Heterotypic patterns, psychopathology beyond symptomatology, and the legacy constructs of the DSM-ICD.

Abstract

This article extends the ideas expressed in a special section on theories of psychopathology by expounding on heterotypic patterns in which different arrangements of symptoms appear over time. With heterotypic continuity, the different arrangements are somewhat predictable; with discontinuity, they are not. Among the reasons the articles in the special section give for heterotypic patterns are the lack of central controllers for producing symptom clusters, the importance of transdiagnostic factors, and the dynamics of gene-environment correlations. The articles also consider what more there is to psychopathology than symptoms—largely by modeling normal, adaptive psychology as flexible and maladaptive psychology too rigid or too pliable. The articles espouse a variety of views on the Diagnostic and Statistical Manual of Mental Disorders (DSM) and International Classification of Diseases (ICD) legacy disorders moving forward, with some of them seeking to eliminate DSM-ICD categories from the classification of psychopathology and others seeing the DSM-ICD constructs as having continued roles to play. I use Lakatos’ notion that elimination of a theory requires that an alternative theory demonstrate competitive superiority to account for why legacy constructs have not been eliminated. I examine a debate about the existence or not of basic emotions and apply it to psychopathology to identify a common ground or potential point of agreement between those who want to eliminate DSM-ICD categories and those who believe DSM-ICD constructs can continue to be useful moving forward.