Justifying the diagnostic status of social phobia: a reply to Wakefield, Horwitz, and Schmitz.

We believe that the harmful dysfunction model is important to consider when defining disorders. However, we question whether, when used in isolation, it provides an adequate basis for discriminating disorders from normal variations of temperament. We believe that it is important to consider the interaction between the individual's temperament and the demands of present-day society. We also assert that, when taken in the aggregate, the DSM-IV criteria for social phobia adequately establish the presence of harmful dysfunctions, particularly when significant impairment in one or more important domains of functioning is present. Finally, we argue that practical issues must be considered when we classify conditions as disorders. The fact that social phobia is classified as a legitimate disorder has undoubtedly spurred research efforts and encouraged countless individuals to seek relief for their suffering.