Do Perceptions of Dysfunction and Normality Mediate Clinicians’ Judgments of Adolescent Antisocial Behavior?

Abstract

Are mental health clinicians guided by the injunctions of the Diagnostic and Statistical Manual of Mental Disorders (DSM) in making judgments of mental disorder in youth engaging in antisocial behavior? The DSM requires clinicians making a judgment of mental disorder to first make complex mediating inferences about internal dysfunction and rule out the possibility that behaviors are normal reactions to a problematic environment. Responding to a case vignette in which the social context of antisocial behavior was systematically varied, a sample of 1,500 social workers, psychologists, and psychiatrists made judgments about the presence of mental disorder, internal dysfunction, and normality in the antisocial behavior of a youth. Perceptions about the presence of internal dysfunction and normality are found to be related to judgments of mental disorder, but they do not fully mediate the relationship between the influence of social context and judgments of mental disorder.