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5 - Contemporary Psychopathology Diagnosis

from Part I - General Issues in Clinical Assessment and Diagnosis

Published online by Cambridge University Press:  06 December 2019

By
Christopher C. Conway ,
Lee Anna Clark  and
Robert F. Krueger
Edited by
Martin Sellbom  and
Julie A. Suhr
Martin Sellbom
Affiliation:
University of Otago, New Zealand
Julie A. Suhr
Affiliation:
Ohio University
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Summary

Diagnosis and classification for mental disorder are in flux. This transition has downstream consequences on the nature of clinical assessment in research and treatment settings. We begin this chapter by describing the prevailing categorical rubrics, which are the predominant guide to clinical assessment worldwide. These systems, despite their popularity, suffer from serious defects, which have prompted the development of alternate frameworks for conceptualization and assessment of psychopathology. We focus the remainder of the chapter on two prominent contenders to supplement, and perhaps eventually supplant, traditional categorical models. The Hierarchical Taxonomy of Psychopathology is an empirically derived system of the phenotypic dimensions of psychopathology and the Research Domain Criteria represent a biologically oriented approach to understanding risk processes implicated in mental disorder. We describe the promise and challenges facing these two emerging systems, and we speculate about how they will shape the future of clinical assessment.

Keywords

classificationDiagnostic and Statistical Manual of Mental Disorders (DSM)Hierarchical Taxonomy of Psychopathology (HiTOP)nosologyResearch Domain Criteria (RDoC)
Type
Chapter
Information
The Cambridge Handbook of Clinical Assessment and Diagnosis , pp. 49 - 62
Publisher: Cambridge University Press
Print publication year: 2019

