Cited by 691Mental Health Research TopicsPsychometric Methodologies and TestingAnxiety, Depression, Psychometrics, Treatment, Cognitive Processes

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Psychometric perspectives on diagnostic systems

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Borsboom, Denny·2008·Journal of Clinical Psychology

DOI 10.1002/jclp.20503

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Abstract

The author identifies four conceptualizations of the relation between symptoms and disorders as utilized in diagnostic systems such as the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM‐IV; American Psychiatric Association, 1994): A constructivist perspective, which holds that disorders are conveniently grouped sets of symptoms; a diagnostic perspective, which holds that disorders are latent classes underlying the symptoms; a dimensional perspective, which holds that symptoms measure latent continua; and a causal systems perspective, which holds that disorders are causal networks consisting of symptoms and direct causal relations between them. Advantages and disadvantages of these conceptualizations are discussed. The author concludes that the psychometric analysis of diagnostic systems is not settled, and that these systems require deeper psychometric analysis than they currently receive. © 2008 Wiley Periodicals, Inc. J Clin Psychol 64: 1089–1108, 2008.

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Li, M., Lv, J., Li, S., Liu, C., Wang, Z., Liu, Z., Liu, H., Liu, X., Du, Y., & Li, Y. (2025) · Frontiers in Psychology · doi:10.3389/fpsyg.2025.1658007 · Cited by 2
“Gaussian Graphical Models (GGMs) have become essential tools for exploratory psychological network analysis, with their validity and widespread application demonstrated in multiple studies (Chacko et al., 2024; Cramer et al., 2010; Borsboom, 2008).”
Intervention for network of depressive symptoms in disadvantaged rural children: A computer simulated evaluation
Li, Q., Liu, X., Yin, X., Wang, L., Wang, W.-L., & Zhou, F. (2025) · Journal of Health Psychology · doi:10.1177/13591053251378339 · Cited by 2
“…whereas current network analysis methods emphasize that mental disorders are not merely the result of individual symptoms but rather the outcome of multiple emotional, cognitive, and behavioral symptoms interacting within a dynamic network (Borsboom, 2008, 2017; McInerney and Deschênes, 2025).”
The Future of the Biopsychosocial Model: Toward a Transdisciplinary Systems Science of Mental Health
Robinaugh, D. J., Blanken, T. F., Bridger, E. K., Casamento‐Moran, A., de Ron, J., Henry, T. R., Hoekstra, R. H. A., Stratis, G., van de Leemput, I. A., van Nes, E. H., et al. (2026) · Clinical Psychological Science · doi:10.1177/21677026261435464 · Cited by 6
“Interest in this approach grew substantially following work in psychometrics (Borsboom, 2008) and the philosophy of psychiatry (Kendler et al., 2011) that reconceptualized the relationship between symptom and disorder as one of mereology rather than one of measurement (Cramer et al., 2010).”
How does parental psychological control influence adolescent depression? A sequential mediation and network analysis of smartphone addiction and sleep disturbance
Zhu, Y., Xue, A., Wang, Z., Wang, Q., & Luo, X. (2026) · BMC Public Health · doi:10.1186/s12889-025-26049-x · Cited by 2
“This method is rooted in traditional psychopathological theories, which typically emphasize the association of individual symptoms with prototypical symptoms of other syndromes rather than highlighting the differences among individual symptoms themselves [50].”
Symptom Networks in Depression: Temporal Dynamics of Mood, Cognition, and Behavior During Treatment
Quaatz, S. M., Benz, S., Just, L., Vierl, L., Tamm, J., Egli, S., & Kopf‐Beck, J. (2026) · Cognitive Therapy and Research · doi:10.1007/s10608-025-10709-8 · Cited by 3
“Cognitive therapy and the cognitive-behavioral model in CBT explain the interaction between thoughts, mood, and behavior, forming a dynamic cycle that influences men - tal health (e.g., Beck, 1976 , 2008, 2016 ; Tsolakis, 2025).”
Symptom network structure across stigma subgroups in maintenance hemodialysis: a latent profile and network analysis
娜, 宋., Zhang, N., Gao, W., Zhang, Z., Lei, J., Han, H., Li, B., Liu, J., Li, L., & Jiang, N. (2026) · BMC Nephrology · doi:10.1186/s12882-026-04798-0 · Cited by 2
“1) based on social cognitive theory [9] and the network theory of psychopathology [10].”
General Strategies for the Management of Comorbidity in Eating Disorders
Grave, R. D., Sartirana, M., & Calugi, S. (2021) · Springer eBooks · doi:10.1007/978-3-030-69341-1_4 · Cited by 2
心理ネットワークアプローチがもたらす「臨床革命」—認知行動療法の文脈に基づく展望—
樫原, 潤., & 正哉, 伊. (2021) · doi:10.24468/jjbct.20-015 · Cited by 2
Transdiagnostic symptom networks in relation to mental health service use in community youth
Imperiale, M. N., Lieb, R., Calkins, M. E., & Meinlschmidt, G. (2022) · Clinical Psychology & Psychotherapy · doi:10.1002/cpp.2782 · Cited by 1
“Given that mental disorders symptoms largely interact with each other (Borsboom, 2008, 2017; Cramer et al., 2010; Fried, 2015) and, hence, should not be viewed as interchangeable, new approaches are needed to evaluate the relationship between MH service use and characteristics of symptom networks.”
Background
Investigating the invariance of non-cognitive skills in countries with different immigration policies: a psychometric network approach
Gorgun, G., & Kilmen, S. (2023) · Social Psychology of Education · doi:10.1007/s11218-023-09871-2 · Cited by 2
“Following the confirmatory factor analysis, we used the psychometric network modeling (Schmank et al., 2021 ) to examine the network structure of the non-cog - nitive variables derived from the PISA 2018 test (Borsboom, 2008 ).”
