Conceptual models of normative content in mental disorders

The idea that mental disorders are value-laden means that they harbor action-guiding meanings and are subject to praise or blame. This domain of values includes a specific kind of value—vice—which describes wrongful, immoral, or criminal thought or conduct (e.g., antisocial personality disorder, pedophilia, conduct disorder, intermittent explosive disorder). Vice-laden mental disorders are problematic because they imply that (1) psychiatrists police antisocial conduct; (2) vice-laden disorders contribute to stigmatizing mental illness; and (3) they generate incoherent social policy and programs that both intrude upon and neglect the “served” population and community welfare. With this background, this chapter addresses the ethical, practical, and political implications of these conditions; presents four models of normative content in vice-laden mental disorders (i.e., coincidental, moralization, medicalization, and mixed); assesses their “pros” and “cons” for public policy; and concludes with considerations for psychiatric and public policy in addressing social problems associated with vice-laden mental disorders.