Toward a Cognitive-Behavioral Classification System for Mental Disorders

Probably not a substantial claim: may not pass S3 (load-bearing).

RDoC uses molecular, brain-circuit, behavioral, and symptom levels of analysis to define constructs assumed to be core symptoms of mental disorders.

“Thus, the RDoC initiative uses different units of levels of analysis (molecular, brain circuit, behavioral and symptom level) in order to define constructs that are assumed to be the core symptoms of mental disorders”

• cites Insel et al., 2010 sourceNot checked yet

  Not checked in the free run.

May combine two claims.

The cognitive behavioral model provides a classification framework that is compatible with the complex causal network approach and is a treatment-relevant alternative to the latent disease model underlying the DSM-5 and RDoC.

“The cognitive behavioral model offers a classification framework that is compatible with the complex causal network approach and offers a treatment-relevant alternative to the latent disease model that is the basis for the DSM-5 and the RDoC initiative”

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

Earlier DSM versions were grounded in psychoanalytic theory and assumed mental disorders arise from deep-seated conflicts, while modern versions implicate genetic, biological, psychological, and developmental dysfunctions as root causes.

“Whereas earlier versions of the DSM were grounded in psychoanalytic theory and assumed that mental disorders are rooted in deep-seated conflicts, modern versions implicate dysfunctions in genetic, biological, psychological, and developmental processes as the root-cause”

May combine two claims.

Both the DSM-5 and the RDoC initiative assume that psychological problems are expressions of specific latent disease entities.

“Both the DSM-5 and the RDoC initiative make the strong assumption that psychological problems are expressions of specific latent disease entities”

• Also stated in: § The RDoC Initiative · boosted

  “Most importantly, the RDoC initiative shares with the DSM the strong theoretical assumption that, similar to a viral infection, psychological problems are caused by a latent disease”

May combine two claims.

From a cognitive-behavioral perspective, classifying individuals by maintenance factors is more important than classifying them by vulnerabilities, because CBT focuses on the present rather than past experiences.

“Therefore, from a cognitive-behavioral perspective, classifying individuals based on maintenance factors is of far greater importance than based on their vulnerabilities (i.e., genetic factors or malfunctioning brain circuits), because CBT is focused on the here and now rather than past experiences”

Probably not a substantial claim: may not pass S3 (load-bearing).

The cognitive-behavioral approach adopts a diathesis-stress model in which individual vulnerability factors together with environmental stressors can lead to disorder development.

“The cognitive-behavioral approach embraces the general diathesis-stress model, which assumes that individual vulnerability factors in conjunction with environmental stressors can lead to the development of the disorder”

Probably not a substantial claim: may not pass S4 (based). May combine two claims.

The DSM-5 offers little that is new compared with its predecessors, which has caused substantial dissatisfaction in the medical and research community.

“As a result, the DSM-5 offers little that is new compared to its predecessors, sparking a great degree of dissatisfaction in the medical and research community”

Classified as probably not a substantial claim.

The complex causal network approach treats psychological problems as mutually interacting and often reciprocally reinforcing elements of a complex causal network.

“the complex causal network approach conceptualizes psychological problems as mutually interacting, often reciprocally reinforcing, elements of a complex causal network”

Classified as probably not a substantial claim.

A classification system for mental disorders provides the field with a common language for reliably assessing patients.

“First, it provides the field with a common language to reliably assess patients”

Classified as probably not a substantial claim. May combine two claims.

Information from a classification system can eventually be used to optimize and tailor existing treatments or to develop new interventions.

“Third, it is hoped that eventually this information can be used to optimize and tailor existing treatments or to develop new interventions”

Probably not a substantial claim: may not pass S4 (based). May combine two claims.

The DSM-5 defines mental disorder categories using arbitrary criteria and cutoffs, and those categories have questionable validity and give no treatment guidance.

“the recently published DSM-5 uses arbitrary criteria and cutoffs to define categories of mental disorders that are of questionable validity and that provide no guidance for treatment”

Classified as probably not a substantial claim.

The structure of the DSM is rooted in a medical model that assumes symptoms reflect underlying latent disease entities.

“However, the structure of the DSM is firmly rooted in a medical model, assuming that symptoms reflect underlying and latent disease entities”

May combine two claims.

Studying people who share similar psychopathology may advance science and reveal underlying pathology and etiology.

