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Externalizing disorders: Cluster 5 of the proposed meta-structure for DSM-V and ICD-11

Paper 6 of 7 of the thematic section: ‘A proposal for a meta-structure for DSM-V and ICD-11’

Published online by Cambridge University Press:  01 October 2009

R. F. Krueger  and
S. C. South
R. F. Krueger*
Affiliation:
Departments of Psychology and Psychiatry, Washington University in St Louis, St Louis, MO, USA
S. C. South
Affiliation:
Department of Psychology, Purdue University, Lafayette, IN, USA
*
*Address for correspondence: Dr R. F. Krueger, Washington University in St Louis, Campus Box 1125, St Louis, MO 63130-4899, USA. (Email: rkrueger@artsci.wustl.edu)
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Abstract

Background

The extant major psychiatric classifications DSM-IV and ICD-10 are purportedly atheoretical and largely descriptive. Although this achieves good reliability, the validity of a medical diagnosis is greatly enhanced by an understanding of the etiology. In an attempt to group mental disorders on the basis of etiology, five clusters have been proposed. We consider the validity of the fifth cluster, externalizing disorders, within this proposal.

Method

We reviewed the literature in relation to 11 validating criteria proposed by the Study Group of the DSM-V Task Force, in terms of the extent to which these criteria support the idea of a coherent externalizing spectrum of disorders.

Results

This cluster distinguishes itself by the central role of disinhibitory personality in mental disorders spread throughout sections of the current classifications, including substance dependence, antisocial personality disorder and conduct disorder. Shared biomarkers, co-morbidity and course offer additional evidence for a valid cluster of externalizing disorders.

Conclusion

Externalizing disorders meet many of the salient criteria proposed by the Study Group of the DSM-V Task Force to suggest a classification cluster.

Keywords

Behaviorclassificationimpulsivitypersonalitysubstance dependence
Type
Thematic section: A proposal for a meta-structure for DSM-V and ICD-11
Information
Psychological Medicine , Volume 39 , Issue 12 , December 2009 , pp. 2061 - 2070
Copyright
Copyright © Cambridge University Press 2009

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