Why psychiatric research must abandon traditional diagnostic classification and adopt a fully dimensional scope: Two solutions to a persistent problem

Frontiers in Psychiatry

Volumn 8, Issue JUN, 2017, Pages

  Hengartner, Michael P ^a   Lehmann, Sandrine N ^b  

^a ZURICH UNIVERSITY OF APPLIED SCIENCES   (Switzerland)

^b UNIVERSITY HOSPITAL OF PSYCHIATRY   (Switzerland)

Author keywords

Diagnosis; DSM; Hierarchical taxonomy of psychopathology; ICD; Psychiatric nosology; Psychopathology; Research; Research domain criteria

Indexed keywords

ARTICLE; DIAGNOSTIC AND STATISTICAL MANUAL OF MENTAL DISORDERS; HIERARCHICAL TAXONOMY OF PSYCHOPATHOLOGY; HUMAN; INTERNATIONAL CLASSIFICATION OF DISEASES; MENTAL DISEASE; MENTAL DISEASE ASSESSMENT; MENTAL HEALTH RESEARCH; RESEARCH DOMAIN CRITERIA;

EID: 85019768470     PISSN: None     EISSN: 16640640     Source Type: Journal    
DOI: 10.3389/fpsyt.2017.00101     Document Type: Article

References (73)

1. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders DSM-5. Washington, DC: American Psychiatric Association (2013)
2. World Health Organization. International Classification of Diseases ICD-10. 10th ed. Geneva: World Health Organization (1992)
3. Hyman SE. The diagnosis of mental disorders: the problem of reification. Annu Rev Clin Psychol (2010) 6:155-79. doi: 10.1146/annurev.clinpsy.3.022806.091532
4. Krueger RF, Bezdjian S. Enhancing research and treatment of mental disorders with dimensional concepts: toward DSM-V and ICD-11. World Psychiatry (2009) 8:3-6. doi:10.1002/j.2051-5545.2009.tb00197.x
5. Lilienfeld SO. DSM-5: centripetal scientific and centrifugal antiscientific forces. Clin Psychol Sci Pract (2014) 21:269-79. doi:10.1111/Cpsp.12075
6. Hankin BL, Fraley RC, Lahey BB, Waldman ID. Is depression best viewed as a continuum or discrete category? A taxometric analysis of childhood and adolescent depression in a population-based sample. J Abnorm Psychol (2005) 114:96-110. doi:10.1037/0021-843X.114.1.96
7. Haslam N, Holland E, Kuppens P. Categories versus dimensions in personality and psychopathology: a quantitative review of taxometric research. Psychol Med (2012) 42:903-20. doi:10.1017/S0033291711001966
8. Markon KE, Krueger RF. Categorical and continuous models of liability to externalizing disorders: a direct comparison in NESARC. Arch Gen Psychiatry (2005) 62:1352-9. doi:10.1001/archpsyc.62.12.1352
9. Walton KE, Ormel J, Krueger RF. The dimensional nature of externalizing behaviors in adolescence: evidence from a direct comparison of categorical, dimensional, and hybrid models. J Abnorm Child Psychol (2011) 39:553-61. doi:10.1007/s10802-010-9478-y
10. Wright AG, Krueger RF, Hobbs MJ, Markon KE, Eaton NR, Slade T. The structure of psychopathology: toward an expanded quantitative empirical model. J Abnorm Psychol (2013) 122:281-94. doi:10.1037/a0030133
11. Kendell R, Jablensky A. Distinguishing between the validity and utility of psychiatric diagnoses. Am J Psychiatry (2003) 160:4-12. doi:10.1176/appi.ajp.160.1.4
12. Widiger TA, Samuel DB. Diagnostic categories or dimensions? A question for the diagnostic and statistical manual of mental disorders-fifth edition. J Abnorm Psychol (2005) 114:494-504. doi:10.1037/0021-843X.114.4.494
13. Coghill D, Sonuga-Barke EJ. Annual research review: categories versus dimensions in the classification and conceptualisation of child and adolescent mental disorders-implications of recent empirical study. J Child Psychol Psychiatry (2012) 53:469-89. doi:10.1111/j.1469-7610.2011.02511.x
14. Jablensky A. Psychiatric classifications: validity and utility. World Psychiatry (2016) 15:26-31. doi:10.1002/wps.20284
15. Kotov R, Ruggero CJ, Krueger RF, Watson D, Yuan Q, Zimmerman M. New dimensions in the quantitative classification of mental illness. Arch Gen Psychiatry (2011) 68:1003-11. doi:10.1001/archgenpsychiatry.2011.107
16. Krueger RF, Caspi A, Moffitt TE, Silva PA. The structure and stability of common mental disorders (DSM-III-R): a longitudinal-epidemiological study. J Abnorm Psychol (1998) 107:216-27. doi:10.1037/0021-843X.107.2.216
17. Markon KE. Modeling psychopathology structure: a symptom-level analysis of axis I and II disorders. Psychol Med (2010) 40:273-88. doi:10.1017/S0033291709990183
18. Rhebergen D, van der Steenstraten IM, Sunderland M, de Graaf R, Ten Have M, Lamers F, et al. An examination of generalized anxiety disorder and dysthymic disorder by latent class analysis. Psychol Med (2014) 44:1701-12. doi:10.1017/S0033291713002225
19. Wright AG, Simms LJ. A metastructural model of mental disorders and pathological personality traits. Psychol Med (2015) 45:2309-19. doi:10.1017/S0033291715000252
20. Chmielewski M, Clark LA, Bagby RM, Watson D. Method matters: understanding diagnostic reliability in DSM-IV and DSM-5. J Abnorm Psychol (2015) 124:764-9. doi:10.1037/abn0000069
21. Regier DA, Narrow WE, Clarke DE, Kraemer HC, Kuramoto SJ, Kuhl EA, et al. DSM-5 field trials in the United States and Canada, part II: test-retest reliability of selected categorical diagnoses. Am J Psychiatry (2013) 170:59-70. doi:10.1176/appi.ajp.2012.12070999
22. Markon KE, Chmielewski M, Miller CJ. The reliability and validity of discrete and continuous measures of psychopathology: a quantitative review. Psychol Bull (2011) 137:856-79. doi:10.1037/a0023678
23. Cuthbert BN, Insel TR. Toward the future of psychiatric diagnosis: the seven pillars of RDoC. BMC Med (2013) 11:126. doi:10.1186/1741-7015-11-126
24. Kotov R, Krueger RF, Watson D, Achenbach TM, Althoff RR, Bagby RM, et al. The hierarchical taxonomy of psychopathology (HiTOP): a dimensional alternative to traditional nosologies. J Abnorm Psychol (2017) 126(4):454-77. doi:10.1037/abn0000258
25. Watson D, Clark LA. Clinical diagnosis at the crossroads. Clin Psychol Sci Pract (2006) 13:210-5. doi:10.1111/j.1468-2850.2006.00026.x
26. Clark LA. Assessment and diagnosis of personality disorder: perennial issues and an emerging reconceptualization. Annu Rev Psychol (2007) 58:227-57. doi:10.1146/annurev.psych.57.102904.190200