“Second, science may be advanced by studying people who share similar psychopathology. It is hoped that the underlying pathology and etiology becomes apparent by studying individuals who share similar symptoms”

May combine two claims.

Contemporary cognitive-behavioral theory distinguishes initiating factors from maintaining factors, and these two kinds of factors are typically not the same.

“the contemporary cognitive-behavioral perspective makes a critical distinction between initiating factors (factors that contribute to the development of a problem) and maintaining factors (factors that are responsible for the maintenance of a problem), and these factors are typically not the same”

May combine two claims.

Consciousness or cancer cannot be reduced to a single synaptic activity or a single gene mutation; they involve hundreds of genes and billions of synapses, creating an elusive combinatorial problem.

“consciousness or cancer cannot be reduced to a single synaptic activity or mutations of a single gene, but are associated with hundreds of genes and billions of synapses, resulting in an elusive combinatorial problem”

• cites Barabasi, 2012 sourceNot checked yet

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May combine two claims.

A classification system of psychiatric disorders is a complex system because each disorder is defined by interrelated symptoms and no symptom is specific to any particular disorder.

“A classification system of psychiatric disorders is an example of a complex system, because each disorder is defined by a number of interrelated symptoms and no symptom is specific to any particular disorder”

Classified as probably not a substantial claim.

The general CBT model offers a framework for classifying mental disorders using a complex causal network perspective.

“The general cognitive-behavioral model, as depicted in Figure 1, offers a framework for classifying mental disorders using a complex causal network perspective”

May combine two claims.

Schemata tend to develop early, often during childhood and adolescence, and become early maladaptive schemata.

“These schemata often develop early on, often during childhood and adolescence, and take on the form of early maldaptive schemata (Young et al., 2003).”

• cites Young et al., 2003Not checked yet

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Probably not a substantial claim: may not pass S3 (load-bearing), S4 (based).

Triggers can be associated with the development of a disorder.

“The triggers can be associated with the development of the disorder”

May combine two claims.

Maladaptive schemata are longstanding characterological problems and general vulnerability factors for a broad range of psychiatric diagnoses.

“These maladaptive schemata are longstanding characterological problems and viewed as general vulnerability factors for psychopathology as they are relevant for a broad range of psychiatric diagnoses.”

• cites Young et al., 2003Not checked yet

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Probably not a substantial claim: may not pass S2 (checkable), S4 (based).

Adopting a complex causal network approach would further pave the way toward personalized medicine.

“Adopting a complex causal network approach would further pave the way toward personalized medicine”

Classified as probably not a substantial claim.

A mental disorder is thought to be a reflective construct that causes observable symptoms.

“In other words, a mental disorder is thought to be a reflective construct that causes the observable symptoms”

Probably not a substantial claim: may not pass S3 (load-bearing).

Schemata can be assessed with the Young Schema Questionnaire.

“Schemata can be assessed with the Young Schema Questionnaire (Young, 2003).”

• cites Young, 2003Not checked yet

  Not checked in the free run.

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

In the DSM, latent constructs are measured through symptom reports and clinical impressions, whereas in RDoC the latent disease is measured through behavioral tests and biological instruments such as genetic tests and neuroimaging.

“In the case of the DSM, these latent constructs are measured through symptom reports and clinical impressions, whereas in the case of RDoC, the latent disease is measured through sophisticated behavioral tests and biological instruments, such as genetic tests and neuroimaging”

Classified as probably not a substantial claim. May combine two claims.

CBT is not a single treatment protocol but a family of interventions sharing basic elements that focus on the importance of cognitive processes for emotion regulation.

“CBT is not a single treatment protocol. Rather, CBT describes a family of interventions that share the same basic elements of the treatment model that focus on the importance of cognitive processes for emotion regulation”

May combine two claims.

Even if the identity and combinations of relevant genes were known, predicting who will develop a psychological problem would be very difficult because genes are not the only biological determinants of psychopathology.

“Even if we knew the identity and combinations of those genes, it would be very difficult to predict who will and will not develop a psychological problem, because genes are not the only biological determinants for psychopathology, as has been shown by the evolving field of epigenetics”

Probably not a substantial claim: may not pass S3 (load-bearing), S4 (based). May combine two claims.

Triggers can be external or situational, physiological or interoceptive, or cognitive, and can be assessed through questionnaires, interviews, or psychological experiments.

“These triggers can be external/situational, physiological/interoceptive, or cognitive in nature and they can be assessed via questionnaires, interviews, or psychological experiments”

May combine two claims.

