Dimensional Approaches in Diagnostic Classification: Refining the Research Agenda for DSM-V

Dimensional Approaches in Diagnostic Classification: Refining the Research Agenda for DSM-V

by John E. Helzer
     
 

Since its initial publication more than 50 years ago, the DSM has systematized the complex intellectual and clinical process of diagnosing mentally ill persons through the use of categories and classification. The manuals have provided a consistent diagnostic language for clinical work, research, and teaching; have established a common international taxonomic

Overview

Since its initial publication more than 50 years ago, the DSM has systematized the complex intellectual and clinical process of diagnosing mentally ill persons through the use of categories and classification. The manuals have provided a consistent diagnostic language for clinical work, research, and teaching; have established a common international taxonomic standard; and have provided psychiatrists with a means of communicating with patients and the public. With a new iteration of the DSM on the horizon, the APA has initiated a multiphase research review process designed to set the stage for the fifth revision, due to be published in 2013.

This book brings together the most promising research presented at the conference "The Future of Psychiatric Diagnosis: Refining the Research Agenda," which was convened by the APA, in collaboration with the World Health Organization and the U.S. National Institutes of Health. Conferees were challenged to go beyond the current categorical definitions set forth in DSM-III and DSM-IV and suggest ways of incorporating more quantitative, dimensional concepts into DSM-V. The resulting work: • Addresses the challenge of creating dimensional measures that are compatible with existing categorical definitions and do not unduly disrupt clinical practice• Applies a dimensional approach to a broad range of diagnoses, including substance dependence, major depressive episode, psychosis, anxiety disorders, developmental psychopathology, and personality disorders• Facilitates the development of broadly agreed upon criteria that researchers worldwide can use in planning and conducting future research exploring the etiology and pathophysiology of mental disorders• Identifies and encourages the empirical research necessary to allow informed decision making regarding deficiencies acknowledged in DSM-IV• Promotes international collaboration with the objective of eliminating the remaining disparities between DSM-V and the International Classification of Diseases Mental and Behavioural Disorders Section, the next edition of which is due to be released in 2014.

The book's painstaking scholarship and thoughtful conclusions should stimulate interest in finding new ways of combining categorical and dimensional approaches in psychiatric nosology. Clinicians and researchers in the United States and the international psychiatric community will discover, in these pages, the beginnings of a new, quantitative methodology that represents the next stage in the evolution of DSM.

American Psychiatric Publishing

Editorial Reviews

Doody's Review Service
Reviewer: Michael Joel Schrift, DO, MA (Northwestern University Feinberg School of Medicine)
Description: Psychiatric diagnoses as represented in the DSM-IV are similar to what the classification of animals and plants was prior to Darwin and the theory of evolution: there are no foundational or fundamental principles to guide the categorization. By design, the DSMs have been atheoretical with the intention of improving the reliability of psychiatric diagnoses. Unfortunately, the validity of the diagnoses has not improved. The DSMs have not been able to "carve nature at its joints." The brain, which is the final common pathway for all behavior, is not organized according to DSM-IV. This interesting new book reviews a fresh conceptualization: the dimensional approach to the classification of psychopathology. The chapters in this book were first published in a supplement to the International Journal of Methods in Psychiatric Research, which grew out of a conference focused on the dimensional approach to psychiatric diagnosis and part of the review process in the development of DSM-V. Written and edited by a group of internationally recognized researchers in the field, these reviews present an important and compelling justification for the use of dimensions, at least as a supplement, to the categorical diagnosis of psychopathology.
Purpose: The purpose of this book is to inform clinicians and researchers about a "new, quantitative methodology that will transform diagnosis and represents the next stage in the evolution of DSM."
Audience: Clinicians and researchers in psychiatry and related field are the intended audience.
Features: The first chapter provides an overview of dimensional approaches in psychiatric classification, followed by an appraisal of the use of categories and dimensions in clinical and research contexts. The next several chapters address the use of dimensions in the various clinical domains including substance dependence, major depressive episode, psychosis, anxiety disorders, personality disorders, and developmental psychopathology. The concluding chapter proposes the use of a dimensional option for the next DSM. Each chapter ends with citations of the relevant scientific literature.
Assessment: This informative new book details the dimensional approach to psychiatric nosology. Clinicians actually do not treat patients according to the DSM categories (or the diagnostic criteria) but rather use the heuristic of target symptoms. Clinicians and researchers who are interested in understanding the rationale for the modifications proposed in the next iteration of the DSM should read this book.

Product Details

ISBN-13:
9780890423431
Publisher:
American Psychiatric Publishing, Incorporated
Publication date:
04/14/2008
Pages:
164
Product dimensions:
6.00(w) x 8.90(h) x 0.40(d)
Age Range:
18 Years

Meet the Author

John E. Helzer, M.D., is Professor of Psychiatry and Director of the Health Behavior Research Center at University of Vermont College of Medicine in Burlington, Vermont.

Helena Chmura Kraemer, Ph.D., is Professor Emerita of Biostatistics in Psychiatry in the Department of Psychiatry and Behavioral Sciences at Stanford University in Palo Alto, California.

Robert F. Krueger, Ph.D., is Professor of Clinical Psychology, and Personality, Individual Differences, and Behavior Genetics in the Department of Psychology at the University of Minnesota in Minneapo¬lis, Minnesota.

Hans-Ulrich Wittchen, Ph.D., is Director of the Institute of Clinical Psychology and Psychotherapy at Technische Univer¬sität Dresden in Dresden, Germany.

Paul J. Sirovatka, M.S., was Director of Research Policy Analysis at the Division of Research and American Psychiatric Institute for Research and Education at the American Psychiatric Association in Arlington, Virginia.

Darrel A. Regier, M.D., M.P.H., is Executive Director of the American Psychiatric Institute for Research and Education and Director of the Division of Research at the American Psychiatric Association in Arlington, Virginia.

American Psychiatric Publishing

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