What’s A Mental Disorder?

What’s A Mental Disorder? Even Experts Can’t Agree
December 29, 2010

“Pediatricians and child psychiatrists would see kids who could talk but who had social discomfort — severe social discomfort — and awkwardness and a very restricted and impairing level of interests and activities, and they wanted a diagnosis for this,” Frances says.

A study was done to figure out how common Asperger’s was, and the results were clear: It was vanishingly rare. Then Frances put it in the DSM, and the number of kids diagnosed with the disorder exploded. Frances remembers sitting in his condo reading articles about this new epidemic of Asperger’s that was sweeping the nation.

“At that point I did an ‘oops,’ ” he says. “This is a complete misunderstanding.

Brain regions implicated in decision making under uncertainty

Brain regions implicated in decision making under uncertainty

Risky business: the neuroeconomics of decision making under uncertainty
Nature Neuroscience 11, 398 – 403 (2008)
Michael L Platt & Scott A Huettel

Brain regions implicated in decision making under uncertainty:

  • insular cortex (INS)
  • ventrolateral prefrontal cortex (vlPFC)
  • striatum (STR)
  • medial prefrontal cortex (mPFC)
  • dorsolateral prefrontal cortex (dlPFC)
  • posterior parietal cortex (PPC)

Many decisions involve uncertainty, or imperfect knowledge about how choices lead to outcomes.
Colloquial notions of uncertainty, particularly when describing a decision as ‘risky’, often carry connotations of potential danger as well. Gambling on a long shot, whether a horse at the racetrack or a foreign oil company in a hedge fund, can have negative consequences, but the impact of uncertainty on decision making extends beyond gambling.
Indeed, uncertainty in some form pervades nearly all our choices in daily life.
Stepping into traffic to hail a cab, braving an ice storm to be the first at work, or dating the boss’s son or daughter also offer potentially great windfalls, at the expense of surety.
We continually face trade-offs between options that promise safety and others that offer an uncertain potential for jackpot or bust. When mechanisms for dealing with uncertain outcomes fail, as in mental disorders such as problem gambling or addiction, the results can be disastrous.
Thus, understanding decision making—indeed, understanding behavior itself—requires knowing how the brain responds to and uses information about uncertainty.