The DSM-5 separated agoraphobia from panic disorder and ignored the causal relationship between panic concerns and avoidance, which will likely introduce high comorbidity between the two newly distinct categories.

“Interestingly, the DSM-5 separated agoraphobia from panic disorder, ignoring the causal relationship between concerns about experiencing panic attacks and avoidance of certain situations or places, which will likely introduce a high comorbidity between the two newly created distinct diagnostic categories, panic disorder and agoraphobia”

May combine two claims.

The primary conceptual problems with traditional approaches include uncertainty about causal pathways between the latent construct and symptoms and disregard of causal relationships among symptoms.

“The primary conceptual problems with these traditional approaches include the uncertainty about causal pathways and processes between the latent construct and symptoms and the disregard of the causal relationships between the symptoms (Schmittmann et al., 2013)”

• cites Schmittmann et al., 2013 sourceNot checked yet

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Probably not a substantial claim: may not pass S2 (checkable), S3 (load-bearing), S4 (based).

Core beliefs are extreme, one-sided views of self, others, and the world that give rise to conditional assumptions and automatic thoughts.

“Core beliefs represent extreme, one-sided views towards the self, others, and the world that give rise both to the conditional assumptions and automatic thoughts.”

• AssumptionThe authors state this as an assumption: Core beliefs are primitive, extreme views formed as a result of early experiences.

Classified as probably not a substantial claim.

In the CBT model, maladaptive beliefs or schemata lead to maladaptive specific and often automatic cognitions when attention is allocated to triggers such as situations, events, sensations, or thoughts.

“In this model, maladaptive beliefs (schemata) lead to maladaptive specific (and often automatic) cognitions when attention is allocated to aspects of certain triggers, such as situations, events, sensations, or even other thoughts”

Probably not a substantial claim: may not pass S4 (based).

Appraisal processes lead to specific subjective experiences, physiological symptoms, and behavioral responses.

“These appraisal processes then lead to specific subjective experiences, physiological symptoms, and behavioral responses”

May combine two claims.

Some emotion regulation strategies, such as acceptance, reappraisal, and problem solving, are adaptive and associated with less psychopathology.

“It has been shown that some strategies tend to be maladaptive and associated with greater psychopathology (i.e., rumination, avoidance, suppression), whereas others tend to be adaptive (i.e., acceptance, reappraisal, and problem solving) and associated with less psychopathology (Aldao, Nolen-Hoeksema, & Schweizer, 2010; Hofmann, Sawyer, Fang, & Asnaani, 2012).”

• cites Aldao, Nolen-Hoeksema, & Schweizer, 2010 sourceNot checked yet

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• cites Hofmann, Sawyer, Fang, & Asnaani, 2012Not checked yet

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Probably not a substantial claim: may not pass S4 (based). May combine two claims.

At the core of the CBT model are maladaptive cognitive processes, which can take the form of trait or state variables.

“At the core of the model are maladaptive cognitive processes. These cognitions can take on the form of trait or state variables”

May combine two claims.

Adopting a complex causal network approach allows study of the entire complexity of the system and avoids the assumption that symptoms are caused by the same latent disease or are merely labels for an arbitrary symptom set.

“Adopting a complex causal network approach provides the opportunity to study the entire complexity of the system and has the advantage of not being limited to the assumption that symptoms of a psychiatric disorder are caused by the same latent disease (as is the case for the reflective model) or are merely labels for an arbitrary set of symptoms (as is the case for the formative model)”

Probably not a substantial claim: may not pass S3 (load-bearing).

Attentional bias can be assessed using the dot-probe paradigm, the modified Stroop task, or other methods.

“Attentional bias can be measured with the dot-probe paradigm, the modified Stroop task (e.g., Stroop, 1938), or other methods (McLeod, Mathews, & Tata, 1986).”

• cites Stroop, 1938 sourceNot checked yet

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• cites McLeod, Mathews, & Tata, 1986Not checked yet

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May combine two claims.

RDoC has limited clinical utility because it is primarily intended to advance future research and is not yet intended to guide clinical decision making.

“RDoC has limited clinical utility because it is primarily intended to advance future research, but is not yet intended as a guide for clinical decision making (Cuthbert & Kozak, 2013)”

• cites Cuthbert & Kozak, 2013Not checked yet

  Not checked in the free run.

May combine two claims.

