Diagnostic categories or dimensions? A question for the Diagnostic and statistical manual of mental disorders--fifth edition.

Widiger, Thomas A.; Samuel, Douglas B.

doi:10.1037/0021-843x.114.4.494

Cited by 754Mental Health Research TopicsMental Health and PsychiatryPersonality Disorders and Psychopathology

Diagnostic categories or dimensions? A question for the Diagnostic and statistical manual of mental disorders--fifth edition.

Widiger, Thomas A., Samuel, Douglas B.·2005·Journal of Abnormal Psychology

DOI 10.1037/0021-843x.114.4.494

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Abstract

The question of whether mental disorders are discrete clinical conditions or arbitrary distinctions along dimensions of functioning is a long-standing issue, but its importance is escalating with the growing recognition of the frustrations and limitations engendered by the categorical model. The authors provide an overview of some of the dilemmas of the categorical model, followed by a discussion of research that addresses whether mental disorders are accurately or optimally classified categorically or dimensionally. The authors' intention is to document the importance of this issue and to suggest that future editions of the Diagnostic and Statistical Manual of Mental Disorders give more recognition to dimensional models of classification. They conclude with a dimensional mental disorder classification that they suggest provides a useful model.

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The juxtaposition of categorical and dimensional approaches to mental health has led historically to strong debates about which approach best characterizes a given phenomenon.
“The juxtaposition of categorical and dimensional approaches to mental health and related challenges has led historically to strong debates about which approach best characterizes a given phenomenon or set of phenomena such as mental disorders”
From Reconciling Contemporary Approaches to School Attendance and School Absenteeism: Toward Promotion and Nimble Response, Global Policy Review and Implementation, and Future Adaptability (Part 1) (2019) · cites this paper as Widiger and Samuel, 2005

