How the DSM Is Used in Clinical Practice

First, Michael B.; Erlich, Matthew D.; Adler, David A.; Leong, Shirley H.; Dixon, Lisa B.; Oslin, David W.; Goldman, Beth; Koh, Steve; Levine, Bruce; Berlant, Jeffrey; Siris, Samuel G.

doi:10.1097/nmd.0000000000000953

Cited by 15 publications

(15 citation statements)

References 11 publications

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“…Our main results precisely pertain to a criterion-based diagnosis and not to prototype-based diagnostic conceptions. In this regard, it is known that clinicians do not algorithmically apply DSM criteria in reaching diagnoses, and that the criteria are prone to be differentially weighted and applied [29, 56, 57]. Hence, additional studies of the AMPD with respect to BPD in naturalistic settings are needed.…”

Section: Discussionmentioning

confidence: 99%

Borderline personality disorder diagnosis in a new key

Mulay

Waugh

Fillauer

et al. 2019

bord personal disord emot dysregul

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BackgroundConceptualizations of personality disorders (PD) are increasingly moving towards dimensional approaches. The definition and assessment of borderline personality disorder (BPD) in regard to changes in nosology are of great importance to theory and practice as well as consumers. We studied empirical connections between the traditional DSM-5 diagnostic criteria for BPD and Criteria A and B of the Alternative Model for Personality Disorders (AMPD).MethodRaters of varied professional backgrounds possessing substantial knowledge of PDs (N = 20) characterized BPD criteria with the four domains of the Level of Personality Functioning Scale (LPFS) and 25 pathological personality trait facets. Mean AMPD values of each BPD criterion were used to support a nosological cross-walk of the individual BPD criteria and study various combinations of BPD criteria in their AMPD translation. The grand mean AMPD profile generated from the experts was compared to published BPD prototypes that used AMPD trait ratings and the DSM-5-III hybrid categorical-dimensional algorithm for BPD. Divergent comparisons with DSM-5-III algorithms for other PDs and other published PD prototypes were also examined.ResultsInter-rater reliability analyses showed generally robust agreement. The AMPD profile for BPD criteria rated by individual BPD criteria was not isomorphic with whole-person ratings of BPD, although they were highly correlated. Various AMPD profiles for BPD were generated from theoretically relevant but differing configurations of BPD criteria. These AMPD profiles were highly correlated and showed meaningful divergence from non-BPD DSM-5-III algorithms and other PD prototypes.ConclusionsResults show that traditional DSM BPD diagnosis reflects a common core of PD severity, largely composed of LPFS and the pathological traits of anxiousness, depressively, emotional lability, and impulsivity. Results confirm the traditional DSM criterion-based BPD diagnosis can be reliably cross-walked with the full AMPD scheme, and both approaches share substantial construct overlap. This relative equivalence suggests the vast clinical and research literatures associated with BPD may be brought forward with DSM-5-III diagnosis of BPD.

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Section: Discussionmentioning

confidence: 99%

Borderline personality disorder diagnosis in a new key

Mulay

Waugh

Fillauer

et al. 2019

bord personal disord emot dysregul

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“…Although past efforts at improving official diagnoses focused on improving the specification and reliability of criteria, the current revision shifted to prioritizing improvements in clinical utility (First et al, 2015; International Advisory Group for the Revision of ICD-10, 2011). This decision was responsive to observations that operationalized criteria tended to be too long and complicated (Hyman, 2007;Keeley et al, 2016;Maj, 2015;Reed, 2010) to be useful in clinical practice (First et al, 2019).…”

Section: The Current State Of Official Diagnostic Criteria In Icd-11 and Dsm-5mentioning

confidence: 99%

Commentary on evidence in support of a grief‐related condition as a DSM diagnosis

et al. 2020

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The death of a loved one is one of life's greatest stressors. Most bereaved individuals experience a period of acute grief that diminishes in intensity as they adapt to the changes brought about by their loss. Over the past four decades a growing body of research has focused on a form of prolonged grief that is painful and impairing. There is a substantial and growing evidence base supports the validity and significance of a grief-related disorder, including the clinical value of being able to diagnose it and provide effective targeted treatment. ICD-11 will include a new diagnosis of Prolonged Grief Disorder (PGD). DSM-5 called this condition Persistent Complex Bereavement Disorder (PCBD) and included it in Section III, signaling agreement that a diagnosis is warranted while further research is needed to determine the optimal criteria. Given the remaining uncertainties, reading this literature can be confusing. There is inconsistency in naming the condition (including complicated grief as well as PGD and PCBD) and lack of uniformity in identifying it, with respect to the optimal threshold and timeframe for distinguishing it from normal grief. As an introductory commentary for this Depression and Anxiety special edition on this form of grief, the authors discuss the history, commonalities, and key areas of variability in

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“…Finally, a recent study shows that clinicians do often explicitly consider DSM diagnostic criteria in clinical settings. First et al ([2019]) write that 'a majority of clinicians review the DSM criteria either from memory or in written form to determine whether diagnostic criteria are met during the initial assessment' (p.160).…”

Section: Ronald Giere's Philosophy Of Sciencementioning

confidence: 99%

The Value of Categorical Polythetic Diagnoses in Psychiatry

Fellowes¹

2022

The British Journal for the Philosophy of Science

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Forthcoming in the British Journal for the Philosophy of Science Some critics argue that the type of psychiatric diagnosis found in the DSM and ICD are superfluous and should be abandoned. These are known as categorical polythetic psychiatric diagnoses. To receive a categorical polythetic psychiatric diagnosis an individual need only exhibit some, rather than all, of the symptoms on the diagnostic criteria. Consequently, categorical polythetic psychiatric diagnoses only associate an individual with a range of symptoms rather than specify which symptoms they have. Drawing upon Ronald Giere's account of scientific models, I portray categorical polythetic psychiatric diagnoses as abstract models which guide the building of less abstract models.These models can specify which symptoms a particular individual has.Additionally, categorical polythetic psychiatric diagnoses can guide investigation of symptoms towards difficult to spot symptoms, guide investigation towards changing symptoms and guide investigation towards how symptoms manifest. These important roles mean categorical polythetic psychiatric diagnoses should not be abandoned. assist accurately detecting symptoms 4.2 Advantage two: Categorical polythetic psychiatric diagnoses can assist with detecting changing symptoms 4.3 Advantage three: Categorical polythetic psychiatric diagnoses can associate symptoms with more specific behaviour 5 Broadening The Argument Beyond ASD

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How the DSM Is Used in Clinical Practice

Cited by 15 publications

References 11 publications

Borderline personality disorder diagnosis in a new key

Borderline personality disorder diagnosis in a new key

Commentary on evidence in support of a grief‐related condition as a DSM diagnosis

The Value of Categorical Polythetic Diagnoses in Psychiatry

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