The reflective model is consistent with causal essentialism in kinds because clinicians are more likely to believe that symptoms result from a single cause, that all patients with the disorder have this cause, and that causal relations among symptoms are similar among patients when symptoms are correlated.

“This model is also consistent with causal essentialism in kinds (Ahn, Taylor, Kato, Marsh, & Bloom, 2013), because clinicians are more likely to believe that symptoms result from a single cause, that all patients with the disorder have this cause, and that the causal relations among symptoms are similar among patients with these disorders if the symptoms are correlated”

• cites Ahn et al., 2013 sourceNot checked yet

  Not checked in the free run.

Probably not a substantial claim: may not pass S4 (based).

The current disease model of the DSM assumes that a psychiatric problem is caused by an underlying disease entity.

“The current disease model of the DSM assumes that a psychiatric problem is caused by an underlying disease entity”

Probably not a substantial claim: may not pass S4 (based).

The success of CBT protocols is remarkable given that the interventions target DSM categories grounded in a medical disease model.

“Nevertheless, the success of the CBT protocols is remarkable, given that the interventions target the DSM categories that are grounded in a medical disease model”

Probably not a substantial claim: may not pass S3 (load-bearing).

Interview data and behavioral or experimental tests can also help identify schemata.

“However, interview data and behavioral/experimental tests can also provide information to identify the schemata.”

Probably not a substantial claim: may not pass S3 (load-bearing), S4 (based).

Once cognitive processes reach consciousness, triggers are evaluated and interpreted.

“Once these processes reach the level of consciousness, the triggers are evaluated and interpreted”

Probably not a substantial claim: may not pass S2 (checkable), S4 (based).

Triggers are stimuli that set off the cognitive behavioral network associated with a psychological problem.

“Triggers are stimuli that set off the cognitive behavioral network associated with a psychological problem”

May combine two claims.

CBT treatments are typically effective with children, adults, and older adults, and they last longer and are less likely to require additional treatments than pharmacotherapy.

“These treatments are typically effective with children, adults, and older adults and they last longer and are less likely to require additional treatments than pharmacotherapy”

• cites Hofmann et al., 2012Not checked yet

  Not checked in the free run.

May combine two claims.

Identifying initiating factors is neither necessary nor sufficient for treating a psychological problem.

“In contrast, it is neither necessary nor sufficient to identify the initiating factors in order to treat a psychological problem”

Probably not a substantial claim: may not pass S2 (checkable), S4 (based).

The complex causal network approach offers an alternative and less restrictive theoretical foundation for an empirically based classification system.

“The complex causal network approach offers an alternative, less restrictive, theoretical foundation for an empirically-based classification system”

Probably not a substantial claim: may not pass S3 (load-bearing).

The general CBT model depicts components that provide the framework for the general between-subjects complex causal network approach.

“This model depicts the components that provide the framework for the general, between- subjects complex causal network approach”

May combine two claims.

Functional connectivity analyses provide clinically useful data and are considerably less expensive than other techniques.

“newer techniques, such a functional connectivity analyses, provide clinically useful data and are considerably less expensive than other techniques (Anteraper, Triantafyllou, Sawyer, Hofmann, Gabrieli, & Whitfield-Gabrieli, S. (in press)”

• cites Anteraper et al., in pressNot checked yet

  Not checked in the free run.

May combine two claims.

Epigenetics research suggests that environmental experiences can lead to expression or deactivation of genes, producing long-term trait changes within an individual and possibly transmission to later generations.

“This body of research suggests that environmental experiences can lead to the expression or deactivation of genes, and these changes not only lead to long-term changes in traits within an individual, but it might also be transmitted to later generations”

Classified as probably not a substantial claim.

The reflective model, which is the DSM model, assumes that different attributes such as symptoms are caused by the same latent construct such as a mental disorder.

“In contrast, the reflective model, which is the model of the DSM, assumes that different attributes (e.g., symptoms) are caused by the same latent construct (e.g., a mental disorder)”

• cites Schmittmann et al., 2013 sourceNot checked yet

  Not checked in the free run.

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

CBT protocols have been developed to align with DSM categories, although specific techniques depend on the targeted symptoms.

“Although the specific treatment techniques depend on the symptoms that are targeted, the CBT protocols have been developed to be aligned with DSM categories”

Probably not a substantial claim: may not pass S2 (checkable).

Analyzing individual person-specific networks requires methodologies that capture relevant variables to gather an individual's thoughts, experiences, and behaviors in situations with specific triggers.

