DIMENSIONAL APPROACHES IN DIAGNOSTIC CLASSIFICATION Refining the Research Agenda for DSM-V This page intentionally left blank DIMENSIONAL APPROACHES IN DIAGNOSTIC CLASSIFICATION Refining the Research Agenda for DSM-V Edited by John E. Helzer, M.D. Helena Chmura Kraemer, Ph.D. Robert F. Krueger, Ph.D. Hans-Ulrich Wittchen, Ph.D. Paul J. Sirovatka, M.S. Darrel A. Regier, M.D., M.P.H. Published by the American Psychiatric Association Arlington, Virginia Note: The authors have worked to ensure that all information in this book is ac- curate at the time of publication and consistent with general psychiatric and med- ical standards, and that information concerning drug dosages, schedules, and routes of administration is accurate at the time of publication and consistent with standards set by the U.S. Food and Drug Administration and the general medical community. As medical research and practice continue to advance, however, ther- apeutic standards may change. Moreover, specific situations may require a specific therapeutic response not included in this book. For these reasons and because hu- man and mechanical errors sometimes occur, we recommend that readers follow the advice of physicians directly involved in their care or the care of a member of their family. The findings, opinions, and conclusions of this report do not necessarily represent the views of the officers, trustees, or all members of the American Psychiatric As- sociation. The views expressed are those of the authors of the individual chapters. Copyright © 2008 American Psychiatric Association ALL RIGHTS RESERVED Manufactured in the United States of America on acid-free paper 12 11 10 09 08 5 4 3 2 1 First Edition Typeset in Adobe’s Frutiger and AGaramond. American Psychiatric Association 1000 Wilson Boulevard Arlington, VA 22209-3901 www.psych.org Library of Congress Cataloging-in-Publication Data Dimensional approaches in diagnostic classification : refining the research agenda for DSM-V / edited by John Helzer ... [et al.]. p. ; cm. Includes bibliographical references and index. ISBN 978-0-89042-343-1 (alk. paper) 1. Diagnostic and statistical manual of mental disorders. 2. Mental illness— Classification. 3. Mental illness—Diagnosis. I. Helzer, John E. II. American Psychiatric Association. [DNLM: 1. Diagnostic and statistical manual of mental disorders. 5th ed. 2. Mental Disorders—diagnosis. 3. Mental Disorders— classification. 4. Research. WM 141 D582 2008] RC455.2.C4D56 2008 616.89′075—dc22 2008011900 British Library Cataloguing in Publication Data A CIP record is available from the British Library. This monograph is dedicated to Paul J. Sirovatka, whose untimely death in September 2007 deprived the American Psychiatric Association and the larger mental health community of an outstanding science writer and colleague. His long career at the National Institute of Mental Health and his many contributions to the development of the DSM-V revision are honored by our dedication of this volume of our research development series to Paul. This page intentionally left blank CONTENTS CONTRIBUTORS. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ix DISCLOSURE STATEMENT. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . xiii FOREWORD: Dimensional Approaches to Psychiatric Classification . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .xvii Darrel A. Regier, M.D., M.P.H. PREFACE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .xxv John E. Helzer, M.D. 1 DIMENSIONAL APPROACHES IN DIAGNOSTIC CLASSIFICATION: A Critical Appraisal . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 Marsha F. Lopez, Ph.D., M.H.S. Wilson M. Compton, M.D., M.P.E. Bridget F. Grant, Ph.D. James P. Breiling, Ph.D. 2 DSM CATEGORIES AND DIMENSIONS IN CLINICAL AND RESEARCH CONTEXTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5 Helena Chmura Kraemer, Ph.D. 3 A DIMENSIONAL OPTION FOR THE DIAGNOSIS OF SUBSTANCE DEPENDENCE IN DSM-V . . . . . . . . . . . . . . . . . . . . . . . 19 John E. Helzer, M.D. Kathleen K. Bucholz, Ph.D. Michael Gossop, Ph.D. 4 DIMENSIONALITY AND THE CATEGORY OF MAJOR DEPRESSIVE EPISODE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 35 Gavin Andrews, M.D. Traolach Brugha, M.D. Michael E. Thase, M.D. Farifteh Firoozmand Duffy, Ph.D. Paola Rucci, Ph.D. Timothy Slade, Ph.D. 5 DIMENSIONS AND THE PSYCHOSIS PHENOTYPE . . . . . . . . . . . . . . . 53 Judith Allardyce, M.B., Ch.B., MRCPsych, CCST Trisha Suppes, M.D., Ph.D. Jim van Os, M.D. 6 SUPPLEMENTARY DIMENSIONAL ASSESSMENT IN ANXIETY DISORDERS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 65 M. Katherine Shear, M.D. Ingvar Bjelland, M.D., Ph.D. Katja Beesdo, Ph.D. Andrew T. Gloster, Ph.D. Hans-Ulrich Wittchen, Ph.D. 7 SYNTHESIZING DIMENSIONAL AND CATEGORICAL APPROACHES TO PERSONALITY DISORDERS: Refining the Research Agenda for DSM-V Axis II . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 85 Robert F. Krueger, Ph.D. Andrew E. Skodol, M.D. W. John Livesley, M.D., Ph.D. Patrick E. Shrout, Ph.D. Yueqin Huang, M.D., M.P.H., Ph.D. 8 A DIMENSIONAL APPROACH TO DEVELOPMENTAL PSYCHOPATHOLOGY . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 101 James J. Hudziak, M.D. Thomas M. Achenbach, Ph.D. Robert R. Althoff, M.D. Daniel S. Pine, M.D. 9 DIMENSIONAL OPTIONS FOR DSM-V: The Way Forward . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 115 John E. Helzer, M.D. Hans-Ulrich Wittchen, Ph.D. Robert F. Krueger, Ph.D. Helena Chmura Kraemer, Ph.D. INDEX . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 129 CONTRIBUTORS Thomas M. Achenbach, Ph.D. Professor of Psychiatry and Psychology, Department of Psychiatry, University of Vermont, Burlington, Vermont Judith Allardyce, M.B., Ch.B., MRCPsych, CCST Researcher, Department of Psychiatry and Neuropsychology, South Limburg Mental Health Research and Teaching Network, EURON, Maastricht University, Maastricht, The Netherlands Robert R. Althoff, M.D. Assistant Professor of Psychiatry and Pediatrics, Department of Psychiatry, Uni- versity of Vermont, Burlington, Vermont Gavin Andrews, M.D. Director and Scientia Professor of Psychiatry, Clinical Research Unit for Anxiety and Depression, University of New South Wales at St. Vincent’s Hospital, Sydney, Australia Katja Beesdo, Ph.D. Research Fellow, Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany Ingvar Bjelland, M.D., Ph.D. Specialist in Psychiatry and Child and Adolescent Psychiatry, Clinic for Child and Adolescent Mental Health Services, Haukeland University Hospital, Bergen, Norway James P. Breiling, Ph.D. Program Chief, Psychopathology, Behavioral Dysregulation, and Measurement Devel- opment Research Program, Division of Adult Translational Research and Treatment Development, National Institute of Mental Health, Bethesda, Maryland Traolach Brugha, M.D. Professor of Psychiatry and Director of Research, Department of Health Sciences, Clinical Division of Psychiatry, University of Leicester, Leicester, United Kingdom ix