title: Logic and justification for dimensional assessment of symptoms and related clinical phenomena in psychosis: relevance to DSM-5.
abstract: Work on the causes and treatment of schizophrenia and other psychotic disorders has long recognized the heterogeneity of the symptoms that can be displayed by individuals with these illnesses. Further, researchers have increasingly emphasized the ways in which the severity of different symptoms of this illness can vary across individuals, and have provided evidence that the severity of such symptoms can predict other important aspects of the illness, such as the degree of cognitive and/or neurobiological deficits. Additionally, research has increasingly emphasized that the boundaries between nosological entities may not be categorical and that the comorbidity of disorders may reflect impairments in common dimensions of genetic variation, human behavior and neurobiological function. As such, it is critical to focus on a dimensional approach to the assessment of symptoms and clinically relevant phenomena in psychosis, so as to increase attention to and understanding of the causes and consequences of such variation. In the current article, we review the logic and justification for including dimensional assessment of clinical symptoms in the evaluation of psychosis in the Fifth Edition of the Diagnostic and Statistical Manual for Mental Disorders (DSM-5).
authors.affiliation: Department of Psychology, Washington University, St. Louis, MO, USA; Department of Psychiatry, Washington University, St. Louis, MO, USA; Department of Radiology, Washington University, St. Louis, MO, USA. Electronic address: dbarch@artsci.wustl.edu.
authors.forename: Deanna M
authors.initials: DM
authors.lastname: Barch
authors.forename: Juan
authors.initials: J
authors.lastname: Bustillo
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Gaebel
authors.forename: Raquel
authors.initials: R
authors.lastname: Gur
authors.forename: Stephan
authors.initials: S
authors.lastname: Heckers
authors.forename: Dolores
authors.initials: D
authors.lastname: Malaspina
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Owen
authors.forename: Susan
authors.initials: S
authors.lastname: Schultz
authors.forename: Rajiv
authors.initials: R
authors.lastname: Tandon
authors.forename: Ming
authors.initials: M
authors.lastname: Tsuang
authors.forename: Jim
authors.initials: J
authors.lastname: Van Os
authors.forename: William
authors.initials: W
authors.lastname: Carpenter
mesh_terms: D001526:Behavioral Symptoms / Q000209:etiology*; D003072:Cognition Disorders / Q000209:etiology*; D039721:Diagnostic and Statistical Manual of Mental Disorders; D006212:Hallucinations / Q000209:etiology*; D006801:Humans; D008128:Logic; D011618:Psychotic Disorders / Q000145:classification / Q000150:complications / Q000175:diagnosis
keywords: Cognition; DSM-5; Diagnosis; Dimensions; Psychosis; Schizoaffective