Dimensional Approaches in Diagnostic Classification

Dimensional Approaches in Diagnostic Classification

Author: John E. Helzer

Publisher: American Psychiatric Pub

Published: 2009-02-20

Total Pages: 165

ISBN-13: 0890426546

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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.


Re-Visioning Psychiatry

Re-Visioning Psychiatry

Author: Laurence J. Kirmayer

Publisher: Cambridge University Press

Published: 2015-07-29

Total Pages: 725

ISBN-13: 1107032202

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Revisioning Psychiatry brings together new perspectives on the causes and treatment of mental health problems. The contributors emphasize the importance of understanding experience and explore how the brain, the person, and the social world interact to give rise to mental health problems as well as resilience and recovery.


Contemporary Directions in Psychopathology

Contemporary Directions in Psychopathology

Author: Theodore Millon

Publisher: Guilford Press

Published: 2011-08-03

Total Pages: 622

ISBN-13: 1606235338

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This forward-thinking volume grapples with critical questions surrounding the mechanisms underlying mental disorders and the systems used for classifying them. Edited and written by leading international authorities, many of whom are actively involved with the development of DSM-V and ICD-11, the book integrates biological and psychosocial perspectives. It provides balanced analyses of such issues as the role of social context and culture in psychopathology and the pros and cons of categorical versus dimensional approaches to diagnosis. Cutting-edge diagnostic instruments and research methods are reviewed. Throughout, contributors highlight the implications of current theoretical and empirical advances for understanding real-world clinical problems and developing more effective treatments.


Handbook of Diagnostic Classification Models

Handbook of Diagnostic Classification Models

Author: Matthias von Davier

Publisher: Springer Nature

Published: 2019-10-11

Total Pages: 646

ISBN-13: 3030055841

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This handbook provides an overview of major developments around diagnostic classification models (DCMs) with regard to modeling, estimation, model checking, scoring, and applications. It brings together not only the current state of the art, but also the theoretical background and models developed for diagnostic classification. The handbook also offers applications and special topics and practical guidelines how to plan and conduct research studies with the help of DCMs. Commonly used models in educational measurement and psychometrics typically assume a single latent trait or at best a small number of latent variables that are aimed at describing individual differences in observed behavior. While this allows simple rankings of test takers along one or a few dimensions, it does not provide a detailed picture of strengths and weaknesses when assessing complex cognitive skills. DCMs, on the other hand, allow the evaluation of test taker performance relative to a potentially large number of skill domains. Most diagnostic models provide a binary mastery/non-mastery classification for each of the assumed test taker attributes representing these skill domains. Attribute profiles can be used for formative decisions as well as for summative purposes, for example in a multiple cut-off procedure that requires mastery on at least a certain subset of skills. The number of DCMs discussed in the literature and applied to a variety of assessment data has been increasing over the past decades, and their appeal to researchers and practitioners alike continues to grow. These models have been used in English language assessment, international large scale assessments, and for feedback for practice exams in preparation of college admission testing, just to name a few. Nowadays, technology-based assessments provide increasingly rich data on a multitude of skills and allow collection of data with respect to multiple types of behaviors. Diagnostic models can be understood as an ideal match for these types of data collections to provide more in-depth information about test taker skills and behavioral tendencies.


The Conceptual Evolution of DSM-5

The Conceptual Evolution of DSM-5

Author: Darrel A. Regier

Publisher: American Psychiatric Pub

Published: 2011

Total Pages: 392

ISBN-13: 1585623881

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The Conceptual Evolution of DSM-5 highlights recent advances in our understanding of cross-cutting factors relevant to psychiatric diagnosis and nosology. These include developmental age-related aspects of psychiatric diagnosis and symptom presentation; underlying neuro-circuitry and genetic similarities that may clarify diagnostic boundaries and inform a more etiologically-based taxonomy of disorder categories; and gender/culture-specific influences in the prevalence of and service use for psychiatric disorders. This text also considers the role of disability in the diagnosis of mental disorders and the potential utility of integrating a dimensional approach to psychiatric diagnosis. A powerful reference tool for anyone practicing or studying psychiatry, social work, psychology, or nursing, The Conceptual Evolution of DSM-5 details the proceedings from the 2009 American Psychopathological Association's Annual Meeting. In its chapters, readers will find a thorough review of the empirical evidence regarding the utility of cross-cutting factors in nosology, as well as specific suggestions for how they may be fully integrated into the forthcoming fifth edition of Diagnostic and Statistical Manual of Mental Disorders.


