Externalizing disorders: Cluster 5 of the proposed meta-structure for DSM-V and ICD-11: Paper 6 of 7 of the thematic section: ‘A proposal for a meta-structure for DSM-V and ICD-11’

Krueger, R. F.; South, S. C.

doi:10.1017/s0033291709990328

Cited by 145Personality Disorders and PsychopathologyMental Health Research TopicsMental Health and Psychiatry

Externalizing disorders: Cluster 5 of the proposed meta-structure for DSM-V and ICD-11: Paper 6 of 7 of the thematic section: ‘A proposal for a meta-structure for DSM-V and ICD-11’

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Krueger, R. F., South, S. C.·2009·Psychological Medicine

DOI 10.1017/s0033291709990328

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Abstract

Background: The extant major psychiatric classifications DSM-IV and ICD-10 are purportedly atheoretical and largely descriptive. Although this achieves good reliability, the validity of a medical diagnosis is greatly enhanced by an understanding of the etiology. In an attempt to group mental disorders on the basis of etiology, five clusters have been proposed. We consider the validity of the fifth cluster, externalizing disorders, within this proposal. Method: We reviewed the literature in relation to 11 validating criteria proposed by the Study Group of the DSM-V Task Force, in terms of the extent to which these criteria support the idea of a coherent externalizing spectrum of disorders. Results: This cluster distinguishes itself by the central role of disinhibitory personality in mental disorders spread throughout sections of the current classifications, including substance dependence, antisocial personality disorder and conduct disorder. Shared biomarkers, co-morbidity and course offer additional evidence for a valid cluster of externalizing disorders. Conclusion: Externalizing disorders meet many of the salient criteria proposed by the Study Group of the DSM-V Task Force to suggest a classification cluster.

