Exploring the feasibility of a meta-structure for DSM-V and ICD-11: could it improve utility and validity?

Andrews, Gavin; Goldberg, David; Krueger, R. F.; Carpenter, William T.; Hyman, Steven E.; Sachdev, Perminder S.; Pine, Daniel S.

doi:10.1017/s0033291709990250

Cited by 217 publications

(218 citation statements)

References 22 publications

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“…Moreover, schizotypy as a latent construct (personality organization) is centrally embedded in a diathesis-stressor theoretical model that has considerable utility as an organizing framework for the study of schizophrenia, schizophrenia-related psychopathology (e.g., delusional disorder, psychosis not otherwise specified, schizotypal, paranoid and other related personality disorders) as well as putative schizophrenia endophenotypes, a view I have advocated for several decades [3][4][5][6] . Note, the term schizotypy is not restricted to describe only those clinical manifestations that are associated with schizotypal personality disorder 2,5,6 .…”

Section: Schizotypy Schizotypic Psychopathology and Schizophreniamentioning

confidence: 99%

“…Note, the term schizotypy is not restricted to describe only those clinical manifestations that are associated with schizotypal personality disorder 2,5,6 . Nor is the term reserved to indicate a methodological preference, e.g.…”

Section: Schizotypy Schizotypic Psychopathology and Schizophreniamentioning

confidence: 99%

“…Second, dimensions have been shown to be more useful in clinical research. HiTOP aligns much better than traditional diagnostic systems with the genetic architecture of mental disorders and with the effects of environmental risk factors, such as childhood maltreatment 2,5,6 . HiTOP dimensions can explain nearly all longterm chronicity of psychopathology 7 .…”

mentioning

confidence: 99%

“…HiTOP also far outperforms traditional systems in accounting for functional impairment 3 . Moreover, HiTOP dimensions can help to explain why disorders from different classes respond to the same treatment (e.g., social anxiety disorder to antidepressants) 5 . Indeed, some spectra already have become useful targets for treatment development 8 .…”

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confidence: 99%

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A paradigm shift in psychiatric classification: the Hierarchical Taxonomy Of Psychopathology (HiTOP)

2018

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Section: Schizotypy Schizotypic Psychopathology and Schizophreniamentioning

confidence: 99%

Section: Schizotypy Schizotypic Psychopathology and Schizophreniamentioning

confidence: 99%

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confidence: 99%

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confidence: 99%

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A paradigm shift in psychiatric classification: the Hierarchical Taxonomy Of Psychopathology (HiTOP)

2018

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“…If twin studies are extended to include multiple disorders, it is possible to examine the causes of familial co-aggregation of several disorders, that is, whether their co-occurrence is due to common genetic and/or environmental risk factorsoften quantified as genetic and environmental correlation (Kendler, 2001(Kendler, , 2006. Knowledge about common genetic and environmental risk factors can both broaden our understanding of co-occurrence of psychiatric disorders (Kendler, 2006;Krueger & Markon, 2006) and be used to inform the development of classification systems such as DSM-5 (Andrews et al, 2009). Shared genetic and environmental risk factors are 2 of 11 "validators" listed by the Diagnostic Spectra Study Group of the DSM-5 task force (Andrews et al, 2009).…”

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confidence: 99%

Genetic and Environmental Contributions to the Co-Occurrence of Depressive Personality Disorder and DSM-IV Personality Disorders

