title: Challenges and strategies in helping the DSM become more dimensional and empirically based.
abstract: The DSM-5 creation process and outcome underlines a core tension in psychiatry between empirical evidence that mental pathologies tend to be dimensional and a historical emphasis on delineating categorical disorders to frame psychiatric thinking. The DSM has been slow to reflect dimensional evidence because doing so is often perceived as a disruptive paradigm shift. As a result, other authorities are making this shift, circumventing the DSM in the process. For example, through the Research Domain Criteria (RDoC), NIMH now encourages investigators to focus on a dimensional and neuroscientific conceptualization of mental disorder research. Fortunately, the DSM-5 contains a dimensional model of maladaptive personality traits that provides clinical descriptors that align conceptually with the neuroscience-based dimensions delineated in the RDoC and in basic science research. Through frameworks such as the DSM-5 trait model, the DSM can evolve to better incorporate evidence of the dimensionality of mental disorder.
authors.affiliation: Department of Psychology, University of Minnesota, N414 Elliott Hall, 75 E. River Rd., Minneapolis, MN, 55455, USA, krueg038@umn.edu.
authors.forename: Robert F
authors.initials: RF
authors.lastname: Krueger
authors.forename: Christopher J
authors.initials: CJ
authors.lastname: Hopwood
authors.forename: Aidan G C
authors.initials: AG
authors.lastname: Wright
authors.forename: Kristian E
authors.initials: KE
authors.lastname: Markon
mesh_terms: D039721:Diagnostic and Statistical Manual of Mental Disorders; D006801:Humans; D001523:Mental Disorders / Q000145:classification* / Q000175:diagnosis*; D009315:National Institute of Mental Health (U.S.) / Q000592:standards*; D014481:United States