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There is a need to refine our current psychiatric nosology
to produce diagnostic criteria and disorder categories that keep pace with
advances in neuroscience while at the same time enhance clinical utility.
Furthermore, dimensional aspects of psychiatric disorders require greater
recognition so as to improve our understanding of boundaries between
disorders and underscore the heterogeneous nature of psychopathology. The
Conceptual Evolution of DSM-5 provides a framework for the evolution
of the forthcoming diagnostic system in the fifth edition of Diagnostic
and Statistical Manual of Mental Disorders (DSM-5), which will help
advance clinical practice and facilitate ongoing development of diagnostic
criteria. This manual:
• Highlights recent progress in our understanding of cross-cutting
factors relevant to psychiatric diagnosis and symptom presentation
•
Includes detailed discussions on the role of factors such as age, gender,
culture, and disability in the expression of mental disorders
• Provides
a review of genetic evidence supporting a cross-cutting approach to
nosology
• Offers suggestions for integrating cross-cutting factors with
DSM-5.
The Conceptual Evolution of DSM-5 was written to impart
a theoretical context for understanding potential revisions to DSM-5. The
authors reevaluate the structure of the current manual and discuss
cross-cutting approaches to facilitate clinical practice and refine research
approaches that will guide clinical trials, genetics, imaging, and treatment
guidelines. The authors provide the following insights:
• Detailed descriptions of age-, gender-, and culture-specific aspects
relevant to psychiatric diagnosis and the need for sensitivity to these
factors when making diagnoses
• Discussions on the dimensional aspects
of mental disorders, including overlapping symptoms relevant to many or most
diagnoses
• Consideration of alternative classifications of disorders
that recognize disorders sharing validating features
• Presentation of
neuroscientific and epidemiologic evidence to expand understanding of
disorders beyond that of the categorical organization presented in
DSM-IV
• A review of clinical implications, including how clinicians may
shift their conceptualization of previously reified diagnostic criteria and
their consequences.
As presented to the 99th Annual Meeting of the American Psychopathological Association, The Conceptual Evolution of DSM-5 explores the rapidly changing research base for the understanding of neurodevelopmental, neurocognitive, addictive, and other psychiatric disorders. The contributions in this volume confirm that DSM-5 is intended to be a living document that can accommodate revisions to specific diagnostic areas based on new evidence that is replicable and subject to review. This efficient updating process will help researchers and clinicians keep abreast of the latest protocols for the research, diagnosis, and treatment of mental illness.
The Conceptual Evolution of DSM-5 is an outstanding book that provides the reader with an in-depth understanding of the complexities of developing a new DSM that is clinically useful and yet also reflects the most current research findings in the field. The book is highly recommended, as it will provide an excellent platform to "jump" into DSM-5.
— Michael H. Ebert, M.D.,
Darrel A. Regier, M.D., M.P.H., is Executive Director of the American Psychiatric Institute for Research and Education and Director of the Division of Research at the American Psychiatric Association in Arlington, Virginia, and Vice-Chair of the DSM-5 Task Force.
William E. Narrow, M.D., M.P.H., is Associate Director of the Division of Research at the American Psychiatric Association and the American Psychiatric Institute for Research and Education in Arlington, Virginia, and Research Director of the DSM-5 Task Force.
Emily A. Kuhl, Ph.D., is a science writer in the Division of Research at the American Psychiatric Association in Arlington, Virginia.
David J. Kupfer, M.D., is Thomas Detre Professor in the Department of Psychiatry at the University of Pittsburgh and Western Psychiatric Institute & Clinic in Pittsburgh, Pennsylvania, and Chair of the DSM-5 Task Force.
Contributors
Introduction
PART I: Diagnostic
Spectra: Assessing the Validity of Disorder Groupings
Chapter 1.
Diagnosis of Mental Disorders in Light of Modern Genetics
Chapter 2.
Integration of Dimensional Spectra for Depression and Anxiety Into
Categorical Diagnoses for General Medical Practice
Chapter 3. One Way
Forward for Psychiatric Nomenclature: The Example of the Spectrum Project
Approach
Chapter 4. Meta Effects of Classifying Mental
Disorders
PART II: Integrating Dimensional Concepts Into a Categorical
System
Chapter 5. A Proposal for Incorporating Clinically Relevant
Dimensions Into DSM-5
Chapter 6. Empirically Derived Personality
Disorder Prototypes: Bridging Dimensions and Categories in DSM-5
Chapter
7. Options and Dilemmas of Dimensional Measures for DSM-5: Which Types of
Measures Fare Best in Predicting Course and Outcome?
PART III: Assessing
Functional Impairment for Clinical Significance and Disability
Chapter
8. Clinical Significance and Disorder Thresholds in DSM-5: The Role of
Disability and Distress
Chapter 9. Assessing Activity Limitations and
Disability Among Adults
Chapter 10. Measuring Disability Across
Physical, Mental, and Cognitive Disorders
PART IV: Identifying Important
Culture- and Gender- Related Expressions of Disorders
Chapter 11.
Assessing Mental Disorders and Service Use Across Countries: The WHO World
Mental Health Survey Initiative
Chapter 12. The Intersection of Race,
Ethnicity, Immigration, and Cultural Influences on the Nature and
Distribution of Mental Disorders: An Examination of Major
Depression
Chapter 13. Gender and Gender-Related Issues in
DSM-5
PART V: Incorporating Developmental Variations of Disorder
Expression Across the Lifespan
Chapter 14. Increasing the Developmental
Focus in DSM-5: Broad Issues and Specific Potential Applications in
Anxiety
Chapter 15. Diagnostic Issues Relating to Lifespan From
Adulthood Into Later Life
Index