In the ongoing quest to improve our psychiatric diagnostic
system, we are now searching for new approaches to understanding
the etiological and pathophysiological mechanisms that can improve
the validity of our diagnoses and the consequent power of our
preventive and treatment interventions -- venturing beyond the
current DSM paradigm and DSM-IV framework.
This thought-provoking volume -- produced as a partnership
between the American Psychiatric Association, the National
Institute of Mental Health, the National Institute on Alcohol Abuse
and Alcoholism, and the National Institute on Drug Abuse --
represents a far-reaching attempt to stimulate research and
discussion in the field in preparation for the eventual start of
the DSM-V process, still several years hence. The book - Explores a
variety of basic nomenclature issues, including the desirability of
rating the quality and quantity of information available to support
the different disorders in the DSM in order to indicate the
disparity of empirical support across the diagnostic system.
- Offers a neuroscience research agenda to guide development of
a pathophysiologically based classification for DSM-V, which
reviews genetic, brain imaging, postmortem, and animal model
research and includes strategic insights for a new research
agenda.
- Presents highlights of recent progress in developmental
neuroscience, genetics, psychology, psychopathology, and
epidemiology, using a bioecological perspective to focus on the
first two decades of life, when rapid changes in behavior, emotion
and cognition occur.
- Discusses how to address two important gaps in the current
DSM-IV: (1) the categorical method of diagnosing personality
disorders and their relationship with Axis I disorders, and (2) the
limited provision for the diagnosis of relational disorders --
suggesting a research agenda for personality disorders that
considers replacing the current categorical approach with a
dimensional classification of personality.
- Reevaluates the relationship between mental disorders and
disability, asserting that research into disability and impairment
would benefit from the diagnosis of mental disorders be uncoupled
from a requirement for impairment or disability to foster a more
vigorous research agenda on the etiologies, courses, and treatment
of mental disorders as well as disabilities and to avert unintended
consequences of delayed diagnosis and treatment.
- Examines the importance of culture in psychopathology and the
main cultural variables at play in the diagnostic process, stating
that training present and future professionals in the need to
include cultural factors in the diagnostic process is a logical
step in any attempt to develop comprehensive research programs in
psychology, psychiatry, and related disciplines.
This fascinating work, with contributions from an international
group of research investigators, reaches into the core of
psychiatry, providing invaluable background and insights for all
psychology and psychiatry professionals -- food for thought and
further research that will be relevant for years to come.
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