Externalizing disorders: Cluster 5 of the proposed meta-structure for DSM-V and ICD-11

Abstract

"Externalizing disorders: Cluster 5 of the proposed meta-structure for DSM-V and ICD-11." Psychological Medicine.39,12. 2061-2070. http://digitalcommons.wustl.edu/open_access_pubs/3931Externalizing disorders: Cluster 5 of the proposed meta-structure for DSM-V and ICD-11Paper 6 of 7 of the thematic section : ' A proposal for a meta-structure for DSM-V and ICD-11 ' R. F. Krueger 1 * and S. C. South 2 1 Departments of Psychology and Psychiatry, Washington University in St Louis, St Louis, MO, USA 2 Department of Psychology, Purdue University, Lafayette, IN, USA 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.

The Hierarchical Taxonomy of Psychopathology (HiTOP): A Dimensional Alternative to Traditional Nosologies

“…This meta-structure project examined internalizing/emotional (consisting of DSM-IV anxiety, depressive and somatoform disorders, and neurasthenia), disinhibited externalizing (conduct, antisocial personality, and substancerelated disorders), thought disorder/psychotic (schizophrenia spectrum disorders, schizotypal PD, and bipolar I disorder), neurocognitive (delirium, dementias, amnestic and other cognitive disorders), and neurodevelopmental (learning, motor skills and communication disorders, pervasive developmental disorders, and mental retardation) spectra. Overall, data for validators included in the reviews generally supported the coherence of these five spectra (Andrews, Pine et al, 2009;Carpenter et al, 2009;Goldberg, Krueger, Andrews, & Hobbs, 2009;Krueger & South, 2009;Sachdev et al, 2009), and more recent reviews have continued to support these conclusions (Beauchaine & McNulty, 2013;Eaton, Rodriguez-Seijas, Carragher, & Krueger, 2015;Nelson et al, 2013).…”

Clustering of psychiatric and somatic illnesses in the general population: multimorbidity and socioeconomic correlates

“…Examples are the rate of 29.7% for medical multimorbidity in the general practice setting found by van den Akker et al (20), and of 6% for 12-month psychiatric comorbidity in the NCS-R (8). Recently, the pattern of comorbidity of major mental disorders (e.g., internalizing anxiety and depressive disorders, and externalizing disorders such as alcohol/substance use disorders and behavioral disorders) has been extensively explored through different multivariate techniques in large population-based data sets (23,24), underscoring the importance of this topic. This debate calls attention to the natural co-occurrence of psychiatric morbidities and may improve future schemes of diagnostic classification.…”

Modelo estrutural de internalização e externalização: emergência, validade e utilidade clínica

“…Esse modelo ainda teria importantes implicações conceituais no que tange a compreensão da relação entre psicopatologias e traços do temperamento e da personalidade (de Carvalho, 2012;Krueger et al, 2007) e a sobreposição neurobiológica e psicofarmacológica entre diferentes transtornos mentais . Por fi m, é um modelo apresentado como uma proposta para reformulação dos manuais oficiais de diagnóstico e classifi cação psiquiátrica, tendo um potencial efeito na conduta clínica de profi ssionais e pesquisadores em nível mundial (Goldberg, Krueger, Andrews, & Hobbs, 2009;Krueger & South, 2009).…”