapeutic agents, and publications in biomedical journals directed toward internalizing versus externalizing symptoms all confirm this pattern. It is likely that this asymmetry results from multiple forces, including cognitive and cultural biases that influence decision-making processes among scientists and policymakers alike and ultimately erode support for the study of antisociality as a form of mental illness …”

You can read more from here.

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