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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 [32]
The Introduction describes validators for clusters of psychiatric illness, and the Co-morbidity patterns section says research on broad underlying factors is likely to be more profitable than research on their individual manifestations. These passages support the preference for a spectrum-level approach, but do not establish the broader claim that applying validators is much more meaningful for spectra than for individual categorical diagnoses, or that this was rapidly recognized. Page numbers are unavailable in our copy. (LLM, conf=0.78)
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The joint structure of DSM-IV Axis I and Axis II disorders.
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Beyond comorbidity: Toward a dimensional and hierarchical approach to understanding psychopathology across the life span
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Developmental stability of general and specific factors of psychopathology from early childhood to adolescence: dynamic mutualism or p ‐differentiation?
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Levels of explanation in psychiatric and substance use disorders: implications for the development of an etiologically based nosology
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Schizophrenia in the Internalizing-Externalizing Framework: A Third Dimension?
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Posttraumatic stress disorder and the genetic structure of comorbidity.
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Evidence for a Multi-Dimensional Latent Structural Model of Externalizing Disorders
the Conduct Problems Prevention Research Group, Witkiewitz, K., King, K., McMahon, R. J., Wu, J., Luk, J., Bierman, K. L., Coie, J. D., Dodge, K. A., Greenberg, M. T., et al. (2013) · Journal of Abnormal Child Psychology · doi:10.1007/s10802-012-9674-z · Cited by 110 · see citing works
The psychoses: Cluster 3 of the proposed meta-structure for DSM-V and ICD-11: Paper 4 of 7 of the thematic section: ‘A proposal for a meta-structure for DSM-V and ICD-11’
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Self-citation
Neurodevelopmental disorders: Cluster 2 of the proposed meta-structure for DSM-V and ICD-11: Paper 3 of 7 of the thematic section: ‘A proposal for a meta-structure for DSM-V and ICD-11’
Andrews, G., Pine, D. S., Hobbs, M. J., Anderson, T. M., & Sunderland, M. (2009) · Psychological Medicine · doi:10.1017/s0033291709990274 · Cited by 94 · see citing works
“This paper is one of a set of reviews (Andrews et al. 2009 ; Carpenter et al. 2009 ; Goldberg et al. 2009 ; Krueger & South, 2009 ; Sachdev et al. 2009) that present a case that DSM-IV and ICD-10 disorders can be organized by reference to a set of ‘validating criteria ’ listed by the DSM-V Study…”
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Clinical presentations, social functioning, and treatment receipt among individuals with comorbid life‐time PTSD and alcohol use disorders versus drug use disorders: Findings from NESARC‐III
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Developmental associations between externalizing behaviors, peer delinquency, drug use, perceived neighborhood crime, and violent behavior in urban communities
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Mental Health Professionals’ Natural Taxonomies of Mental Disorders: Implications for the Clinical Utility of the ICD‐11 and the DSM‐5
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Mapping Common Psychiatric Disorders
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Neurobiological Mechanisms for Impulsive-Aggression: The Role of MAOA
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Gender differences in the relationship of internalizing and externalizing psychopathology to alcohol dependence: Likelihood, expression and course☆
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Between DSM and ICD: Paraphilias and the Transformation of Sexual Norms
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Stress responsivity and the structure of common mental disorders: Transdiagnostic internalizing and externalizing dimensions are associated with contrasting stress appraisal biases.
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Latent class analysis of co-morbidity in the Adult Psychiatric Morbidity Survey in England 2007: implications for DSM-5 and ICD-11
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Validity of Adolescent and Parent Reports on the Six-Item ADHD Self-Report Scale (ASRS-6) in Clinical Assessments of Adolescent Social Anxiety
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Psychiatric comorbidity and causal disease models
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Personality traits as an organizing framework for personality pathology
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Adapting Dialectical Behavior Therapy (DBT) for the Treatment of Psychopathy
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Social information processing and the perpetration of intimate partner violence: It is (and isn’t) what you think.
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Diminished error-related negativity and error positivity in children and adults with externalizing problems and disorders: a meta-analysis on error processing
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Clustering of psychiatric and somatic illnesses in the general population: multimorbidity and socioeconomic correlates
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Declines in prevalence of adolescent substance use disorders and delinquent behaviors in the USA: a unitary trend?
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Trajectories of psychopathology in extremely low birth weight survivors from early adolescence to adulthood: a 20‐year longitudinal study
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Mehrfachdiagnosen bei Schweizer Heimjugendlichen
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The Genetic and Neural Substrates of Externalizing Behavior
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Personality and the latent structure of PTSD comorbidity
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HiTOP Assessment of Externalizing Antagonism and Disinhibition
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The ankyrin-3 gene is associated with posttraumatic stress disorder and externalizing comorbidity
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Toward an Externalizing Spectrum in DSM–V : Incorporating Developmental Concerns
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Individual differences in fears of negative versus positive evaluation: frequencies and clinical correlates
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Mapping the MMPI–2–RF Specific Problems Scales Onto Extant Psychopathology Structures
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Should our major classifications of mental disorders be revised?
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Conceptualizing traumatic stress and the structure of posttraumatic psychopathology through the lenses of RDoC and HiTOP
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Cognitive Performance in Treatment‐Naïve Active Alcoholics
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Early and late signals of unexpected reward contribute to low extraversion and high disinhibition, respectively
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Declining Prevalence of Marijuana Use Disorders Among Adolescents in the United States, 2002 to 2013
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More inflammation but less brain-derived neurotrophic factor in antisocial personality disorder
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Premorbid Personality and Insight in First-Episode Psychosis
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A new meta-structure of mental disorders: a helpful step into the future or a harmful step back to the past?: A commentary on ‘A Proposal for a meta-structure for DSM-V and ICD-11’
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Profiles of Social Anxiety and Impulsivity Among College Students: A Close Examination of Profile Differences in Externalizing Behavior
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Dimensionality, hierarchical structure, age generalizability, and criterion validity of the GAIN's Behavioral Complexity Scale.
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The effects of implicit and explicit self-control on self-reported aggression
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Latent Personality Profiles and the Relations with Psychopathology and Psychopathic Traits in Detained Adolescents
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Schema modes and their associations with emotion regulation, mindfulness, and self-compassion among patients with personality disorders
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The contributions of early adverse experiences and trajectories of respiratory sinus arrhythmia on the development of neurobehavioral disinhibition among children with prenatal substance exposure
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Event-related potential (ERP) measures of error processing as biomarkers of externalizing disorders: A narrative review
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Conduct Disorder and Alcohol Use Disorder Trajectories, Predictors, and Outcomes for Indigenous Youth
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Urbanicity is Associated with Behavioral and Emotional Problems in Elementary School-Aged Children
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Measurement invariance of DSM ‐ IV alcohol, marijuana and cocaine dependence between community‐sampled and clinically overselected studies
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Ventral Striatal Dopamine Synthesis Capacity Predicts Financial Extravagance in Parkinson’s Disease
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Validity of Adult Psychopathology Model Using Psychiatric Patient Sample from a Developing Country: Confirmatory Factor Analysis
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Mild Traumatic Brain Injury as a Predictor of Classes of Youth Internalizing and Externalizing Psychopathology
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Adolescents' Neural Processing of Risky Decisions: Effects of Sex and Behavioral Disinhibition
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Resilience to trauma in the two largest cities of Brazil: a cross-sectional study
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The structure of personality disorders in individuals with posttraumatic stress disorder.
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Mental Health Problems are Associated with Low-Frequency Fluctuations in Reaction Time in A Large General Population Sample. The TRAILS Study
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Role of murine models in psychiatric illness drug discovery: a dimensional view
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Examining the shared and unique relationships among substance use and mental disorders
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Characterization of South African Adolescents With Alcohol Use Disorders but Without Psychiatric or Polysubstance Comorbidity
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Psychosis within dimensional and categorical models of mental illness
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Efficiently measuring dimensions of the externalizing spectrum model: Development of the Externalizing Spectrum Inventory-Computerized Adaptive Test (ESI-CAT).
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El DSM-V. Luces y sombras de un manual no publicado. Retos y expectativas para el futuro
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Externalizing personality traits, empathy, and gray matter volume in healthy young drinkers
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Validation of the full and brief Externalizing Spectrum Inventory in Dutch forensic inpatients
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Personality Traits Predict the Developmental Course of Externalizing: A Four‐Wave Longitudinal Study Spanning Age 17 to Age 29
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Reductions in the internalising construct following internet-delivered treatment for anxiety and depression in primary care
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Factors associated with hospitalization of adult psychiatric patients: cluster analysis
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The generalizability of the structure of substance abuse and antisocial behavioral syndromes: A systematic review
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Multidimensional Patterns of Sexual Risk Behavior and Psychiatric Disorders in Men with Substance Use Disorders
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The classification of mental disorder: a simpler system for DSM–V and ICD–11
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Psychometric Properties of the Externalizing Spectrum Inventory: Replication and Extension across Clinical and Non-Clinical Samples
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Self-citation

