Retiring Categorical Systems and the Biomedical Model of Mental Illness: The Why and the How—A Clinician’s Perspective

Abstract

This article offers a transdiagnostic framework for the prevention and treatment of mental health by reducing early psychopathology. The framework supports the contention that the time has come to retire dominant categorical classification systems of mental disorders (e.g. DSM and ICD), and the current prevailing biomedical model of mental illness by moving to a psychosocial model of psychopathology. This entails reclaiming and integrating the long-standing legacy of psychology with recent advances in neuroscience and related disciplines. To this end, this conceptual paper synthesizes and integrates the extant literature and empirical findings, takes a scientist-practitioner stance, and draws on recent developments in transdiagnostic approaches to mental health, psychotherapy integration and advances in modern attachment theory. The advantages of this approach are that: 1) Clarifies the existing confusion surrounding the myriad of different interventions available; 2) Enables consistent funding guidelines from healthcare and community education systems; 3) Is more likely to have a greater positive impact for most people; 4) Reduces general psychopathology risks in childhood; 5) Avoids the challenge that prevention is less successful in later life; 6) Better addresses the stigma associated with mental illness; and 7) Maximizes the efficiency of interventions.

Reflection on the future of autism research: the continuum hypothesis - Réflexion sur l'avenir de la recherche sur l'autisme : l'hypothèse du continuum

“…Considerations are already being made on autism with the RDoC framework (Harrison et al, 2021;Hennessey et al, 2018;Ibrahim & Sukhodolsky, 2018) but much remains to be done. Other medical taxonomies and models exist (Gillberg, 2010;Knott et al, 2021;Kotov et al, 2017;Salicru, 2020) but don't fully include the genetic overlap between neurodevelopmental disorders.…”

“…Des réflexions sont déjà menées sur l'autisme avec le cadre du RDoC (Harrison et al, 2021 ;Hennessey et al, 2018 ;Ibrahim & Sukhodolsky, 2018) mais beaucoup reste à faire. D'autres taxonomies et modèles médicaux existent (Gillberg, 2010 ;Knott et al, 2021 ;Kotov et al, 2017 ;Salicru, 2020) mais n'incluent pas complètement le chevauchement génétique entre les troubles du neurodéveloppement. B) Caractéristiques phénotypiques et génétiques partagées en intra-psychopathologie : chevauchement et continuum neurodéveloppemental Les relations entre les différentes pathologies se retrouvent dans des variations génétiques partagées.…”

Re-visiting the relevance and importance of health psychology in South Africa

“…Traditionally models, such as the biomedical and psychosomatic models, were used to understand health and illness. However, these models have been widely criticised for failing to consider the many other factors that play a role in health and illness (Salicru, 2020; Williams, 2017). In 1977, health and other professionals began to use the biopsychosocial model (Engel, 1977) in their work which considers the many biological, psychological, social, and cultural variables play a role in health and illness.…”

Identification of structural brain alterations in adolescents with depressive symptomatology

“…Many morphometric studies looking at depression tend to focus on group comparison using individuals with depression vs healthy controls ( ENIGMA et al, 2017 ; Suh et al, 2019 ; van Eijndhoven et al, 2016 ). As there are varying levels of symptom severity and heterogeneity among individuals, using depressive symptomatology instead of strict categorical diagnoses can lead to more generalizable results ( Forbes et al, 2016 ; Salicru, 2020 ).…”