Age and Gender Considerations in Psychiatric Diagnosis

Age and Gender Considerations in Psychiatric Diagnosis

Author: William E. Narrow

Publisher: American Psychiatric Pub

Published: 2008-05-20

Total Pages: 609

ISBN-13: 1585626767

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Written to help identify major gaps in our knowledge of how gender and age affect psychiatric diagnoses and to stimulate much-needed research to fill these gaps, Age and Gender Considerations in Psychiatric Diagnosis serves as both a valuable short-term source for the DSM-V Task Force and its disorder-specific workgroups, and a long-term guide for future studies that will contribute to revised psychiatric classifications in these three areas. Here, 47 experts present findings in three areas of psychiatric research that historically have been neglected but rightfully have received increasing attention in recent years and thus are worthy of investigation into their clinical features, etiology, and course: 1. Significant gender differences in prevalence, symptom profiles, and risk factors for mental disorders, including neurodevelopmental, neurophysiological, and environmental factors for men and women that cut across diagnostic categories-for example, the critical importance of gender in how psychiatric illness develops and presents; DSM's approach to gender to date; and relevant research findings and gaps in the epidemiology, etiology, and pathophysiology of disorders and the gender-related expression of psychopathology, including the controversial and complex question of whether DSM should have different diagnostic criteria for men and women. 2. Mental disorders in infancy and early childhood, including diagnosis and measurement of psychopathology; PTSD and social and cognitive factors related to the experience of stress; reactive attachment disorder (unique in part because of its specificity to early childhood); mood and anxiety disorders and difficulties in diagnosis; sleep disorders, including two new disorders, Night-Waking Dysomnia and Sleep-Onset Dysomnia; feeding disorders, including the need to address overeating and overfeeding (especially given the alleged U.S. epidemic of obesity); early childhood manifestations of behavior disorders; and early symptoms and diagnosis of autism. 3. Mental disorders in the elderly, such as dementia and depression, once considered normal consequences of aging but now understood to represent mental disorders, including the need to identify specific brain structure abnormalities, biomarkers, and the many contributing biological, psychosocial, and environmental factors of mental illness in late life and to understand their roles in the elderly to better diagnose and monitor disease progression. Written for clinicians and researchers alike, this thought-provoking compendium contributes critical information that helps enhance our understanding of the causes of mental disorders, develop effective preventive and treatment interventions, and inform future editions of DSM and ICD.


The Medical Model in Mental Health

The Medical Model in Mental Health

Author: Ahmed Samei Huda

Publisher: Oxford University Press

Published: 2019-05-16

Total Pages: 417

ISBN-13: 0192534092

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Many published books that comment on the medical model have been written by doctors, who assume that readers have the same knowledge of medicine, or by those who have attempted to discredit and attack the medical practice. Both types of book have tended to present diagnostic categories in medicine as universally scientifically valid examples of clear-cut diseases easily distinguished from each other and from health; with a fixed prognosis; and with a well-understood aetiology leading to disease-reversing treatments. These are contrasted with psychiatric diagnoses and treatments, which are described as unclear and inadequate in comparison. The Medical Model in Mental Health: An Explanation and Evaluation explores the overlap between the usefulness of diagnostic constructs (which enable prognosis and treatment decisions) and the therapeutic effectiveness of psychiatry compared with general medicine. The book explains the medical model and how it applies in mental health, assuming little knowledge or experience of medicine, and defends psychiatry as a medical practice.


