Externalizing disorders: cluster 5 of the proposed meta-structure for DSM-V and ICD-11.
BACKGROUND
The extant major psychiatric classifications DSM-IV and ICD-10 are purportedly atheoretical and largely descriptive. Although this achieves good reliability, the validity of a medical diagnosis is greatly enhanced by an understanding of the etiology. In an attempt to group mental disorders on the basis of etiology, five clusters have been proposed. We consider the validity of the fifth cluster, externalizing disorders, within this proposal.


METHODS
We reviewed the literature in relation to 11 validating criteria proposed by the Study Group of the DSM-V Task Force, in terms of the extent to which these criteria support the idea of a coherent externalizing spectrum of disorders.


RESULTS
This cluster distinguishes itself by the central role of disinhibitory personality in mental disorders spread throughout sections of the current classifications, including substance dependence, antisocial personality disorder and conduct disorder. Shared biomarkers, co-morbidity and course offer additional evidence for a valid cluster of externalizing disorders.


CONCLUSIONS
Externalizing disorders meet many of the salient criteria proposed by the Study Group of the DSM-V Task Force to suggest a classification cluster.
Department of Psychology, Washington University in St Louis, St Louis, MO 63130-4899, USA. rkrueger@artsci.wustl.edu
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D000374:Aggression / Q000523:psychology; D000987:Antisocial Personality Disorder / Q000145:classification / Q000175:diagnosis / Q000235:genetics / Q000523:psychology; D003072:Cognition Disorders / Q000145:classification / Q000175:diagnosis / Q000235:genetics / Q000523:psychology; D015897:Comorbidity; D019955:Conduct Disorder / Q000145:classification* / Q000175:diagnosis* / Q000235:genetics / Q000523:psychology; D039721:Diagnostic and Statistical Manual of Mental Disorders; D006801:Humans; D007389:Internal-External Control; D038801:International Classification of Diseases; D001523:Mental Disorders / Q000145:classification* / Q000175:diagnosis* / Q000235:genetics / Q000523:psychology; D018187:Personal Construct Theory; D010554:Personality Disorders / Q000145:classification* / Q000175:diagnosis* / Q000235:genetics / Q000523:psychology; D010641:Phenotype; D011379:Prognosis; D012307:Risk Factors; D012931:Social Environment; D019966:Substance-Related Disorders / Q000145:classification* / Q000175:diagnosis* / Q000235:genetics / Q000523:psychology; D013694:Temperament