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Taxometrics in Psychopathology Research: An Introduction to Some of the Procedures and Related Methodological Issues.
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The effects of changing axis II diagnostic criteria
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What Can Be Learned From Taxometric Analyses?
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Subthreshold mental disorders: Nosological and research recommendations.
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Panic disorder in a patient taking oxaprozin
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The Hierarchical Taxonomy of Psychopathology (HiTOP): A dimensional alternative to traditional nosologies.
Kotov, R., Krueger, R. F., Watson, D., Achenbach, T. M., Althoff, R. R., Bagby, R. M., Brown, T. A., Carpenter, W. T., Caspi, A., Clark, L. A., et al. (2017) · Journal of Abnormal Psychology · doi:10.1037/abn0000258 · Cited by 3,335 · see citing works
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Linking “big” personality traits to anxiety, depressive, and substance use disorders: A meta-analysis
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A Handbook for the Study of Mental Health Second Edition
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A meta-analytic review of the relationships between the five-factor model and DSM-IV-TR personality disorders: A facet level analysis
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Plate tectonics in the classification of personality disorder: Shifting to a dimensional model.
Widiger, T. A., & Trull, T. J. (2007) · American Psychologist · doi:10.1037/0003-066x.62.2.71 · Cited by 957 · see citing works
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The Future of Emotion Regulation Research: Capturing Context
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Clinical Staging of Psychiatric Disorders: A Heuristic Framework for Choosing Earlier, Safer and more Effective Interventions
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Dalgleish, T., Black, M., Johnston, D., & Bevan, A. (2020) · Journal of Consulting and Clinical Psychology · doi:10.1037/ccp0000482 · Cited by 883 · see citing works
Linking antisocial behavior, substance use, and personality: An integrative quantitative model of the adult externalizing spectrum.
Krueger, R. F., Markon, K. E., Patrick, C. J., Benning, S. D., & Kramer, M. D. (2007) · Journal of Abnormal Psychology · doi:10.1037/0021-843x.116.4.645 · Cited by 861 · see citing works
Assessment and Diagnosis of Personality Disorder: Perennial Issues and an Emerging Reconceptualization
Clark, L. A. (2006) · Annual Review of Psychology · doi:10.1146/annurev.psych.57.102904.190200 · Cited by 808 · see citing works
A proposal for a dimensional classification system based on the shared features of the DSM-IV anxiety and mood disorders: implications for assessment and treatment
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Resolving the paradox of common, harmful, heritable mental disorders: Which evolutionary genetic models work best?
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Personality Assessment in DSM-5: Empirical Support for Rating Severity, Style, and Traits
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The Structure of Genetic and Environmental Risk Factors for Syndromal and Subsyndromal Common DSM-IV Axis I and All Axis II Disorders
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Mixed anxiety/depression symptoms in a large cancer cohort: prevalence by cancer type
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Higher-order genetic and environmental structure of prevalent forms of child and adolescent psychopathology
Lahey, B. B., Van Hulle, C. A., Singh, A. L., Waldman, I. D., & Rathouz, P. J. (2011) · Archives of General Psychiatry · doi:10.1001/archgenpsychiatry.2010.192 · Cited by 341 · see citing works
The time has come for dimensional personality disorder diagnosis
Hopwood, C. J., Kotov, R., Krueger, R. F., Watson, D., Widiger, T. A., Althoff, R. R., Ansell, E. B., Bach, B., Bagby, R. M., Blais, M. A., et al. (2017) · Personality and Mental Health · doi:10.1002/pmh.1408 · Cited by 321 · see citing works
Self-citation
Subthreshold conditions as precursors for full syndrome disorders: a 15‐year longitudinal study of multiple diagnostic classes
Shankman, S. A., Lewinsohn, P. M., Klein, D. N., Small, J. W., Seeley, J. R., & Altman, S. E. (2009) · Journal of Child Psychology and Psychiatry · doi:10.1111/j.1469-7610.2009.02117.x · Cited by 300 · see citing works
Modeling psychopathology structure: a symptom-level analysis of Axis I and II disorders
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The importance of assessing clinical phenomena in Mechanical Turk research.
Hall, K. A. A., Çek, D., Shaw, A. M., & Timpano, K. R. (2015) · Psychological Assessment · doi:10.1037/pas0000217 · Cited by 311 · see citing works
Temporal course and structural relationships among dimensions of temperament and DSM-IV anxiety and mood disorder constructs.
Brown, T. A. (2007) · Journal of Abnormal Psychology · doi:10.1037/0021-843x.116.2.313 · Cited by 306 · see citing works
Labeling and Stigma
Link, B. G., & Phelan, J. C. (2012) · Handbooks of sociology and social research · doi:10.1007/978-94-007-4276-5_25 · Cited by 304 · see citing works
