Why hierarchical dimensional approaches to classification will fail to transform diagnosis in psychiatry

Zimmerman, Mark

doi:10.1002/wps.20815

Cited by 23 publications

(17 citation statements)

References 8 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Features of NMD have long been recognized as transdiagnostic in nature as reviewed. Regardless, the DSM and measures based on categorical DSM disorders likely will continue to serve as the standard for many research areas and clinical practice for the foreseeable future (Zimmerman, 2021). Therefore, in addition to discussing transdiagnostic perspectives on NMD, we provide ideas for optimally studying and assessing NMD features within a categorical DSM framework.…”

Section: Expanded Construct Definitions and Issues Concerning Discrim...mentioning

confidence: 99%

Negative mood dysregulation loads strongly onto common factors with many forms of psychopathology: Considerations for assessing nonspecific symptoms

Stanton¹,

Balzen²,

Levin‐Aspenson³

2022

Preprint

View full text Add to dashboard Cite

There have been proposals to expand definitions for categorical disorders and dimensionally-conceptualized syndromes (e.g., psychopathy) to include negative mood lability and dysregulation (NMD). Factor analytic results are often presented in support of these proposals, and we provide factor analytic demonstrations across clinically-oriented samples showing that NMD indicators load strongly onto factors with a range of psychopathology. This is unsurprising from a transdiagnostic perspective but shows that factor analysis could potentially be used to justify expanding definitions for specific constructs even though NMD indicators show strong, nonspecific loadings on other psychopathology factors ranging widely in nature. Expanding construct definitions and assessment approaches to emphasize NMD also may negatively impact discriminant validity. Acknowledging differing viewpoints on expanding construct definitions, we agree that targeting NMD is essential for comprehensive assessment. We use our analytic demonstrations to discuss model interpretation and balancing comprehensiveness with specificity when assessing NMD across traditional categorical and transdiagnostic frameworks.

show abstract

Section: Expanded Construct Definitions and Issues Concerning Discrim...mentioning

confidence: 99%

Negative mood dysregulation loads strongly onto common factors with many forms of psychopathology: Considerations for assessing nonspecific symptoms

Stanton¹,

Balzen²,

Levin‐Aspenson³

2022

Preprint

View full text Add to dashboard Cite

show abstract

“…However, research evidence that demonstrated that patient evaluated using a dimensional approach improves with treatment is lacking. Replacing the categorical DSM-5/ICD-11 classification system with a dimensional one appears not feasible if clinical outcomes are not demonstrably better [10].…”

Section: The Limitations Of Personalized Medicine In Psychiatrymentioning

confidence: 99%

Human-Induced Pluripotent Stem Cell Technology: Toward the Future of Personalized Psychiatry

Alciati¹,

Reggiani²,

Caldirola³

et al. 2022

Preprint

View full text Add to dashboard Cite

The polygenic and multifactorial nature of many psychiatric disorders has hampered the personalized medicine approach implementation in clinical practice. However, induced pluripotent stem cell (iPSC) technology has emerged as an innovative tool for patient-specific disease modeling to expand the pathophysiology knowledge and treatment perspectives in the last decade. Current technologies enable adult human somatic cell reprogramming into induced pluripotent stem cells (iPSCs) to generate neural cells and direct neural cell conversion to model organisms that exhibit phenotypes close to human diseases, thereby effectively representing relevant aspects of neuropsychiatric disorders. iPSCs reflect patient pathophysiology and pharmacological responsiveness, particularly when cultured under conditions that recapitulate spatial tissue organization in brain organoids. Recently, the application of iPSCs has been frequently associated with gene editing that targets the disease-causing gene to deepen the illness pathophysiology and conduct drug screening. Moreover, gene editing has provided a unique opportunity to repair the putative causative genetic lesions in patient-derived cells. Here, we review the use of iPSC technology to model and potentially treat neuropsychiatric disorders by illustrating the key studies on a series of mental disorders, including schizophrenia, major depression disorder, bipolar disorder, and autism spectrum disorder. The future perspective will involve the development of organ-on-a-chip platforms that control the microenvironmental conditions to reflect individual pathophysiological by adjusting physiochemical parameters according to personal health data. This strategy could open new ways to build a disease model that considers individual variability and tailors personalized treatments.

show abstract

“…The development of the CDDR, to which WPA experts have extensively contributed (including through chairmanship of several Workgroups), is regarded as the most broadly international and participative process ever implemented for a classification of mental disorders 1 . The main differences between the CDDR and the DSM‐5 diagnostic criteria, and the main contentious issues that have been debated in the development of the CDDR, have been extensively dealt with in this journal 2‐13 .…”

mentioning

confidence: 99%

The ICD‐11 is now officially in effect

Pezzella¹

2022

World Psychiatry

View full text Add to dashboard Cite

Why hierarchical dimensional approaches to classification will fail to transform diagnosis in psychiatry

Cited by 23 publications

References 8 publications

Negative mood dysregulation loads strongly onto common factors with many forms of psychopathology: Considerations for assessing nonspecific symptoms

Negative mood dysregulation loads strongly onto common factors with many forms of psychopathology: Considerations for assessing nonspecific symptoms

Human-Induced Pluripotent Stem Cell Technology: Toward the Future of Personalized Psychiatry

The ICD‐11 is now officially in effect

Contact Info

Product

Resources

About