Ørstavik¹,

Kendler²,

Røysamb³

et al. 2012

Journal of Personality Disorders

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One of the main controversies with regard to depressive personality disorder (DPD) concerns the co-occurrence with the established DSM-IV personality disorders (PDs). The main aim of this study was to examine to what extent DPD and the DSM-IV PDs share genetic and environmental risk factors, using multivariate twin modeling. The DSM-IV Structured Interview for Personality was applied to 2,794 young adult twins. Paranoid PD from Cluster A, borderline PD from Cluster B, and all three PDs from Cluster C were independently and significantly associated with DPD in multiple regression analysis. The genetic correlations between DPD and the other PDs were strong (.53-.83), while the environmental correlations were moderate (.36-.40). Close to 50% of the total variance in DPD was disorder specific. However, only 5% was due to disorder-specific genetic factors, indicating that a substantial part of the genetic vulnerability to DPD also increases the vulnerability to other PDs.Depressive personality disorder (DPD) was first formally introduced in the fourth version of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV; American Psychiatric Association, 1994), where it was placed in Appendix B among other diagnostic categories in need of further studies. In the ongoing work on DSM-5, the Personality and Personality Disorders Work Group suggests that DPD is not included as a specific type, but is represented by a combination of core impairment in personality functioning and a set of prominent personality traits (www.dsm5.org).One of the key questions originally posed by the DSM-IV personality disorder (PD) work group was to what extent DPD can be distinguished from Axis I mood disorders and from the 10 established DSM-IV PDs (Phillips, Hirschfeld, Shea, & Gunderson, 1995). Several studies addressing diagnostic overlap have been published, both with regard to mood disorders (Klein & Miller, 1993;Klein & Shih, 1998;McDermut, Zimmerman, & Chelminski, 2003;Ryder, Bagby, & Dion, 2001;Ryder, Bagby, & Schuller, 2002) and PDs (Huprich, 2004;Huprich, Zimmerman, & Chelminski, 2006;Klein & Shih, 1998; © 2012 The Guilford Press Address correspondence to Dr. Ragnhild E. Ørstavik, Norwegian Institute of Public Health, Box 4404, Nydalen N-0403, Oslo, Norway; ragnhild.orstavik@fhi.no. This article was accepted under the editorship of Paul S. Links. Markowitz et al., 2005;McDermut et al., 2003), where there is evidence for substantial cooccurrence between DPD and borderline PD in Cluster B and the three Cluster C PDs (for review, see Huprich, 2009). NIH Public AccessAn important criterion for diagnostic validity is familial aggregation (Robins & Guze, 1970). Familial aggregation can be the result of both common genetic or environmental factors, and twin studies can be used to distinguish these causes (Plomin, DeFries, McClearn, & McGuffin, 2001). If twin studies are extended to include multiple disorders, it is possible to examine the causes of familial co-aggregation of several disorders, that is, whether their c...

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Development of Lifetime Comorbidity in the World Health Organization World Mental Health Surveys

Kessler¹,

Ormel²,

Petukhova³

et al. 2011

Arch Gen Psychiatry

451

351

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CONTEXT Although numerous studies have examined the role of latent variables in the structure of comorbidity among mental disorders, none has examined their role in the development of comorbidity. OBJECTIVE To study the role of latent variables in the development of comorbidity among 18 lifetime DSM-IV disorders in the WHO World Mental Health (WMH) surveys. SETTING/PARTICIPANTS Nationally or regionally representative community surveys in 14 countries with a total of 21,229 respondents. MAIN OUTCOME MEASURES First onset of 18 lifetime DSM-IV anxiety, mood, behavior, and substance disorders assessed retrospectively in the WHO Composite International Diagnostic Interview (CIDI). RESULTS Separate internalizing (anxiety and mood disorders) and externalizing (behavior and substance disorders) factors were found in exploratory factor analysis of lifetime disorders. Consistently significant positive time-lagged associations were found in survival analyses for virtually all temporally primary lifetime disorders predicting subsequent onset of other disorders. Within-domain (i.e., internalizing or externalizing) associations were generally stronger than between-domain associations. The vast majority of time-lagged associations were explained by a model that assumed the existence of mediating latent internalizing and externalizing variables. Specific phobia and obsessive-compulsive disorder (internalizing) and hyperactivity disorder and oppositional-defiant disorder (externalizing) were the most important predictors. A small number of residual associations remained significant after controlling the latent variables. CONCLUSIONS The good fit of the latent variable model suggests that common causal pathways account for most of the comorbidity among the disorders considered here. These common pathways should be the focus of future research on the development of comorbidity, although several important pair-wise associations that cannot be accounted for by latent variables also exist that warrant further focused study.

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Exploring the feasibility of a meta-structure for DSM-V and ICD-11: could it improve utility and validity?

Cited by 217 publications

References 22 publications

A paradigm shift in psychiatric classification: the Hierarchical Taxonomy Of Psychopathology (HiTOP)

A paradigm shift in psychiatric classification: the Hierarchical Taxonomy Of Psychopathology (HiTOP)

Genetic and Environmental Contributions to the Co-Occurrence of Depressive Personality Disorder and DSM-IV Personality Disorders

Development of Lifetime Comorbidity in the World Health Organization World Mental Health Surveys

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