Deriving an Empirical Structure of Personality Pathology for DSM-5
Krueger, R. F., Eaton, N. R., Clark, L. A., Watson, D., Markon, K. E., Derringer, J. L., Skodol, A. E., & Livesley, W. J. (2011) · Journal of Personality Disorders · doi:10.1521/pedi.2011.25.2.170 · Cited by 294 · see citing works
Sexual dysfunction in depression and anxiety: Conceptualizing sexual dysfunction as part of an internalizing dimension
Laurent, S. M., & Simons, A. D. (2009) · Clinical Psychology Review · doi:10.1016/j.cpr.2009.06.007 · Cited by 288 · see citing works
Validity and utility of Hierarchical Taxonomy of Psychopathology ( HiTOP ): III . Emotional dysfunction superspectrum
Watson, D., Levin‐Aspenson, H. F., Waszczuk, M. A., Conway, C. C., Dalgleish, T., Dretsch, M. N., Eaton, N. R., Forbes, M. K., Forbush, K. T., Hobbs, K. A., et al. (2022) · World Psychiatry · doi:10.1002/wps.20943 · Cited by 285 · see citing works
Dimensions over categories: a meta-analysis of taxometric research
Haslam, N., McGrath, M. J., Viechtbauer, W., & Kuppens, P. (2020) · Psychological Medicine · doi:10.1017/s003329172000183x · Cited by 281 · see citing works
The Structure of Genetic and Environmental Risk Factors for DSM-IV Personality Disorders
Kendler, K. S., Aggen, S. H., Czajkowski, N. O., Røysamb, E., Tambs, K., Torgersen, S. O., Neale, M. C., & Reichborn‐Kjennerud, T. (2008) · Archives of General Psychiatry · doi:10.1001/archpsyc.65.12.1438 · Cited by 278 · see citing works
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Five-Factor Model of Personality Disorder: A Proposal for DSM-V
Widiger, T. A., & Mullins‐Sweatt, S. N. (2008) · Annual Review of Clinical Psychology · doi:10.1146/annurev.clinpsy.032408.153542 · Cited by 253 · see citing works
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Diagnostic and Statistical Manual of Mental Disorders (DSM)
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Personality traits and the classification of mental disorders: Toward a more complete integration in DSM–5 and an empirical model of psychopathology.
Krueger, R. F., & Eaton, N. R. (2010) · Personality Disorders: Theory, Research, and Treatment · doi:10.1037/a0018990 · Cited by 244 · see citing works
Validating the distinction between computer addiction and engagement: online game playing and personality
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Clinical utility: A prerequisite for the adoption of a dimensional approach in DSM.
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Can you feel the beat? Interoceptive awareness is an interactive function of anxiety- and depression-specific symptom dimensions
Dunn, B. D., Stefanovitch, I., Evans, D., Oliver, C., Hawkins, A., & Dalgleish, T. (2010) · Behaviour Research and Therapy · doi:10.1016/j.brat.2010.07.006 · Cited by 235 · see citing works
Structures of personality and their relevance to psychopathology: II. Further articulation of a comprehensive unified trait structure
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Dimensional representations of DSM-IV cluster B personality disorders in a population-based sample of Norwegian twins: a multivariate study
Torgersen, S. O., Czajkowski, N. O., Jacobson, K. C., Reichborn‐Kjennerud, T., Røysamb, E., Neale, M. C., & Kendler, K. S. (2008) · Psychological Medicine · doi:10.1017/s0033291708002924 · Cited by 227 · see citing works
DSM-V and the stigma of mental illness
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Interpersonal Dynamics in Personality and Personality Disorders
Hopwood, C. J. (2018) · European Journal of Personality · doi:10.1002/per.2155 · Cited by 229 · see citing works
An integrative dimensional classification of personality disorder.
Widiger, T. A., Livesley, W. J., & Clark, L. A. (2009) · Psychological Assessment · doi:10.1037/a0016606 · Cited by 211 · see citing works
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Targets and Outcomes of Psychotherapies for Mental Disorders: An Overview
Cuijpers, P. (2019) · World Psychiatry · doi:10.1002/wps.20661 · Cited by 206 · see citing works
Preinjury somatization symptoms contribute to clinical recovery after sport-related concussion
Nelson, L. D., Tarima, S., LaRoche, A. A., Hammeke, T. A., Barr, W. B., Guskiewicz, K., Randolph, C., & McCrea, M. A. (2016) · Neurology · doi:10.1212/wnl.0000000000002679 · Cited by 204 · see citing works
On the Value of Homogeneous Constructs for Construct Validation, Theory Testing, and the Description of Psychopathology
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Anterior Cingulate Cortexγ-Aminobutyric Acid in Depressed Adolescents: Relationship to Anhedonia
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The general factor of psychopathology
Smith, G. T., Atkinson, E. A., Davis, H. A., Riley, E. N., & Oltmanns, J. R. (2020) · Annual Review of Clinical Psychology · doi:10.1146/annurev-clinpsy-071119-115848 · Cited by 195 · see citing works
A Cybernetic Theory of Psychopathology
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Hierarchical models of psychopathology: empirical support, implications, and remaining issues
Lahey, B. B., Moore, T. M., Kaczkurkin, A. N., & Zald, D. H. (2021) · World Psychiatry · doi:10.1002/wps.20824 · Cited by 188 · see citing works
Integrating Normal and Pathological Personality
