SOCIAL MALADJUSTMENT was one of several specific diagnostic categories under the general heading of "Conditions without Manifest Psychiatric Disorder" in the Diagnostic and Statistical Manual of Mental Disorders (DSM-II). 1 Some of the other categories under this heading were occupational and marital maladjustment. The mere existence of this heading is already indication of the difficulties faced by anyone who wants to provide a diagnostic manual that will be of use to practitioners. Clinicians see a wide variety of people, for a wide variety of difficulties, some of which are not psychiatric in any simple sense. This occurs for many complicated reasons, but two important ones include (1) the role of the psychiatrist in our society, which is vaguely defined and which permits attempts to treat almost any manner of problem in living; and (2) the ever-broadening notions of what constitutes mental illness, which in turn are based on that form of psychiatric theory that points up the continuity between illness and health, or that, as in some forms of Freudian theory, even erodes the distinction between illness and health altogether.
"Social maladjustment" does not appear in the same form in the new edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-III).2 There is instead a section called "Codes for Conditions Not Attributable to a Known Mental Disorder that Are a Focus of Attention or Treatment." This includes, for example, malingering, childhood or adolescent antisocial behavior, marital problems, parent-child problems, and a residual category of "other interpersonal" problems. In addition, there is a section called "Adjustment Disorders." In describing this section, the new manual states that "The essential feature is a maladaptive reaction to an identifiable psychosocial stressor ... It is assumed that the disturbance will eventually remit after the stressor ceases. ..."56 This attempt at adumbrating the essential features of the "Adjustment Disorders" condition is a good place to begin consideration of social maladjustment.
First of all, it is clear that the emphasis here is on a circumscribed maladaptive reaction. That is, it is not a chronic condition that is being talked about, but instead importance of the life event that is assumed to precipi