How Coparenting Is Linked to Depression among Chinese Young Girls and Boys: Evidence from a Network Analysis
Zhao, D., Gao, X., Chen, W. J., & Zhou, Q. (2024) · Behavioral Sciences · doi:10.3390/bs14040297 · Cited by 2
“The thickness and polarity (positive or negative) of edges are utilized to describe the partial correlations between variables [65,67,68].”
Method
A novel machine learning-based prediction method for patients at risk of developing depressive symptoms using a small data
Yun, M., Jeon, M., & Yang, H. (2024) · PLoS ONE · doi:10.1371/journal.pone.0303889 · Cited by 2
Estimation of Personal Symptom Networks Using the Ising Model for Adult Survivors of Childhood Cancer: A Simulation Study with Real-World Data Application
Zhou, Y., Horan, M. R., Deshpande, S., Ness, K. K., Hudson, M. M., Huang, I., & Srivastava, D. K. (2024) · Clinical Epidemiology · doi:10.2147/clep.s464104 · Cited by 2
Comparing two major approaches to unifying psychology: Different goals, different outcomes
Young, G. C. (2024) · Current Psychology · doi:10.1007/s12144-024-06838-0 · Cited by 2
Network psychometrics and the network approach to posttraumatic stress disorder: A conceptual and methodological overview
Robinaugh, D. J., Hotchkin, C. M., Wright, S., & de Ron, J. (2025) · Journal of Traumatic Stress · doi:10.1002/jts.23135 · Cited by 2
“…and reflect the presence of an underlying disease entity, researchers working in the philosophy of psychiatry (Kendler et al., 2011) and psychometrics (Borsboom, 2008) independently developed the idea that, for many mental disorders, the relationship may instead be mere-ological: part to whole.”
Mapping Connection and Direction Among Symptoms of Sleep Disturbance and Perceived Stress in Firefighters: Embracing the Network Analysis Perspective
Liu, B., Zou, M., Liu, L., Wu, Z., Jin, Y., Feng, Y., Jia, Q., Li, M., Ren, L., & Yang, Q. (2025) · Nature and Science of Sleep · doi:10.2147/nss.s517178 · Cited by 3
“44,45 Unlike the latent variable model, the network model posits that mental illness arises from interactions among symptoms.”
On post-traumatic stress disorder and the accessibility of memories: traumatic memories in refugees and asylum seekers
Manzanero, A. L., Guarch-Rubio, M., Vallet, R., & Vara, A. (2025) · Psychiatry Psychology and Law · doi:10.1080/13218719.2025.2510227 · Cited by 3
“As an alternative, the differential dimen-sion has been proposed, which understands the psychological disorder as an extreme within a continuum of a latent variable, where the levels of intensity and functionality determine the distinction between normal and pathological (Borsboom, 2008).”
The Centrality of Sadness: Networks of Depression, Grief, and Trauma Symptoms in a Spousally Bereaved Sample
Malgaroli, M. (2018) · doi:10.7916/d87m1rfq · Cited by 1
“Borsboom (2008) argued that psychological variables by contrast are interconnected and thus not independent.”
BackgroundMethodInfluential
The Terminology of Addictive Behavior
Glantz, M. D. (2013) · Elsevier eBooks · doi:10.1016/b978-0-12-398336-7.00002-4 · Cited by 2
The Network Structure of Trauma Symptoms of Abuse-exposed Children and Adolescents in South Africa
Makhubela, M. S. (2020) · Journal of Interpersonal Violence · doi:10.1177/0886260520969239 · Cited by 2
Traduction en français de trois textes clefs contemporains sur de nouvelles propositions de classifications en psychiatrie : RDoC, HiTOP et approche en réseau de la psychopathologie
Gauld, C., Micoulaud‐Franchi, J., Gagné‐Julien, A., Giroux, É., & Demazeux, S. (2020) · Annales Médico-psychologiques revue psychiatrique · doi:10.1016/j.amp.2020.11.012 · Cited by 2
An Enactive Approach to Causes, Diagnosis, and Treatment of Psychiatric Disorders
de Haan, S. (2020) · Cambridge University Press eBooks · doi:10.1017/9781108685214.009 · Cited by 2
Las características centrales, las relaciones internas y las diferencias de sexo en el compromiso académico musical: un análisis de redes
Lu, S., Yang, X., & Zhao, Y. (2023) · Revista de Psicodidáctica · doi:10.1016/j.psicod.2023.06.002 · Cited by 2
Applicability of network perspectives of psychopathology: To promote tailored therapy for depression
Kashihara, J. (2019) · doi:10.24602/sjpr.62.2_143 · Cited by 2
Covert Heterogeneity of Major Depressive Disorder: Depression Is More Than the Sum-Score of its Symptoms
Fried, E. I. (2014) · Universitätsbibliothek der FU Berlin Hochschulschriftenstelle u. Dokumentenserver · doi:10.17169/refubium-14966 · Cited by 2
Searching for PTSD's Biological Signature
Rosen, G. M., Lilienfeld, S. O., & Orr, S. P. (2010) · Wiley eBooks · doi:10.1002/9781118269961.ch5 · Cited by 2
The Ising on the Tree: The Master Model for Learning, Assessment, and NavigationPreprint
Deonovic, B., Bechger, T. M., & Maris, G. (2020) · doi:10.31234/osf.io/t65wa · Cited by 2
A Network Analysis of DSM-5 posttraumatic stress disorder symptoms and correlates in U.S. military veteransPreprint
Fried, E. I. (2016) · PsyArXiv (OSF Preprints) · doi:10.31234/osf.io/p69m7 · Cited by 2
Interventions in dynamic systems: A causal approach to continuous-time mediation analysisPreprint
Ryan, O. (2018) · doi:10.31234/osf.io/n2fwt · Cited by 2
Detecting hysteresis in psychological processes with the hysteretic threshold autoregressive (HysTAR) modelPreprint
de Jong, D., Ryan, O., van der Maas, H. L. J., & Hamaker, E. L. (2023) · doi:10.31234/osf.io/zrcft · Cited by 4
Enactive Psychiatry
de Haan, S. (2020) · Cambridge University Press eBooks · doi:10.1017/9781108685214.008 · Cited by 1
Affektive Störungen: Depressive Episoden, rezidivierende depressive Störungen, Dysthymie
Haun, M. W. (2024) · Springer eBooks · doi:10.1007/978-3-662-64728-8_16 · Cited by 1