Essential Psychiatry

Essential Psychiatry

Author: Robin M. Murray

Publisher: Cambridge University Press

Published: 2008-09-18

Total Pages: 1385

ISBN-13: 1139473654

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This is a major international textbook for psychiatrists and other professionals working in the field of mental healthcare. With contributions from opinion-leaders from around the globe, this book will appeal to those in training as well as to those further along the career path seeking a comprehensive and up-to-date overview of effective clinical practice backed by research evidence. The book is divided into cohesive sections moving from coverage of the tools and skills of the trade, through descriptions of the major psychiatric disorders and on to consider special topics and issues surrounding service organization. The final important section provides a comprehensive review of treatments covering all of the major modalities. Previously established as the Essentials of Postgraduate Psychiatry, this new and completely revised edition is the only book to provide this depth and breadth of coverage in an accessible, yet authoritative manner.


Dimensional Models of Personality Disorders

Dimensional Models of Personality Disorders

Author: Thomas A. Widiger

Publisher: American Psychiatric Pub

Published: 2007-05-03

Total Pages: 324

ISBN-13: 1585626732

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DSM-IV and ICD-10 both diagnose personality disorders categorically, yet studies indicate that many patients meet criteria for an excessive number of diagnoses, raising the question of whether personality disorders are discrete conditions or rather distinctions along dimensions of general personality functioning. This collection of papers renews long-standing proposals for a dimensional model of personality disorder, describing alternative models, addressing questions about their clinical application and utility, and suggesting that future research seek to integrate such models within a common hierarchical structure. With contributions by preeminent researchers in the field, Dimensional Models of Personality Disorders is drawn from a conference series convened by APA, WHO, and NIH in order to plan for the fifth edition of the DSM. The Nomenclature Work Group concluded that consideration should be given to basing part or all of DSM-V on dimensions rather than categories, and recommended that a dimensional model for personality disorders should serve as a basis for exploring dimensional approaches in other areas. Accordingly, the volume opens with a presentation of 18 proposals for dimensional models and proceeds with provocative contributions on a number of related issues ranging from hard science to clinical practice. Among the topics addressed are Behavioral and molecular genetic research supporting an etiologically informed dimensional classification of personality disorders The as-yet tenuous associations between dimensional trait measures of personality as contained in the models of Cloninger, Depue, and Siever-Davis, and specific neurobiological measures, as examined in neurotransmitter research Potential links between childhood and adolescent temperament and personality dimensions and adult personality psychopathology Studies examining the covariation of personality dimensions across cultures The continuity of Axis I and Axis II disorders and a proposed hierarchical structure of mental disorders that integrates the psychopathology of Axis I disorders with specific personality traits The dual challenges of coverage and cutoffs that must be addressed if dimensional models are to be considered viable alternatives to the existing categorical diagnostic system Although the editors acknowledge that concerns are certain to be raised regarding conversion to a dimensional classification -- such as the disruption to clinical practice by a radical shift in diagnosing personality disorder -- these papers make a strong case for opening the field to alternative ways of enhancing clinical utility and improving the validity of basic classification concepts. Together, they offer stimulating insight into how we approach personality disorders, with the hope of encouraging a new model of diagnosis for DSM-V.


Clinical Psychopharmacology

Clinical Psychopharmacology

Author: S. Nassir Ghaemi

Publisher: Oxford University Press

Published: 2018-12-05

Total Pages: 601

ISBN-13: 0199995508

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Clinical Psychopharmacology offers a comprehensive guide to clinical practice that explores two major aspects of the field: the clinical research that exists to guide clinical practice of psychopharmacology, and the application of that knowledge with attention to the individualized aspects of clinical practice. The text consists of 50 chapters, organized into 6 sections, focusing on disease-modifying effects, non-DSM diagnostic concepts, and essential facts about the most common drugs. This innovative book advocates a scientific and humanistic approach to practice and examines not only the benefits, but also the harms of drugs. Providing a solid foundation of knowledge and a great deal of practical information, this book is a valuable resource for practicing psychiatrists, psychiatric nurse practitioners, medical students and trainees in psychiatry, as well as pharmacists.