“Analyzing such individual, person-specific networks requires methodologies to capture the relevant variables to gather an individual’s thoughts, experiences, and behaviors in situations with specific triggers”

Probably not a substantial claim: may not pass S4 (based).

Symptoms of psychiatric illnesses are assumed to correlate because they are assumed to be caused by the same underlying disorder.

“In other words, the symptoms of psychiatric illnesses are assumed to correlate because they are assumed to be caused by the same underlying disorder”

May combine two claims.

Some emotion regulation strategies, such as rumination, avoidance, and suppression, are maladaptive and associated with greater psychopathology.

“It has been shown that some strategies tend to be maladaptive and associated with greater psychopathology (i.e., rumination, avoidance, suppression), whereas others tend to be adaptive (i.e., acceptance, reappraisal, and problem solving) and associated with less psychopathology (Aldao, Nolen-Hoeksema, & Schweizer, 2010; Hofmann, Sawyer, Fang, & Asnaani, 2012).”

• cites Aldao, Nolen-Hoeksema, & Schweizer, 2010 sourceNot checked yet

  Not checked in the free run.

• cites Hofmann, Sawyer, Fang, & Asnaani, 2012Not checked yet

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Probably not a substantial claim: may not pass S3 (load-bearing), S4 (based). May combine two claims.

Attention processes typically show a high degree of automaticity and can occur on a subconscious level.

“These attention processes typically show a high degree of automaticity and can occur on a subconscious level”

Probably not a substantial claim: may not pass S4 (based). May combine two claims.

For most psychological problems, initiating and maintaining factors are very different, because the reason a problem developed is often unrelated or only tangentially related to the reason it persists.

“for most psychological problems, initiating and maintaining factors are very different, because the reason a problem developed in the first place is often unrelated, or only tangentially related, to the reason the problem persists”

Probably not a substantial claim: may not pass S4 (based). May combine two claims.

Each individual has specific vulnerabilities and unique experiences that lead to particular problems and form individual networks.

“Each individual shows specific vulnerabilities and unique experiences, leading to particular problems, thus forming individual networks”

May combine two claims.

Reliance on suppression to cope with emotional distress is associated with greater vulnerability to developing emotional disorders and to symptom persistence.

“Similarly, the reliance on suppression to cope with emotional distress is associated with greater vulnerability for both the development of emotional disorders and the persistence of symptoms (Amstadter, 2008).”

• cites Amstadter, 2008 sourceNot checked yet

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Classified as probably not a substantial claim.

The primary components of the complex causal network include maladaptive cognitive processes activated by triggers and moderated by attentional processes and trait cognitions such as beliefs, schemata, and habitual affective or cognitive styles.

“The primary components of this complex causal network include maladaptive cognitive processes that are activated by specific triggers and moderated by attentional processes and trait cognitions, which include beliefs (schemata) and habitual affective/cognitive styles”

Probably not a substantial claim: may not pass S2 (checkable), S4 (based). May combine two claims.

The cognitive-behavioral approach offers a treatment model and a sound theoretical framework for developing a classification system in line with the complex causal network approach.

“In conclusion, the cognitive-behavioral approach not only offers a treatment model, but also constitutes a sound theoretical framework for developing a classification system that is in line with the complex causal network approach.”

Probably not a substantial claim: may not pass S3 (load-bearing), S4 (based).

For anxiety, important specific dimensions include anxiety sensitivity, perfectionism, and intolerance of uncertainty.

“For example, in the case of anxiety, important specific dimensions include anxiety sensitivity, perfectionism, and intolerance to uncertainty, to name only few.”

Probably not a substantial claim: may not pass S4 (based). May combine two claims.

Emotion regulation is a willful, cognitive activity that requires executive control.

“Thus, emotion regulation is a willful, cognitive activity that requires executive control.”

• AssumptionThe authors state this as an assumption: Maladaptive cognitive processes are the primary mediators between triggers and psychological distress and are the optimal treatment target.

May combine two claims.

RDoC is of questionable clinical utility and disconnected from the treatment literature, especially cognitive-behavioral evidence.

“Moreover, the system is of questionable clinical utility and disconnected from the treatment literature, especially the overwhelming evidence from the cognitive-behavioral literature.”

Probably not a substantial claim: may not pass S3 (load-bearing).

RDoC's goal is to determine cut-points along these dimensions, similar to defining pathological hypertension on a blood-pressure dimension.

