There is a need to refine our current psychiatric nosology to produce diagnostic criteria and disorder categories that keep pace with advances in neuroscience while at the same time enhance clinical utility. Furthermore, dimensional aspects of psychiatric disorders require greater recognition so as to improve our understanding of boundaries between disorders and underscore the heterogeneous nature of psychopathology. The Conceptual Evolution of DSM-5 provides a framework for the evolution of the forthcoming diagnostic system in the fifth edition of Diagnostic and Statistical Manual of Mental Disorders (DSM-5), which will help advance clinical practice and facilitate ongoing development of diagnostic criteria. This manual: • Highlights recent progress in our understanding of cross-cutting factors relevant to psychiatric diagnosis and symptom presentation • Includes detailed discussions on the role of factors such as age, gender, culture, and disability in the expression of mental disorders • Provides a review of genetic evidence supporting a cross-cutting approach to nosology • Offers suggestions for integrating cross-cutting factors with DSM-5. The Conceptual Evolution of DSM-5 was written to impart a theoretical context for understanding potential revisions to DSM-5. The authors reevaluate the structure of the current manual and discuss cross-cutting approaches to facilitate clinical practice and refine research approaches that will guide clinical trials, genetics, imaging, and treatment guidelines. The authors provide the following insights: • Detailed descriptions of age-, gender-, and culture-specific aspects relevant to psychiatric diagnosis and the need for sensitivity to these factors when making diagnoses • Discussions on the dimensional aspects of mental disorders, including overlapping symptoms relevant to many or most diagnoses • Consideration of alternative classifications of disorders that recognize disorders sharing validating features • Presentation of neuroscientific and epidemiologic evidence to expand understanding of disorders beyond that of the categorical organization presented in DSM-IV • A review of clinical implications, including how clinicians may shift their conceptualization of previously reified diagnostic criteria and their consequences. As presented to the 99th Annual Meeting of the American Psychopathological Association, The Conceptual Evolution of DSM-5 explores the rapidly changing research base for the understanding of neurodevelopmental, neurocognitive, addictive, and other psychiatric disorders. The contributions in this volume confirm that DSM-5 is intended to be a living document that can accommodate revisions to specific diagnostic areas based on new evidence that is replicable and subject to review. This efficient updating process will help researchers and clinicians keep abreast of the latest protocols for the research, diagnosis, and treatment of mental illness.

Compiled from presentations given at the 2004 American Psychopathological Association (APPA) annual meeting, "Medical and Psychiatric Comorbidity Over the Course of Life" reviews the comorbidity of mental and chronic physical syndromes in an epidemiological and life course context, offering fresh insights and identifying crucial clues& mdash;gleaned from the overlapping areas or areas of mutual pathogenesis linking disparate realms of knowledge& mdash;to the etiology and nosological distinctiveness of both physical and mental disorders.

Once relatively ignored, the study of lifetime comorbidity has the potential to suggest etiological clues and to advance our ability to prevent secondary disorders by increasing our knowledge about the course and pathology of the primary disease.

The etiologically relevant period, beginning with the earliest causal action and ending with diagnosis, helps us understand this potential and thus is vital to the study of comorbidity. Divided into five main sections (epidemiology, risk factors, mood disorders, emotions and health, and schizophrenia), "Medical and Psychiatric Comorbidity Over the Course of Life" discusses critical aspects of the life course characteristics of the etiologically relevant period: "It can be long," e.g., temperament, a relatively enduring emotional predisposition, may situate an individual more or less permanently at high risk, culminating in irreversibility only after decades of induction. The action of identical genes produces different disorders that may occur at different stages of life, such as the comorbidity of panic disorder and cystitis. "It may involve critical stages," i.e., relatively narrow periods duringdevelopment, such as fetal growth and puberty, to which the action of a given cause is limited. Critical periods of varying durations may exist throughout the course of life. "It may have a cumulative quality to it," in which years or even decades of accumulation are required to reach the point of irreversibility, e.g., the years-long burden of lower class life, or of increased allostatic burden, for the causal nexus to reach sufficiency. "It may involve multiple causes," representing different disciplines and different spheres of action spread throughout the life course.

"Medical and Psychiatric Comorbidity Over the Course of Life" will prove invaluable for practitioners in general and consultation-liaison psychiatry, family practice and internal medicine, and psychosomatics, behavioral medicine, and health psychology.

Personality and Psychopathology compiles the conclusions of more than 30 internationally recognized experts who each carefully examine the link between personality traits and psychopathology. Recent findings have clarified the importance of personality in the development and expression of psychopathology.

In light of such discoveries, this reference examines the relationship of personality traits with psychopathology from several interlocking perspectives -- descriptive, developmental, etiological, and therapeutic. It successfully tackles - A description of the frequency and patterns of overlap between personality and psychopathology- The structure and stability of normal personality traits across the life span and their relation to psychopathology- An analysis of personality disorders from three different approaches- The causes of individual differences in personality and psychopathology from genetic, psychosocial, and neurobiological perspectives- The role of personality in the treatment of psychopathology

Complete with illustrative charts, this all-inclusive resource provides invaluable information on the link between personality and psychopathology.

Recognizing that favorable clinical outcomes are associated with earlier initiation of treatment -- and even more ideally with prevention -- this volume addresses the current status of early intervention in, and prevention of, major mental and substance use disorders. A team of distinguished participants addresses this problem at many levels -- from the DNA molecule to public policy -- in order to show how prevention efforts should be informed by a better understanding of etiology and by a knowledge of indicators of vulnerability.

In considering the current standing of etiological knowledge, Recognition and Prevention of Major Mental and Substance Use Disorders addresses issues that are critical precursors to the prevention of mental disorders and offers an understanding of factors that contribute to the disorders' development. The contributors review genetic methodologies and current findings in mental disorders, with an emphasis on schizophrenia, and then show how biological and psychosocial environmental variables may affect vulnerability. Chapters devoted specifically to lessons in prevention drawn from recent research into schizophrenia discuss the implications of prodromal studies and relationships between stress, critical periods, and the development of the disorder. The book includes contributions from NIH representatives on how basic scientific understanding of mental disorders can be translated into public policy. It also features chapters that describe cutting-edge projects in prevention research for Alzheimer's disease, drug dependence, antisocial behavior, and posttraumatic stress disorder -- each providing compelling accounts of how existing knowledge can be adapted to promising prevention efforts. Among the volume's contributions: - New data on the role of substance abuse -- particularly marijuana and psychostimulants -- in increasing vulnerability to schizophrenia- Review of vulnerability factors for several relevant disorders, examining stress and its concomitant psychobiological responses and the contribution of cognitive factors to vulnerability to depression- Intriguing approach for translating successful treatment methods for schizophrenia into efforts to prevent the transition from the prodrome of the disorder to the full-blown illness- Program for prevention of antisocial behavior that can be implemented as early as the first grade- Secondary prevention efforts for posttraumatic stress disorder, with a focus on pharmacological interventions

Each chapter reviews clinical implications of the research presented, contributing to a volume that will benefit clinicians and researchers who share the goal of preventing these debilitating conditions. This multidimensional, interdisciplinary work represents a major step toward cutting the social costs of these disorders -- and, more important, their untold cost in human suffering.