Rethinking Categories and Dimensions in the DSM

Author(s):  
James Phillips

Abstract This paper addresses the role of categories and dimensions in the classification of psychopathology. While psychopathology does not sort itself out neatly into natural categories, we do find rough, symptom-based groupings that, through refinement, become diagnostic categories. Given that these categories suffer from comorbidity, uncertain boundaries, and excessive “unspecified disorder” diagnoses, there has been a move toward refining the diagnoses with dimensional measures. The paper traces efforts both to improve the diagnostic categories with validators that allow at least partial validity and to introduce dimensional measures into the diagnostic manual. Drawing from the philosophical pragmatism of Charles Sanders Peirce, William James, and John Dewey, which emphasizes the practical, effect-sensitive consequences of a theory along with an emphasis on empirical evidence and the progressive, probabilistic character of knowledge, the paper argues that these efforts must be guided both by scientific validity and clinical utility.

2020 ◽  
Vol 22 (1) ◽  
pp. 81-85 ◽  

The Research Domain Criteria (RDoC) project constitutes a translational framework for psychopathology research, initiated by the National Institute of Mental Health in an attempt to provide new avenues for research to circumvent problems emerging from the use of symptom-based diagnostic categories in diagnosing disorders. The RDoC alternative is a focus on psychopathology based on dimensions simultaneously defined by observable behavior (including quantitative measures of cognitive or affective behavior) and neurobiological measures. Key features of the RDoC framework include an emphasis on functional dimensions that range from normal to abnormal, integration of multiple measures in study designs (which can foster computational approaches), and high priority on studies of neurodevelopment and environmental influences (and their interaction) that can contribute to advances in understanding the etiology of disorders throughout the lifespan. The paper highlights key implications for ways in which RDoC can contribute to future ideas about classification, as well as some of the considerations involved in translating basic behavioral and neuroscience data to psychopathology.


2020 ◽  
Vol 22 (1) ◽  
pp. 7-15 ◽  

This article provides a brief overview of the changes from ICD-10 to ICD-11 regarding the classification of mental, behavioral, or neurodevelopmental disorders. These changes include a new chapter structure, new diagnostic categories, changes in diagnostic criteria, and steps towards dimensionality. Additionally, we review evaluative field studies of ICD-11, which provide preliminary evidence for higher reliability and clinical utility of ICD-11 compared with ICD-10. Despite the extensive revision process, changes from ICD-10 to ICD-11 were relatively modest in that both systems are categorical, classifying mental phenomena based on self-reported or clinically observable symptoms. Other recent approaches to psychiatric nosology and classification (eg, neurobiology-based or hierarchical) are discussed. To meet the needs of different user groups, we propose expanding the stepwise approach to diagnosis introduced for some diagnostic categories in ICD-11, which includes categorical and dimensional elements.


Crisis ◽  
2016 ◽  
Vol 37 (3) ◽  
pp. 212-217 ◽  
Author(s):  
Thomas E. Joiner ◽  
Melanie A. Hom ◽  
Megan L. Rogers ◽  
Carol Chu ◽  
Ian H. Stanley ◽  
...  

Abstract. Background: Lowered eye blink rate may be a clinically useful indicator of acute, imminent, and severe suicide risk. Diminished eye blink rates are often seen among individuals engaged in heightened concentration on a specific task that requires careful planning and attention. Indeed, overcoming one’s biological instinct for survival through suicide necessitates premeditation and concentration; thus, a diminished eye blink rate may signal imminent suicidality. Aims: This article aims to spur research and clinical inquiry into the role of eye blinks as an indicator of acute suicide risk. Method: Literature relevant to the potential connection between eye blink rate and suicidality was reviewed and synthesized. Results: Anecdotal, cognitive, neurological, and conceptual support for the relationship between decreased blink rate and suicide risk is outlined. Conclusion: Given that eye blinks are a highly observable behavior, the potential clinical utility of using eye blink rate as a marker of suicide risk is immense. Research is warranted to explore the association between eye blink rate and acute suicide risk.


2007 ◽  
pp. 80-92
Author(s):  
A. Kireev

The paper studies the problem of raiders activity on the market for corporate control. This activity is considered as a product of coercive entrepreneurship evolution. Their similarities and sharp distinctions are shown. The article presents the classification of raiders activity, discribes its basic characteristics and tendencies, defines the role of government in the process of its transformation.


Author(s):  
Petar Halachev ◽  
Victoria Radeva ◽  
Albena Nikiforova ◽  
Miglena Veneva

This report is dedicated to the role of the web site as an important tool for presenting business on the Internet. Classification of site types has been made in terms of their application in the business and the types of structures in their construction. The Models of the Life Cycle for designing business websites are analyzed and are outlined their strengths and weaknesses. The stages in the design, construction, commissioning, and maintenance of a business website are distinguished and the activities and requirements of each stage are specified.


