Three Approaches to Understanding and Classifying Mental Disorder: ICD-11, DSM-5 , and the National Institute of Mental Health’s Research Domain Criteria (RDoC)

作者：Lee Anna Clark, Bruce N. Cuthbert, Roberto Lewis‐Fernández, William E. Narrow, Geoffrey M. Reed · 发表于：Gothic.net · 年份：2017 · DOI：10.1177/1529100617727266 · 被引用次数：700 · 研究领域：Mental Health and Psychiatry、Personality Disorders and Psychopathology、Mental Health Treatment and Access

The diagnosis of mental disorder initially appears relatively straightforward: Patients present with symptoms or visible signs of illness; health professionals make diagnoses based primarily on these symptoms and signs; and they prescribe medication, psychotherapy, or both, accordingly. However, despite a dramatic expansion of knowledge about mental disorders during the past half century, understanding of their components and processes remains rudimentary. We provide histories and descriptions of three systems with different purposes relevant to understanding and classifying mental disorder. Two major diagnostic manuals-the International Classification of Diseases and the Diagnostic and Statistical Manual of Mental Disorders-provide classification systems relevant to public health, clinical diagnosis, service provision, and specific research applications, the former internationally and the latter primarily for the United States. In contrast, the National Institute of Mental Health's Research Domain Criteria provides a framework that emphasizes integration of basic behavioral and neuroscience research to deepen the understanding of mental disorder. We identify four key issues that present challenges to understanding and classifying mental disorder: etiology, including the multiple causality of mental disorder; whether the relevant phenomena are discrete categories or dimensions; thresholds, which set the boundaries between disorder and nondisorder; and comorbidity, the fact th...