scholarly journals HiTOP Is Not an Improvement Over the DSM

2022 ◽  
pp. 216770262110688
Author(s):  
Gerald J. Haeffel ◽  
Bertus F. Jeronimus ◽  
Aaron J. Fisher ◽  
Bonnie N. Kaiser ◽  
Lesley Jo Weaver ◽  
...  
Keyword(s):  
Factor Analysis ◽  
Mental Disorders ◽  
Simple Structure ◽  
Dimensional Space ◽  
Clinical Settings ◽  
Clinical Judgments ◽  
Statistical Manual ◽  
Folk Classification ◽  
Diagnostic And Statistical Manual ◽  
Factor Analytic

In their response to our article (both in this issue), DeYoung and colleagues did not sufficiently address three fundamental flaws with the Hierarchical Taxonomy of Psychopathology (HiTOP). First, HiTOP was created using a simple-structure factor-analytic approach, which does not adequately represent the dimensional space of the symptoms of psychopathology. Consequently, HiTOP is not the empirical structure of psychopathology. Second, factor analysis and dimensional ratings do not fix the problems inherent to descriptive (folk) classification; self-reported symptoms are still the basis on which clinical judgments about people are made. Finally, HiTOP is not ready to use in real-world clinical settings. There is currently no empirical evidence demonstrating that clinicians who use HiTOP have better clinical outcomes than those who use the Diagnostic and Statistical Manual of Mental Disorders ( DSM). In sum, HiTOP is a factor-analytic variation of the DSM that does not get the field closer to a more valid and useful taxonomy.

Folk Classification and Factor Rotations: Whales, Sharks, and the Problems With the Hierarchical Taxonomy of Psychopathology (HiTOP)

2021 ◽  
pp. 216770262110025
Author(s):  
Gerald J. Haeffel ◽  
Bertus F. Jeronimus ◽  
Bonnie N. Kaiser ◽  
Lesley Jo Weaver ◽  
Peter D. Soyster ◽  
...  
Keyword(s):  
Theory Building ◽  
Clinical Settings ◽  
Current Form ◽  
Statistical Manual ◽  
Folk Classification ◽  
Underrepresented Groups ◽  
Diagnostic And Statistical Manual ◽  
High Degree ◽  
Group Self ◽  
Algorithmic Bias

The Hierarchical Taxonomy of Psychopathology (HiTOP) uses factor analysis to group self-reported symptoms of mental illness (i.e., like goes with like). It is hailed as a significant improvement over other diagnostic taxonomies. However, the purported advantages and fundamental assumptions of HiTOP have received little, if any, scientific scrutiny. We critically evaluated five fundamental claims about HiTOP. We conclude that HiTOP does not demonstrate a high degree of verisimilitude and has the potential to hinder progress on understanding the etiology of psychopathology. It does not lend itself to theory building or taxonomic evolution, and it cannot account for multifinality, equifinality, or developmental and etiological processes. In its current form, HiTOP is not ready to use in clinical settings and may result in algorithmic bias against underrepresented groups. We recommend a bifurcation strategy moving forward in which the Diagnostic and Statistical Manual of Mental Disorders is used in clinical settings while researchers focus on developing a falsifiable theory-based classification system.

Angststörungen – von der ICD-10 zur ICD-11

2020 ◽  
pp. 1-5
Author(s):  
Timo D. Vloet ◽  
Marcel Romanos
Keyword(s):  
Mental Disorders ◽  
International Classification Of Diseases ◽  
International Classification ◽  
Statistical Manual ◽  
Diagnostic And Statistical Manual ◽  
Dsm 5 ◽  
Classification Of Diseases ◽  
Icd 10

Zusammenfassung. Hintergrund: Nach 12 Jahren Entwicklung wird die 11. Version der International Classification of Diseases (ICD-11) von der Weltgesundheitsorganisation (WHO) im Januar 2022 in Kraft treten. Methodik: Im Rahmen eines selektiven Übersichtsartikels werden die Veränderungen im Hinblick auf die Klassifikation von Angststörungen von der ICD-10 zur ICD-11 zusammenfassend dargestellt. Ergebnis: Die diagnostischen Kriterien der generalisierten Angststörung, Agoraphobie und spezifischen Phobien werden angepasst. Die ICD-11 wird auf Basis einer Lebenszeitachse neu organisiert, sodass die kindesaltersspezifischen Kategorien der ICD-10 aufgelöst werden. Die Trennungsangststörung und der selektive Mutismus werden damit den „regulären“ Angststörungen zugeordnet und können zukünftig auch im Erwachsenenalter diagnostiziert werden. Neu ist ebenso, dass verschiedene Symptomdimensionen der Angst ohne kategoriale Diagnose verschlüsselt werden können. Diskussion: Die Veränderungen im Bereich der Angsterkrankungen umfassen verschiedene Aspekte und sind in der Gesamtschau nicht unerheblich. Positiv zu bewerten ist die Einführung einer Lebenszeitachse und Parallelisierung mit dem Diagnostic and Statistical Manual of Mental Disorders (DSM-5). Schlussfolgerungen: Die entwicklungsbezogene Neuorganisation in der ICD-11 wird auch eine verstärkte längsschnittliche Betrachtung von Angststörungen in der Klinik sowie Forschung zur Folge haben. Damit rückt insbesondere die Präventionsforschung weiter in den Fokus.