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References

Achenbach, T. M. (1966). The classification of children’s psychiatric symptoms: A factor-analytic study. Psychological Monographs: General and Applied, 80, 1–37.Google Scholar
American Psychiatric Association. (1952). Diagnostic and statistical manual of mental disorders. Washington, DC: Author.Google Scholar
American Psychiatric Association. (1968). Diagnostic and statistical manual of mental disorders (2nd ed.). Washington, DC: Author.Google Scholar
American Psychiatric Association. (1980). Diagnostic and statistical manual of mental disorders (3rd ed.). Washington, DC: Author.Google Scholar
American Psychiatric Association. (1987). Diagnostic and statistical manual of mental disorders (rev. 3rd ed.). Washington, DC: Author.Google Scholar
American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders (4th ed.). Washington, DC: Author.Google Scholar
American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders (rev. 4th ed.). Washington, DC: Author.Google Scholar
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.Google Scholar
Andrews, G., Goldberg, D. P., Krueger, R. F., Carpenter, W. T., Hyman, S. E., Sachdev, P., & Pine, D. S. (2009). Exploring the feasibility of a meta-structure for DSM-V and ICD-11: Could it improve utility and validity? Psychological Medicine, 39, 1993–2000.Google Scholar
Barlow, D. H., Farchione, T. J., Bullis, J. R., Gallagher, M. W., … & Cassiello-Robbins, C. (2017). The Unified Protocol for Transdiagnostic Treatment of Emotional Disorders compared with diagnosis-specific protocols for anxiety disorders: A randomized clinical trial. JAMA Psychiatry, 74, 875–884.Google Scholar
Barlow, D. H., Sauer-Zavala, S., Carl, J. R., Bullis, J. R., & Ellard, K. K. (2014). The nature, diagnosis, and treatment of neuroticism: Back to the future. Clinical Psychological Science, 2, 344–365.CrossRefGoogle Scholar
Brown, T. A., Campbell, L. A., Lehman, C. L., Grisham, J. R., & Mancill, R. B. (2001). Current and lifetime comorbidity of the DSM-IV anxiety and mood disorders in a large clinical sample. Journal of Abnormal Psychology, 110, 585–599.CrossRefGoogle Scholar
Clark, L. A. (2014). Schedule for Nonadaptive and Adaptive Personality, Second Edition (SNAP-2). Notre Dame, IN: University of Notre Dame.Google Scholar
Clark, L. A., Cuthbert, B., Lewis-Fernández, R., Narrow, W. E., & Reed, G. M. (2017). Three approaches to understanding and classifying mental disorder: ICD-11, DSM-5, and the National Institute of Mental Health’s Research Domain Criteria (RDoC). Psychological Science in the Public Interest, 18, 72–145.CrossRefGoogle ScholarPubMed
Clark, L. A., Simms, L. J., Wu, K. D., & Casillas, A. (2014). Schedule for Nonadaptive and Adaptive Personality – Second Edition. Notre Dame, IN: University of Notre Dame.Google Scholar
Cuthbert, B. N., & Insel, T. R. (2013). Toward the future of psychiatric diagnosis: The seven pillars of RDoC. BMC Medicine, 11, 126–134.Google Scholar
DeYoung, C. G., Peterson, J. B., & Higgins, D. M. (2002). Higher-order factors of the big five predict conformity: Are there neuroses of health? Personality and Individual Differences, 33(4), 533–552.Google Scholar
Digman, J. M. (1990). Personality structure: Emergence of the five-factor model. Annual Review of Psychology, 41, 417–440.Google Scholar
Eaton, N. R., Krueger, R. F., Markon, K. E., Keyes, K. M., Skodol, A. E., Wall, M., … & Grant, B. F. (2013). The structure and predictive validity of the internalizing disorders. Journal of Abnormal Psychology, 122, 86–92.CrossRefGoogle ScholarPubMed
First, M. B., Williams, J. B. W., Karg, R. S., & Spitzer, R. L. (2015). Structured clinical interview for DSM-5 – Clinician version (SCID-5-CV). Arlington, VA: American Psychiatric Association.Google Scholar
Hopwood, C. J. (2018). A framework for treating DSM-5 alternative model for personality disorder features. Personality and Mental Health, 12, 107–125.Google Scholar
Insel, T. R., & Cuthbert, B. N. (2015). Brain disorders? Precisely. Science, 348, 499–500.Google Scholar
Keeley, J. W., Webb, C., Peterson, D., Roussin, L., & Flanagan, E. H. (2016). Development of a response inconsistency scale for the personality inventory for DSM–5. Journal of Personality Assessment, 98, 351–359.Google Scholar
Kessler, R. C., McGonagle, K. A., Zhao, S., Nelson, C. B., Hughes, M., Eshleman, S., … & Kendler, K. S. (1994). Lifetime and 12-month prevalence of DSM-III-R psychiatric disorders in the United States: Results from the national comorbidity study. Archives of General Psychiatry, 51, 8–19.Google Scholar
Kessler, R. C., Petukhova, M., & Zaslavsky, A. M. (2011). The role of latent internalizing and externalizing predispositions in accounting for the development of comorbidity among common mental disorders. Current Opinion in Psychiatry, 24, 307–312.Google Scholar
Kirschbaum, C., Pirke, K., & Hellhammer, D. H. (1993). The “trier social stress test”: A tool for investigating psychobiological stress responses in a laboratory setting. Neuropsychobiology, 28(1–2), 76–81.Google Scholar
Kotov, R., Krueger, R. F., Watson, D., Achenbach, T. M., Althoff, R. R., Bagby, R. M., … & Zimmerman, M. (2017). The Hierarchical Taxonomy of Psychopathology (HiTOP): A dimensional alternative to traditional nosologies. Journal of Abnormal Psychology, 126, 454–477.Google Scholar
Kotov, R., Perlman, G., Gámez, W., & Watson, D. (2015). The structure and short-term stability of the emotional disorders: A dimensional approach. Psychological Medicine, 45(8), 1687–1698.CrossRefGoogle ScholarPubMed
