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Beyond comorbidity: Toward a dimensional and hierarchical approach to understanding psychopathology across the life span

Published online by Cambridge University Press:  14 October 2016

Miriam K. Forbes ,
Jennifer L. Tackett ,
Kristian E. Markon  and
Robert F. Krueger
Miriam K. Forbes*
Affiliation:
University of Minnesota
Jennifer L. Tackett
Affiliation:
Northwestern University
Kristian E. Markon
Affiliation:
University of Iowa City
Robert F. Krueger
Affiliation:
University of Minnesota
*
Address correspondence and reprint requests to: Miriam Forbes, Department of Psychiatry, University of Minnesota, 2450 Riverside Avenue, F227, Minneapolis, MN 55454; E-mail: mkforbes@umn.edu.
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Abstract

We propose a novel developmentally informed framework to push research beyond a focus on comorbidity between discrete diagnostic categories and to move toward research based on the well-validated dimensional and hierarchical structure of psychopathology. For example, a large body of research speaks to the validity and utility of the internalizing and externalizing spectra as organizing constructs for research on common forms of psychopathology. The internalizing and externalizing spectra act as powerful explanatory variables that channel the psychopathological effects of genetic and environmental risk factors, predict adaptive functioning, and account for the likelihood of disorder-level manifestations of psychopathology. As such, our proposed theoretical framework uses the internalizing and externalizing spectra as central constructs to guide future psychopathology research across the life span. The framework is particularly flexible, because any of the facets or factors from the dimensional and hierarchical structure of psychopathology can form the focus of research. We describe the utility and strengths of this framework for developmental psychopathology in particular and explore avenues for future research.

Type
Special Issue Articles
Information
Development and Psychopathology , Volume 28 , Special Issue 4pt1: Mechanisms of Comorbidity, Continuity, and Discontinuity in Psychopathology , November 2016 , pp. 971 - 986
Copyright
Copyright © Cambridge University Press 2016 

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