Abstract
The DSM-5 creation process and outcome underlines a core tension in psychiatry between empirical evidence that mental pathologies tend to be dimensional and a historical emphasis on delineating categorical disorders to frame psychiatric thinking. The DSM has been slow to reflect dimensional evidence because doing so is often perceived as a disruptive paradigm shift. As a result, other authorities are making this shift, circumventing the DSM in the process. For example, through the Research Domain Criteria (RDoC), NIMH now encourages investigators to focus on a dimensional and neuroscientific conceptualization of mental disorder research. Fortunately, the DSM-5 contains a dimensional model of maladaptive personality traits that provides clinical descriptors that align conceptually with the neuroscience-based dimensions delineated in the RDoC and in basic science research. Through frameworks such as the DSM-5 trait model, the DSM can evolve to better incorporate evidence of the dimensionality of mental disorder.
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Robert F. Krueger, Christopher J. Hopwood, and Aidan G. C. Wright declare that they have no conflict of interest.
Kristian E. Markon was an Adviser to the DSM-5 Personality and Personality Disorders Workgroup.
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Krueger, R.F., Hopwood, C.J., Wright, A.G.C. et al. Challenges and Strategies in Helping the DSM Become More Dimensional and Empirically Based. Curr Psychiatry Rep 16, 515 (2014). https://doi.org/10.1007/s11920-014-0515-3
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DOI: https://doi.org/10.1007/s11920-014-0515-3