2020 ◽  
Vol 63 (4) ◽  
pp. 115-131
Author(s):  
Maria M. Kuznetsova

The article examines the philosophy of Henri Bergson and William James as independent doctrines aimed at rational comprehension of spiritual reality. The doctrines imply the paramount importance of consciousness, the need for continuous spiritual development, the expansion of experience and perception. The study highlights the fundamental role of spiritual energy for individual and universal evolution, which likens these doctrines to the ancient Eastern teaching as well as to Platonism in Western philosophy. The term “spiritual energy” is used by Bergson and James all the way through their creative career, and therefore this concept should considered in the examination of their solution to the most important philosophical and scientific issues, such as the relationship of matter and spirit, consciousness and brain, cognition, free will, etc. The “radical empiricism” of William James and the “creative evolution” of Henry Bergson should be viewed as conceptions that based on peacemaking goals, because they are aimed at reconciling faith and facts, science and religion through the organic synthesis of sensory and spiritual levels of experience. Although there is a number of modern scientific discoveries that were foreseen by philosophical ideas of Bergson and James, both philosophers advocate for the artificial limitation of the sphere of experimental methods in science. They call not to limit ourselves to the usual intellectual schemes of reality comprehension, but attempt to touch the “living” reality, which presupposes an increase in the intensity of attention and will, but finally brings us closer to freedom.


Author(s):  
Robert Hasegawa

Musicians have long framed their creative activity within constraints, whether imposed externally or consciously chosen. As noted by Leonard Meyer, any style can be viewed as an ensemble of constraints, requiring the features of the artwork to conform with accepted norms. Such received stylistic constraints may be complemented by additional, voluntary limitations: for example, using only a limited palette of pitches or sounds, setting rules to govern repetition or transformation, controlling the formal layout and proportions of the work, or limiting the variety of operations involved in its creation. This chapter proposes a fourfold classification of the limits most often encountered in music creation into material (absolute and relative), formal, style/genre, and process constraints. The role of constraints as a spur and guide to musical creativity is explored in the domains of composition, improvisation, performance, and even listening, with examples drawn from contemporary composers including György Ligeti, George Aperghis, and James Tenney. Such musical constraints are comparable to self-imposed limitations in other art forms, from film (the Dogme 95 Manifesto) and visual art (Robert Morris’s Blind Time Drawings) to the writings of authors associated with the Oulipo (Ouvroir de littérature potentielle) such as Georges Perec and Raymond Queneau.


Author(s):  
Victor L. Shabanov ◽  
Marianna Ya Vasilchenko ◽  
Elena A. Derunova ◽  
Andrey P. Potapov

The aim of the work is to find relevant indicators for assessing the relationship between investments in fixed assets in agriculture, gross output of the industry, and agricultural exports using tools for modeling the impact of innovation and investment development on increasing production and export potential in the context of the formation of an export-oriented agricultural economy. The modeling methodology and the proposed estimating and forecasting tools for diagnosing and monitoring the state of sectoral and regional innovative agricultural systems are used to analyze the relationship between investments in fixed assets in agriculture, gross output of the industry, and agricultural exports based on the construction of the classification of Russian regions by factors that aggregate these features to diagnose incongruence problems and to improve institutional management in regional innovative export-oriented agrosystems. Based on the results of the factor analysis application, an underestimated role of indicators of investment in agriculture, the intensity and efficiency of agricultural production, were established. Based on the results of the cluster analysis, the established five groups of regions were identified, with significant differences in the level of investment in agriculture, the volume of production of the main types of agricultural products, and the export and exported food. The research results are of practical value for use in improving institutional management when planning reforms and transformations of regional innovative agrosystems.


2021 ◽  
Vol 4 (2) ◽  
pp. e000196
Author(s):  
Yue Wu ◽  
Xiaosi Jin ◽  
Yuhao Zhang ◽  
Jing Zheng ◽  
Rulai Yang

Congenital heart disease (CHD) is the most common of congenital cardiovascular malformations associated with birth defects, and it results in significant morbidity and mortality worldwide. The classification of CHD is still elusive owing to the complex pathogenesis of CHD. Advances in molecular medicine have revealed the genetic basis of some heart anomalies. Genes associated with CHD might be modulated by various epigenetic factors. Thus, the genetic and epigenetic factors are gradually accepted as important triggers in the pathogenesis of CHD. However, few literatures have comprehensively elaborated the genetic and epigenetic mechanisms of CHD. This review focuses on the etiology of CHD from genetics and epigenetics to discuss the role of these factors in the development of CHD. The interactions between genetic and epigenetic in the pathogenesis of CHD are also elaborated. Chromosome abnormalities and gene mutations in genetics, and DNA methylations, histone modifications and on-coding RNAs in epigenetics are summarized in detail. We hope the summative knowledge of these etiologies may be useful for improved diagnosis and further elucidation of CHD so that morbidity and mortality of children with CHD can be reduced in the near future.


ESMO Open ◽  
2021 ◽  
Vol 6 (2) ◽  
pp. 100040 ◽  
Author(s):  
R. Danesi ◽  
S. Fogli ◽  
S. Indraccolo ◽  
M. Del Re ◽  
A.P. Dei Tos ◽  
...  

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