“The goal is to determine cut-points along these dimensions, similar to defining the pathological state of hypertension on the blood- pressure dimension (Cuthbert & Insel, 2013).”

• cites Cuthbert & Insel, 2013Not checked yet

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May combine two claims.

Limitations of the complex causal network approach include overemphasis on self-reported symptoms and lack of a theoretical framework explaining why some symptoms cause others.

“The limitations of the complex causal network approach include the overemphasis on self-reported symptoms (which was one of the major objections of RDoC toward the DSM) and the lack of a theoretical framework that explains why some symptoms or features of a disorder should cause others.”

Probably not a substantial claim: may not pass S2 (checkable), S4 (based). May combine two claims.

The biggest advantage of the cognitive-behavioral approach is that its system is based on a refutable and empirically-based theoretical model that integrates different scientific disciplines and can change as science advances.

“The biggest advantage of the cognitive behavioral approach is that the system is based on a refutable and empirically-based theoretical model that integrates different scientific disciplines and that can (and will) change as science further advances.”

Classified as probably not a substantial claim.

RDoC implies that mental disorders are complex traits that are extremes on a spectrum of normal functioning.

“This approach implies that mental disorders are complex traits that are extremes on a spectrum of normal functioning.”

• cites Cuthbert & Insel, 2013Not checked yet

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Classified as probably not a substantial claim.

RDoC offers a dimensional alternative for classifying psychiatric disorders to capture the full variation from normal to abnormal.

“RDoC offers a dimensional alternative for classifying psychiatric disorders in order to capture the full variation from normal to abnormal.”

• cites Cuthbert & Insel, 2013Not checked yet

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Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

Verbalizing a fearful situation can induce less cardiovascular response than visually imagining it, possibly because verbalization serves abstraction and disengagement.

“For example, verbalizing a fearful situation can induce less cardiovascular response than visually imagining the same situation, possibly because verbalizations are used as a strategy for abstraction and disengagement (Borkovec et al., 1998; but also see Newman & Llera, 2011, and Newman, Llera, Erickson, Przeworski, & Castonguay, 2013, who did not find support for this).”

• cites Borkovec et al., 1998 sourceNot checked yet

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• cites Newman & Llera, 2011 sourceNot checked yet

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• cites Newman, Llera, Erickson, Przeworski, & Castonguay, 2013 sourceNot checked yet

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Probably not a substantial claim: may not pass S2 (checkable), S4 (based).

The proposed approach provides a heuristically useful model of between-subjects complex causal network that allows for a treatment-relevant classification system.

“In addition, the proposed approach also provides a heuristically useful model of between-subjects complex causal network that allows for the basis of a treatment-relevant classification system.”

May combine two claims.

A testable psychopathology model is missing from the complex causal network approach; it should explain why and how certain symptoms are causally related.

“What is missing in this innovative approach is a testable psychopathology model that explains why and how certain symptoms are causally related.”

Probably not a substantial claim: may not pass S3 (load-bearing), S4 (based). May combine two claims.

Physiological, subjective, and behavioral responses are best assessed with behavioral or experimental tests, but can also be measured through self-report and interview.

“The physiological, subjective, and behavioral responses are best assessed with behavioral/experimental tests, but can also be measured through self-report and interview measures.”

Classified as probably not a substantial claim.

In the complex causal network approach, symptoms are strongly correlated because they are part of the same system and causally influence one another.

“Instead, the symptoms are strongly correlated because they are part of the same system, i.e., because they causally influence one another.”

• AssumptionRests on an assumption: Symptoms of a mental disorder are strongly correlated because they are part of the same system and causally influence one another.

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

The present cognitive-behavioral model is limited by its simplicity; many additional factors not considered might contribute to psychopathology and form a more complex network.

“The limitation of the present cognitive behavioral model is also one of its advantages – its simplicity. Many additional factors that have not been considered in this simplistic model might contribute to an individual’s psychopathology, resulting in a considerably more complex network that is depicted in Figure 1.”

Probably not a substantial claim: may not pass S2 (checkable). May combine two claims.

Adopting a cognitive-behavioral complex causal network framework provides an individually tailored approach for classification and concrete treatment guidance.

“Adopting such a cognitive behavioral complex causal network framework not only provides an individually-tailored approach for classification purposes, but it also gives concrete guidance for treatment.”

May combine two claims.

Effective treatments promote beneficial emotion regulation strategies and discourage ineffective ones.