27. Farmer RF. Issues in the assessment and conceptualization of personality disorders. Clin Psychol Rev (2000) 20:823-51. doi:10.1016/S0272-7358(99)00014-8
28. Tyrer P, Reed GM, Crawford MJ. Classification, assessment, prevalence, and effect of personality disorder. Lancet (2015) 385:717-26. doi:10.1016/S0140-6736(14)61995-4
29. Widiger TA, Trull TJ. Plate tectonics in the classification of personality disorder: shifting to a dimensional model. Am Psychol (2007) 62:71-83. doi:10.1037/0003-066X.62.2.71
30. Verheul R, Widiger TA. A meta-analysis of the prevalence and usage of the personality disorder not otherwise specified (PDNOS) diagnosis. J Pers Disord (2004) 18:309-19. doi:10.1521/pedi.18.4.309.40350
31. Kendler KS, Aggen SH, Czajkowski N, Roysamb E, Tambs K, Torgersen S, et al. The structure of genetic and environmental risk factors for DSM-IV personality disorders: a multivariate twin study. Arch Gen Psychiatry (2008) 65:1438-46. doi:10.1001/archpsyc.65.12.1438
32. Livesley WJ, Jang KL, Vernon PA. Phenotypic and genetic structure of traits delineating personality disorder. Arch Gen Psychiatry (1998) 55:941-8. doi:10.1001/archpsyc.55.10.941
33. O'Connor BP. A search for consensus on the dimensional structure of personality disorders. J Clin Psychol (2005) 61:323-45. doi:10.1002/jclp.20017
34. Widiger TA, Livesley WJ, Clark LA. An integrative dimensional classification of personality disorder. Psychol Assess (2009) 21:243-55. doi:10.1037/a0016606
35. Hengartner MP, Ajdacic-Gross V, Rodgers S, Muller M, Rossler W. The joint structure of normal and pathological personality: further evidence for a dimensional model. Compr Psychiatry (2014) 55:667-74. doi:10.1016/j.comppsych.2013.10.011
36. Samuel DB, Simms LJ, Clark LA, Livesley WJ, Widiger TA. An item response theory integration of normal and abnormal personality scales. Personal Disord (2010) 1:5-21. doi:10.1037/a0018136
37. Clark LA. Stability and change in personality disorder. Curr Dir Psychol Sci (2009) 18:27-31. doi:10.1111/j.1467-8721.2009.01600.x
38. Gunderson JG, Stout RL, McGlashan TH, Shea MT, Morey LC, Grilo CM, et al. Ten-year course of borderline personality disorder: psychopathology and function from the collaborative longitudinal personality disorders study. Arch Gen Psychiatry (2011) 68:827-37. doi:10.1001/archgenpsychiatry.2011.37
39. Morey LC, Hopwood CJ. Stability and change in personality disorders. Annu Rev Clin Psychol (2013) 9:499-528. doi:10.1146/annurev-clinpsy-050212-185637
40. Caspi A, Houts RM, Belsky DW, Goldman-Mellor SJ, Harrington H, Israel S, et al. The p factor: one general psychopathology factor in the structure of psychiatric disorders? Clin Psychol Sci (2014) 2:119-37. doi:10.1177/2167702613497473
41. Lahey BB, Applegate B, Hakes JK, Zald DH, Hariri AR, Rathouz PJ. Is there a general factor of prevalent psychopathology during adulthood? J Abnorm Psychol (2012) 121:971-7. doi:10.1037/a0028355
42. Vollebergh WA, Iedema J, Bijl RV, de Graaf R, Smit F, Ormel J. The structure and stability of common mental disorders: the NEMESIS study. Arch Gen Psychiatry (2001) 58:597-603. doi:10.1001/archpsyc.58.6.597
43. Eaton NR, Rodriguez-Seijas C, Carragher N, Krueger RF. Transdiagnostic factors of psychopathology and substance use disorders: a review. Soc Psychiatry Psychiatr Epidemiol (2015) 50:171-82. doi:10.1007/s00127-014-1001-2
44. Krueger RF, Markon KE. Reinterpreting comorbidity: a model-based approach to understanding and classifying psychopathology. Annu Rev Clin Psychol (2006) 2:111-33. doi:10.1146/annurev.clinpsy.2.022305.095213
45. Brown TA. Temporal course and structural relationships among dimensions of temperament and DSM-IV anxiety and mood disorder constructs. J Abnorm Psychol (2007) 116:313-28. doi:10.1037/0021-843X.116.2.313
46. Hengartner MP, Ajdacic-Gross V, Wyss C, Angst J, Rossler W. Relationship between personality and psychopathology in a longitudinal community study: a test of the predisposition model. Psychol Med (2016) 46:1693-705. doi:10.1017/S0033291716000210
47. Krueger RF. Personality traits in late adolescence predict mental disorders in early adulthood: a prospective-epidemiological study. J Pers (1999) 67:39-65. doi:10.1111/1467-6494.00047
48. Wilson S, Vaidyanathan U, Miller MB, McGue M, Iacono WG. Premorbid risk factors for major depressive disorder: are they associated with early onset and recurrent course? Dev Psychopathol (2014) 26:1477-93. doi:10.1017/S0954579414001151
49. Hengartner MP, Kawohl W, Haker H, Rossler W, Ajdacic-Gross V. Big five personality traits may inform public health policy and preventive medicine: evidence from a cross-sectional and a prospective longitudinal epidemiologic study in a Swiss community. J Psychosom Res (2016) 84:44-51. doi:10.1016/j.jpsychores.2016.03.012
50. Hengartner MP, Tyrer P, Ajdacic-Gross V, Angst J, Rossler W. Articulation and testing of a personality-centred model of psychopathology: evidence from a longitudinal community study over 30 years. Eur Arch Psychiatry Clin Neurosci (2017). doi:10.1007/s00406-017-0796-8
