Exploring the feasibility of a meta-structure for DSM-V and ICD-11: could it improve utility and validity?: Paper 1 of 7 of the thematic section: ‘A proposal for a meta-structure for DSM-V and ICD-11’
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Background: The organization of mental disorders into 16 DSM-IV and 10 ICD-10 chapters is complex and based on clinical presentation. We explored the feasibility of a more parsimonious meta-structure based on both risk factors and clinical factors. Method: Most DSM-IV disorders were allocated to one of five clusters as a starting premise. Teams of experts then reviewed the literature to determine within-cluster similarities on 11 predetermined validating criteria. Disorders were included and excluded as determined by the available data. These data are intended to inform the grouping of disorders in the DSM-V and ICD-11 processes. Results: The final clusters were neurocognitive (identified principally by neural substrate abnormalities), neurodevelopmental (identified principally by early and continuing cognitive deficits), psychosis (identified principally by clinical features and biomarkers for information processing deficits), emotional (identified principally by the temperamental antecedent of negative emotionality), and externalizing (identified principally by the temperamental antecedent of disinhibition). Conclusions: Large groups of disorders were found to share risk factors and also clinical picture. There could be advantages for clinical practice, public administration and research from the adoption of such an organizing principle.
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The application of validity criteria (validators) is much more meaningful for larger groups or disorder spectra than for individual categorical diagnoses.
“It was rapidly recognized that the application of such 'validators' was much more meaningful for larger groups or disorder spectra than for individual categorical diagnoses.”
From The DSM-5: Classification and criteria changes (2013) · cites this paper as [27]
The Introduction says that delimitation by validating factors might be best observed at the cluster rather than the individual-disorder level. The Criteria section also says validators originally developed for disorders were extended to clusters. But the paper does not establish that applying validators generally is much more meaningful for clusters, as the citing sentence asserts; the comparison in the Introduction is narrower and tentative. Page numbers are unavailable in our copy. (LLM, conf=0.84)
Experimental — accuracy not yet measuredA broad internalising liability or a common distress/negative affectivity component underlies anxiety and depressive disorders.
“structural modelling studies showing that a broad internalising liability or a common distress/negative affectivity component underlies anxiety and depressive disorders (Andrews et al., 2009;Watson, 2005)”
From Systematic review and meta-analysis of transdiagnostic psychological treatments for anxiety and depressive disorders in adulthood (2015) · cites this paper as Andrews et al., 2009
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- Authors
- Andrews, G., Goldberg, D. P., Krueger, R. F., Carpenter, W. T., Hyman, S. E., Sachdev, P., & Pine, D. S.
- Affiliations
- UNSW Sydney (AU)
- King's College London (GB)
- Washington University in St. Louis (US)
- University of Maryland, Baltimore (US)
- Harvard University (US)
- National Institute of Mental Health (US)
- Corresponding author
- Andrews, G.
- Venue
- Psychological Medicine
- Publisher
- Cambridge University Press (CUP)
- Published
- 2009-10-01
- Volume
- 39
- Issue
- 12
- Pages
- 1993-2000
- ISSN
- 0033-2917 (ISSN-L)
- 1469-8978
- OpenAlex
- W2147152064
- Cited by
- 242
- References
- 26
- Citations by year
- 2026: 2 · 2025: 5 · 2024: 7 · 2023: 3 · 2022: 9 · 2021: 11 · 2020: 14 · 2019: 12 · 2018: 5 · 2017: 13 · 2016: 11 · 2015: 15 · 2014: 18 · 2013: 23 · 2012: 32
- FWCI
- 273.65
- Type
- journal article
- Language
- en
- Open access
- Licence
- public-domain
- www.cambridge.org/core/terms (unspecified)
- Locations
- Psychological Medicine (publishedVersion)
- PubMed (publishedVersion)
- Digital Commons@Becker (Washington University School of Medicine) (submittedVersion, public-domain)
- Topics
- Social Sciences › Arts and Humanities › Philosophy › Mental Health and Psychiatry
- Social Sciences › Psychology › Clinical Psychology › Personality Disorders and Psychopathology
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Mental Health Research Topics
- Keywords
- DSM-V, ICD-11, psychiatric classification, metastructures, risk factors, neurocognitive disorders, neurodevelopmental disorders, psychosis, emotional disorders, externalizing disorders, negative affectivity, disinhibition, information processing deficits, diagnostic validity
- MeSH terms
- Mental Disorders, Feasibility Studies, Humans, Publishing, United States, Reproducibility of Results, Editorial Policies, International Classification of Diseases, Diagnostic and Statistical Manual of Mental Disorders
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