Developmentally sensitive diagnostic criteria for mental health disorders in early childhood: The diagnostic and statistical manual of mental disorders—IV, the research diagnostic criteria—preschool age, and the Diagnostic Classification of Mental Health and Developmental Disorders of Infancy and Early Childhood—Revised.

As the infant mental health field has turned its focus to the presentation, course, and treatment of clinically significant mental health disorders, the need for reliable and valid criteria for identifying and assessing mental health symptoms and disorders in early childhood has become urgent. In this article we offer a critical perspective on diagnostic classification of mental health disorders in young children. We place the issue of early childhood diagnosis within the context of classification of psychopathology at other ages and describe, in some detail, diagnostic classifications that have been developed specifically for young children, including the Diagnostic Classification of Mental Health and Developmental Disorders of Infancy and Early Childhood (DC:0–3R; ZERO TO THREE, 2005), a diagnostic classification for mental health symptoms and disorders in infants, toddlers, and preschoolers. We briefly outline the role of diagnostic classification in clinical assessment and treatment planning. Last, we review the limitations of current approaches to the diagnostic classification of mental health disorders in young children. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Developmental pathways in oppositional defiant disorder and conduct disorder.

The Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM–IV; American Psychiatric Association, 1994) specifies a developmental relationship between oppositional defiant disorder (ODD) and conduct disorder (CD). Evidence for this link is mixed, however, and recent studies suggest that different symptom dimensions in ODD may have different outcomes. The authors examined links between ODD, CD, and their young adult outcomes in the Great Smoky Mountains Study (E. J. Costello et al., 1996), a longitudinal data set with over 8,000 observations of 1,420 individuals (56% male) covering ages 9–21 years. ODD was a significant predictor of later CD in boys but not in girls after control for comorbid CD and subthreshold CD symptomatology. Transitions between ODD and CD were less common than anticipated, however, particularly during adolescence. The authors examined characteristics and outcomes of children with pure ODD, pure CD, and combined CD/ODD. Alongside many similarities in childhood and adolescent correlates, key differences were also identified: CD largely predicted behavioral outcomes, whereas ODD showed stronger prediction to emotional disorders in early adult life. Factor analysis identified irritable and headstrong dimensions in ODD symptoms that showed differential prediction to later behavioral and emotional disorders. Overall, the results underscore the utility of retaining separate ODD and CD diagnoses in DSM–V. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Emotional disorders in primary care.

Individuals with emotional disorders are more likely to use primary medical care than specialty mental health services, but these disorders are likely to be undetected or inadequately treated. Recognition of the importance of primary medical care for the treatment of mental disorder has resulted in pressing new research priorities. One set of issues concerns the adequacy of existing nosological systems for conceptualizing emotional disorder in primary care and identifying need for treatment. Another concerns the difficulties translating efficacious treatment into effective strategies that can be integrated into the competing demands of primary medical care. Psychologists have played only a limited role in defining and addressing emerging questions. Irreversible changes in mental health services have created the need for the development of a psychosocial perspective for what would otherwise be defined as narrowly biomedical issues. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A personality trait model for the Diagnostic and Statistical Manual of Mental Disorders (DSM): The challenges ahead.

Replies to comments (see record 2010-13810-004), (see record 2010-13810-005), (see record 2010-13810-006), (see record 2010-13810-007) on the original article Personality traits and the classification of mental Disorders: Toward a more complete integration in DSM–5 and an empirical model of psychopathology by Robert F. Krueger and Nicholas R. Eaton (see record 2010-13810-003). We were sincerely flattered to discover that John Gunderson, Michael First, Paul Costa, Robert McCrae, Michael Hallquist, and Paul Pilkonis provided commentaries on our target article. In this brief response, we cannot hope to discuss the myriad points raised by this august group. Such a task would be particularly daunting given the diversity of the commentaries. Indeed, the diversity of the commentaries provides a kind of “metacommentary” on the state of personality and psychopathology research. That is, the intellectual diversity contained in the commentaries underlines the substantial challenges that lie ahead of us, in terms of articulating a model of personality and psychopathology with both scientific validity and clinical applicability. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Introduction to the special issue on diagnoses, dimensions, and DSM-IV: The science of classification.

This special issue grew out of a meeting of the editorial board of the Journal of Abnormal Psychology chaired by Susan Mineka at the annual meeting of the American Psychological Association in 1989 in New Orleans. At that time the processes were in place for developing the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV), and it was clear that for the first time many psychologists were strongly involved. In addition, committees were completing work on the mental disorders section of the 10th edition of the International Classification of Diseases and Related Health Problems (ICD-10; World Health Organization, 1990), and a concerted effort was underway to make the DSM-IV and ICD-10 as compatible as possible. These developments pointed to something that approaches a worldwide system of nosology for use in both clinical and research endeavors. Quite naturally, these events have resulted in renewed interest in nosology, particularly the scientific basis of our nosological systems. The board felt that a series of invited papers on various scientific issues in this area might be very useful to the field. It also agreed that it would be important to concentrate on the scientific approaches to classification and the scientific underpinnings of the DSM-IV as it approximates some ideal. (PsycINFO Database Record (c) 2010 APA, all rights reserved)