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Critics of the dysfunction requirement argue that it is often difficult, if not impossible, to identify the evolved function of complex mental mechanisms.<ref>{{Cite journal |last=McNally |first=Richard J |date=2001-03-01 |title=On Wakefield's harmful dysfunction analysis of mental disorder |url=https://www.sciencedirect.com/science/article/abs/pii/S0005796700000681?via=ihub |journal=Behaviour Research and Therapy |volume=39 |issue=3 |pages=309–314 |doi=10.1016/S0005-7967(00)00068-1 |issn=0005-7967}}</ref><ref>{{Cite journal |last=Aftab |first=Awais |last2=and Rashed |first2=Mohammed Abouelleil |date=2021-07-04 |title=Mental disorder and social deviance |url=https://www.tandfonline.com/doi/full/10.1080/09540261.2020.1815666 |journal=International Review of Psychiatry |volume=33 |issue=5 |pages=478–485 |doi=10.1080/09540261.2020.1815666 |issn=0954-0261 |pmid=33016793}}</ref> Many mental functions may have arisen as by-products of other adaptations or evolved to serve multiple purposes, making it challenging to pinpoint a single, clearly ‘designed’ function.
Philosopher Maël Lemoine questioned whether the dysfunction component is genuinely value-free, suggesting that it may inherently involve assumptions and interpretations about what counts as a function rather than being purely descriptive.<ref>{{Cite journal |last=Lemoine |first=Maël |date=2021-02-16 |title=Is the Dysfunction Component of the “Harmful Dysfunction Analysis” Stipulative? |url=https://direct.mit.edu/books/oa-edited-volume/5015/chapter/2812058/Is-the-Dysfunction-Component-of-the-Harmful |journal=MIT Press |language=en |doi=10.7551/mitpress/9949.003.0016}}</ref> Further, Justin Garson points to developmental plasticity, the capacity to develop different traits in response to early environmental conditions, as a challenge to the dysfunction requirement of HDA. He argues that this adaptability can lead to 'mismatches', where traits that were once beneficial in childhood become harmful later in life. Such cases, he suggests, result in genuine mental disorders without technically involving a biological dysfunction.<ref>{{Cite journal |last=Garson |first=Justin |date=2021-02-16 |title=The Developmental Plasticity Challenge to Wakefield’s View |url=https://direct.mit.edu/books/oa-edited-volume/5015/chapter/2812063/The-Developmental-Plasticity-Challenge-to |journal=MIT Press |language=en |doi=10.7551/mitpress/9949.003.0021}}</ref>
=== On Harm ===
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=== Alternative Models ===
Notably, Christopher Boorse has continued to defend his biostatistical theory of mental disorder. Boorse argues that this model avoids the ambiguities associated with cultural judgements.<ref>{{Citation |last=Boorse |first=Christopher |title=A Rebuttal on Health |date=1997 |work=What Is Disease? |pages=1–134 |editor-last=Humber |editor-first=James M. |url=https://link.springer.com/chapter/10.1007/978-1-59259-451-1_1 |access-date=2025-04-17 |place=Totowa, NJ |publisher=Humana Press |language=en |doi=10.1007/978-1-59259-451-1_1 |isbn=978-1-59259-451-1 |editor2-last=Almeder |editor2-first=Robert F.}}</ref> He also contends that HDA conflicts with actual medical practice, particularly in its treatment of so-called ‘harmless dysfunctions’. Boorse points out that many conditions Wakefield classifies as harmless are nonetheless widely recognised as disorders in clinical settings, raising concerns about HDA’s legitimacy as a theory of disorder.<ref>{{Cite journal |last=Boorse |first=Christopher |date=2024-08-01 |title=Wakefield’s Harm-Based Critique of the Biostatistical Theory |url=https://academic.oup.com/jmp/article-abstract/49/4/367/7695216?redirectedFrom=fulltext |journal=The Journal of Medicine and Philosophy: A Forum for Bioethics and Philosophy of Medicine |volume=49 |issue=4 |pages=367–388 |doi=10.1093/jmp/jhae017 |issn=0360-5310}}</ref> Rachel has also proposed a Harmful Abnormality Analysis as an alternative.
== References ==
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