> Do not include impairment in functioning due to physical or environmental limitations.

Hmm.. So if my parents pick arguments with me and I argue with them then does my having occasional arguments with them not show that I'm malfunctioning after all? It is just that my environment is limited?

If I get depressed in response to having lost my family in terrorist attacks then does my response count as being due to 'environmental limitations' again?

What if I meet criteria for borderline personality because of my invalidating childhood environment? Is that an environmental limitation? If I have a genetic predisposition that acts as part of that then does that count as a physical limitation?

How can this be used to make treatment decisions (in all seriousness)?

It was introduced in an attempt to justify removing homosexuality from the DSM (no harm is present). But is is of course absurd to say that the homosexual who lives in an intolerant society isn't harmed by their condition.

And it is absurd to attempt to distinguish facts that are internal to the person from facts that are external to the person (e.g., 'internal nature' from 'environmental limitations' and of course 'physical limitations' would count as both). We are inexorably tied together with our environment. %#@&#!, it would have been adaptive to have had a trigger startle response to loud noises when loud noises reliably signalled threat...

I don't understand how this is supposed to ground psychiatry as a science

:-(