51. Khan AA, Jacobson KC, Gardner CO, Prescott CA, Kendler KS. Personality and comorbidity of common psychiatric disorders. Br J Psychiatry (2005) 186:190-6. doi:10.1192/bjp.186.3.190
52. Zinbarg RE, Mineka S, Bobova L, Craske MG, Vrshek-Schallhorn S, Griffith JW, et al. Testing a hierarchical model of neuroticism and its cognitive facets: latent structure and prospective prediction of first onsets of anxiety and unipolar mood disorders during 3 years in late adolescence. Clin Psychol Sci (2016) 4:805-24. doi:10.1177/2167702615618162
53. Conway CC, Craske MG, Zinbarg RE, Mineka S. Pathological personality traits and the naturalistic course of internalizing disorders among high-risk young adults. Depress Anxiety (2016) 33:84-93. doi:10.1002/da.22404
54. Griffith JW, Zinbarg RE, Craske MG, Mineka S, Rose RD, Waters AM, et al. Neuroticism as a common dimension in the internalizing disorders. Psychol Med (2010) 40:1125-36. doi:10.1017/S0033291709991449
55. Walton KE, Krueger RF, Elkins I, D'Accordo C, McGue M, Iacono WG. Personality traits predict the developmental course of externalizing: a four-wave longitudinal study spanning age 17 to age 29. J Pers (2016) 85(3):364-75. doi:10.1111/jopy.12245
56. Castellanos-Ryan N, Briere FN, O'Leary-Barrett M, Banaschewski T, Bokde A, Bromberg U, et al. The structure of psychopathology in adolescence and its common personality and cognitive correlates. J Abnorm Psychol (2016) 125:1039-52. doi:10.1037/abn0000193
57. Hankin BL, Davis EP, Snyder H, Young JF, Glynn LM, Sandman CA. Temperament factors and dimensional, latent bifactor models of child psychopathology: transdiagnostic and specific associations in two youth samples. Psychiatry Res (2017) 252:139-46. doi:10.1016/j.psychres.2017.02.061
58. Tackett JL, Lahey BB, van Hulle C, Waldman I, Krueger RF, Rathouz PJ. Common genetic influences on negative emotionality and a general psychopathology factor in childhood and adolescence. J Abnorm Psychol (2013) 122:1142-53. doi:10.1037/a0034151
59. Hettema JM, Neale MC, Myers JM, Prescott CA, Kendler KS. A population-based twin study of the relationship between neuroticism and internalizing disorders. Am J Psychiatry (2006) 163:857-64. doi:10.1176/appi.ajp.163.5.857
60. Hicks BM, Krueger RF, Iacono WG, McGue M, Patrick CJ. Family transmission and heritability of externalizing disorders: a twin-family study. Arch Gen Psychiatry (2004) 61:922-8. doi:10.1001/archpsyc.61.9.922
61. Kendler KS, Aggen SH, Knudsen GP, Roysamb E, Neale MC, Reichborn-Kjennerud T. The structure of genetic and environmental risk factors for syndromal and subsyndromal common DSM-IV axis I and all axis II disorders. Am J Psychiatry (2011) 168:29-39. doi:10.1176/appi.ajp.2010.10030340
62. Kendler KS, Prescott CA, Myers J, Neale MC. The structure of genetic and environmental risk factors for common psychiatric and substance use disorders in men and women. Arch Gen Psychiatry (2003) 60:929-37. doi:10.1001/archpsyc.60.9.929
63. Lahey BB, Van Hulle CA, Singh AL, Waldman ID, Rathouz PJ. Higher-order genetic and environmental structure of prevalent forms of child and adolescent psychopathology. Arch Gen Psychiatry (2011) 68:181-9. doi:10.1001/archgenpsychiatry.2010.192
64. Insel T, Cuthbert B, Garvey M, Heinssen R, Pine DS, Quinn K, et al. Research domain criteria (RDoC): toward a new classification framework for research on mental disorders. Am J Psychiatry (2010) 167:748-51. doi:10.1176/appi.ajp.2010.09091379
65. Cuthbert BN. The RDoC framework: facilitating transition from ICD/DSM to dimensional approaches that integrate neuroscience and psychopathology. World Psychiatry (2014) 13:28-35. doi:10.1002/wps.20087
66. Reynolds CF III, Lewis DA, Detre T, Schatzberg AF, Kupfer DJ. The future of psychiatry as clinical neuroscience. Acad Med (2009) 84:446-50. doi:10.1097/ACM.0b013e31819a8052
67. Wong EH, Yocca F, Smith MA, Lee CM. Challenges and opportunities for drug discovery in psychiatric disorders: the drug hunters' perspective. Int J Neuropsychopharmacol (2010) 13:1269-84. doi:10.1017/S1461145710000866
68. Miller G. Is pharma running out of brainy ideas? Science (2010) 329:502-4. doi:10.1126/science.329.5991.502
69. Lilienfeld SO. The research domain criteria (RDoC): an analysis of methodological and conceptual challenges. Behav Res Ther (2014) 62:129-39. doi:10.1016/j.brat.2014.07.019
70. Weinberger DR, Glick ID, Klein DF. Whither research domain criteria (RDoC)? The good, the bad, and the ugly. JAMA Psychiatry (2015) 72:1161-2. doi:10.1001/jamapsychiatry.2015.1743
71. Muller VI, Cieslik EC, Serbanescu I, Laird AR, Fox PT, Eickhoff SB. Altered brain activity in unipolar depression revisited: meta-analyses of neuroimaging studies. JAMA Psychiatry (2017) 74:47-55. doi:10.1001/jamapsychiatry.2016.2783
72. Button KS, Ioannidis JP, Mokrysz C, Nosek BA, Flint J, Robinson ES, et al. Power failure: why small sample size undermines the reliability of neuroscience. Nat Rev Neurosci (2013) 14:365-76. doi:10.1038/nrn3475
73. Eklund A, Nichols TE, Knutsson H. Cluster failure: why fMRI inferences for spatial extent have inflated false-positive rates. Proc Natl Acad Sci U S A (2016) 113:7900-5. doi:10.1073/pnas.1602413113