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Comorbidity in the DSM Childhood Mental Disorders: A Functional Perspective

Research on Social Work Practice

Published online on

Abstract

In this article, I address the issue of comorbidity and its prevalence in the prior Diagnostic and Statistical Manual of Mental Disorders (DSM) classification systems. The focus on the topography or form of presenting problems as the venue for determining mental disorders is scrutinized as the possible cause. Addressing the function of problem behaviors, that is, positive symptoms, would appear to be an alternate approach that accounts for context variables. I propose an alternate function-based classification system that could be used by social workers, psychologists, and other mental health professionals. Two major functions (diagnostic classifications) are presented; (a) socially mediated access and (b) socially mediated escape. Under these two major categories, there are specific motivative conditions that set the stage for whatever behavior is functional in a given social context. A functional approach to assessing human behavior is more of a person-in-environment perspective than classification schemes presupposing so-called mental disorders.