Authors: Krueger, R. F., & South, S. C.
Affiliations: Washington University in St. Louis (US)
Purdue University West Lafayette (US)
Corresponding author: Krueger, R. F.
ORCID: Krueger, R. F.
South, S. C.
Venue: Psychological Medicine
Publisher: Cambridge University Press (CUP)
Published: 2009-10-01
Volume: 39
Issue: 12
Pages: 2061-2070
ISSN: 0033-2917 (ISSN-L)
1469-8978
DOI: 10.1017/s0033291709990328
OpenAlex: W2060288140
Semantic Scholar: 0fb1e02b3e604b73a798a18e46c31dcc65cf374f
Cited by: 145
References: 71
Citations by year: 2026: 1 · 2024: 12 · 2023: 4 · 2022: 4 · 2021: 13 · 2020: 4 · 2019: 3 · 2018: 5 · 2017: 12 · 2016: 13 · 2015: 8 · 2014: 9 · 2013: 12 · 2012: 15
FWCI: 2.02
Type: journal article
Language: en
Open access: green
digitalcommons.wustl.edu
Licence: www.cambridge.org/core/terms (unspecified)
Locations: Psychological Medicine (publishedVersion)
PubMed (publishedVersion)
Digital Commons@Becker (Washington University School of Medicine) (submittedVersion)
Topics: Social Sciences › Psychology › Clinical Psychology › Personality Disorders and Psychopathology
Social Sciences › Psychology › Experimental and Cognitive Psychology › Mental Health Research Topics
Social Sciences › Arts and Humanities › Philosophy › Mental Health and Psychiatry
Keywords: externalizing disorders, psychiatric classification, DSM-V, ICD-11, antisocial personality disorder, conduct disorder, substance dependence, comorbidities, shared biomarkers, course of mental disorders, classification validity
MeSH terms: Aggression, Antisocial Personality Disorder, Mental Disorders, Cognition Disorders, Humans, Internal-External Control, Personality Disorders, Phenotype, Prognosis, Risk Factors, Social Environment, Temperament, Comorbidity, Personal Construct Theory, Conduct Disorder, Substance-Related Disorders, International Classification of Diseases, Diagnostic and Statistical Manual of Mental Disorders

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Externalizing disorders: Cluster 5 of the proposed meta-structure for DSM-V and ICD-11: Paper 6 of 7 of the thematic section: ‘A proposal for a meta-structure for DSM-V and ICD-11’

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