“Effective treatments focus on promoting beneficial emotion regulation strategies and discouraging the use of ineffective strategies.”

• AssumptionThe authors state this as an assumption: Maladaptive cognitive processes are the primary mediators between triggers and psychological distress and are the optimal treatment target.

Probably not a substantial claim: may not pass S2 (checkable).

The complex causal network approach offers a less restrictive approach toward classifying mental disorders.

“The complex causal network approach offers a less restrictive approach toward classifying mental disorders.”

Probably not a substantial claim: may not pass S4 (based).

Behavioral and experimental tests should be well suited to assess many aspects of the cognitive behavioral system.

“As shown in Table 1, behavioral/experimental tests should be well suited to assess many aspects of the cognitive behavioral system.”

Probably not a substantial claim: may not pass S3 (load-bearing), S4 (based).

State reappraisal is often an adaptive strategy.

“As is true for trait reappraisal, state reappraisal is often an adaptive strategy.”

May combine two claims.

The cognitive-behavioral model offers a testable psychopathology system that derives predictions about causal relationships between its components and considers moderating variables.

“The cognitive-behavioral model offers such a system. Not only does it derive clearly testable predictions about the causal relationship between its components (e.g., self-deprecating thoughts cause low mood), but it also considers moderating variables (e.g., a negative self-schemata moderates the influence of triggers experiences on specific thoughts).”

Probably not a substantial claim: may not pass S3 (load-bearing).

Many of the ideas in the proposed approach are not new; behaviorally and cognitively oriented clinicians have advocated for clinical case formulation rather than targeting a latent disease for decades.

“It should be noted that many of these ideas are not new. Behaviorally and cognitively oriented clinicians and scholars have been advocating for a clinical case formulation approach rather than targeting a latent disease for decades (Eells, 2010; Goldfried & Wolfe, 1998; Lazarus, 1973; Staats, 1999).”

• cites Eells, 2010Not checked yet

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• cites Goldfried & Wolfe, 1998Not checked yet

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• cites Lazarus, 1973 sourceNot checked yet

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Probably not a substantial claim: may not pass S4 (based).

The cognitive-behavioral approach is not restricted to clinician judgments and self-report data but necessitates other data sources, including psychophysiological and behavioral measures.

“In line with the RDoC initiative, the cognitive behavioral approach is not restricted to clinician judgments and self-report data, but necessitates other data sources, including psychophysiological and behavioral measures.”

May combine two claims.

Two individuals with the same DSM-5 diagnosis can have problems maintained by different factors, requiring different interventions because their problems form different complex causal networks.

“For example, two individuals, Harry and Sally, might receive the same DSM-5 diagnosis of social anxiety disorder and are, therefore, indistinguishable on a diagnostic level. However, their problems are maintained by different factors, requiring different interventions because their problems form two very different complex causal networks.”

Probably not a substantial claim: may not pass S2 (checkable).

If symptoms and causal connections between them constitute a mental disorder, then comorbidity cannot be meaningfully explained as correlation between two distinct disorders or as result of common underlying dysfunction.

“Moreover, if one accepts that symptoms and causal connections between them are what constitute a mental disorder, the term “comorbidity” gathers a different meaning, because comorbidity can no longer meaningfully explained as a correlation between two distinct disorders, or as the result of a common underlying (neurobiological) dysfunction.”

Probably not a substantial claim: may not pass S3 (load-bearing).

In the cognitive-behavioral model, physiological symptoms, behaviors, and subjective experience can feed onto each other and support maladaptive cognitive appraisal, creating a positive feedback loop.

“In both cases, the physiological symptoms, behaviors, and the subjective experience feed onto each other and further support the maladaptive cognitive appraisal of the situation, establishing a positive feedback loop and vicious cycle.”

Probably not a substantial claim: may not pass S2 (checkable), S3 (load-bearing).

The person-specific complex causal network approach is fully in line with the behavioral and cognitive tradition.

“In fact, the person-specific complex causal network approach is fully in line with this behavioral and cognitive tradition.”

Probably not a substantial claim: may not pass S4 (based).

RDoC is based on the strong and unsubstantiated assumption that symptoms of psychiatric disorders reflect latent disease entities.

“However, the cognitive-behavioral framework makes less restrictive model assumptions; RDoC is based on the strong and unsubstantiated assumption that symptoms of psychiatric disorders reflect the existence of latent disease entities.”