Validación de la escala de sintomas somáticos (SSS-8) en pacientes de una zona rural en Ecuador

2018 ◽  
Vol 3 (2) ◽  
Author(s):  
Mercy García ◽  
Ernestina Tamami ◽  
Giovanni Rojas-Velasco ◽  
Carolina Posso ◽  
Galo Sánchez del Hierro ◽  
...  
Keyword(s):  
Mental Disorders ◽  
Somatic Symptom ◽  
Symptom Scale ◽  
Statistical Manual ◽  
Diagnostic And Statistical Manual ◽  
Calidad De Vida ◽  
Dsm V ◽  
Scale 8

Introducción.- Los síntomas somáticos causan malestar y afectan la calidad de  vida de los pacientes, incrementando la frecuencia del uso de los servicios de salud. En Ecuador no existe un instrumento validado que evalúe somatización. La escala Somatic Symtom Scale-8 (SSS-8), es un instrumento usado como medida de referencia en the Diagnostic and Statistical Manual of Mental Disorders(DSM-V), para evaluar la carga de síntomas somáticos, validada en inglés y adaptada culturalmente a los idiomas alemán y japonés. Objetivos.- En esta investigación el propósito fue validar la escala “Somatic Symptom Scale-8” y determinar sus propiedades métricas. Métodos.- Investigación descriptiva y transversal en la que se realizó la validación de la herramienta clínica SSS-8 en 401 pacientes en la consulta externa del hospital Pedro Vicente Maldonado, desde mayo a julio de 2017. Para el análisis de datos se utilizaron los programas estadísticos SPSS versión 23, Latent gold y EpiDat 3.1. Resultados.- El grupo mayoritario fue de 30 a 47 años, con ligero predominio del sexo masculino (con 52,6%) sobre el femenino (47,4%). El SSS-8 mostró adecuadas propiedades métricas (alfa de Cronbach de 0,73). Mediante este análisis se obtuvo que, los pacientes que respondieron: algo, bastante o muchísimo en las dimensiones sentirse cansado, dolor de cabeza, dolor de brazos y dolor de espalda; tenían un 99% de probabilidades de presentar somatización. Conclusiones.- En este estudio, el SSS-8 demostró ser una herramienta útil para evaluar los síntomas somáticos en pacientes que acuden a consulta externa, ya que presentó buenas propiedades métricas: consistencia interna elevada, buena validez y una apropiada capacidad discriminativa.

Diagnoses, Dimensions, and DSM-5

2010 ◽  
pp. 254-279
Author(s):  
Thomas A. Widiger ◽  
Maryanne Edmundson
Keyword(s):  
Substance Use ◽  
Mental Disorders ◽  
Paradigm Shift ◽  
Empirical Support ◽  
Statistical Manual ◽  
Diagnostic And Statistical Manual ◽  
Dsm 5 ◽  
Dimensional Classification ◽  
Diagnosis And Classification

The Diagnostic and Statistical Manual of Mental Disorders, Third Edition (DSM-III) is often said to have provided a significant paradigm shift in how psychopathology is diagnosed. The authors of DSM-5 have the empirical support and the opportunity to lead the field of psychiatry to a comparably bold new future in diagnosis and classification. The purpose of this chapter is to address the validity of the categorical and dimensional models for the classification and diagnosis of psychopathology. Considered in particular will be research concerning substance use disorders, mood disorders, and personality disorders. Limitations and concerns with respect to a dimensional classification of psychopathology are also considered. The chapter concludes with a recommendation for a conversion to a more quantitative, dimensional classification of psychopathology.

scholarly journals Use of empathy in psychiatric practice: Constructivist grounded theory study

BJPsych Open ◽  
2017 ◽  
Vol 3 (1) ◽  
pp. 26-33 ◽  
Author(s):  
James Ross ◽  
Chris Watling
Keyword(s):  
Grounded Theory ◽  
Mental Disorders ◽  
Major Elements ◽  
Qualitative Theory ◽  
Constructivist Grounded Theory ◽  
Psychiatric Practice ◽  
Teaching Approaches ◽  
Statistical Manual ◽  
Diagnostic And Statistical Manual ◽  
Iterative Coding

BackgroundPsychiatry has faced significant criticism for overreliance on the Diagnostic and Statistical Manual of Mental Disorders (DSM) and medications with purported disregard for empathetic, humanistic interventions.AimsTo develop an empirically based qualitative theory explaining how psychiatrists use empathy in day-to-day practice, to inform practice and teaching approaches.MethodThis study used constructivist grounded theory methodology to ask (a) ‘How do psychiatrists understand and use empathetic engagement in the day-to-day practice of psychiatry?’ and (b) ‘How do psychiatrists learn and teach the skills of empathetic engagement?’ The authors interviewed 17 academic psychiatrists and 4 residents and developed a theory by iterative coding of the collected data.ResultsThis constructivist grounded theory of empathetic engagement in psychiatric practice considered three major elements: relational empathy, transactional empathy and instrumental empathy. As one moves from relational empathy through transactional empathy to instrumental empathy, the actions of the psychiatrist become more deliberate and interventional.ConclusionsParticipants were described by empathy-based interventions which are presented in a theory of ‘empathetic engagement’. This is in contrast to a paradigm that sees psychiatry as purely based on neurobiological interventions, with psychotherapy and interpersonal interventions as completely separate activities from day-to-day psychiatric practice.

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