Krueger, R. F. (1999). The structure of common mental disorders. Archives of General Psychiatry, 56, 921–926.CrossRefGoogle ScholarPubMed
Krueger, R. F., Caspi, A., Moffitt, T. E., & Silva, P. A. (1998). The structure and stability of common mental disorders (DSM-III-R): A longitudinal-epidemiological study. Journal of Abnormal Psychology, 107, 216–227.Google Scholar
Krueger, R. F., Derringer, J., Markon, K. E., Watson, D., & Skodol, A. E. (2012). Initial construction of a maladaptive personality trait model and inventory for DSM-5. Psychological Medicine, 42, 1879–1890.Google Scholar
Krueger, R. F., Kotov, R., Watson, D., Forbes, M. K., Eaton, N. R., Ruggero, C. J., et al. (2018). Progress in achieving quantitative classification of psychopathology. World Psychiatry, 17, 282–293.CrossRefGoogle ScholarPubMed
Krueger, R. F., Markon, K. E., Patrick, C. J., Benning, S. D., & Kramer, M. D. (2007). Linking antisocial behavior, substance use, and personality: An integrative quantitative model of the adult externalizing spectrum. Journal of Abnormal Psychology, 116, 645–666.Google Scholar
Lahey, B. B., Krueger, R. F., Rathouz, P. J., Waldman, I. D., & Zald, D. H. (2017). A hierarchical causal taxonomy of psychopathology across the life span. Psychological Bulletin, 143, 142–186.Google Scholar
Loranger, A. W. (1999). IPDE: International Personality Disorder Examination: DSM-IV and ICD-10 interviews. Odessa, FL: Psychological Assessment Resources.Google Scholar
Markon, K. E. (2010). Modeling psychopathology structure: A symptom-level analysis of Axis I and II disorders. Psychological Medicine, 40, 273–288.Google Scholar
Markon, K. E., Chmielewski, M., & Miller, C. J. (2011). The reliability and validity of discrete and continuous measures of psychopathology: a quantitative review. Psychological Bulletin, 137, 856–877.Google Scholar
Morey, L. C., Hopwood, C. J., Markowitz, J. C., Gunderson, J. G., Grilo, C. M., McGlashan, T. H., … & Skodol, A. E. (2012). Comparison of alternative models for personality disorders, II: 6-, 8- and 10-year follow-up. Psychological Medicine, 42, 1705–1713.Google Scholar
Narrow, W. E., Clarke, D. E., Kuramoto, S. J., Kraemer, H. C., Kupfer, D. J., Greiner, L., & Regier, D. A. (2013). DSM-5 field trials in the United States and Canada, Part III: Development and reliability testing of a cross-cutting symptom assessment for DSM-5. American Journal of Psychiatry, 170, 71–82.CrossRefGoogle ScholarPubMed
Nelson, G. H., O’Hara, M. W., & Watson, D. (2018). National norms for the Expanded Version of the Inventory of Depression and Anxiety Symptoms (IDAS-II). Journal of Clinical Psychology, 74, 953–968.Google Scholar
Patrick, C. J., Kramer, M. D., Krueger, R. F., & Markon, K. E. (2013). Optimizing efficiency of psychopathology assessment through quantitative modeling: Development of a brief form of the Externalizing Spectrum Inventory. Psychological Assessment, 25, 1332–1348.Google Scholar
Regier, D. A., Narrow, W. E., Clarke, D. E., Kraemer, H. C., Kuramoto, S. J., Kuhl, E. A., & Kupfer, D. J. (2013). DSM-5 field trials in the United States and Canada, Part II: Test-retest reliability of selected categorical diagnoses. American Journal of Psychiatry, 170, 59–70.CrossRefGoogle ScholarPubMed
Rodriguez-Seijas, C., Eaton, N. R., Stohl, M., Mauro, P. M., & Hasin, D. S. (2017). Mental disorder comorbidity and treatment utilization. Comprehensive Psychiatry, 79, 89–97.Google Scholar
Rodriguez-Seijas, C., Stohl, M., Hasin, D. S., & Eaton, N. R. (2015). Transdiagnostic factors and mediation of the relationship between perceived racial discrimination and mental disorders. Journal of the American Medical Association Psychiatry, 72, 706–713.Google Scholar
Ruggero, C. (2018). Integrating a dimensional, hierarchical taxonomy of psychopathology into clinical practice, PsyArXiv Preprints, August 18. psyarxiv.com/r2jt6Google Scholar
Sellbom, M., Dhillon, S., & Bagby, R. M. (2018). Development and validation of an overreporting scale for the personality inventory for DSM–5 (PID-5). Psychological Assessment, 30(5), 582–593.Google Scholar
Spiegel, A. (2005). The dictionary of disorder. New Yorker, 80, 56–63.Google Scholar
Tyrer, P., Reed, G. M., & Crawford, M. J. (2015). Classification, assessment, prevalence and effect of personality disorder. Lancet, 385, 717–726.Google Scholar
Waszczuk, M. A., Zimmerman, M., Ruggero, C., Li, K., MacNamara, A., Weinberg, A., … & Kotov, R. (2017). What do clinicians treat: Diagnoses or symptoms? The incremental validity of a symptom-based, dimensional characterization of emotional disorders in predicting medication prescription patterns. Comprehensive Psychiatry, 79, 80–88.Google Scholar
Watson, D., O’Hara, M. W., Naragon-Gainey, K., Koffel, E., Chmielewski, M., Kotov, R., … Ruggero, C. J. (2012). Development and validation of new anxiety and bipolar symptom scales for an expanded version of the IDAS (the IDAS-II). Assessment, 19, 399–420.CrossRefGoogle ScholarPubMed
Vittengl, J. R., Clark, L. A., Thase, M. E., & Jarrett, R. B. (2013). Nomothetic and idiographic symptom change trajectories in acute-phase cognitive therapy for recurrent depression. Journal of Consulting and Clinical Psychology, 81, 615–626.Google Scholar
Wilk, J. E., West, J. C., Narrow, W. E., Marcus, S., Rubio-Stipec, M., Rae, D. D., … & Regier, D. A. (2006). Comorbidity patterns in routine psychiatric practice: Is there evidence of under-detection and under-diagnosis? Comprehensive Psychiatry, 47, 258–264.Google Scholar

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