Authors: Borsboom, D.
Affiliations: University of Amsterdam (NL)
Corresponding author: Borsboom, Denny
ORCID: Borsboom, Denny
Venue: Journal of Clinical Psychology
Publisher: Wiley
Published: 2008-08-06
Volume: 64
Issue: 9
Pages: 1089-1108
ISSN: 0021-9762 (ISSN-L)
1097-4679
DOI: 10.1002/jclp.20503
OpenAlex: W2064794182
Cited by: 691
References: 48
Citations by year: 2026: 53 · 2025: 72 · 2024: 82 · 2023: 82 · 2022: 62 · 2021: 73 · 2020: 67 · 2019: 40 · 2018: 33 · 2017: 27 · 2016: 27 · 2015: 14 · 2014: 11 · 2013: 14 · 2012: 15
FWCI: 8.06
Type: journal article
Language: en
Open access: bronze
doi.org
Licence: onlinelibrary.wiley.com/termsAndConditions#vor (vor)
Locations: Journal of Clinical Psychology (publishedVersion)
PubMed (publishedVersion)
UvA-DARE (University of Amsterdam) (submittedVersion)
Data Archiving and Networked Services (DANS) (submittedVersion)
Funders: Nederlandse Organisatie voor Wetenschappelijk Onderzoek (451-03-068)
Topics: Social Sciences › Psychology › Experimental and Cognitive Psychology › Mental Health Research Topics
Social Sciences › Decision Sciences › Management Science and Operations Research › Psychometric Methodologies and Testing
Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
Keywords: diagnostic systems, DSM-IV, constructivist approach, latent class models, dimensional models, causal systems, psychiatric classification
MeSH terms: Mental Disorders, Humans, Psychological Theory, Psychometrics, Psychopathology

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