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How should we revise diagnostic criteria for substance use disorders in the DSM-V?
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Assessing rejection-related disease in kidney transplant biopsies based on archetypal analysis of molecular phenotypes
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The Cycle of Classification: DSM-I Through DSM-5
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Psychologists' perspectives on the diagnostic classification of mental disorders: Results from the WHO‐IUPsyS Global Survey
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What is being assessed and why it matters: The impact of transient error on trait research.
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Interpersonal dysfunction in personality disorders: A meta-analytic review.
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Borderline personality disorder in adolescents: evidence in support of the Childhood Interview for DSM-IV Borderline Personality Disorder in a sample of adolescent inpatients
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The DSM Diagnostic Criteria for Female Sexual Arousal Disorder
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Intolerance of Uncertainty as a Transdiagnostic Mechanism of Psychological Difficulties: A Systematic Review of Evidence Pertaining to Causality and Temporal Precedence
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Relevant dimensions of delusions: Continuing the continuum versus category debate
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Understanding Psychopathology
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Collective self-esteem as a coping resource for male-to-female transsexuals.
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Conscientiousness and obsessive-compulsive personality disorder.
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Distracted and down: neural mechanisms of affective interference in subclinical depression
Kaiser, R. H., Andrews-Hanna, J. R., Spielberg, J. M., Warren, S. L., Sutton, B. P., Miller, G. A., Heller, W., & Banich, M. T. (2015) · Social Cognitive and Affective Neuroscience · doi:10.1093/scan/nsu100 · Cited by 147 · see citing works
Investigating the nature of co-occurring depression and anxiety: Comparing diagnostic and dimensional research approaches
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Psychological Distress After Major Burn Injury
Fauerbach, J. A., McKibben, J. B. A., Bienvenu, O. J., Magyar‐Russell, G., Smith, M. T., Holavanahalli, R. K., Patterson, D. R., WIECHMAN, S. A., Blakeney, P., & Lezotte, D. C. (2007) · Psychosomatic Medicine · doi:10.1097/psy.0b013e31806bf393 · Cited by 145 · see citing works
Variations in FKBP5 and BDNF genes are suggestively associated with depression in a Swedish population-based cohort
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Examining an obsessive-compulsive core dimensions model: Structural validity of harm avoidance and incompleteness
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Clinicians' judgments of clinical utility: A comparison of the DSM-IV and five-factor models.
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Reconciling Contemporary Approaches to School Attendance and School Absenteeism: Toward Promotion and Nimble Response, Global Policy Review and Implementation, and Future Adaptability (Part 1)
Kearney, C. A., Gonzálvez, C., Graczyk, P. A., & Fornander, M. J. (2019) · Frontiers in Psychology · doi:10.3389/fpsyg.2019.02222 · Cited by 130 · see citing works
On the hierarchical structure of mood and anxiety disorders: Confirmatory evidence and elaboration of a model of temperament markers.
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Anger and Psychopathology
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Authors: Widiger, T. A., & Samuel, D. B.
Affiliations: University of Kentucky (US)
ORCID: Widiger, Thomas A.
Samuel, Douglas B.
Venue: Journal of Abnormal Psychology
Publisher: American Psychological Association (APA)
Published: 2005-11
Volume: 114
Issue: 4
Pages: 494-504
ISSN: 0021-843X (ISSN-L)
1939-1846
DOI: 10.1037/0021-843x.114.4.494
OpenAlex: W2125664898
Cited by: 752
References: 136
Citations by year: 2026: 18 · 2025: 28 · 2024: 20 · 2023: 20 · 2022: 30 · 2021: 42 · 2020: 34 · 2019: 34 · 2018: 30 · 2017: 75 · 2016: 25 · 2015: 56 · 2014: 50 · 2013: 31 · 2012: 50
FWCI: 35.28
Type: journal article
Language: en
Open access: closed
Locations: Journal of Abnormal Psychology (publishedVersion)
PubMed (publishedVersion)
Topics: Social Sciences › Psychology › Experimental and Cognitive Psychology › Mental Health Research Topics
Social Sciences › Arts and Humanities › Philosophy › Mental Health and Psychiatry
Social Sciences › Psychology › Clinical Psychology › Personality Disorders and Psychopathology
Keywords: dimensional classification, categorical classification, DSM-5, mental disorder classification, dimensional models of psychopathology, diagnostic categories, psychopathology
MeSH terms: Mental Disorders, Humans, Reproducibility of Results, Diagnostic and Statistical Manual of Mental Disorders

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Diagnostic categories or dimensions? A question for the Diagnostic and statistical manual of mental disorders--fifth edition.

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