[Show abstract][Hide abstract] ABSTRACT: The creation of each edition of the Diagnostic and Statistical Manual (DSM) of psychiatry has proven enormously controversial. The current effort to revise the 'bible' of disorder definitions for the field of mental health is no exception. The controversy around DSM-5 reached a crescendo with the announcement from National Institute of Mental Health (NIMH) that the institute would focus efforts on the development of their own psychiatric nosology, the Research Domain Criteria (RDoC) (NIMH, 2013).
The RDoC seem to be structured around the concern that the only way to find objectivity in the classification of diseases or disorders in psychiatry is to begin with biology and work back to symptoms. Values infuse medical categories in various ways and drive practical considerations about where and how to divide up constellations of already agreed upon symptoms.
We briefly argue that all nosologies are infused with values and, while we should continue to sharpen the psychiatric nosology, normativity will permeate even the strictest biologically based taxonomy; this need not be a bad thing.
[Show abstract][Hide abstract] ABSTRACT: The development of the DSM-5 over the past decade included a systematic review of the major scientific and methodological advances made in the last two decades. The organizational chapter structure for the DSM has been reorganized to facilitate both clinical practice and teaching to improve assessment skills and at the same time, appreciate how to incorporate new knowledge not ready to be specified as diagnostic criteria. More specifically, we anticipate that we will have a structure that contains "receptors" for new biological, neurocognitive, and environmental risk factors as they emerge to guide future research and clinical practice. The emphasis in the manual on the medical psychiatric interface is of particular relevance for residency education. In addition to the didactic and practical import of the content of DSM-5, increased attention is being given to the new communication technology that makes it possible for the emergence of electronic versions and various types of "apps."
[Show abstract][Hide abstract] ABSTRACT: In a bold effort to address the longstanding shortcomings of the Diagnostic and Statistical Manual (DSM) framework for the classification and diagnosis of psychopathology, the National Institute of Mental Health recently launched a research program – the Research Domain Criteria (RDoC) – in the hopes of developing an alternative taxonomic system rooted in dysfunctional brain circuitry. Although the RDoC endeavor has considerable promise, it faces several methodological and conceptual challenges, four of which I address here: (a) an overemphasis on biological units and measures, (b) neglect of measurement error, (c) biological and psychometric limitations of endophenotypes, and (d) the distinction between biological predispositions and their behavioral manifestations. Because none of these challenges is in principle insurmountable, I encourage investigators to consider potential remedies for them. RDoC is a calculated gamble that appears to be worth the risk, but its chances of success will be maximized by a thoughtful consideration of hard-won lessons learned – but frequently forgotten – over the past several decades of psychological and psychiatric research.
Behaviour Research and Therapy 11/2014; · 3.85 Impact Factor
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