Cited by 688Mental Health and PsychiatryPsychology and Mental HealthPersonality Disorders and Psychopathology

Three Approaches to Understanding and Classifying Mental Disorder: ICD-11, DSM-5 , and the National Institute of Mental Health’s Research Domain Criteria (RDoC)

Clark, Lee Anna, Cuthbert, Bruce, Lewis-Fernández, Roberto, Narrow, William E., Reed, Geoffrey M.·2017·Psychological Science in the Public Interest

Abstract

The diagnosis of mental disorder initially appears relatively straightforward: Patients present with symptoms or visible signs of illness; health professionals make diagnoses based primarily on these symptoms and signs; and they prescribe medication, psychotherapy, or both, accordingly. However, despite a dramatic expansion of knowledge about mental disorders during the past half century, understanding of their components and processes remains rudimentary. We provide histories and descriptions of three systems with different purposes relevant to understanding and classifying mental disorder. Two major diagnostic manuals—the International Classification of Diseases and the Diagnostic and Statistical Manual of Mental Disorders—provide classification systems relevant to public health, clinical diagnosis, service provision, and specific research applications, the former internationally and the latter primarily for the United States. In contrast, the National Institute of Mental Health’s Research Domain Criteria provides a framework that emphasizes integration of basic behavioral and neuroscience research to deepen the understanding of mental disorder. We identify four key issues that present challenges to understanding and classifying mental disorder: etiology, including the multiple causality of mental disorder; whether the relevant phenomena are discrete categories or dimensions; thresholds, which set the boundaries between disorder and nondisorder; and comorbidity, the fact that individuals with mental illness often meet diagnostic requirements for multiple conditions. We discuss how the three systems’ approaches to these key issues correspond or diverge as a result of their different histories, purposes, and constituencies. Although the systems have varying degrees of overlap and distinguishing features, they share the goal of reducing the burden of suffering due to mental disorder.

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Crossref · 10.1177/1529100617727266

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Authors
Clark, L. A., Cuthbert, B., Lewis-Fernández, R., Narrow, W. E., & Reed, G. M.
Affiliations
  • University of Notre Dame (US)
  • National Institute of Mental Health (US)
  • Department of Psychiatry, Columbia University, New York State Psychiatric Institute
  • University of New Mexico (US)
  • Columbia University Irving Medical Center (US)
Corresponding author
Clark, Lee Anna
Venue
Psychological Science in the Public Interest
Published
2017-11
Volume
18
Issue
2
Pages
72-145
ISSN
  • 1539-6053 (ISSN-L)
  • 1529-1006
OpenAlex
W2773726752
Cited by
688
References
249
Citations by year
2026: 56 · 2025: 62 · 2024: 72 · 2023: 93 · 2022: 89 · 2021: 80 · 2020: 133 · 2019: 64 · 2018: 37 · 2017: 2
FWCI
417.92
Type
journal article
Language
en
Open access
closed
Locations
  • Gothic.net (publishedVersion)
  • PubMed (publishedVersion)
Funders
World Health Organization
Topics
  • Social Sciences › Arts and Humanities › Philosophy › Mental Health and Psychiatry
  • Social Sciences › Psychology › Clinical Psychology › Psychology and Mental Health
  • Social Sciences › Psychology › Clinical Psychology › Personality Disorders and Psychopathology
Keywords
mental disorder classification, ICD-11, DSM-5, Research Domain Criteria, diagnostic classification systems, etiology of mental disorders, diagnostic thresholds, comorbidities, history of psychiatry
MeSH terms
Mental Disorders, Humans, National Institute of Mental Health (U.S.), United States, Comorbidity, International Classification of Diseases, Diagnostic and Statistical Manual of Mental Disorders

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