Psychiatric Versus Social Factors: An Attempt at Integration

Abstract

This paper attempts to resolve the controversy between the proponents of clinical psychiatry and their critics who favor sociocultural explanations of mental disorders. The validity and the limitations of both approaches are analyzed. The labeling and societal reaction approaches are differentiated from more general sociological explanations and, depending on which of their tenets is under evaluation, are shown to have varying degrees of validity. Similarly, empirical research in psychiatry suggests that levels of reliability and validity are low compared to other branches of medicine. The problems of validity and reliability are compounded in psychiatry due to the lack of demonstrable organic pathology for the functional mental disorders and the lack of convergent but independent diagnostic indices. The question of whether psychiatry's primary function is medical or one of social control is discussed. Finally, an interactional framework is presented. This framework encompasses major research findings from both sides and attempts to integrate the two approaches.